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Background: Psoriasiform dermatitis can be defined both clinically and histologically, but is not a traditionally recognized clinical or histologic diagnosis., Objective: Analyze the final clinical diagnosis, demographics and clinical characteristics in patients with histologic psoriasiform dermatitis., Methods: Retrospective cross-sectional analysis of patients with histologic psoriasiform dermatitis 2004-2017., Results: Patients (N = 586) were most often female (53.4%) and race/ethnicity included White (61.3%), Black (29.5%), Asian (4.8%), Hispanic (0.7%); mean (SD) age was 52.0 (17.9) years. Median time from histologic psoriasiform dermatitis to final clinical diagnosis was 0.5 months and median duration of follow-up was 6.0 years. The most frequently involved body sites were legs (37.2%), trunk (35.8%) and arms (25.3%). Final clinical diagnoses most associated with histologic psoriasiform dermatitis were psoriasis (N = 191, 32.6%), dermatitis (N = 173, 29.5%), "no clinical diagnosis" (N = 59, 10.1%) and cutaneous T-cell lymphoma (CTCL) or parapsoriasis (N = 48, 8.2%)., Limitations: Retrospective study at one academic center., Conclusion: The most frequent clinical diagnoses associated with histologic psoriasiform dermatitis were psoriasis in about one third of patients, dermatitis in just under one third of patients, "no clinical diagnosis" in approximately 10% and CTCL/parapsoriasis in just under 10%., Competing Interests: Declarations. Competing interests: ARA was previously employed by and was previously a stockholder of Eli Lilly and Company. IRB approval status: Reviewed and approved by Duke University IRB: approval # Pro00104455. Previous presentations: This study was presented as a poster at the 2021 American Contact Dermatitis Society Meeting., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To describe the presentation of giant cell tumors (GCT) of the bone in the pediatric population to (1) improve the differential diagnosis of pediatric bone tumors and (2) identify the origin of GCT. Understanding the origin of bone tumors assists in establishing appropriate diagnoses and recommending treatment options. This is particularly important in children, where evaluating the need for invasive procedures is balanced with the desire to avoid overtreatment. GCT have historically been considered epiphyseal lesions with potential metaphyseal extension. Therefore, GCT may be inappropriately excluded from the differential diagnosis of metaphyseal lesions in the skeletally immature., Materials and Methods: We identified 14 patients from 1981 to 2021 at a single institution who had histologic confirmation of GCT and were less than 18 years old at diagnosis. Patient characteristics, tumor location, surgical treatment, and local recurrence rates were collected., Results and Conclusions: Ten (71%) patients were female. Eleven (78.6%) were epiphysiometaphyseal (1 epiphyseal, 4 metaphyseal, 6 epiphysiometaphyseal). Five patients had an open adjacent physis, of which three (60%) had tumors confined solely to the metaphysis. Of the five patients with open physis, four (80%) developed local recurrence while only one patient (11%) with a closed physis had local recurrence (p value = 0.0023). Our results illustrate that for the skeletally immature, GCT can (and in our results more commonly did) occur in the metaphyseal location. These findings suggest that GCT should be included in the differential diagnosis of primary metaphyseal-only lesions in the skeletally immature., (© 2023. The Author(s), under exclusive licence to International Skeletal Society (ISS).)

Background: In melanoma patients, microscopic tumor in the sentinel lymph-node biopsy (SLN) increases the risk of distant metastases, but the transition from tumor in the SLN to metastatic disease remains poorly understood., Methods: Fluorescent staining for CD3, CD20, CD11c, and DNA was performed on SLN tissue and matching primary tumors. Regions of interest (ROI) were then chosen geometrically (e.g., tumor) or by fluorescent cell subset markers (e.g., CD11c). Each ROI was further analyzed using NanoString Digital Spatial Profiling high-resolution multiplex profiling. Digital counts for 59-panel immune-related proteins were collected and normalized to account for system variation and ROI area., Results: Tumor regions of SLNs had variable infiltration of CD3 cells among patients. The patient with overall survival (OS) > 8 years had the most CD11c- and CD3-expressing cells infiltrating the SLN tumor region. All patients had CD11c (dendritic cell, DC) infiltration into the SLN tumor region. Selecting ROI by specific cell subtype, we compared protein expression of CD11c cells between tumor and non-tumor/normal tissue SLN regions. Known markers of DC activation such as CD86, HLA-DR, and OX40L were lowest on CD11c cells within SLN tumor for the patient with OS < 1 year and highest on the patient with OS > 8 years., Conclusion: We demonstrate the feasibility of profiling the protein expression of CD11c cells within the SLN tumor. Identifying early regulators of melanoma control when the disease is microscopically detected in the SLN is beneficial and requires follow-up studies in a larger cohort of patients.