Clinical and pathologic findings of paraneoplastic dermatoses

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Presentation transcript:

Clinical and pathologic findings of paraneoplastic dermatoses Vinh Q. Chung, MD, MPharm Sci, Samuel L. Moschella, MD, Artur Zembowicz, MD, PhD, Vincent Liu, MD Journal of the American Academy of Dermatology Volume 54, Issue 5, Pages 745-762 (May 2006) DOI: 10.1016/j.jaad.2004.06.051 Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Acanthosis nigricans. Velvety brown pigmentation in the axilla of a 42-year-old woman. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Acanthosis nigricans. Orthohyperkeratotic papillary folds. (Hematoxylin-eosin stain; original maginification: ×5.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Sign of Leser-Trélat. Eruption of numerous, waxy, “stuck-on,” variably-pigmented, seborrheic keratoses in a 64-year-old man. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Sign of Leser-Trélat. Orthohyperkeratotic papillomatosis. (Hematoxylin-eosin stain; original magnification: ×2.5.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 Bazex Syndrome. Acrokeratosis with associated nail dystrophy in a 63-year-old man. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 6 Bazex Syndrome. Psoriasiform spongiotic epidermal hyperplasia with overlying scale crust. (Hematoxylin-eosin stain; original magnification: ×10.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 7 Dermatomyositis. Gottron's papules, heliotrope periocular rash, and facial erythema in 47-year-old woman. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 8 Paraneoplastic pemphigus. Prominent, crusted, mucosal erosions in 79-year-old woman with gastric lymphoma. (Courtesy of M. Avram, MD.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 9 Paraneoplastic pemphigus. Suprabasilar acantholysis. (Hematoxylin-eosin stain; original magnification: ×40.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 10 Paraneoplastic pemphigus. Direct immunofluorescence demonstrating intercellular and basement membrane zone staining for IgG. (DIF; original magnification: ×40.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 11 Erythema gyratum repens. Strikingly geometric, serpiginous, and arciform migrating erythematous plaques resembling wood grain in 54-year-old man. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 12 Necrolytic migratory erythema. Moist erythematous eroded perineal plaques in 47-year-old woman with a glucagon-secreting pancreatic tumor. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 13 Sweet's syndrome. Dusky, violaceous, edematous dorsal finger plaque in 48-year-old woman. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 14 Sweet's syndrome. Diffuse neutrophilic infiltrate with vasculopathy and superficial dermal edema. (Hematoxylin-eosin stain; original magnification: ×2.5.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 15 Pyoderma gangrenosum. Pathergic ulcer at surgical site of coronary bypass surgery in a 64-year-old man. (Courtesy of J. Jones, MD.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 16 Multicentric reticulohistiocytosis. Digital smooth erythematous papules reminiscent of “coral beads”" in 65-year-old man. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 17 Multicentric reticulohistiocytosis. Prominent, multinucleated giant cells with ground glass cytoplasm. (Hematoxylin-eosin stain; original magnification: ×40.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 18 Necrobiotic xanthogranuloma. Yellow-orange plaques around eyes and on clavicles in 71-year-old man. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 19 Necrobiotic xanthogranuloma. Vaguely palisaded necrobiosis with associated granulomatous inflammation. (Hematoxylin-eosin stain; original magnification: ×10.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 20 Scleromyxedema. Numerous smooth, firm papules over dorsal digits in 52-year-old man. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 21 Scleromyxedema. Increased dermal mucin deposition. (Colloidal iron stain; original magnification: ×10.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 22 Amyloidosis. Periorbital pinched purpura in 62-year-old man. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 23 Amyloidosis. A, Deposition of amorphous eosinophilic substance. (Hematoxylin-eosin stain; original magnification: ×4.) B, Amyloid birefringence highlighted on Congo red stain. (Congo red stain; original magnifications: ×4, inset, ×20.) Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 24 Hypertrichosis lanuginosa acquisita. Soft, downy nonpigmented hair on face of a 45-year-old woman. Journal of the American Academy of Dermatology 2006 54, 745-762DOI: (10.1016/j.jaad.2004.06.051) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions