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Dermatopathology: Practical & Conceptual April - June 1995
>
Searching for Diogenes: Bulge-Activation Hypothesis Part II—The Bulge is Not a Bulge
Michael Radonich
Cosimo Misciali, MD
A. Bernard Ackerman, MD
Introduction
1876 Unna
1877 Schulin
1883 Unna
1892 Garcia
1904 Stöhr
1927 Felix Pinkus
1935 Zimmermann
1951 Hermann Pinkus
1958 Hermann Pinkus
1961 Sanderson & Thiede
1961 Sanderson
1964 Madsen
1964 Montagna
1984 Headington
1986 Mehregan
1987 Headington & Astle
1990 Leshin & White
1990 Cotsarelis, Sun, Lavker
1991 Sun, Cotsarelis, Lavker
1991 Lavker, Cotsarelis, Wei, Sun
1991 Lane, Wilson, Hughes, Leigh
1992 Jaworsky, Kligman, Murphy
1993 Yang, Lavker, Sun
1993 Lavker, Miller, Wilson, Costarelis, Wei, Yang, Sun
1993 Headington
1993 Whiting
1993 Kobayashi, Rochat, Barrandon
1994 Rochat, Kobayashi, Barrandon
References
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1990 Leshin & White
Folliculocentric basaloid proliferation. Arch Dermatol. 1990;126:900-6 (
Fig. 16
).
View Figure
Fig. 16 [Fig.3] A vertically oriented girondolelike arrangement of basaloid proliferations is displayed around a follicular axis. Inset, the lacelike basaloid proliferation, arising from the apparent external root sheath, has a hyaline basement membrane (frozen section, hematoxylin-eosin, x60; inset, x300). (Reproduced with permission.)
Message
Folliculocentric basaloid proliferations seen in patients undergoing Mohs" micrographic surgery for basal-cell carcinoma represent complex growths of bulge epithelium. Folliculocentric basaloid proliferation is characterized histologically by a girondolelike arrangement of basaloid cells.
Critique
The insert in one of the photomicrographs shows sebocytes within the latticelike arrangement of epithelial cells, an indication that folliculocentric basaloid proliferation is a hyperplasia of mantle, rather than bulge, epithelium. The mantle is the anlage of sebaecous glands and ducts.
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