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Cutaneous malignant melanoma (CMM) is an aggressive tumour with a high metastatic potential. Deletions of chromosome 9p have been detected in CMM, some of which involve the CDKN2A/p14ARF genes. Loss of heterozygosity (LOH) of 16 microsatellite markers on 9p and mutations in the CDKN2A/p14ARF genes had been previously studied in 32 melanoma patients by our group. 9p deletions were detected in 15 primary tumours (45.5%) and are here correlated with the clinical outcome over 5 years and compared with classical prognostic factors. Eight of the 32 patients developed metastases (25%). The metastases were all detected within 768 days of the initial diagnosis. The patients without metastases were last monitored at least 1621 days after diagnosis. None of the 21 patients with more than eight microsatellites conserved developed metastases, whereas all of the eight patients who developed metastases had eight or more markers deleted. The sensitivity of this analysis to predict metastases was 100% (specificity 84%), whereas the sensitivity for the same sample using a Breslow thickness > 3 mm was 62.5% (specificity 68%). LOH of eight or more of the 9p microsatellite markers is therefore a useful prognostic factor to predict the development of metastases in the first 4.4-6.3 years (1621-2294 days).

Genetic predisposition plays an important role in the development of nearly 10% of cases of cutaneous malignant melanoma (CMM). The CDKN2A gene has been described as responsible for melanoma susceptibility in a proportion of families with CMM linked to 9p. CDKN2A encodes a cyclin-dependent kinase inhibitor also implicated in the carcinogenesis of several sporadic tumors. Even though the incidence of other cancers is higher in CMM families, pancreatic adenocarcinoma is the only other well demonstrated cancer associated with CDKN2A mutations in some CMM pedigrees. We describe a family with four cases of CMM, eight patients affected by other cancers, and nine patients affected by dysplastic nevus (DN) syndrome. A CDKN2A frameshift mutation (358delG) was present in all the CMM patients, in at least three of the patients with other cancers (CDKN2A status is unknown in four patients), and in only two of the DN patients (CDKN2A status is unknown in one patient). An absence of linkage between chromosome 9p markers and the 358delG CDKN2A mutation and DN was detected, indicating genetic heterogeneity for DN and CMM in this family. The study strongly suggests that CDKN2A mutations are involved not only in the predisposition to CMM but also to several other types of cancer.

Primary cutaneous B-cell lymphomas (CBCL) are a group of malignant lymphomas with apparently distinct clinicopathological and immunophenotypical features. As in other B-cell lymphomas, the accompanying benign cell population in CBCL includes a variable number of T lymphocytes whose role is not well understood. In the present study we characterized the immunophenotype of these T cells and compared it with that of the reactive T-cell population in specific skin involvement by noncutaneous B-cell malignancies. Our results indicated that most T cells in both primary and secondary B-cell lymphomas were CLA+ memory/effector helper T cells which differed from the currently known CLA+ memory/effector helper T lymphocytes of the skin-associated lymphoid tissue (SALT) system. However, the endothelial CLA ligand, E-selectin, was expressed on dermal vessels. These results suggest that a B cell environment and/or a lack of epidermal involvement promote(s) the recruitment into the skin of a different, apparently less specific, subset of memory helper T cells from those seen in T-cell-mediated dermatoses.

We have analyzed 12 microsatellite markers on chromosome 9p in 54 paired cutaneous malignant melanoma (CMM) tumors and normal tissues. Forty-six percent of the tumors, including two in situ CMMs, showed loss of heterozygosity (LOH) at 9p. Only one tumor was homozygously deleted for 9p markers. The smallest deleted region was defined by five tumors and included markers D9S126 to D9S259. Loss of eight or more markers correlated significantly with worse prognosis (P < .002). Among the primary tumors, 87.5% of those with large deletions have a high risk of metastasis, as compared with only 18% of those without deletions or with loss of fewer than 8 markers (P < .001). It was not possible to demonstrate homozygous deletions of p16 in any of the CMM tumors. In four tumors, the LOH for 9p markers did not involve p16. The reported data suggest the existence of several tumor suppressor genes at 9p that are involved in the predisposition to and/or progression of CMM and exclude p16 from involvement in the early development of some melanoma tumors.

Histopathologic, immunohistochemical, and ultrastructural studies were carried out on cutaneous lesions of a 43-year-old man with an aggressive peripheral T-cell lymphoma involving the lung, central nervous system, bone marrow, and skin. Some results are distinctive and not previously reported, such as extremely strong epidermotropism, aberrant CD8+ immunophenotype with lack of one pan T antigen (CD5), and giant cytoplasmic granules. We discuss these features comparing them with other hematologic malignancies usually involving the skin, such as cutaneous T-cell lymphoma, adult T-cell leukemia/lymphoma, angiocentric lymphomas, and malignant histiocytosis.

Two cases of metastasic alopecia from breast adenocarcinoma were reported. Clinical and differential aspects from other types of alopecia are also commented.

We report a case of dyskeratotic subungual tumor in a 28-year-old woman. The patient presented achromic lineal lesions, typical of residual incontinentia pigmenti (IP), on her legs. Furthermore, the physical examination showed anodontia of the right incisor tooth. The familial background demonstrated miscarriages of male fetuses and characteristic dental abnormalities of IP in female siblings. The patient's daughter presented a typical background of IP and dyschromic splashed lesions. Light and electron microscopic studies of the subungual tumors were made. The analogy between subungual tumors of IP and keratoacanthoma is emphasized.

A 77 year old man, who presented cutaneous T cell lymphoma, was treated with polychemotherapy and cyclosporine. After one year, erythemato-papulonodules were seen on the face, neck and trunk. Histologic examination showed specific infiltration myelomonocytic, bone marrow examination revealed the same characteristics. The patient died one month after the diagnosis. We comment the association between these two hemoproliferative processus.

Dilated pore (Winer) is a not uncommon adnexal benign tumor with follicular differentiation. Clinically the lesion looks like a giant comedo, usually located on the facial area of the elderly. Due to annular elevation of the borders, differential diagnosis needs to be made with basal cell epithelioma and senile sebaceous adenoma. The histology shows a typical infundibular dilatation with subinfundibular atrophy of hair structures. The authors report two typical cases of this badly known but not infrequent lesions.

Plasma cells within the infiltrate of primary cutaneous malignant melanoma have been reported as a valuable criterion for the prediction of lymph node metastases. In order to evaluate plasma cells, their prognostic significance and their relationship with other clinical and histological parameters, 132 cases of malignant melanoma (29 plasma cell positive and 103 plasma cell negative) were studied. The Breslow thickness, location, and ulceration were the variables related to the presence of plasma cells. The most important variables in predicting survival were lymph node involvement, clinico-pathological type, age, plasma cells, and lymphatic emboli. The most important variables for disease-free interval were lymph node involvement, plasma cells, and age.

A case of a 8 year girl presenting a congenital tumoral lesion of the lumbar region is reported. Histologically a hamartomatous fibromatosis was found. A review of the literature was made. The final diagnosis was solitary infantile myofibromatosis, cutaneous type (peculiar form of congenital generalized fibromatosis, also named infantile myofibromatosis). Probably this variety is less rare than thought, because biopsies of apparently benign superficial lesions on children are not usually performed.