2017 Annual Meeting

Evening Specialty Conference
Dermatopathology

'Zebras' in Dermatopathology. Relatively Rare Entities That May Be Missed in a Skin Biopsy with Serious Consequences

March 7 2017, 7:30pm to 9:30pm

Moderator:
Victor G. Prieto, MD, PhD
Panelists:
Aeree Kim, MD - Phyu Aung, MD, PhD - Rami Al-Rohil, MBBS - Gonzalo de Toro, MD - George Jour, MD

Pre-Meeting Materials

Speaker 1
Faculty:
Aeree Kim, MD

Case 1

Clinical History:

63-year-old man has had 3 surgeries due to recurrent abdominal wall mass in 1997, 2002 and 2005 in a hospital. The mass was pathologically diagnosed as fibrous histiocytoma, leiomyoma and vascular leiomyoma. In 2015, he again found a growing mass at the same location and visited our hospital. The CT scan disclosed a well- defined, lobulated, and poorly enhancing mass measuring 15.3 X 11 X 6.4 cm. Grossly, the excised specimen shows a relatively well- demarcated tumor with infiltration into the dermis. Its cut surface was yellowish-white, glistening, and it was myxoid and focally hemorrhagic.

Morphological Findings (click to enlarge):

Case 2

Clinical History:

73 year-old male admitted to our hospital because of fever and generalized weakness. He had been treated and followed up for erythrodermic psoriasis for 3 years in a hospital. At first, the skin lesion was localized on the face, and started spreading to the whole body for 2 years before he visited our hospital. He complained of itchy sensation over the erythematous patches. On ophthalmologic exam, narrowing of right visual field and disk swelling was detected. Axillary and inguinal lymphadenopathy was also found on physical exam. Biopsies of abdominal skin and inguinal lymph nodes were performed.

Morphological Findings (click to enlarge):


Speaker 2
Faculty:
Phyu Aung, MD, PhD

Case 1

Clinical History:

A 65 year-old gentleman presented with a seven month history of multiple erythematous nodules on the face, neck and chest, starting on his chest and progressed to involve head and neck, trunk and extremities.

Morphological Findings (click to enlarge):

Case 2

Clinical History:

A 63-year-old man presented with a lesion on his right middle digit. The patient did not have a known history of malignant neoplasm. The clinical differential diagnosis included basal cell carcinoma and lentigo maligna.

Morphological Findings (click to enlarge):


Speaker 3
Faculty:
Rami Al-Rohil, MBBS

Case 1

Clinical History:

48 year-old-male patient presented with a 2nd toe lesion, clinically suspected to be cyst.

Morphological Findings (click to enlarge):

Case 2

Clinical History:

53-year-old female with a "xanthelasma" on her right lower eyelid. Past medical history significant for micropapillary thyroid carcinoma and retroperitoneal fibrosis involving both ureters causing bilateral hydronephrosis. Blood testing showed normal lipid profile.

Morphological Findings (click to enlarge):


Speaker 4
Faculty:
Gonzalo de Toro, MD

Case 1

Clinical History:

A 30-year-old woman presented to the Puerto Montt Hospital in August 2012 by progressive dyspnea on exertion. Also, she was seeking cosmetic treatment of multiple facial papules that had been gradually increasing in number over the past three years. She had a medical history of epilepsy, hypotiroidism and a surgical procedure in 2009, for a skin colored firm, plaque over her forehead. A descriptive diagnosis was made, referring fibrosis, sebaceous hyperplasia and follicular dilatation. At that time, she was diagnosed as having facial acne vulgaris and was prescribed topical antibiotics. However, no improvement was noticed.

Morphological Findings (click to enlarge):

Case 2

Clinical History:

A 57-year-old woman without medical history presents to the dermatology clinic with a two months history of multiples violaceous and painful subcutaneous nodules on her left leg. In the last 2 week, she developed a 5 cm ulcer on her left calf. A biopsy was taken from that area. Additionally, she is referring a mild rhinorrhea starting the last month.


Speaker 5
Faculty:
George Jour, MD

Case 1

Clinical History:

35 year old female history of breast carcinoma in 2009 s/p treatment with chemotheropy and radiation. Follow up was negative for recurrences. She presented to the dermatology clinic for a left chest wall itchy vesicle that did not respond to topical steroid treatment. Punch biopsy was performed.

Morphological Findings (click to enlarge):

Case 2

Clinical History:

78 year old male with history of multiple basal cell carcinomas and squamous cell carcinomas, presented for right temple ulcerated crusted lesion. Electrodessication and curettage was performed.

Morphological Findings (click to enlarge):

Meetings

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