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Home , Acral fibrokeratoma, Dermal cylindroma

Dr Sarma’s Dermpath: Quick diagnosis (100 cases)

1. Superficial BCC 2. Invasive SCC 3. Neurofibroma 4. Granular cell tumor 5. Clear cell acanthoma 6. Chondroid (Cutaneous mixed tumor) 7. Scabies 8. Molluscum contagiosum 9. Herpes simplex 10. Hemangioma 11. Basosquamous cell 12. Dermal 13. Psoriasis vulgaris 14. Proliferating pilar tumor 15. Pilar 16. Nodular BCC 17. Nevus lipomatosus superficialis 18. Glomangioma 19. Chromomycosis 20. Blue nevus 21. Pemphigus vulgaris 22. Halo nevus 23. Acute febrile neutrophilic dermatosis (Sweet’s syndrome) 24. Angiolipoma 25. Angioleiomyoma 26. Bullous pemphigoid 27. 28. Acquired digital fibrokeratoma 29. Basal cell carcinoma, fibroepithelioma of Pinkus type (Fibroepithelioma of Pinkus) 30. Sclerosing basal cell carcinoma (Morpheaform basal cell carcinoma) 31. Squamous cell carcinoma in situ 32. Basal cell carcinoma, pilar type 33. Apocrine 34. Cystic 35. 36. Blastomycosis 37. Dermatophytosis (Tinea) 38. Tick-bite dermatitis 39. Epidermal nevus 40. Acrochordon (Fibroepitelial polyp, Squamous , Skin tag) 41. Squamous cell carcinoma, in situ and invasive 42. Desmoplastic melanoma 43. Keratoacanthoma 44. 45. Majocchi’s granuloma 46. Schwannoma 47. Lichen sclerosus et atrophicus 48. Lichen planus 49. Lentigo simplex 50. Alopecia areata 51. Acantholytic squamous cell carcinoma 52. Melanoma in situ 53. Steatocystoma 54. Sebaceous 55. Pyogenic granuloma 56. Darier disease 57. Balanitis circumscripta plasmacellularis 58. Acrochordon 59. 60. Xanthogranuloma 61. Basal cell carcinoma, infiltrative type 62. Cutaneous lupus erythematosus 63. Angiokeratoma 64. Piloleiomyoma 65. Sarcoidosis 66. Angioleiomyoma 67. Scrotal (Genital leiomyoma) 68. Lipomatous dermal melanocytic nevus 69. Seborrheic keratosis 70. Cutaneous dermoid cyst 71. Solar Lentigo (1) 72. Solar lentigo (2) 73. Lentigo simplex 74. Verruca vulgaris 75. Lymphomatoid papulosis 76. of Winer 77. Syringocystadenoma papilliferum 78. Poroma 79. Hidrocystoma 80. Syringoma 81. Microcystic adnexal carcinoma (Syringomatous carcinoma) 82. 83. Glomus tumor 84. Seborrheic keratosis, reticulated type 85. Drug dermatitis (Drug eruption, Drug-induced dermatitis) 86. Dysplastic nevus 87. Spitz nevus (Epitheliod nevus) 88. , subcutaneous 89. Squamous cell carcinoma in situ 90. Seborrheic keratosis, clonal type 91. 92. Pigmented follicular cyst 93. Gouty tophus 94. Arteriovenous hemangioma 95. Angiosarcoma 96. Dermal melanoma 97. Demodex 98. Demodex folliculitis (Demodicosis) 99. Pustular psoriasis 100. Cutaneous cysticercosis

1. Superficial BCC

2. Invasive SCC

3. Neurofibroma

4. Granular cell tumor

5. Clear cell acanthoma

6. Chondroid syringoma (Cutaneous mixed tumor)

7. Scabies

8. Molluscum contagiosum

9. Herpes simplex

10. Hemangioma

11. Basosquamous cell carcinoma

12. Dermal cylindroma

13. Psoriasis vulgaris

14. Proliferating pilar tumor

15. Pilar cyst

16. Nodular BCC

17. Nevus lipomatosus superficialis

18. Glomangioma

19. Chromomycosis

20. Blue nevus

21. Pemphigus vulgaris

22. Halo nevus

23. Acute febrile neutrophilic dermatosis

24. Angiolipoma

25. Angioleiomyoma

26. Bullous pemphigoid

27. Trichoepithelioma

28. Acquired digital fibrokeratoma

29. Basal cell carcinoma, fibroepithelioma of Pinkus type (Fibroepithelioma of Pinkus)

Basal cell carcinoma, fibroepithelioma of pinkus type M 82, buttock (Fibroepithelioma of Pinkus) A. Infiltrative basal cell carcinoma is a hybrid between nodulocystic and morpheaform BCC.

B. Expansile nodules mixed with branched, angulated and linear basaloid cells.

C. Epidermal ulceration and deep dermal invasion with perineural invasion is common. Stroma is cellular.

D. Retraction artefact around the branched and angulated basaloid infiltrates are not present.

E. A wider exsision is required because of the infiltrating nature of this type of BCC.

Comment

A. Fibroepithelioma of Pinkus (FEP) was first described by Herman Pinkus in 1953.

B. FEP is an indolent variant of basal cell carcinoma (BCC).

C. Mostly male, 40–60 years of age.

D. Single or multiple pedunculated or sessile nodules with broad base on the trunk or extremities.

E. Tumor is composed of long, thin, and branching strands of basal cell carcinoma anastomosing in fibrovascular stroma.

30. Sclerosing basal cell carcinoma (Morpheaform basal cell carcinoma)

31. Squamous cell carcinoma in situ

32. Basal cell carcinoma, pilar type (Keratotic basal cell carcinoma)

33. Apocrine hidrocystoma

34. Cystic spiradenoma

35. Acral fibrokeratoma

36. Blastomycosis

37. Dermatophytosis (Tinea)

38. Tick-bite dermatitis

Tick-bite dermatitis M 75, back, persistent papule at the previous tick bite site

Fig 1. In the center of the biopsy, there is a downward epidermal tunnel containing keratin material. In the deep part, the thick hyaline structure (black arrows) represents the chitinous wall of the mouthpart (hypostome) of a tick. Fig 2. In higher magnification: within the chitinous wall shows several barb-like projections (green arrows) that serve as anchor during feeding. Note the tick mouthparts in the dermis. Figures 1 and 2 show remnants of the tick hypostome (mouth part) with thick chitinous wall as well as several sharp barb-like projections (green arrows in Figure 2) on the hypostome that serve to anchor the tick during feeding. Histologically, tick bite reactions often display endothelial swelling as well as a wedge-shaped perivascular chronic inflammation composed of eosinophils and CD30+ lymphocytes, suggesting hypersensitivity reaction . Whereas their presence is helpful in diagnosis, tick mouthparts (Figures 1 and 2) are a relatively uncommon finding on biopsy. Clinical history as well as the extent and type of inflammatory infiltrate prove to be valuable clues in diagnosis. Once the diagnosis is made, treatment for hypersensitivity reactions can involve topical or intralesional corticosteroids.

39. Epidermal nevus

40. Acrochordon (Fibroepithelial polyp, squamous papilloma, skin tag)

41. Squamous cell carcinoma in situ

42. Desmoplastic melanoma

43. Keratoacanthoma

44. Sebaceous hyperplasia

45. Majocchi’s granuloma

46. Schwannoma (Neurilemmoma)

47. Lichen sclerosus et atrophicus

48. Lichen planus

49. Lentigo simplex

50. Alopecia areata

51. Acantholytic squamous cell carcinoma

52. Melanoma in situ

53. Steatocystoma

54.

55. Lobular capillary hemangioma (Pyogenic granuloma)

56. Darier disease

57. Balanitis circumscripta plasmacellularis (Zoon’s balanitis, Plasma cell balanitis)

58. Acrochordon (Skin tag)

59. Dermatofibroma

60. Xanthogranuloma

61. Basal cell carcinoma, infiltrative type

62. Cutaneous lupus erythematosus

63. Angiokeratoma

64. Piloleiomyoma

65. Sarcoidosis

66. Angioleiomyoma

67. Scrotal leiomyoma (Genital leiomyoma)

68. Lipomatous dermal melanocytic nevus

69. Seborrheic keratosis

70. Cutaneous dermoid cyst

71. Solar lentigo

72. Solar lentigo

73. Lentigo simplex

74. Verruca vulgaris

75. Lymphomatoid papulosis

76. Dilated pore of Winer

77. Syringocystadenoma papilliferum

78. Poroma

79. Hidrocystoma

80. Syringoma

81. Microcystic adnexal carcinoma (Syringomatous carcinoma)

82. Hidradenoma

83. Glomus tumor

84. Seborrheic keratosis, reticulated (adenoid) type

85. Drug eruption (Drug-induced dermatitis)

86. Dysplastic nevus

87. Spitz nevus

88. Leiomyosarcoma, subcutaneous

89. Squamous cell carcinoma in situ

90. Seborrheic keratosis, clonal type

91. Pilomatricoma (Pilomatrixoma, Calcifying epithelioma of Malherbe)

92. Pigmented follicular cyst

93. Gouty tophus

94. Arteriovenous hemangioma (Arteriovenous malformation)

95. Angiosarcoma

96. Dermal melanoma

97. Demodex

98. Demodex folliculitis (Demodicosis)

99. Pustular psoriasis

100. Cutaneous cysticercosis