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A neurofibroma with focal glomus-like body differentiation is an unusual phenomenon recently encountered in an excision specimen from the right lateral distal forearm of a 26-year-old man. Glomus cells are modified smooth muscle cells normally present in glomus-like bodies but can also be found in glomus tumors (GT) or lesions considered in the spectrum of GT, including myopericytoma, myofibroma, and angiolipoma. Neurofibromas are peripheral nerve sheath tumors derived from the neural crest cells. While both GT and its variants and neurofibroma are thought to be derived from different cell types, there is growing evidence that glomus cells have a neural crest origin. This is based on multiple theories, with some overlapping pathways, including neural crest cell differentiation, Schwann cell reprogramming, VEGF expression, and NF1 gene biallelic inactivation. This report adds to the growing evidence of possible neural crest origin for glomus cells and would help explain finding glomus-like bodies scattered through a neurofibroma., (© 2024 The Authors. Journal of Cutaneous Pathology published by John Wiley & Sons Ltd.)

Fibroadipose vascular anomaly (FAVA) is a rare, complex mesenchymal malformation combining fibrofatty replacement of the affected muscles and slow-flow vascular malformation. The condition is characterized by localized swelling, severe pain, phlebectasia, and contracture of the affected limb. Treatment paradigms are not well established for this rare, recently recognized condition. We report two cases of FAVA in which treatment with sirolimus produced rapid, dramatic improvement in pain and quality of life., (© 2017 Wiley Periodicals, Inc.)

Subcutaneous granuloma annulare (SGA) is a rarely reported subtype of granuloma annulare that occurs almost exclusively in children. The etiology of these lesions is unknown, although a possible relationship to insulin-dependent diabetes mellitus (IDDM) has been proposed in the literature. Here we present an unusual case of SGA on the right forearm in a 3-year-old girl. Unlike the typical lesions noted on the extremities, on magnetic resonance imaging her lesions involved the subcutaneous tissue and adjacent muscles in multiple locations. Histopathologically, the case was consistent with SGA but was unusual in its distribution involving multiple muscles, a finding that has not been previously reported. Weeks after incisional biopsy, she was readmitted with diabetic ketoacidosis (DKA) secondary to IDDM. After treatment of her DKA and control of her glycemia, the forearm SGA vanished, which supported the pathologic diagnosis and alleviated our concerns secondary to the unusual distribution., (© 2011 Wiley Periodicals, Inc.)

Background: Hairdressers and hairdressing apprentices have a high incidence of occupational hand eczema, owing to excessive wet work and exposure to chemical substances. Hairdressing apprentices, in particular, seem to be at high risk of developing hand eczema. Previous hand eczema and atopic dermatitis are known risk factors for the development of hand eczema in wet work occupations., Objectives: To estimate the prevalence of hand eczema, eczema on wrists or forearms and atopic dermatitis in a cohort of hairdressing apprentices at the start of their education, and subsequently evaluate any potential healthy worker effect., Methods: During the first 2 weeks of training, 382 hairdressing apprentices were enrolled in this study. All apprentices completed a self-administered questionnaire, including previously validated questions regarding, for example, previous and present hand eczema, eczema on the wrists or forearms, and atopic dermatitis. For comparison, the questionnaire was sent to a control group matched for age, gender and city code from the general population (n = 1870)., Results: Response rates were 99.7% for the hairdressing apprentices (mean age 17.5 years, range 15-39 years, 96.3% females) and 68.3% for the control group (mean age 17.4 years, range 15-39 years, 96.8% females). Previous or present hand eczema were reported by 8.0% of hairdressing apprentices and by 12.5% of the matched control group (p = 0.009), and eczema on the wrists or forearms was reported by 5.3% of the apprentices and by 11.9% of the controls (p < 0.001). We classified 21.4% of the hairdressing apprentices as having atopic dermatitis versus 29.8% of the matched control group (p = 0.001)., Conclusions: These results indicate a healthy worker effect, as there was a lower reported incidence of hand eczema and eczema on wrists or forearms, and there were fewer cases classified as having atopic dermatitis, among hairdressing apprentices than in a matched control group from the general population., (© 2011 John Wiley & Sons A/S.)

Currently, the treatment of choice for refractory tertiary hyperparathyroidism is a total parathyroidectomy with autotransplantation of the parathyroid tissue into the forearm. Recurrent hyperparathyroidism after autotransplantation requiring surgical excision of the autograft is uncommon. We describe a female patient with recurrent hyperplasia who underwent an excision of her parathyroid autograft. The excisional specimen was submitted to pathology with the only provided history of a 'left arm mass'. The lack of clinical history led to a preliminary impression of an adnexal neoplasm by the primary pathologist., (Copyright © 2009 John Wiley & Sons A/S.)

Congenital Volkmann ischemic contracture is a rare condition in which a neonate presents with an ulcerated forearm, necrotic subcutaneous tissue, nerve palsy, and muscular necrosis. We report a case of a 1-day-old infant who presented with an ulceration of the left forearm noted at delivery combined with decreased motor function of the left distal forearm. Histologic examination of the ulceration revealed findings of subcutaneous fat necrosis of the newborn. To our knowledge, this is the first case for which the findings of subcutaneous fat necrosis have been seen histologically.

Primary cutaneous marginal zone lymphoma of the mucosa-associated lymphoid tissue predominantly occurs in adults and is rare in children. There have been no prior reports of this lymphoma occurring in American children. We present a case of a 15-year-old male with a history of atopic diathesis and chronic use of antihistamine agents who presented with an asymptomatic lesion on his left forearm of 6 months duration. Because histopathological and immunohistochemical studies were compatible with marginal zone lymphoma, and the patient had no associated extracutaneous disease, the diagnosis of primary cutaneous marginal zone lymphoma was rendered. Based on the patient's past medical history prior to appearance of lesion, it was postulated that the development of lymphoma was associated with the ingestion of antihistamines and further propagated by his underlying atopic diathesis.

Objective: Conflicting data exists about the possible contribution of the homozygous Asp/Asp genotype of the Glu298Asp polymorphism of endothelial nitric oxide synthase to human atherosclerotic vascular disease. We investigated the polymorphism in two independent study populations: a case-control study including patients with angiographically verified coronary artery disease (CAD) on the one hand and a cross-sectional epidemiological study on the other hand., Methods: The Glu298Asp polymorphism was determined by PCR-RFLP as established. In the case-control study (240 patients and 248 controls) a possible association between the polymorphism and CAD, and age of onset of CAD and myocardial infarction was investigated. In the cross-sectional epidemiological study (932 subjects) intima-media thickness (IMT) of the carotid artery as well as morphological plaque burden and forearm vascular reactivity (peak postischemic reactive hyperaemia, determined by venous occlusion plethysmography) were measured., Results: In the case-control study genotype distribution (Glu/Glu; Glu/Asp; Asp/Asp) was not different between the CAD patients (43/46/11%) and the controls (49/41/10%, P = NS). No association of the polymorphism with age of onset of CAD or myocardial infarction was found. In the epidemiological study no influence of the genetic variant on IMT was observed after correction for classical determinants of IMT (average IMT: Asp/ Asp: 0.077 +/- 0.011 mm; Glu/Glu and Glu/Asp: 0.080 +/- 0.012 mm, P = NS). Forearm vascular reactivity was also not different between homozygous Asp/Asp subjects and Glu/Glu and Glu/Asp subjects (peak-reactive hyperaemia 20.1 +/- 7.3 mL min-1 100 mL-1 vs. 20.0 +/- 6.5 mL min-1 100 mL-1, P = NS)., Conclusions: Our results suggest that there is no association of the Glu298Asp polymorphism with coronary or carotid atherosclerosis or forearm vascular reactivity in these populations recruited in a country with a rather high risk for atherosclerosis. We suggest additional investigations to be performed in populations at different risk for coronary events to further elucidate the possible contribution of this polymorphism to vascular disease.

A 9-year-old girl newly diagnosed with systemic lupus erythematosus (SLE) developed a localized linear papulovesicular eruption over the right dorsal hand and ulnar forearm. The skin findings were clinically suggestive of herpes zoster, lichen striatus, or lichen planus-lupus erythematosus overlap. However, histologic, immunofluorescent, immunoelectron microscopic, and immunoblot studies revealed findings compatible with bullous SLE. Our patient is noteworthy because she is the first one reported with bullous SLE presenting in a localized linear pattern. She is also the second-youngest reported patient with bullous SLE.

Congenital giant juvenile xanthogranuloma is an uncommon lesion that apparently has benign biologic behavior in most reported patients. In one of our three patients it was necessary to perform histochemical reactions with CD 1 (-), MAC 387, and electron microscopy to rule out Langerhans cell histiocytosis. The other patients had a typical histologic picture, with foamy histiocytes and Touton cells in association with lymphocytes and eosinophils. Comments about treatment are also made.

An intravenous glomus tumor occurring in a forearm vein is reported. The patient had a painful subcutaneous mass which was completely excised. This mass was a neoplasm which expanded the lumen of a vein and extended throughout its wall into the surrounding subcutaneous fat. The neoplasm consisted of sheets of rounded cells with a capillary stroma. The neoplastic cells were closely apposed to the capillary vessels and were positive for vimentin, smooth muscle actin and muscle specific actin. The cells were negative for desmin, factor VIII-related antigen, epithelial membrane antigen, cytokeratins, S-100 protein and chromogranin. This is the 2nd reported case of intravenous glomus tumor of the forearm. This unusual presentation may be due to intravascular extension by a cutaneous glomus tumor. The potential for intravascular growth by glomus tumor should be recognized by surgeons, dermatologists and pathologists.

We measured forearm bone mineral density (BMD) using single photon absorptiometry (SPA) and bone mineral content (BMC) and BMD of lumbar spine by dual photon absorptiometry (DPA). The population consisted of 463 bone healthy subjects, 346 females and 117 males aged 20-85 years. Any underlying bone disease or other diseases known to affect bone mass were excluded by physical examination, thoracic and lumbar radiographs and laboratory screening. Patients with osteoarthritis of lumbar spine were excluded as well as patients taking drugs known to affect bone mass. All bone mass values declined with age. Body height also declined with age by 1.2 cm and 1.8 cm per 10 years (-0.7% and -1%) in females and males respectively. Main effects of age, body height, -surface, -weight and -mass index on bone mass were calculated using multiple regression models. In males and females lumbar BMC measured in gHA depended primarily on body height and secondarily on age. Spinal BMD as measured in g cm-2 was primarily dependent on age and then on height. In females forearm BMD depended primarily on age and then on body surface, in males on body surface only. Using receiver operating characteristic (ROC) analysis the ROC area increased from 0.81-0.85 (n.s.) including body height into spinal BMD values leading to a higher sensitivity of measurements of spinal bone mass in recognizing 58 patients with spinal postmenopausal osteoporosis. Including body surface into forearm BMD measurements ROC area increased from 0.66-0.69 (P = 0.055).(ABSTRACT TRUNCATED AT 250 WORDS)