Case Report OPEN ACCESS Overexpression of linker for activated T cells, cyclooxygenase-2, CD1a, CD68 and myeloid/histiocyte antigen in an inflamed seborrheic keratosis

Abstract Context: Inflamed seborrheic keratoses are generally associated with the accumulation of variable numbers of lymphocytes and histiocytes in the superficial dermis. The precise immunologic mechanism of this histologic phenomenon is not known Case Report: A 62-year-old male presented with a patch on the right neck with additional features of inflammation. Skin biopsies for hematoxylin and eosin examination, as well as for immunohistochemistry analysis were performed. Results: H&E staining demonstrated classic features of an inflamed seborrheic keratosis. Overexpression of LAT, COX-2, CD1a, and CD68 was noticed in the inflammatory infiltrate. A strong presence of CD1a was also seen in the epidermis suprajacent to the inflammation. Myeloid/histiocyte antigen was strongly expressed by the keratinocytes. Conclusion: A complex immune response seems to be involved in the pathophysiology of an inflamed seborrheic keratosis

Seboreik keratozların klinik ve dermoskopik özelliklerinin değerlendirilmesi

Bu çalışmada seboreik kera ik ve dermoskopik özelliklerinin değerlendirilmesi amaçlanmıştır. ine başvuran, yaşları 13-93 arasında değişen, vücudu 105 hastadaki toplam, keskin beraber artış gösterdiği, seboreik keratoz lezyonlarının dermos tozların klinÇalışmaya Ocak 2007- Haziran 2008 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Dermatoloji polikliniğnda en az 1 adet seboreik keratozu bulunan 105 hasta alındı. Çalışmaya alınan 105 hastanın %69,5’i erkek, %30,5’i kadındı. SK görülme sıklığı 50 yaş üzerinde %72,4 olarak bulundu. Çalışmaya alınan 742 adet seboreik keratozun 338’i (%45,9) sırtta, 191’i (%25,7) yüzde, 132’si (%17,7) gövde ön yüzde, 30’u (%4,0) üst ekstremitede, 28’i (%3,7) alt ekstremitede, 14’ü (%1,8) saçlı deride ve 9’u (%1,2) boyunda yerleşmekteydi. Seboreik keratozların %80,5’i açık kahverengi renkte, %16,5’i koyu kahverengi renkte ve %3’ü siyah renkte idi. Hastalarda tespit edilen seboreik keratozların %90,2’sinin boyutu 1 cm’den küçüktü. Olguların %58,1’inde 1 adet, %15,2’sinde 6 adet ve üzerinde seboreik keratoz tespit edildi. Olguların %28,6’sında lezyonlarda kaşıntı semptomu mevcuttu. Olguların %44,8’inde kronik güneş maruziyeti öyküsü vardı. Dermoskopik olarak incelenen 214 adet seboreik keratoz lezyonunda; komedon benzeri açıklıklar %89,7, milia benzeri kistler %56,5, fissürler %36,9 kenar %20,1, verrüköz yüzey %13,6, güve yeniği sınır %12,1, sosis parmaklar %6,1, hipopigmente alanlar %5,1, parmak izi görünümü %4,2, mavi-beyaz yapı %3,7, psödopigment ağı %3,3, saç tokası kan damarları %1,9 ve mavi-gri leke %1,9 oranlarında görüldü. Çalışmamızın sonuçlarında seboreik keratozların kişilerde görülme olasılığının yaş ile kopik incelemesinde komedon benzeri açıklıklar, milia benzeri kistler, fissürler ve keskin kenar özelliklerinin en sık karşılaşılan dermoskopik özellikler olduğunu gördük. Bu bulgular literatürdeki diğer sonuçlar ile benzerlik göstermekle birlikte daha fazla sayıda çalışmaya ihtiyaç vardır. Anahtar Kelimeler: Seboreik keratoz, klinik özellikler, dermoskopik özelliklerIn this study, determination of clinical and dermoscopic characteristics of seborrheic keratoses was aimed. A total of 105 patients who applied to the Department of Dermatology, Medical Research Hospital, Dicle University between January 2007- June 2008, whose ages varied between 13 and 93 years, and who had at least one seborrheic keratose (SK) in his or her body, were included into the study. Of 105 patients in the study, 69,5% were male and 30,5% female. The frequency of SK was found to be 72,4% in over 50 years old. Of the total 742 SK in 105 patients, 338 (45,9%)were localized on back, 191 (25,7%) on face, 132 (17,7%) on the front part of the body, 30 (4,0%) on upper extremities, 28 (3,7%) on lower extremities, 14 (1,8%) on scalp and 9 (1,2%) on neck. Of these seborrheic keratoses detected in our patients, the size of 90,2% was less than 1 cm. One SK was determined in 58,1% of the cases, 6 and more SK in 15,2%. Seborrheic keratoses were itching in 28,6%. In addition, there was sun exposure history in 44,8%. In 214 seborrheic keratose lesions examined dermoscopically, comedolike openings was seen at a rate of 89,7%, milialike cysts as 56,5%, fissures as 36,9%, sharp demarcation as 20,1%, verrucose surface as 13,6%, moth-eaten border as 12,1%, fat fingers as 6,1%, hypopigmented sites as 5,1%, fingerprinting as 4,2%, blue-whitish veil as 3,7%, pseudopigment network as 3,3%, hairpin blood vessels as 1,9% and blue-gray blotches as 1,9%. In conclusion, it was determined that the prevalence of seborrheic keratoses in individuals increases with age. In dermoscopic examinatin of seborrheic keratoses that the most commonly encountered characteristic of seborrheic keratose lesions were comedolike openings, milialike cysts, fissures and sharp demarcation. Although these findings were similar to those in literature, more extensive studies are required to be carried out. Key Words: Seborrheic keratosis, clinical characteristics, dermoscopic characteristic

Cyanoacrylate Skin Surface Stripping and the 3S-Biokit Advent in Tropical Dermatology: A Look from Liège

In the dermatopathology field, some simple available laboratory tests require minimum equipment for establishing a diagnosis. Among them, the cyanoacrylate skin surface stripping (CSSS), formerly named skin surface biopsy or follicular biopsy, represents a convenient low cost procedure. It is a minimally invasive method collecting a continuous sheet of stratum corneum and horny follicular casts. In the vast majority of cases, it is painless and is unassociated with adverse events. CSSS can be performed in subjects of any age. The method has a number of applications in diagnostic dermatopathology and cosmetology, as well as in experimental dermatology settings. A series of derived analytic procedures include xerosis grading, comedometry, corneofungimetry, corneodynamics of stratum corneum renewal, corneomelametry, corneosurfametry, and corneoxenometry

Dermoscopy of trichostasis spinulosa

<p>TRICHOSTASIS SPINULOSA (TS) is a relatively common but underdiagnosed disorder of hair follicles that retain successive telogen hairs. It has been described within skin lesions (secondary TS) or as an isolated finding (primary TS). Dermoscopy may help identify the characteristic hair tuft. We report 2 cases of TS. The first case involved a 23-year-old woman who presented with a long-standing history of a light-brown papule on the lower part of her back. There was a black punctum in the upper central area of the lesion (Figure 1). Dermoscopy showed a sparse pigment network, multiple commalike blood vessels that are typical of intradermal melanocytic nevi, a few peripheral vellous hairs, and a small hair tuft emerging from the central punctum (Figure 2). Histologic examination confirmed the presence of an intradermal melanocytic nevus along with dilated folliculosebaceous bunits containing several cross-sectioned hair shafts (Figure 3). The second case involved a 30-yearold man who presented with a micropapular eruption on both flanks. Dermoscopy showed multiple vellous hairs erupting through the follicles (Figure 4).</p> <p>Hair tufts are the result of folliculosebaceous hamartomas with multiple units around a central pore (trichofolliculomas) or retained hair shafts within follicles with infundibular keratosis (TS). Trichostasis spinulosa may appear as an isolated finding or in association with expansile nondestructive lesions that narrow hair infundibulae, such as melanocytic nevi, seborrheic keratoses, syringomas, or nodular basal cell carcinomas. Dermoscopy is helpful in diagnosing TS.</p