Journal Article Nonablative laser treatment of wrinkles: meeting the objective? Assessment by 25 dermatologists Get access D. Kopera, D. Kopera Department of Dermatology, University of Graz, Auenbruggerplatz 8, A‐8036 Graz, Austria Daisy Kopera. E‐mail: daisy.kopera@uni‐graz.at Search for other works by this author on: Oxford Academic Google Scholar J. Smolle, J. Smolle Department of Dermatology, University of Graz, Auenbruggerplatz 8, A‐8036 Graz, Austria Search for other works by this author on: Oxford Academic Google Scholar S. Kaddu, S. Kaddu Department of Dermatology, University of Graz, Auenbruggerplatz 8, A‐8036 Graz, Austria Search for other works by this author on: Oxford Academic Google Scholar H. Kerl H. Kerl Department of Dermatology, University of Graz, Auenbruggerplatz 8, A‐8036 Graz, Austria Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 150, Issue 5, 1 May 2004, Pages 936–939, https://doi.org/10.1111/j.1365-2133.2004.05873.x Published: 01 May 2004 Article history Accepted: 09 October 2003 Published: 01 May 2004
The clinicopathological features and prognosis of primary cutaneous malignant melanoma with benign melanocytic naevus (BMN) components are still under debate. The purpose of this study was to characterize further the clinical and histopathological features of naevus-associated melanomas, with emphasis on the BMN components, and to examine their prognosis based on a large series. Following a histopathological review of 667 consecutive cases of primary cutaneous melanoma, 148 melanomas with BMN components (22.1%) were identified for further study. A control group of 519 melanomas without BMN components seen in a similar period were also studied. Clinically, patients with melanomas containing BMN components (n = 148; age range 25–86 years, mean age 54 ± 16 years; male to female ratio 1:1.02) presented with tumours located mainly on the trunk (34.5%), followed by the upper extremities (24.3%), lower extremities (20.3%), and head and neck (14.2%). Compared with tumours without BMN components (n = 519; age range 19–89 years, mean age 57 ± 15 years; male to female ratio 1:1.3), melanomas with BMN components occurred in slightly younger individuals (P = 0.027). Histopathologically, BMN components mainly showed features of acquired naevi (total 87 cases; dysplastic, 80 cases; banal, seven cases) or congenital naevi (total 57 cases; superficial, 56 cases; deep, one case), but a minority of these lesions (four cases) could not be further subcategorized. Generally, melanomas containing BMN components were relatively thinner than melanomas without BMN components (mean Breslow index 0.95 ± 0.83 mm and 1.3 ± 1.6 mm, respectively) (P = 0.015). The follow-up data available in 69 patients with naevus-associated melanomas consistently revealed a relatively good outcome (5 year metastasis-free survival rate 93.75%), although no statistical difference in prognosis was observed between this group and a subset of 283 melanomas patients without BMN components stratified by tumour thickness. We conclude that BMN components in naevus-associated melanomas constitute a heterogeneous group morphologically, consisting mainly of dysplastic and superficial congenital naevi. This finding indicates a more important role for superficial congenital naevus as a precursor lesion of naevus-associated melanomas than presently recognized. Patients with naevus-associated melanomas generally show a good clinical outcome, reflecting their small Breslow index.
The many clinical faces of psoriasis are reflected by the spectrum of histopathologic changes ranging from guttate psoriasis to generalized pustular psoriasis. Psoriasis is a dynamic process and consequently the morphologic changes vary during the evolution and subsequent resolution of the individual lesions. For example, a fully developed psoriatic lesion reveals psoriasiform acanthosis of the epidermis characterized by elongated thin or club shaped rete ridges of equal length alternating with thin dermal papillae that are covered by thin suprapapillary plates. Typically, there is confluent parakeratosis, which contains accumulation of neutrophils. The granular layer is decreased or absent. In the upper part of the dermis there is a moderately dense perivascular and interstitial infiltrate of lymphocytes in association with dilated spiraled capillaries in the dermal papillae and marked edema of the papillary dermis. Besides early, fully developed and late lesions of 'classical' psoriasis, palmoplantar psoriasis, pustular psoriasis and erythrodermic psoriasis are all characterized by distinctive morphologic changes that, in many instances, allow a histopathologic diagnosis with certainty. The most important differential diagnoses from a histopathologic point of view are as follows: psoriasiform trichophytia, pityriasis rubra pilaris, pityriasis rosea, nummular dermatitis, chronic contact dermatitis, lichen simplex chronicus and rupial syphilis. In conclusion, the histopathologic findings of the many faces of psoriasis are distinctive and allow a definitive diagnosis by the experienced dermatopathologist in nearly all instances. Until today no laboratory methods including modem molecular technologies are replacing conventional histopathology in the diagnosis of psoriasis.
Coexistence (collision) of two different neoplasms in the same lesion has previously been documented by several authors. In this report, we describe a 13-year-old boy with xeroderma pigmentosum presenting with squamous-cell carcinoma and melanoma arising at the same site on the nose. Histopathologically, the melanoma component of the lesion was located mainly eccentrically to the squamous-cell carcinoma component. Immunohistochemical stains confirmed the histopathologic findings. Mutations for p53 assessed using single-strand conformation polymorphism, and sequencing analysis revealed a CC-to-TT transition at codon 159 of the p53 gene in the squamous-cell component but not in the melanoma component. This finding suggests a possible role for UV in the pathogenesis of at least the squamous-cell component of the tumor. To the best of our knowledge, this is the first report of a collision tumor comprising squamous-cell carcinoma and melanoma arising in childhood.
