1
|
Tay YE, Attard NR, Greenblatt D, Morris-Jones R, Stefanato CM. An unusual presentation of toe blisters. Clin Exp Dermatol 2020; 45:786-788. [PMID: 32484593 DOI: 10.1111/ced.14253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Y E Tay
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - N R Attard
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - D Greenblatt
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - R Morris-Jones
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - C M Stefanato
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, London, UK.,Department of Dermatopathology, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, London, UK
| |
Collapse
|
2
|
McSweeney SM, Stefanato CM, Fenton DA, McGrath JA, Tziotzios C. Alopecia areata and frontal fibrosing alopecia: dimorphism by concurrence. Clin Exp Dermatol 2020; 45:734-737. [PMID: 32198940 DOI: 10.1111/ced.14224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 11/27/2022]
Affiliation(s)
- S M McSweeney
- St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK
| | - C M Stefanato
- Department of Dermatopathology, St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK
| | - D A Fenton
- St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK
| | - J A McGrath
- St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK
| | - C Tziotzios
- St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK
| |
Collapse
|
3
|
Lim R, Stefanato CM, Rickaby W, Morley AMS. Periocular discoid lupus erythematosus: diagnostic challenges of a clinical and histopathological masquerader. Clin Exp Dermatol 2020; 45:613-615. [PMID: 32048320 DOI: 10.1111/ced.14192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
- R Lim
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C M Stefanato
- Department of Dermatopathology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - W Rickaby
- Department of Dermatopathology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A M S Morley
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
4
|
Orchard GE, Wojcik K, Rickaby W, Martin B, Semkova K, Shams F, Stefanato CM. Immunohistochemical detection of V600E BRAF mutation is a useful primary screening tool for malignant melanoma. Br J Biomed Sci 2019; 76:77-82. [DOI: 10.1080/09674845.2019.1592885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- GE Orchard
- Viapath Analytics, Dermatopathology Department, St John’s Institute of Dermatology, St. Thomas’ Hospital
| | - K Wojcik
- Viapath Analytics, Dermatopathology Department, St John’s Institute of Dermatology, St. Thomas’ Hospital
| | - W Rickaby
- Dermatopathology Department, St. John’s Institute of Dermatology, St. Thomas’ Hospital
| | - B Martin
- Dermatopathology Department, St. John’s Institute of Dermatology, St. Thomas’ Hospital
| | - K Semkova
- Dermatopathology Department, St. John’s Institute of Dermatology, St. Thomas’ Hospital
| | - F Shams
- Imperial College Healthcare NHS Trust, St. Mary’s Hospital
| | - CM Stefanato
- Dermatopathology Department, St. John’s Institute of Dermatology, St. Thomas’ Hospital
| |
Collapse
|
5
|
Veraitch O, Curto-Garcia N, Harrison C, Stefanato CM, McGibbon D. Hydroxyurea-induced dermatomyositis koebnerizing at the site of previous shingles. Clin Exp Dermatol 2018; 44:546-548. [PMID: 30411394 DOI: 10.1111/ced.13772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2018] [Indexed: 11/28/2022]
Affiliation(s)
- O Veraitch
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, UK
| | - N Curto-Garcia
- Department of Haematology, Guy's and St Thomas' NHS Trust, London, UK
| | - C Harrison
- Department of Haematology, Guy's and St Thomas' NHS Trust, London, UK
| | - C M Stefanato
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, UK.,Department of Dermatopathology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, UK
| | - D McGibbon
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, UK
| |
Collapse
|
6
|
Hughes A, Tull TJ, Semkova K, Calonje E, Stefanato CM. An enlarging nodule on the shin. Clin Exp Dermatol 2018; 43:627-629. [PMID: 29508412 DOI: 10.1111/ced.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A Hughes
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - T J Tull
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - K Semkova
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - E Calonje
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - C M Stefanato
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| |
Collapse
|
7
|
Chan BCY, Stefanato CM, Moonim MT, Morris SL, Fields P, Dasgupta D, Therianou A, Whittaker SJ. Diffuse large B-cell lymphoma developing in erythrodermic cutaneous T-cell lymphoma: a case series. Br J Dermatol 2017; 177:e138-e140. [PMID: 28301708 DOI: 10.1111/bjd.15460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B C Y Chan
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K
| | - C M Stefanato
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - M T Moonim
- Department of Histopathology, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - S L Morris
- Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - P Fields
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - D Dasgupta
- Department of Nuclear Medicine, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - A Therianou
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K
| | - S J Whittaker
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K
| |
Collapse
|
8
|
Ong S, Rodriguez-Garcia C, Grabczynska S, Carton J, Osborn M, Walters J, Kubba F, Stefanato CM. Alopecia areata incognita in Cronkhite-Canada syndrome. Br J Dermatol 2016; 177:531-534. [PMID: 28029683 DOI: 10.1111/bjd.15293] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 11/30/2022]
Abstract
Cronkhite-Canada syndrome is an acquired inflammatory polyposis syndrome in which alopecia, onychomadesis and hyperpigmentation occur concurrently with gastrointestinal symptoms. The pathophysiology of alopecia in Cronkhite-Canada syndrome has not been definitively elucidated. We present evidence for alopecia areata incognita as a possible mechanism of hair loss.
Collapse
Affiliation(s)
- S Ong
- Department of Dermatology, Amersham Hospital, Buckinghamshire Healthcare NHS Trust, Whielden Street, Amersham, HP7 0JD, U.K
| | - C Rodriguez-Garcia
- Department of Dermatology, Amersham Hospital, Buckinghamshire Healthcare NHS Trust, Whielden Street, Amersham, HP7 0JD, U.K
| | - S Grabczynska
- Department of Dermatology, Amersham Hospital, Buckinghamshire Healthcare NHS Trust, Whielden Street, Amersham, HP7 0JD, U.K
| | - J Carton
- Department of Histopathology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, U.K
| | - M Osborn
- Department of Histopathology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, U.K
| | - J Walters
- Department of Gastroenterology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, U.K
| | - F Kubba
- Department of Histopathology, London Northwest Healthcare NHS Trust, London, U.K
| | - C M Stefanato
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| |
Collapse
|
9
|
Seegobin SD, Tziotzios C, Stefanato CM, Bhargava K, Fenton DA, McGrath JA. Frontal fibrosing alopecia: there is no statistically significant association with leave-on facial skin care products and sunscreens. Br J Dermatol 2016; 175:1407-1408. [PMID: 27614082 DOI: 10.1111/bjd.15054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- S D Seegobin
- King's College London, St John's Institute of Dermatology, London, U.K
| | - C Tziotzios
- King's College London, St John's Institute of Dermatology, London, U.K
| | - C M Stefanato
- King's College London, St John's Institute of Dermatology, London, U.K
| | - K Bhargava
- King's College London, St John's Institute of Dermatology, London, U.K
| | - D A Fenton
- King's College London, St John's Institute of Dermatology, London, U.K
| | - J A McGrath
- King's College London, St John's Institute of Dermatology, London, U.K
| |
Collapse
|
10
|
Affiliation(s)
- J D Fleming
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | |
Collapse
|
11
|
Verdolini R, Atkar R, Clayton N, Hasan R, Stefanato CM. Catamenial dermatoses: has anyone ever considered prostaglandins? Clin Exp Dermatol 2014; 39:509-12. [DOI: 10.1111/ced.12333] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 11/27/2022]
Affiliation(s)
- R. Verdolini
- Department of Dermatology; Princess Alexandra Hospital; Harlow Essex UK
| | - R. Atkar
- Department of Dermatology; Princess Alexandra Hospital; Harlow Essex UK
| | - N. Clayton
- Department of Dermatology ; Royal London Hospital; London UK
| | - R. Hasan
- Institute of Pathology; Royal London Hospital; London UK
| | - C. M. Stefanato
- Department of Dermatopathology; St John's Institute of Dermatology; St Thomas’ Hospital; London UK
| |
Collapse
|
12
|
Woolf RT, Ferrara G, Rongioletti F, Agarwal A, Wain EM, Stefanato CM. Unusual plaque and papules affecting the legs. Clin Exp Dermatol 2013; 39:245-7. [DOI: 10.1111/ced.12234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- R. T. Woolf
- St John's Institute of Dermatology; Guy's and St Thomas' NHS Foundation Trust; St Thomas's Hospital; London UK
| | - G. Ferrara
- Department of Oncology; Anatomic Pathology Unit; Gaetano Rummo General Hospital; Benevento Italy
| | - F. Rongioletti
- Section of Dermatology; DISSAL and Unit of Pathology; University of Genoa; Genoa Italy
| | - A. Agarwal
- Department of Dermatopathology; St John's Institute of Dermatology; St Thomas' Hospital; London UK
| | - E. M. Wain
- St John's Institute of Dermatology; Guy's and St Thomas' NHS Foundation Trust; St Thomas's Hospital; London UK
| | - C. M. Stefanato
- St John's Institute of Dermatology; Guy's and St Thomas' NHS Foundation Trust; St Thomas's Hospital; London UK
- Department of Dermatopathology; St John's Institute of Dermatology; St Thomas' Hospital; London UK
| |
Collapse
|
13
|
Ferrara G, Stefanato CM, Gianotti R, Kubba A, Annessi G. Panniculitis with vasculitis. GIORN ITAL DERMAT V 2013; 148:387-394. [PMID: 23900160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Panniculitides encompass a great number of different entities; however, once a vasculitis has been detected histopathologically within the subcutaneous tissue, the differential diagnosis is mainly restricted to polyarteritis (panarteritis) nodosa (PAN), nodular vasculitis (NV), and Bazin's erythema induratum (EI). Patients with PAN may have the disease confined to the skin, but must be followed over a long period because many of them develop late systemic disease. The NV/EI group represents by far the most common type of lobular panniculitis with vasculitis; we prefer keeping the distinction between the two entities by underlining the equation NV positive tuberculin skin test = EI. Other lobular panniculitides with vasculitis are exceedingly rare and set in a systemic background which can be infectious (lepromatous leprosy panniculitides) or autoimmune/dysreactive (neutrophilic lobular panniculitis in rheumatoid arthritis, lobular panniculitis in inflammatory bowel disease).
Collapse
Affiliation(s)
- G Ferrara
- Anatomic Pathology Unit Gaetano Rummo General Hospital, Benevento, Italy -
| | | | | | | | | |
Collapse
|
14
|
Tailor A, Kanatli L, Greenblatt D, Dadzzie O, Calonje E, Stefanato CM. A boggy swelling of the scalp. Clin Exp Dermatol 2012; 38:114-5. [PMID: 23252759 DOI: 10.1111/ced.12008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Tailor
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | | | | | | | | | | |
Collapse
|
15
|
Khan S, Howard V, Stefanato CM. A malicious masquerader. Clin Exp Dermatol 2012; 38:559-61. [PMID: 23171221 DOI: 10.1111/j.1365-2230.2012.04411.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- S Khan
- Department of Dermatopathology, St. John's Institute of Dermatology, St Thomas's Hospital, London, UK
| | | | | |
Collapse
|
16
|
Pink AE, Stefanato CM, Breathnach SM. An unusual presentation of systemic AL amyloidosis: bullae, milia and nail dystrophy. Clin Exp Dermatol 2012; 37:788-90. [DOI: 10.1111/j.1365-2230.2012.04341.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
|
18
|
Affiliation(s)
- E C Benton
- St. John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, St Thomas's Hospital, London, UK.
| | | |
Collapse
|
19
|
Pérez A, Almaani N, Stefanato CM, BhogaL B, Groves RW, Mellerio JE, McGrath JA. Bullous pemphigoid in a patient with suspected non-Herlitz junctional epidermolysis bullosa. Clin Exp Dermatol 2010; 35:881-4. [PMID: 20456391 DOI: 10.1111/j.1365-2230.2010.03828.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 56-year-old man with lifelong trauma-induced blisters, nail dystrophy and dental enamel hypoplasia presented with a new spontaneous blistering eruption. Clinicopathologically, he had evidence of both an inherited and an acquired blistering disorder: non-Herlitz junctional epidermolysis bullosa (nHJEB) and bullous pemphigoid (BP). HIstological examination of a skin biopsy found reduced (but not absent) collagen XVII in nonlesional skin, in vivo bound anticollagen XVII antibodies in perilesional skin, and prominent eosinophils in perilesional and lesional skin, with subepidermal blistering. Circulating anticollagen XVII antibodies were also present. Treatment with oral corticosteroids and mycophenolate mofetil led to clinical control of the BP but had no effect on the mechanobullous blistering. Our patient is unusual in that his skin retains some labelling for collagen XVII rather than having the complete absence of immunoreactivity expected in patients with generalized nHJEB. Moreover, we were unable to identify any pathogenic mutations in the COL17A1 gene encoding collagen XVII (or in other EB-associated basement membrane genes). It is plausible that the long-term consequences of basement membrane disruption in our patient, perhaps associated with atypical inherited COL17A1 pathology, might result in a conformationally altered and more immunogenic protein with the subsequent development of anticollagen XVII antibodies and BP as a secondary pathology.
Collapse
Affiliation(s)
- A Pérez
- St John's Institute of Dermatology, Guys and St Thomas' NHS Foundation Trust and King's College London (Guy's Campus), London, UK
| | | | | | | | | | | | | |
Collapse
|
20
|
Affiliation(s)
- R Verdolini
- Department of Dermatology, Royal London Hospital, Whitechapel, London, UK.
| | | |
Collapse
|
21
|
Perez A, Clements SE, Benton E, Robson A, Bhogal B, Stefanato CM, McGibbon D. Localized bullous pemphigoid in a patient with primary lymphoedema tarda. Clin Exp Dermatol 2010; 34:e931-3. [PMID: 20055870 DOI: 10.1111/j.1365-2230.2009.03722.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a case of localized bullous pemphigoid (BP) in a woman patient with primary lymphoedema tarda. There is only one previous case reported of localized pemphigoid in an area of lymphoedema, this being of the cicatricial variant. Slow circulation in the lymphatic vessels, increased capillary permeability with preferential localization of antibodies in the area, and potential cleavage of the epidermal junction due to increased hydrostatic pressure leading to autoimmunity, have all been advocated as possible pathogenic mechanisms. Nevertheless, we consider that the mechanism by which localized pemphigoid arises on lymphoedema remains elusive, based on a previous case of generalized BP sparing an area of postsurgical lymphoedema.
Collapse
Affiliation(s)
- A Perez
- St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
| | | | | | | | | | | | | |
Collapse
|
22
|
Wain EM, Webber NK, Stefanato CM, Banerjee P, Morris SL. Multiple in-transit cutaneous metastases from a primary cutaneous squamous cell carcinoma. Clin Exp Dermatol 2009; 34:522-4. [DOI: 10.1111/j.1365-2230.2008.02967.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
23
|
Affiliation(s)
- E M Wain
- St. John's Institute of Dermatology, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
| | | | | |
Collapse
|
24
|
Affiliation(s)
- E M Wain
- St. John's Institute of Dermatology, St. Thomas' Hospital, London, UK.
| | | | | | | |
Collapse
|
25
|
|
26
|
Abstract
BACKGROUND Tumor of the follicular infundibulum (TFI) is a relatively rare tumor which clinically presents as a solitary keratotic papule usually on the head and neck which on microscopic examination typically reveals a plate-like fenestrated epithelial tumor composed of pale staining cells. METHODS We describe a new variant of TFI. An 80-year-old male with a history of multiple basal cell carcinomas and a squamous cell carcinoma presented with a 2-year history of a red, scaly, slightly elevated plaque on the lateral aspect of his right buttock. RESULTS Histopathological examination revealed plate-like reticulate epithelial outgrowths of large and pale cells with foci of sebaceous differentiation and numerous colloid bodies. Differential diagnosis included superficial basal cell carcinoma with sebaceous and ductal differentiation, tumor of the follicular infundibulum, an unusual fibroepithelioma of Pinkus or an eccrine fibroadenoma with sebaceous differentiation. CONCLUSION This case illustrates a hybrid adnexal tumor with histologic features common to both tumor of the follicular infundibulum and superficial epithelioma with sebaceous differentiation.
Collapse
Affiliation(s)
- M Mahalingam
- Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | | | | | | |
Collapse
|
27
|
Salopek TG, Kopf AW, Stefanato CM, Vossaert K, Silverman M, Yadav S. Differentiation of atypical moles (dysplastic nevi) from early melanomas by dermoscopy. Dermatol Clin 2001; 19:337-45. [PMID: 11556242 DOI: 10.1016/s0733-8635(05)70271-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Several conventional and new dermoscopic criteria are highly specific for diagnosing early melanomas. Until the reliability of the dermoscopic scoring systems has been validated, the presence of any combination of these specific features should elevate the index of suspicion for melanoma and prompt a biopsy to avoid missing this cancer.
Collapse
Affiliation(s)
- T G Salopek
- Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | | | |
Collapse
|
28
|
Abstract
The intimate association of nevomelanocytic nevi with eccrine ducts commonly seen in congenital nevi was emphasized by Mishima, who described as eccrine-centered nevi those lesions characterized by nevomelanocytic cells predominantly proliferating around and within the eccrine sweat duct walls. However, there were no changes in the overlying epidermis, dermis, or eccrine acrosyringeal or dermal duct proliferation in these lesions. We present the case of a 16-year-old boy with a 1-year-history of a 0.6-cm diameter single tan papule on the right heel, clinically thought to be a Spitz nevus. Histopathologic examination revealed a compound nevomelanocytic nevus associated with epidermal hyperplasia, thin anastomosing cords of acrosyringeal epithelium extending within the dermis, and eccrine ductal proliferation in a syringoma-like pattern associated with a dense fibrous stroma. Features that distinguish our case from eccrine-centered nevus are that the latter lacks epidermal and eccrine duct hyperplasia and a dense fibrous stroma. The location of the lesion on the heel in our case suggests the possibility that the pathologic changes observed could result from repetitive trauma.
Collapse
Affiliation(s)
- C M Stefanato
- Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts 02118, USA
| | | | | |
Collapse
|
29
|
Abstract
A 26-year-old Libyan woman presented with asymptomatic nodulo-ulcerative skin lesions present for 1 year. Three years prior to presentation, she had experienced a nasal discharge followed by the development of a nodule in the nasal cavity and a plaque on the hard palate. These lesions had gradually increased in size and ulcerated, resulting in perforation of the nasal septum and palate. Two years later, the patient noticed the appearance of skin lesions: a nodule on the right thumb and numerous nodulo-ulcerative lesions on the extremities. General physical examination was normal with no significant lymphadenopathy. Examination of the oral cavity revealed perforation of the distal nasal septum, with a perforated nodular plaque involving the entire palate, associated with subluxation of the upper incisors (Fig. 1a). On skin examination, multiple firm nodules and nodulo-ulcerative lesions with a central eschar and raised margins were observed. The lesions ranged in size from 0.5 to 5 cm and were distributed on the right hand and fingers, left upper arm (Fig. 1b), left calf, and right thigh. Routine laboratory investigations (liver function tests, serum calcium, electrolytes, lipid profile, urine and stool culture studies) were normal. Immunoelectrophoresis disclosed normal levels of immunoglobulins IgG, IgA, and IgM. Serologic studies for human immunodeficiency virus (HIV) and syphilis, and a tuberculin test, were all negative. A Giemsa-stained tissue smear was negative for Leishmania tropica organisms. Radiological studies disclosed a slight haziness of the maxillary sinuses with perforation of the nasal septum. A chest X-ray was normal. Histopathologic examination of biopsies taken from both the palate and from ulcerated and nonulcerated skin lesions was performed, and all showed similar findings. The biopsy of a nonulcerated skin lesion showed pseudoepitheliomatous epidermal hyperplasia with neutrophilic microabscesses (Fig. 2a). A dermal diffuse and nodular granulomatous mixed infiltrate of lymphocytes, histiocytes, giant cells, numerous eosinophils, and neutrophilic microabscesses was seen in all tissues examined. Septate hyphae were present both within giant cells and free in the dermis (Fig. 2b). The hyphae were branching at a 45 degrees angle and were positive on periodic acid-Schiff and Grocott methenamine silver stains (Fig. 2c). Fungal culture studies of material taken from an ulcerated skin lesion grew Aspergillus flavus. Blood cultures were negative for Aspergillus sp. or other microorganisms. The patient was treated with intravenous amphotericin B, but the medication was discontinued due to her intolerance to the drug. She was subsequently lost to follow-up.
Collapse
Affiliation(s)
- M L Khatri
- Department of Dermatology, Faculty of Medicine, Al-Fateh University of Medical Sciences, Tripoli, Libya
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
Extramammary Paget disease (EMPD) is a heterogenous entity representing either an intraepidermal adenocarcinoma in situ with apocrine differentiation or an expression of underlying malignancy of the skin or of the intestinal or genitourinary tract. The coexistence of EMPD with a benign underlying hidradenoma papilliferumn (HP) is, however, exceptional. We present the case of a 79-year-old woman with diffuse and patchy gray-white lesions involving her left vulva as well as an underlying 0.7-cm asymptomatic firm nodule. Histologically, the epidermis and dermis showed features characteristic of EMPD and HP, respectively. Malignant transformation in HP giving rise to EMPD in the overlying epithelium has been reported. In our case, however, failure to demonstrate continuity between the two lesions together with the lack of cytologic atypia, mitoses, and necrosis in the HP lends additional support to the possibility that the HP is "innocent" and that its association with EMPD is thus coincidental. A common histogenetic derivation of these two lesions from the mammary-like glands or from related germinative cells in the epidermis is suggested to explain this rare presentation.
Collapse
Affiliation(s)
- C M Stefanato
- Department of Dermatology, Boston University School of Medicine, Massachusetts, USA
| | | | | |
Collapse
|
31
|
Abstract
Ochronosis is an uncommon condition characterized by yellow-brown pigment deposits in the dermis. It occurs in exogenous and endogenous forms. We report a case of exogenous ochronosis in a Hispanic woman and discuss the different forms of this condition. We treated the lesions with Q-switched ruby laser.
Collapse
Affiliation(s)
- K E Kramer
- Boston University School of Medicine, Boston, MA 02118, USA
| | | | | | | |
Collapse
|
32
|
Abstract
Papular acrodermatitis of childhood (Gianotti-Crosti syndrome) is an uncommon, self-limited disease characterized by an erythematous papular eruption symmetrically distributed on the face and limbs and mild lymphadenopathy, thought to be of viral origin. The histopathologic findings are nonspecific and include focal parakeratosis, mild spongiosis, superficial perivascular infiltrate, papillary dermal edema, and extravasated red blood cells. Interface changes with some basal vacuolization may be present, but are not a conspicuous feature. We present a 2 1/2-year-old boy with multiple papules and plaques on the face and extremities and cervical lymphadenopathy. Histopathologic analysis showed compact orthokeratosis, focal parakeratosis, hypergranulosis, psoriasiform epidermal hyperplasia, and a dense lichenoid lymphohistiocytic infiltrate with extensive exocytosis of mononuclear cells. Immunoperoxidase staining with CD 1 a revealed clusters of Langerhans cells in the epidermis and in the papillary dermis. In view of the clinical findings, a diagnosis of Gianotti-Crosti syndrome was made. Although there are a few reports describing a lichenoid pattern of infiltration in Gianotti-Crosti syndrome, this histologic pattern is not widely known. This case is presented to illustrate the fact that Gianotti-Crosti syndrome can present as lichenoid dermatitis, and, especially in children, should be added to the differential diagnoses of lichenoid infiltrates.
Collapse
Affiliation(s)
- C M Stefanato
- Department of Dermatology, Boston University School of Medicine, Massachusetts 02118, USA
| | | | | | | |
Collapse
|
33
|
Kroumpouzos G, Stefanato CM, Wilkel CS, Bogaars H, Bhawan J. Systematized porokeratotic eccrine and hair follicle naevus: report of a case and review of the literature. Br J Dermatol 1999; 141:1092-6. [PMID: 10606858 DOI: 10.1046/j.1365-2133.1999.03210.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a unique case of a congenital keratinocytic naevus associated with severe alopecia, onychodysplasia and palmoplantar involvement in a 13-year-old girl. The lesions, consisting of scaly, spinous and verrucous papules and plaques, mainly followed Blaschko's lines and have remained unchanged since birth. The predominant histopathological picture was that of a column of parakeratosis overlying the eccrine ostia and hair follicles. This is the first case of a systematized keratinocytic naevus characterized by histopathology of eccrine and hair follicle porokeratosis and a widespread bilateral involvement. This may be a distinct entity to be included in the differential diagnosis of linear, hyperkeratotic dermatoses. We suggest its classification as systematized porokeratotic eccrine and hair follicle naevus.
Collapse
Affiliation(s)
- G Kroumpouzos
- Department of Dermatology, Boston University School of Medicine Boston, MA 02118, USA
| | | | | | | | | |
Collapse
|
34
|
Abstract
BACKGROUND Hyperpigmentation is a side effect of several medications, including amiodarone, bleomycin, chlorpromazine, and minocycline. OBJECTIVE The purpose of this study is to describe the clinical and light microscopic findings in 4 patients with imipramine-induced hyperpigmentation and to better understand its origin. METHODS All 4 patients underwent a skin biopsy for light microscopy. In 1 patient, a biopsy specimen was obtained for electron microscopy. Tissue from patient 1 was analyzed with a mass spectrophotometer, and energy-dispersive x-ray analysis was performed on tissue from patients 1 and 2. RESULTS All 4 women had been taking imipramine for at least 2 years. Hyperpigmentation occurred in a photodistribution on the face, arms, and backs of the hands. Light microscopy in all cases demonstrated golden-brown granules in the superficial dermis, which were strongly positive for Fontana-Masson stain. Electron microscopy demonstrated areas of electron-dense inclusion bodies within macrophages, which were distinct from melanosomes. Mass spectrophotometric and energy-dispersive x-ray analysis of the electron-dense bodies showed the presence of sulfur atoms, and no peak corresponding to that expected for imipramine was found. A peak closely corresponding to phaeomelanin, a sulfur-containing compound, was found. CONCLUSION Hyperpigmentation is a side effect of long-term imipramine use. It may result from the deposition of melanin in an unusual form. The melanin pigment is possibly complexed with a metabolite of imipramine, and does not represent the deposition of imipramine in its native form.
Collapse
Affiliation(s)
- M E Ming
- Department of Dermatology and Pathology, University of California, San Francisco, USA
| | | | | | | | | |
Collapse
|
35
|
Abstract
Four mixed Merkel cell and squamous cell carcinomas of the skin are described. The patients ranged in age from 74 to 90 years and demonstrated or had a history of previous ultraviolet or infrared damage to the skin, manifested by basal cell carcinoma, squamous cell carcinoma, actinic keratoses, solar elastosis, and erythema ab igne. Light microscopic examination of all 4 cases revealed invasive neoplasms consisting of 2 distinct but admixed cell types. The predominant cell type was consistent with Merkel cell carcinoma and was characterized by scant cytoplasm, a small dark polygonal nucleus with granular chromatin, a high mitotic rate, and cytokeratin 20 positivity. In each case, the Merkel cell component merged with a cytokeratin 20 negative squamous component characterized by abundant eosinophilic cytoplasm, intercellular bridges, and keratinization with focal squamous pearl formation. Immunohistochemical staining patterns were consistent with the usual pattern for that cell type; transitional cells were not demonstrated. The intimate admixture of the 2 antigenically different neoplastic cell types, and common etiologic role of ultraviolet and possibly infrared damage, lend support to the theory that some Merkel cell carcinomas and squamous cell carcinomas may arise from a pluripotent epidermal stem cell.
Collapse
Affiliation(s)
- M V Iacocca
- Department of Pathology, University of North Carolina at Chapel Hill, 27599, USA
| | | | | | | | | |
Collapse
|
36
|
Abd-el-Baki J, Stefanato CM, Koh HK, Demierre MF, Foss FM. Early detection of cutaneous lymphoma. Oncology (Williston Park) 1998; 12:1521-30; discussion 1532-4. [PMID: 9798206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Cutaneous lymphomas comprise a spectrum of diseases characterized by infiltration of the skin by malignant lymphocytes. The clinical manifestations of cutaneous lymphomas vary, and they can mimic benign dermatoses, as well as nodal or visceral malignancies with cutaneous spread. Cutaneous lymphomas are divided into T-cell lymphomas and B-cell lymphomas. Cutaneous T-cell lymphomas include mycosis fungoides, Sézary syndrome, lymphomatoid papulosis, CD30+ large cell lymphoma, and adult T-cell leukemia/lymphoma. The extent and severity of skin manifestations in cutaneous T-cell lymphomas are prognostic indicators of extracutaneous involvement. Primary cutaneous B-cell lymphomas comprise 10% to 25% of all primary cutaneous non-Hodgkin's lymphomas and are classified according to their cell of origin. Most cutaneous B-cell lymphomas have an indolent course and excellent prognosis when compared to their nodal counterparts. Many factors have been implicated in the etiology of cutaneous lymphomas, including chemical and drug exposures, as well as microbial agents, such as the Epstein-Barr virus (EBV), human T-lymphocyte virus-1 (HTLV-1), and Borrelia burgdorferi. Immunohistochemistry and lymphocyte-receptor gene rearrangement studies are useful in distinguishing malignant from benign conditions.
Collapse
MESH Headings
- Diagnosis, Differential
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/etiology
- Lymphoma, B-Cell/pathology
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/etiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Neoplasm Staging
- Skin Neoplasms/diagnosis
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
Collapse
Affiliation(s)
- J Abd-el-Baki
- Department of Dermatology, Boston University School of Medicine, Massachusetts, USA
| | | | | | | | | |
Collapse
|
37
|
Stefanato CM, Andersen WK, Calonje E, Swain FA, Borghi S, Massone L, Kowalski JV, Bhawan J. Langerhans cell histiocytosis in the elderly: a report of three cases. J Am Acad Dermatol 1998; 39:375-8. [PMID: 9703158 DOI: 10.1016/s0190-9622(98)70395-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Langerhans cell histiocytosis is most common in children and is unusual in the elderly. We describe 3 cases of langerhans cell histiocytosis limited to the skin in elderly patients. Biopsy specimens showed a dermal infiltrate abutting the epidermis composed of atypical langerhans cells with abundant eosinophilic cytoplasm and a "kidney-shaped" nucleus. Immunoperoxidase stain CD1a was positive in all 3 cases and S-100 stain was positive in 2. Electron microscopy revealed Birbeck granules in the cytoplasm of the atypical langerhans cells in 2 cases. Langerhans cell histiocytosis with skin involvement has a chronic course with an overall good prognosis. However, cutaneous manifestations may precede systemic involvement by many years.
Collapse
Affiliation(s)
- C M Stefanato
- Department of Dermatology, Boston University Medical Center, Massachusetts 02118, USA
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Stefanato CM, Tallini G, Crotty PL. Histologic and immunophenotypic features prior to transformation in patients with transformed cutaneous T-cell lymphoma: is CD25 expression in skin biopsy samples predictive of large cell transformation in cutaneous T-cell lymphoma? Am J Dermatopathol 1998; 20:1-6. [PMID: 9504661 DOI: 10.1097/00000372-199802000-00001] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Large cell transformation (LCT) in cutaneous T-cell lymphoma (CTCL) is estimated to occur up to approximately 20% of patients. This morphologic change is associated with aggressive behavior and shortened survival. Our purpose was to identify morphologic and/or immunophenotypic features in CTCL skin biopsies that are predictive of transformation. We analyzed 12 cases of CTCL (three cases of mycosis fungoides and nine cases of Sezary syndrome) that underwent LCT and for which sequential biopsies before and after transformation were available. Eight of 12 cases had pre-LCT marker studies performed on frozen tissue. The histologic and immunophenotypic features of CTCL and LCT were reviewed. Morphologically, CTCL biopsies showed the following: Pautrier microabscesses (five cases), epidermotropism of single lymphoid cells (three cases), and nonspecific histology (four cases). Immunophenotyping prior to transformation showed aberrant loss of T-cell markers (CD5, CD7, CD5 and CD7) in three of eight cases. CD4:CD8 ratios were increased in all cases. Expression of CD25 by the neoplastic lymphoid cells was detected in six of seven cases. LCT immunophenotyping showed additional loss of CD7 in one of five cases and of CD25 in three of five cases. In conclusion, expression of CD25 in CTCL may identify a subset of patients at risk of undergoing LCT.
Collapse
Affiliation(s)
- C M Stefanato
- Department of Pathology, Yale University Medical School, New Haven, CT, USA
| | | | | |
Collapse
|
39
|
Abstract
There are multiple causes of diffuse hyperpigmentation of the skin (DHP) and determination of the exact etiology can sometimes be difficult. A systematic classification based on both clinical and pathological findings that should aid the clinician who is confronted with this situation is presented in this article. The skin diseases that cause DHP are classified based on the pigment characteristics (melanin, non-melanin), pigment distribution (epidermal, epidermal-dermal, dermal) and density of melanocytes (normal, increased). The intent of this review is to provide a "histopathological tool" that increases diagnostic accuracy in the evaluation of a patient with DHP.
Collapse
Affiliation(s)
- C M Stefanato
- Department of Dermatology, Boston University Medical Center, MA, USA
| | | |
Collapse
|
40
|
|
41
|
Abstract
The objective of follow-up examinations of patients who have had Stage I invasive malignant melanoma is the early detection of local recurrences, metastases, and new primary melanomas. Model schedules for follow-up intervals were developed based on a survey of eight physicians. These melanoma experts agree that regular follow-up examinations are indicated and that the time intervals between examination vary according to the thicknesses of the melanomas. The patient follow-up schedule derived is: for melanomas up to 0.75-mm thick, every 6 months for years 1 and 2, and annually for years 3, 4, and 5; for melanomas 0.76-1.50 mm thick, every 3 months for years 1 and 2, semi-annually for years 3, 4, and 5; and for melanomas > 1.50 mm thick, every 3 months for years 1, 2, and 3, and semi-annually for years 4 and 5. After the fifth year, the recommendation is to examine all patients annually for life because of the continued risk for recurrences and new primary melanomas. For those individuals at especially high risk for developing multiple primary melanomas more frequent examinations may be appropriate.
Collapse
Affiliation(s)
- J B Romero
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, NY 10016
| | | | | | | |
Collapse
|
42
|
Stefanato CM, Romero JB, Kopf AW, Bart RS. Solar nevogenesis: a surrogate for predicting a rise in incidence of malignant melanoma because of ozone depletion. J Am Acad Dermatol 1993; 29:486-7. [PMID: 8053993 DOI: 10.1016/s0190-9622(08)82002-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- C M Stefanato
- Ronald O. Perelman Department of Dermatology, New York University, School of Medicine
| | | | | | | |
Collapse
|
43
|
Chorzelski TP, Stefanato CM, Stanley JR, Beutner EH, Korman NJ, Olszewska M, Maciejowska E, Jablonska S. Erythema annulare-like acantholytic dermatosis (EAAD): nonbullous pemphigus or a new entity? Am J Med Sci 1993; 306:145-50. [PMID: 8128974 DOI: 10.1097/00000441-199309000-00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This article describes a case of unusual annular erythema-like dermatosis, with histological features of pemphigus foliaceus (subcorneal acantholysis) and IgG antibodies in circulation and bound in vivo to the keratinocyte surface. The reactivity of the antibodies, restricted to human squamous epithelium, was unique, differing from that of all known forms of pemphigus. This also was confirmed by immunoprecipitation. The problem is that these circulating antibodies could be missed if not determined on human substrate. It is to be established whether such cases present a new type of pemphigus or a unknown dermatosis with an autoimmune response of a pemphigus type.
Collapse
Affiliation(s)
- T P Chorzelski
- Department of Dermatology, Warsaw Medical School, Poland
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Stefanato CM, Youssef EA, Cerio R, Kobza-Black A, Greaves MW. Atypical Nekam's disease--keratosis lichenoides chronica associated with porokeratotic histology and amyloidosis. Clin Exp Dermatol 1993; 18:274-6. [PMID: 8348726 DOI: 10.1111/j.1365-2230.1993.tb02187.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A patient with atypical Nekam's disease is described. Although the histological appearances were lichenoid, the presence of porokeratosis and amyloid deposition, previously reported in this condition, argue against the view that Nekam's disease is a subset of lichen planus.
Collapse
Affiliation(s)
- C M Stefanato
- Institute of Dermatology, St Thomas's Hospital, London, UK
| | | | | | | | | |
Collapse
|
45
|
Abstract
A 20-year-old man with a 9-year history of unusual subcutaneous morphea with nodular lesions in a circular arrangement and wooden-hard symmetrical induration of the arms, had high titers of fibronectin antibodies. A possible role of fibronectin and antifibronectin antibodies in the pathogenesis of scleroderma is discussed.
Collapse
Affiliation(s)
- C M Stefanato
- Department of Dermatology, Warsaw Academy of Medicine, Poland
| | | | | | | | | |
Collapse
|
46
|
Rotoli M, Ferruzzi F, Rezza E, Stefanato CM, Rusciani L. [The hypereosinophilia syndrome]. GIORN ITAL DERMAT V 1988; 123:63-70. [PMID: 3044988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
47
|
Rotoli M, Stefanato CM, Rezza E. [Erythema dyschromicum perstans-ashy dermatosis (EDP-AD). Clinical aspects and problems of classification]. GIORN ITAL DERMAT V 1987; 122:119-20. [PMID: 3596645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|