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Volume 10, September
 
 

Dermatopathology, Volume 10, Issue 4 (December 2023) – 3 articles

Cover Story (view full-size image): Dermatomyositis is an immune-mediated myopathy with cutaneous and systemic manifestations. The classic histopathological findings include vacuolar interface changes with mucin deposition and a predominantly lymphocytic infiltrate. Although eosinophils have traditionally been considered rare in skin biopsies of patients with autoimmune connective tissue diseases, recent studies suggest that tissue eosinophils may be more prevalent than previously thought. In this case report, we present a case of dermatomyositis characterized by intensely pruritic papules and plaques, where the presence of tissue eosinophils on histopathology initially posed a diagnostic challenge. This case highlights the importance of not relying solely on tissue eosinophilia as an exclusion criterion in diagnosing dermatomyositis. View this paper
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8 pages, 1922 KiB  
Case Report
Dermatomyositis with Eosinophils
by Isabella I. Sanchez, Henry O. Herrera, Ashley Elsensohn, Bonnie A. Lee and Christina N. Kraus
Dermatopathology 2023, 10(4), 310-317; https://doi.org/10.3390/dermatopathology10040039 - 21 Nov 2023
Viewed by 3169
Abstract
Dermatomyositis is an idiopathic inflammatory myopathy that often presents with symmetric proximal skeletal muscle weakness and characteristic skin findings. Typical skin biopsy findings include vacuolar changes of the basal layer, increased dermal mucin, and a predominantly lymphocytic infiltrate. We report a case of [...] Read more.
Dermatomyositis is an idiopathic inflammatory myopathy that often presents with symmetric proximal skeletal muscle weakness and characteristic skin findings. Typical skin biopsy findings include vacuolar changes of the basal layer, increased dermal mucin, and a predominantly lymphocytic infiltrate. We report a case of dermatomyositis presenting as intensely pruritic papules and plaques, with initial histopathology being atypical of dermatomyositis due to the presence of eosinophils. The initial biopsy demonstrated a superficial dermatitis with eosinophils, initially thought to represent a drug eruption. A second biopsy of the same cutaneous manifestation was performed at a later time given high clinical suspicion for dermatomyositis and demonstrated a more classic vacuolar interface dermatitis with increased mucin and an absence of eosinophils. Notably, increased pruritus was specifically associated with the lesion that demonstrated tissue eosinophilia. The case illustrates the importance of considering tissue eosinophilia in the histologic presentation of dermatomyositis. Full article
(This article belongs to the Special Issue Educational Case Reports in Dermatopathology)
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7 pages, 1360 KiB  
Communication
Folliculotropic Mycosis Fungoides Is Associated with Decreased PD1 Staining Compared with Classic Mycosis Fungoides
by Haiming Tang, Kristin J. Rybski, Yi Luan and Bruce R. Smoller
Dermatopathology 2023, 10(4), 303-309; https://doi.org/10.3390/dermatopathology10040038 - 23 Oct 2023
Cited by 1 | Viewed by 1784
Abstract
Programmed cell death protein 1 (PD-1) plays a pivotal role in immune system regulation, with its expression levels linked to malignancy prognosis. However, existing reports on PD-1 staining in mycosis fungoides (MF) present conflicting findings, and little attention has been given to PD-1 [...] Read more.
Programmed cell death protein 1 (PD-1) plays a pivotal role in immune system regulation, with its expression levels linked to malignancy prognosis. However, existing reports on PD-1 staining in mycosis fungoides (MF) present conflicting findings, and little attention has been given to PD-1 staining in different MF variants. To address this, we conducted a retrospective study, employing immunohistochemistry to examine PD-1 expression in cases of folliculotropic MF and non-folliculotropic MF. We analyzed 24 cases of folliculotropic MF and 18 cases of non-folliculotropic MF, and recorded both the percentage of PD-1-labeled tumor cells and the intensity score (negative, weak, medium, or strong). Our results revealed significant disparity in PD-1 labeling between patch/plaque MF and folliculotropic MF (p = 0.028). Non-folliculotropic MF exhibited higher PD-1 labeling in tumor cells (58.3%) compared to folliculotropic MF (40.2%). Notably, there was no significant difference in PD-1 staining between folliculotropic MF and non-folliculotropic MF when both were in the early stage/indolent disease category. However, when considering the tumor stage, folliculotropic MF exhibited PD-1 staining in tumor cells at a rate of 21.1%, while non-folliculotropic MF showed PD-1 staining in tumor cells at a rate of 46.6% (p = 0.005). Additionally, among folliculotropic MF cases, 13 out of 24 cases displayed differing PD-1 expression patterns between epidermal and dermal components, with preserved PD-1 staining in the epidermal component and loss of staining in the dermal component. Furthermore, consistent with the prior literature, tumor cells with large cell transformations exhibited significantly lower PD-1 labeling (p = 0.017). Our findings showcase the unique PD-1 staining patterns in MF. Full article
(This article belongs to the Section Clinico-Pathological Correlation in Dermatopathology)
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16 pages, 6395 KiB  
Communication
The Effect of Bacillus coagulans Induced Interactions among Intestinal Bacteria, Metabolites, and Inflammatory Molecules in Improving Natural Skin Aging
by Keiichi Hiramoto, Sayaka Kubo, Keiko Tsuji, Daijiro Sugiyama, Yasutaka Iizuka and Hideo Hamano
Dermatopathology 2023, 10(4), 287-302; https://doi.org/10.3390/dermatopathology10040037 - 28 Sep 2023
Cited by 2 | Viewed by 2585
Abstract
Background: Lactic acid bacteria consumption serves several health benefits to humans. However, their effect on natural skin aging is still unclear. Methods: This study examined the effects of skin naturalization (particularly skin drying) by administering a spore-bearing lactic acid bacteria (Bacillus coagulans [...] Read more.
Background: Lactic acid bacteria consumption serves several health benefits to humans. However, their effect on natural skin aging is still unclear. Methods: This study examined the effects of skin naturalization (particularly skin drying) by administering a spore-bearing lactic acid bacteria (Bacillus coagulans) in mice for 2 years. Results: B. coagulans administration improved the natural skin of mice and significantly increased proportions of the genera Bacteroides and Muribaculum, among other intestinal bacteria. As metabolites, increases in nicotinic acid, putrescin, and pantothenic acid levels and a decrease in choline levels were observed. Increased hyaluronic acid, interleukin-10, and M2 macrophage levels indicate aging-related molecules in the skin. Intestinal permeability was also suppressed. Thus, these changes together improved natural skin aging. Conclusions: This study revealed that B. coagulans administration improved the natural skin aging in mice. This enhancement might be induced by the interaction of alterations in intestinal flora, metabolites, or inflammatory substances. Full article
(This article belongs to the Section Experimental Dermatopathology)
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