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COVID-19 infection and vaccination may be associated with a wide variety of cutaneous and immune manifestations. Here, we describe two patients who presented with monoclonal cutaneous T-cell infiltrates that showed cytologic and immunophenotypic features concerning for lymphoma shortly following COVID-19 vaccination. In one case, the eruption completely resolved. The second patient showed initial resolution, but her disease recurred and progressed following a breakthrough SARSCoV-2 infection. These cases suggest that immune stimulation following exposure to SARS-Cov-2 protein(s) in vaccine or infection may facilitate the development of a lymphoma or lymphoproliferative disorder in susceptible individuals. Moreover, they show that separating these cases from pseudolymphomatous reactive conditions is often challenging and requires close clinical correlation. [ABSTRACT FROM AUTHOR]

Accurate diagnosis of connective tissue diseases is often challenging, and relies upon careful correlation between clinical and histopathological features, direct immunofluorescence studies and laboratory work‐up. Lupus erythematosus (LE) is a prototype of connective tissue disease with a variety of cutaneous and systemic manifestations. Microscopically, cutaneous LE is classically characterised by an interface dermatitis although other histopathological patterns also exist, depending upon the clinical presentation, location and chronicity of the skin lesions. In this article, we review the clinical, serological, histopathological and direct immunofluorescence findings in LE‐specific and LE non‐specific skin lesions, with an emphasis upon lesser‐known variants, newly described features and helpful ancillary studies. This review will guide general pathologists and dermatopathologists in accurately diagnosing and subclassifying cutaneous LE. [ABSTRACT FROM AUTHOR]

Perivascular epithelioid cell tumors (PEComas) are mesenchymal neoplasms with characteristic epithelioid or spindled cytomorphology that typically grow around blood vessels. These tumors are phenotypically and immunohistochemically distinct, expressing markers of both melanocytic and smooth muscle differentiation. Herein, we describe a case of histopathologically malignant cutaneous PEComa without metastatic spread, with review of the pertinent literature. Telescoping punch biopsy demonstrated an epithelioid neoplasm with marked atypia, hypercellularity, and increased mitotic activity. Immunohistochemical stains for HMB‐45, NK1‐C3, PGP9.5, MiTF, CD10, and CD68 were positive within tumor cells. In addition, there was diffuse expression of caldesmon and focal cytoplasmic staining for smooth muscle actin on the excision specimen. The patient underwent treatment with surgical excision with adjuvant radiation and surveillance computed tomography (CT). The patient remains free of recurrence or metastatic disease after 10 months of follow‐up. To our knowledge, this is only the third reported case of a malignant cutaneous PEComa reported in the literature to date. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to summarize the sensitivity and specificity between RCM and dermoscopy in LM diagnosis. Methods: A meta‐analysis was conducted to the study. PubMed, Google Scholar, Cochrane Library, and Wiley Online Library database were searched for relevant studies. The basic information of the patients, sensitivity, and specificity were calculated. I2 was used for the assessment of the heterogeneity. A random‐effect model was used for analyzing the data of the literature study. Results: A total of 498 patients from 7 articles were included in the study. The articles summarized the sensitivity and specificity between RCM and dermoscopy in the treatment of lentigo maligna. The overall sensitivity of RCM was 0.93, and the overall specificity was 0.89. RCM diagnostic odds ratio (DOR) was 104.38, RCM positive likelihood (+LR/PLR) was 8.50, and the negative LR (‐LR/NLR) was 0.08. The overall sensitivity of dermoscopy was 0.73 (95% CI: 0.58‐0.84), and the overall specificity was 0.84 (95% CI: 0.71‐0.92). The DOR, +LR, and −LR of dermoscopy were 14.48, 4.65, and 0.32, respectively. Conclusion: RCM has a better accuracy than dermoscopy in the diagnosis of LM. [ABSTRACT FROM AUTHOR]