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Porokeratoses are acquired and hereditary disorders of keratinization that share a distinctive lesion characterized by raised keratotic borders corresponding histologically to an angled column of parakeratotic cells, called a cornoid lamella. Although a precise mechanistic explanation is lacking, ultraviolet radiation and immunosuppressed states are considered causally-associated with most cases of acquired porokeratosis. Hepatitis C virus (HCV) infection has been proposed as a link between the immunosuppressed states and development of acquired porokeratosis. Among the various recognized clinical entities that constitute this group, rare cases of hyperkeratotic variants have been described that may pose a diagnostic challenge. Herein we describe a remarkable case of the hyperkeratotic variant of porokeratosis that occurred in a patient with known HIV and HCV infections and a coexisting therapy-related immunosuppressed state. We also provide a review of the relevant literature.

Mantle cell lymphoma (MCL) is a form of non-Hodgkin lymphoma that rarely affects skin. Cutaneous involvement is non-specific but usually indicates widespread disease. Herein we present two cases of MCL with secondary skin involvement. One case presented as an acneiform eruption on the face and had aberrant expression of bcl-2 and bcl-6 with weak CD5 expression. The second presented with multiple tumors on the abdomen and thighs. In both cases expression of Cyclin-D1 by the tumor cells was seen. Both patients died shortly after the diagnosis was established. [ABSTRACT FROM AUTHOR]

Red pigment tattoos are known to cause pseudoepitheliomatous hyperplasia in the skin, frequently simulating squamous cell carcinoma or keratoacanthoma. Herein, the authors present two additional cases of red pigment tattoo pseudoepitheliomatous hyperplasia in which they noted a lichenoid tissue reaction. They reviewed the previously published cases and observed a lichenoid reaction in the histopathological images similar to hypertrophic lichen planus. The authors suggest that these reactions might best be referred to as "lichenoid reaction with pseudoepitheliomatous hyperplasia" or "hypertrophic lichen planus-like reaction." Accordingly, recognition of an inflammatory component may allow additional treatment options. [ABSTRACT FROM AUTHOR]

Acantholytic dyskeratosis (AD) is a histologic pattern seen in Darier's disease or dyskeratosis follicularis, warty dyskeratoma, and transient AD. This pattern is characterized by suprabasilar clefting, acantholysis, and formation of corps ronds and grains. We present a case of AD that is unique based on its genital location and cystic architecture. A 53-year-old woman presented with an otherwise asymptomatic cyst on her left vulva of uncertain duration. On microscopic examination, there were fragments of cystic epithelium with areas of hypergranulosis, acantholysis, corps ronds, and corps grains formation. These features are felt by the authors to be a unique presentation of a follicular adnexal neoplasm. [ABSTRACT FROM AUTHOR]

Ledderhose disease, or plantar fibromatosis, is a benign hyperproliferative disorder of the plantar aponeurosis. It presents as one or more round, firm slow-growing plaques or nodules on the plantar surface of the foot, typically on the medial side. The etiology is unknown, though it has been associated with trauma, liver disease, diabetes mellitus, epilepsy and alcoholism. Histopathological examination of plantar fibromatosis reveals dense fibrocellular tissue with parallel and nodular arrays of fibrocytes and fibrillar collagen with a distinctive corkscrew morphology. The differential diagnosis includes various fibroblastic and myofibroblastic proliferations. [ABSTRACT FROM AUTHOR]

Polypoid melanoma represents a distinct variant of melanoma characterized by an ulcerated exophytic nodule. Although this melanocytic tumor is usually restricted to the papillary dermis, it presents with a thick Breslow level and aggressive course. Its rapidly growing vertical phase and its amelanotic nature frequently simulate benign or non-aggressive entities; leading to a delay in biopsy and resulting in an increased risk of metastasis at the time of the diagnosis. [ABSTRACT FROM AUTHOR]

Background: Differentiating between vertical growth cutaneous malignant melanoma (CMM) and predominantly intradermal benign melanocytic nevus (BMN) can be extremely challenging. Reversion-inducing cysteine-rich protein with Kazal motifs (RECK) is an endogenous inhibitor of many proteins that promote tumor invasion and progression. We investigated the difference in expression of RECK between CMM and BMN to determine whether RECK could assist in their differentiation., Materials and Methods: The expression of RECK in skin biopsies of 39 cases, including 20 cases of CMM and 19 cases of BMN, was evaluated by immunohistochemistry., Results: Two out of 20 cases (10%) of CMM were positive for RECK, and all (100%) 19 cases of BMN exhibited positivity at different levels. In 7/8 cases of CMM adjacent to benign nevus cells, malignant melanoma cells did not express RECK, but benign nevus cells stained positively., Conclusion: These findings suggest that immunohistochemical staining for RECK could be useful in the differential diagnosis between CMM and BMN., (Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

► Vulvar basal cell carcinoma is a rare tumor. ► This report highlights the presentation of vulvar basal cell carcinoma in a very young, non-White patient. ► The importance of provider vigilance and timely biopsy of vulvar lesions is highlighted.