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Sampling of interesting Dermatopathology cases from CUMC-1

Deba P Sarma, MD Director of Dermatopathology Creighton University Medical Center Dept of Pathology, Omaha

Case 1

F 55, obese

4-month history of hemorrhagic discharge from the umbilicus
8-mm dark mass from base of the umbilicus

Diagnosis: ‘Lint ball’ omphalitis

• •

Ref: Sarma DP, Teruya B (2009). ‘Lint ball’ omhphalitis, a rare cause of umbilical discharge in an adult woman: a case report. Cases J 2: 7785.PMID 19830013 Steinhauser G (2009). The nature of navel fluff. Med Hypotheses. 72(6):623-5.

Case 2

• M 50 • Possible pilar cyst removed from scalp.

RCC Immunostain

Diagnosis:
Implantation carcinoma of the scalp from renal cell carcinoma

Ref: Sarma DP, Wang JF, McAllister MV, Wang B, Shehan JM. (2008) Possible implantation carcinoma of the scalp following craniotomy for metastatic renal cell carcinoma. Dermatology Online J 14(6):20.

Case 3

M 44, of Chinese heritage had red palms since birth

Mother (74 yrs) and daughter(7 yrs) had bright red palms all their life

Diagnosis

• Erythema palmare hereditarium (Red palm disease, Lane’s disease)
Ref: Sarma DP, Wang B (2007). Erythema palmare hereditarium (Red palms): Lane’s Disease. Dermatol Online J. 13(2). Lane JE.(1929). Erythema palmare hereditarium. Arch Derm Syph. 20:445-448.

Case 4

• M 58, left knee dislocation with neurovascular injury, 1968.
Left below the knee amputation, fitted with an artificial leg. 36 years later (2004), pain at the amputation site, mass, foul discharge.

Diagnosis

• Verrucous carcinoma in the amputation stump Ref: Sarma DP, Hansen TP, Adickes ED(2006): Carcinoma arising in the leg amputation stump. The Internet J Dermatol 4(1).

• Sarma DP, Weilbaecher TG.(1985)) Carcinoma arising in burn scar. J Surg Oncol. 29(2):89-90.
• M 60, left BK amputation 30 years ago after a dynamite explosion injury. Artificial leg since then. Developed squamous cell carcinoma on the amputation stump 30 years later.

Case 5

• F 32 • 5 mm, painless subareolar nodule, left breast

Diagnosis: Infiltrating syringomatous eccrine adenoma of the nipple Ref: Sarma D, Stevens T (2009). Infiltrating syringomatous eccrine adenoma of the nipple: a case report. Cases J 2:0118.

Case 6

F 83, 7-mm painless soft papule, left cheek, present for few months Clinical: Lipoma

CK 20

Chromogranin

Synaptophysin

• Diagnosis: • Subcutaneous Merkel cell carcinoma

Case 7 F 81 Raised hyperkeratotic lesion, left temple, clinical sk

Diagnosis: Malignant seborrheic keratosis Ref: Sharma P, Sarma DP, Adickes ED (2006). Seborrheic keratosis with in-situ carcinoma changes. Dermatology Online J 12(7):19

Case 8

M 86, back, clinical seborrheic keratosis

MITF

Diagnosis: Melanoma in-situ arising in seborrheic keratosis

Ref: Repertinger S, Wang J, Adickes E, Sarma DP. (2008). Melanoma in-situ arising in seborrheic keratosis: a case report. Cases J 1 (1):263.

Case 9

M 72, farmer, sheep handler, left wrist crusted nodule, 0.9 cm.

Diagnosis: Human orf ( Ecthyma contagiosum, Contagious pustular dermatosis)

Case 10

• Three skin biopsies from the face of three men (age: 55-67yrs)

Ref

Winer L H.(1954). The dilated pore, a trichoepithelioma. J Invest Dermatol 23(3):181188.
Sarma Deba P.(2009): Dilated Pore of Winer, Dr. Louis H Winer and Wine Glass. The Internet Journal of Dermatology Vol 7(2).