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Fowlpox is a highly contagious viral disease that is endemic worldwide, caused by the Avipoxvirus genus within the Poxviridae family. To diagnose and study the evolution of this virus, PCR amplification combined with sequencing and phylogenetic analysis are effective methodologies. In this study, nodular tissue from a suspected infected bird was collected and tested for the presence of the Fowlpox virus. The virus was identified using conventional PCR, targeting the virion core protein (P4b) gene with specific primers, resulting in an amplicon of 415 bp. The virus was subsequently isolated from chicken embryonated eggs and confirmed through conventional PCR. The partial P4b gene was sequenced and the sequence was submitted to GenBank with the accession number OQ469498. Phylogenetic analysis of the Fowlpox virus outbreak isolates revealed that it formed a distinct clade with isolates from Germany, the United States, China, South Africa, New Zealand, and Australia, all exhibiting 100% homology. This analysis indicated minimal genetic diversity within the Fowlpox virus, suggesting its stability. Additionally, the investigation into the outbreak highlighted issues such as vaccine failure, changes in tissue tropism, and variations in disease outbreak patterns. Therefore, it is essential to conduct focused and comprehensive molecular epidemiological studies and research on host-pathogen interactions to understand better these factors, which will aid in the effective control and eradication of Fowlpox disease.

Renal cell carcinoma is frequently undiagnosed until it reaches an advanced metastatic stage. Renal cell cancers are also seen as incidental findings on imaging, and rarely can present as physical examination findings. We report a rare case where metastatic renal cell carcinoma presented as a solitary 2 cm subcutaneous chest wall nodule in an otherwise asymptomatic male patient. Initial ultrasound evaluation showed a solid vascular subcutaneous mass, a fine needle aspiration suggested metastatic renal cell cancer, and later, excision biopsy, and CT scan of the abdomen made the final diagnosis of stage IV renal cell carcinoma. The differential diagnosis of a 2 cm nodule can be broad and in appropriate clinical setting should include consideration of malignancy and/ metastasis.

Diagnosis of nodular red lesions is challenging. The differential diagnosis includes dermal nevus, angioma, pyogenic granuloma, amelanotic melanoma, eccrine poroma, Kaposi’s sarcoma, skin malignancy or metastasis. Erythema nodosum is one of the common consideration of the red skin nodules, however fully work up should be done to find the right diagnosis. A 60 years old female admitted to our hospital due to pain dark reddish skin nodules since one month. She had continuously high grade fever of 39 Celsius accompanied by arthralgia and fatigue since two months prior to admission and she lost 6 kg of weight in 2 months. On admission, physical examination revealed slight fever, pale conjunctiva, mild hepatosplenomegaly, tender dark red nodules 0.3 to 2 cm, firm edge, at her cheek, abdominal area and both lower extremities. No lymph nodes enlargement was noticed. Her laboratory test showed haemoglobin 9,1 g/dl, WBC 3,040/mL, PLT 149,000/mL, SGOT 48 U/L, SGPT 43 U/L, urea 12.5 mg/dL, creatinine 0.67 mg/dL. She was found to be non-reactive for HBsAg, HCV, and HIV antigens. Urine routine and microscopic examination was unremarkable. Her histopathology of left foot nodule biopsy revealed cutaneous lymphoma. The immunohistochemical (IHC) stain of CD45, CD20, and CD10 were positive, Ki67 were also positive with >70% tumor cells, while CD3,CD56, CD30, and Granzyme were negative. Her final diagnosed was Cutaneous Diffuse large B cell lymphoma. Primary cutaneous lymphomas of B-cells occur less frequently than primary cutaneous T-cells lymphomas. Primary extra-nodal diffuse large B-Cell lymphoma (DLBCL) can be seen in up to 40% of cases. However skin involvement is less common and in a large cohort of DLBCL cases, skin involvement at presentation was seen only in 3.3% of cases.It characterized by few lesions, in general showing nodules or infiltrations of relatively fast growth and have no itching. The diagnosis is made by the immunohistochemical findings, clinicopathological correlation, and molecular pathology. The lymphomas have different clinical behaviours despite being identical in morphological appearance. The primary lymphomas presents with local recurrence in up to 68% of the cases and with rare extra-cutaneous dissemination, with an average rate of 5-year survival varying from 89 to 96%. Cutaneous lymphoma should be always become one of considered diagnosed of skin red nodules even it is rare.

Poroma is a relatively rare benign adnexal neoplastic lesion that usually affects elderly patients in the extremities, with an unclear pathogenesis. It is notable for having a variety of morphological appearances that make diagnosis challenging, particularly when observed on an uncommon anatomical site. Here, we present a case of a woman in her mid-50s who presented with a skin pedunculated lesion over the right thigh. The lesion had a smooth surface and clinically mimicked a skin tag. The lesion was surgically excised and sent for histopathology. On microscopic examination, anastomosing cords and broad columns of more or less uniform basaloid cells extending to the dermis with no atypical changes were seen, confirming the diagnosis of eccrine poroma. It is emphasized that poromas should be considered in the clinical and histological differential diagnosis of nonacral skin lesions. Complete excision cures the condition and prevents local recurrence., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Hasan et al.)

Primary cutaneous plasmacytosis is a rare disorder. Cases have been mostly reported from Japan. Here, a rare case of cutaneous plasmacytosis with calcium deposits was reported from southern part of India. A 47-year-old male patient presented with solitary asymptomatic nodule on the left leg present for two decades. Skin biopsy showed sheets of plasma cells in mid-dermis with bony trabeculae extending upto subcutis which was unremarkable. Serum electrophoresis did not reveal any M band and Bence Jones protein was absent in urine. Radiograph of the left leg showed focal lesion with calcific areas in soft tissue shadow with probability of calcification. Novelty of the case lies in its rare clinical presentation in this population with histopathological documentation.

Pilomatrixoma (PMX) is a benign skin adnexal tumour with matrical differentiation. It frequently presents as a painless and slow growing solitary skin nodule primarily at the head, face and neck regions. Although there is increasing understanding on the clinical presentations and morphological features of PMX, difficulties are still expected in establishing the clinical and cytological diagnosis. We report a young girl who presented with a painless post-auricular swelling for one year with sudden increased in size. Computed Tomography (CT) scan and fine needle aspiration cytology (FNAC) findings were suggestive of a malignancy. Diagnosis of PMX was established and confirmed by tissue histopathological examination. The purpose of this study is to demonstrate the diagnostic pitfall of PMX in FNAC specimens, especially in patients with unusual clinical presentations. [ABSTRACT FROM AUTHOR]

Primary cutaneous plasmacytosis is a rare disorder. Cases have been mostly reported from Japan. Here, a rare case of cutaneous plasmacytosis with calcium deposits was reported from southern part of India. A 47-year-old male patient presented with solitary asymptomatic nodule on the left leg present for two decades. Skin biopsy showed sheets of plasma cells in mid-dermis with bony trabeculae extending upto subcutis which was unremarkable. Serum electrophoresis did not reveal any M band and Bence Jones protein was absent in urine. Radiograph of the left leg showed focal lesion with calcific areas in soft tissue shadow with probability of calcification. Novelty of the case lies in its rare clinical presentation in this population with histopathological documentation. [ABSTRACT FROM AUTHOR]

Merkel cell carcinoma (MCC) is a cutaneous neoplasm that is challenging to diagnose secondary to its rarity. We report a case involving a 76-year-old Caucasian female with a seemingly benign skin nodule on her right forearm. Histopathological analysis revealed characteristics of MCC, including uniform round cells with minimal cytoplasm and fine granular chromatin. Immunohistochemical staining confirmed insulinoma-associated protein 1 (INSM1) positivity, a marker with high sensitivity and specificity in localized MCC diagnosis. The subsequent treatment plan involved wide local excision, sentinel lymph node evaluation, and radiation therapy, aligning with therapeutic standards for MCC. Negative positron emission tomography (PET) scans and follow-up for one year have demonstrated no evidence of recurrence or additional lesions. This case demonstrates the challenges in diagnosing MCC and the need for histopathological and immunohistochemical assessments for an accurate diagnosis. Diagnostic markers, INSM1, are important distinguishing factors between MCC and other skin cancers. In conclusion, our case contributes to the literature in diagnosing MCC and successful treatment, while emphasizing the need for immunohistochemical markers for accurate diagnosis and guiding therapeutic decisions., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Myers et al.)

Leishmania, an intracellular protozoan parasite, is endemic, widespread and represents a public health problem in most countries of the Mediterranean basin as it is implicated in a wide spectrum of diseases both in humans and animals. Vaccination of canines remains the best control strategy to counteract the progression of active infection for canine disease in areas of the world where transmission to humans is primarily zoonotic. This case report describes the history of a four-year-old dog vaccinated against canine leishmaniosis that was presented to a private clinic for the onset of a nodular skin lesion. Besides normal haematological and biochemical analyses, the histopathological examination of the removed skin lesion revealed the presence of Leishmania amastigotes. The presence of the protozoa in the skin lesion of a vaccinated dog is discussed.

Cutaneous metastasis from internal malignancies, indicative of poor prognosis, is rare and often involves primary sources like lung, breast, and colorectal cancer (CRC). This case details a 66-year-old male developing a scalp lesion 10 years post colon adenocarcinoma diagnosis. The challenging medical journey included a comprehensive biopsy confirming metastatic CRC in cutaneous tissue through CDX2 and CK20 positivity, emphasizing the importance of advanced diagnostic techniques. Despite medical advancements, the patient's unfavorable prognosis led to succumbing within a year, highlighting challenges in managing such cases and the need for vigilant post-diagnosis care. This report underscores the limited understanding of cutaneous metastasis, emphasizing the role of immunostaining and prompting awareness for early detection and tailored treatment. Further research into atypical metastasis mechanisms is crucial for improved prognostic outcomes and enhanced comprehension of these complex manifestations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Okafor et al.)

Multiple trichoepithelioma syndrome is a rare entity, and little is known about its epidemiological features. Patients usually present with multiple nonsuspicious skin lesions. Surgical excision is the mainstay of treatment, and diagnosis is usually made after the first pathology report. Once the diagnosis is established, patients are kept under clinical surveillance, and surgery is performed again if tumor burden and/or size justifies it. The authors present a male patient who presented to our outpatient clinic for the first time in 36 years without any relevant medical history, medication, or allergies. The patient had complaints of multiple skin lesions spreading across the head and neck regions. Surgical excision of the affected area and resurfacing using local advancement flaps were performed. Pathology reports were always consistent with trichoepitheliomas. No pathology of spiradenoma or cylindroma was ever reported. Usually, tumors are small enough for simple excision and primary closure. However, in the presented case, the size of the tumor and the involvement of central facial aesthetic units demanded a more complex approach., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Guerreiro et al.)

Erdheim Chester disease (ECD) is a rare and complex non-Langerhans histiocytic systemic disease that affects multiple organ systems, including the bones, heart, lungs, and central nervous system. Fewer than 1,000 cases have been reported in the medical literature and dermatological manifestations of the disease are rare but can provide valuable diagnostic clues for this challenging disease. The cutaneous manifestations of ECD can take many forms, including nodules, plaques, papules, and xanthomas. These lesions can occur on any part of the body and may be solitary or multiple. Cutaneous manifestations of ECD have been reported to occur in up to 20% of cases, but the true prevalence may be higher, as many cases may go undiagnosed. We present the case of a 62-year-old gentleman with a history of ECD currently on vemurafenib who presented with multiple painless subcutaneous nodules on his back after an excision biopsy under local anesthetic revealed histological features of ECD. The objective of this case report is to raise awareness of ECD and its dermatological manifestations. Further research is warranted to better understand the pathogenesis and morphology of cutaneous involvement in ECD., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Vasandani et al.)

Mycobacterium marinum is a non-tuberculous mycobacterium that presents as a nodular granulomatous disease. The bacillus can infect humans when broken skin is exposed to a contaminated aquatic environment. M. marinum infections are usually isolated to the skin and soft tissues and can spread in a lymphatic distribution. A 26-year-old male cut his right ankle while spelunking in Tulum, Mexico. He presented to his primary care physician three months after he sustained the laceration with a nonhealing wound on the right lateral posterior ankle. Examination of the lesion demonstrated erythematous, violaceous, and hyperpigmented indurated plaques with satellite lesions noted at the right medial, posterior, and lateral ankle. The lesion characteristics raised initial suspicion for an invasive fungal infection. Biopsy of the lesion demonstrated epidermal ulceration covered by neutrophilic serum, marked underlying dermal acute inflammation, and granulation tissue. A mild perivascular, predominantly lymphocytic infiltrate was present in the deep dermis with no evidence of granuloma. Acid-fast bacilli culture plated onto chocolate agar confirmed the species M. marinum., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sulejmani et al.)

Leishmania, an intracellular protozoan parasite, is endemic, widespread and represents a public health problem in most countries of the Mediterranean basin as it is implicated in a wide spectrum of diseases both in humans and animals. Vaccination of canines remains the best control strategy to counteract the progression of active infection for canine disease in areas of the world where transmission to humans is primarily zoonotic. This case report describes the history of a four-year-old dog vaccinated against canine leishmaniosis that was presented to a private clinic for the onset of a nodular skin lesion. Besides normal haematological and biochemical analyses, the histopathological examination of the removed skin lesion revealed the presence of Leishmania amastigotes. The presence of the protozoa in the skin lesion of a vaccinated dog is discussed. [ABSTRACT FROM AUTHOR]

Tungiasis is an animal and human parasitic disease caused by fleas of the genus Tunga (Siphonaptera, Tungidae), endemic in equatorial and subtropical regions and rarely described in European countries, where clinicians and general pathologists could be not aware of this parasitic disease. To our knowledge, only 75 cases of human tungiasis (not all described in detail) were previously reported in Italy. We described a new case in a 34-year-old Italian flight attendant who developed a granuloma-like, ulcerated nodule in the subungual region of his left 5th toe, partially detaching the nail, about 20–30 days after his return from Brazil. We performed a detailed review of the literature of the Italian cases, suggesting the use of histochemical stains (especially Trichrome stain) in order to underline parasitic details. Tourism in endemic regions and globalization may result in new cases in developed countries and previously unaffected regions, therefore pathologists should consider this parasitic disease. [ABSTRACT FROM AUTHOR]

Skin metastasis of testicular choriocarcinoma is very rare. Until now about nine cases have been reported in the English literature; however, only one of them has been diagnosed by fine-needle aspiration (FNA) cytology. Herein, we report our experience with FNA cytology diagnosis of a metastatic testicular choriocarcinoma to the skin of chin. The combination of highly atypical mononuclear cells (cytotrophoblasts) and multinucleated malignant cells (syncytiotrophoblasts) are characteristic of metastatic tumor in a known case of choriocarcinoma of testis.

Rosai-Dorfman disease (RDD) is a rare benign non-Langerhans cell histiocytosis. The most common site of extranodal involvement is the skin. Cutaneous involvement without lymphadenopathy is extremely rare. It is often difficult to diagnose primary cutaneous RDD secondary to the non-specific nature of its clinical and histologic features. Consequently, diagnosis can be significantly delayed. To our knowledge, about 220 reports of purely cutaneous RDD are documented in the literature to date. We present an additional unique case of cutaneous RDD and emphasize the challenging nature of accurate clinical and histopathologic diagnosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, St. Claire et al.)

Diagnosis of nodular red lesions is challenging. The differential diagnosis includes dermal nevus, angioma, pyogenic granuloma, amelanotic melanoma, eccrine poroma, Kaposi's sarcoma, skin malignancy or metastasis. Erythema nodosum is one of the common consideration of the red skin nodules, however fully work up should be done to find the right diagnosis.A 60 years old female admitted to our hospital due to pain dark reddish skin nodules since one month. She had continuously high grade fever of 39 Celsius accompanied by arthralgia and fatigue since two months prior to admission and she lost 6 kg of weight in 2 months. On admission, physical examination revealed slight fever, pale conjunctiva, mild hepatosplenomegaly, tender dark red nodules 0.3 to 2 cm, firm edge, at her cheek, abdominal area and both lower extremities. No lymph nodes enlargement was noticed. Her laboratory test showed haemoglobin 9,1 g/dl, WBC 3,040/mL, PLT 149,000/mL, SGOT 48 U/L, SGPT 43 U/L, urea 12.5 mg/dL, creatinine 0.67 mg/dL. She was found to be non-reactive for HBsAg, HCV, and HIV antigens. Urine routine and microscopic examination was unremarkable.Her histopathology of left foot nodule biopsy revealed cutaneous lymphoma. The immunohistochemical (IHC) stain of CD45, CD20, and CD10 were positive, Ki67 were also positive  with >70% tumor cells, while CD3,CD56, CD30, and Granzyme were negative. Her final diagnosed was Cutaneous Diffuse large B cell lymphoma.Primary cutaneous lymphomas of B-cells occur less frequently than primary cutaneous T-cells lymphomas. Primary extra-nodal diffuse large B-Cell lymphoma (DLBCL) can be seen in up to 40% of cases. However skin involvement is less common and in a large cohort of DLBCL cases, skin involvement at presentation was seen only in 3.3% of cases.It characterized by few lesions, in general showing nodules or infiltrations of relatively fast growth and have no itching. The diagnosis is made by the immunohistochemical findings, clinicopathological correlation, and molecular pathology.  The lymphomas have different clinical behaviours despite being identical in morphological appearance. The primary lymphomas presents with local recurrence in up to 68% of the cases and with rare extra-cutaneous dissemination, with an average rate of 5-year survival varying from 89 to 96%. Cutaneous lymphoma should be always become one of considered diagnosed of skin red nodules even it is rare.

This report describes the case of a horse presented with cutaneous lesions caused by Blastomyces dermatitidis in the absence of signs of other organ involvement. Diagnosis was achieved through cytology, histopathology and culture. Surgical debulking associated with systemic therapy with oral fluconazole resulted in significant remission; however, recurrence occurred following presumed early cessation of treatment. [ABSTRACT FROM AUTHOR]

Aim: To delineate and characterize the cytomorphologic features of pilomatrixoma (PMX) helpful in correct diagnosis of the lesion on fine needle aspiration cytology (FNAC). Materials and Methods: Archival records of clinical findings, FNAC and histopathological reports of PMX cases were analyzed. Aspirate findings in 14 cases of PMX were correlated with detailed clinical data and subsequent histopathology on excisional biopsy. Different morphological findings were graded semiquantitatively from 0 to 3+. Results: The series showed female preponderance, with head and neck being the commonest site. Majority patients had a single tumor with mean size of 1.6 cm. Out of 14 biopsy proven cases of PMX, cytology findings revealed PMX in 7 cases on the basis of ghost cells, groups of basaloid cells, squamous cells in combination with multinucleated giant cells and calcium deposits in a background of debris. The main reasons for erroneous diagnosis were predominance of one component over the others and non-representative aspirated material. Conclusions: The cytological features of PMX are characteristic and allow a conclusive diagnosis provided the smears are examined keenly bearing in mind the diagnostic traps that can mislead a cytopathologist. [ABSTRACT FROM AUTHOR]