Professional Documents
Culture Documents
AMAL KURBAN
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Plz don’t do this to me……
CASE 1
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KOILOCYTE
FORMATION
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CONDYLOMA ACCUMINATA
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Knobby Sport Wheel Knobby Ball
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CONDYLOMA ACCUMINATA
• Genital warts or venereal warts
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MANAGEMENT OF ANOGENITAL WARTS WITH
GRADING OF RECOMMENDATIONS
Physical destruction
• Cryotherapy (liquid nitrogen, cryoprobe) (1)
• Trichloroacetic acid (TCA) 70–90% solution (1)
• Electrosurgery (1)
• Scissors excision (1)
• Laser vaporization (2)
Immunomodulatory
• Imiquimod 5% cream (1)
• Intralesional immunotherapy with skin test
antigens (2)
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• Criteria for diagnosis clinically:
Seborrheic keratosis
Bowenoid Papulosis (HPV16,18)
Verrucous Carcinoma(Giant Condyloma
Acuminatum, HPV 6)
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• Criteria for diagnosis histopathologically:
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Lessons
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Misdiagnosis as Seb. K
It is not uncommon for clinicians and
histopathologists to misdiagnose lesions such as
this one as a seborrheic keratosis. In fact, in
the most recent edition of his textbook, Weedon
wrote these lines:
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CASE 2
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Cystic Squamous Cell Carcinoma
• SCC 2nd most common type of skin cancer
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General Risk Factors
• Age older than 50 years , Male sex
• Chronic immunosuppression
• Certain genodermatoses
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Histopathlogy
• Invasions of dermis by Atypical
Keratinocytes (hyperchromatic,
pleomorphic cells often epitheliod, with
atypical mitosis
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CYSTIC SCC
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CYSTIC SCC
• Criteria for diagnosis histopathologically:
At the periphery of the epithelium-lined sac, atypical
keratinocytes whose nuclei are crowded, large, pleomorphic,
and heterochromatic, and whose cytoplasm is eosinophilic.
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CYSTIC SCC
• Clinico-pathologic correlation:
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CYSTIC SCC
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CYSTIC SCC
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CYSTIC SCC
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CYSTIC SCC
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CASE 3
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DH
• Chronic, intensely pruritic disorder
• Symmetrically distributed bullae or erosions
• Deposition of IgA in the dermal papillae
• Evidence of gluten-sensitive enteropathy
• 10% of patients experience spontaneous
remission
• Therapeutic strategy is control of pruritus and
at least most of the skin lesions
• Drug of choice is Dapsone 100 mg/day
• Sulfapyridine, Colchicines - Alternative
Therapies
• Gluten-free diet
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• Criteria for diagnosis clinically:
Insect "bites"
picker's papule
(usually are not grouped in herpetiform fashion)
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• Criteria for diagnosis histopathologically:
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• Histological changes identical to those of dermatitis
herpetiformis may be seen in linear IgA dermatosis
and changes very similar to them may be encountered
early in the course of a lesion of lupus erythematosus.
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CASE 4
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LYPHOMATOID PAPULOSIS
• Rare
• Corps of pruritic papules or nodules
• Sometimes ulcerate, appear and spontaeously
regress
• Lymphamatoid means resembling lymphoma
• Benign course in 90%
• Lymphoma in 10%
• Low-dose weekly methotrexate, PUVA
• Topical carmustine, topical nitrogen mustard,
topical MTX, topical imiquimod cream,10
intralesional interferon, low-dose
cyclophosphamide, chlorambucil, medium-dose
UVA-1 therapy, excimer laser therapy,11 and
dapsone
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• Term Lymphomatoid Papulosis
originally was used by Macaulay1
in 1968 to describe
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• Criteria for diagnosis clinically:
A red, scaly papule, punctuated in its center by
a hemorrhagic crust, atop an ulcer in company
with lesions less fully developed and joined by
hyperpigmented atrophic scars is a
manifestation of lymphomatoid papulosis.
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• Criteria for diagnosis histopathologically:
-Epidermal Necrosis often or ulceration
-Nodular infiltrate of ordinary lymphocytes,
very atypical CD30 positive activated T
lymphocytes, with epidermotropism into the
epidermis.
-Neutro and Eosin sometimes present
-Extravasated RBC,s often in epidermis
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• Clinicopathologic correlation:
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LyP and PLEVA
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• The immunohistologic hallmark of the
abnormal T-lymphocytes in lymphomatoid
papulosis is their positivity for CD30, but such
positivity is not unique to them.
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CASE 5
CASE 5
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Miescher's Nevus
• Dome-shaped, intradermal melanocytic nevi
that are commonly expressed on the face and
the upper part of the trunk.
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Miescher's Nevus
• Histopathologically by a wedge-shaped
infiltrate of melanocytes of the nevus that
extends throughout much, if not all, of the
dermis
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Miescher's Nevus
• The classification of melanocytic nevi as
"congenital" or "acquired" has serious
limitations.
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Miescher's Nevus
• The decisive discriminative feature between
Unna's and Miescher's nevi is that Unna's nevus
is an almost purely adventitial lesion confined
to expanded papillary dermis and, many times,
to the perifollicular dermis too.
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Miescher's Nevus
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Miescher's Nevus
• Criteria for diagnosis clinically:
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Miescher's Nevus
• Clinicopathologic correlation:
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Miescher's Nevus
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Miescher's Nevus
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Miescher's Nevus
• Although a Miescher's nevus, cutting the
swath that it does throughout the width of
the reticular dermis, qualifies as a lesion
congenital, it is not present at birth, but
rather makes its appearance early in
childhood.
• The dichotomy of a lesion deemed to
be congenital morphologically and yet
is acquired biologically poses a
controversery to dermatologists,
some of whom employ the term
"congenital nevus, tardive type" in an
unsatisfactory effort at resolving the
dilemma.
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Miescher's Nevus
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Miescher's Nevus
• TREATMENT
• Surgical EXCISION
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THANK YOU SO MUCH