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Background Cutaneous squamous cell carcinoma (CSCC) is the second most frequent cancer in humans and can be both locally invasive and metastatic at distant sites. While research efforts have been made to predict poor outcome of CSCC, there is a lack of knowledge regarding molecular markers. PODOPLANIN has been associated with poor outcome in several types of cancer including CSCC, but this is controversial and only a few studies have evaluated the prognostic implications of Podoplanin in the development of this tumor. Methods We evaluated Podoplanin expression in a series of 94 CSCCs, and searched for associations between Podoplanin expression and histopathological characteristics and with events of poor clinical evolution of the disease. Results Podoplanin expression was observed in 48.9% of the cases and the expression was considered moderate to intense in 19 of the cases. Moderate/intense Podoplanin was associated with infiltrative growth pattern, desmoplasia, and lymphovascular invasion, and with a higher risk of nodal progression and with short disease-free survival, specifically with a short latency to nodal progression. Conclusions This paper provides evidence supporting the implication of Podoplanin expression as a marker of bad prognosis of CSCC.

Background: Skin is an inherently heterogeneous tissue, thus the procurement of pure cell populations is critical for the accurate correlation of a molecular profile to a particular cell type or histological location. Laser Capture Microdissection (LCM) permits the efficent procurement of cells and mapping of genetic changes from histologically prepared samples. Methods: This paper describes a robust LCM protocol established in our laboratory for the extraction of high quality DNA which sequenced from 100% of microdissected samples without the need for cloning. The unique properties of skin, in particular its strong intercellular adhesive forces, have dictated a significant modification to the normal procedure of tissue preparation to ensure reliable cell procurement. Results: Using the methods outlined below we were able to precisely map the pattern of genomic mutations in our target gene of interest in normal skin, actinic keratosis and squamous cell carcinoma. Conclusions: The capability to select pure cell populations from the skin will revolutionise our ability to understand the processes involved in cutaneous tumourigenesis.

A recent paper by Torres‐Cabala et al.1 published in the JCP reports that about 10% (13/136) of small (3 mm or less in size) dysplastic melanocytic nevi show severe architectural disorder, which, however, is almost never coupled with severe cytologic atypia. It is therefore suggested that, in order to avoid overdiagnosis of melanoma, the significance of architectural changes of small melanocytic lesions must be interpreted with caution; the small size of the lesion hampers the evaluation of some of these criteria (symmetry, confluence of junctional nests and degree of single cell proliferation).

Communication failures between clinicians and dermatopathologists are prevalent. Our primary objective was to characterize the concerns and challenges of dermatopathologists posed by incomplete or inaccurate clinical information in the skin biopsy requisition form.An explanatory sequential, mixed-methods study design comprised of a survey sent to 1103 members of the American Society of Dermatopathology (ASDP), followed by two focus group sessions.A total of 54% (598/1103) of dermatopathologists completed the questionnaire. Most dermatopathologists (80%; 436/548) viewed their roles to be providers of histopathological diagnosis and a report that is clinically meaningful. Paper or electronic requisition forms were the most common communication method (85%; 458/541) and were associated with the highest rates of dissatisfaction in 36% (193/537) of respondents. Inadequacy of specimens emerged as an important factor influencing judgment of the quality of provided clinical information. 44.7% (261/584) of dermatopathologists spent 30 minutes or more on average every day searching for relevant clinical information to assist with their histopathologic interpretation.ASDP dermatopathologists expressed significant dissatisfaction with the quality of clinical information in the requisition form and the time spent gathering information necessary for accurate, timely and clinically meaningful diagnosis. These findings have implications for the quality, safety and efficiency of dermatologic care.

Mycosis fungoides is one type of T cell lymphoma characterized by a constellation of clinical, histologic, immunologic and molecular findings. Many patients follow a slowly progressive, but indolent disease course, while others have a more aggressive disease. What incites the process and the factors that determine the subsequent biologic behavior remain largely unknown. This paper will explore the aspects of the disease that are generally accepted as fact and will consider some of the more speculative features of the process.

Contains fulltext : 69862.pdf (Publisher’s version ) (Closed access) BACKGROUND: Cutaneous granulomas can occur in patients with a primary immunodeficiency disorder. In some cases, an infectious cause cannot be revealed. The pathogenesis of these granulomas still remains to be elucidated. The aim of this study was to study differences or overlap between these rare granulomas and sarcoidosis-related granulomas. METHODS: Markers for T-cell subsets (CD3, CD4, CD8 and CD45RO), Langerhans' cells (CD1a), macrophages (CD68), B cells (CD20) and NK cells (CD56) were stained immunohistochemically. The amount of CD4+ and CD8+ cells in the granulomas was counted. Results were compared with the CD4+/CD8+ ratio in peripheral blood. RESULTS: In the granulomas of two of three patients with a primary immunodeficiency disorder, the cytotoxic T cells (CD8+) outnumbered the T-helper cells (CD4+) with a counted CD4+/CD8+ ratio <2. CONCLUSIONS: A lower CD4+/CD8+ ratio was found in the cutaneous granulomas of patients with a primary immunodeficiency disorder (unclassified combined immunodeficiency, autoimmune lymphoproliferative syndrome and ataxia teleangiectasia) as compared with the patients with cutaneous sarcoidosis. The possible implications of these findings are discussed in this paper.