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Dermatopathology: Practical & Conceptual January - March 2006
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5. New Heights: An assist to the next (10th) edition of “Lever’s”
Renata A. Joffe, M.D.
Content
Introduction
1. Small plaque parapsoriasis
2. Dysplastic nevus
3. Solar keratosis
4. Inverted follicular keratosis/trichilemmoma
5. Discoid lupus erythematosus vs. systemic lupus erythematosus
6. Lentigo maligna
7. Atopic dermatitis
8. Sebaceous adenoma
9. Muir-Torre syndrome
10. Bowen’s disease
11. Follicular mucinosis/alopecia mucinosa
12. Granuloma faciale and erythema elevatum diutinum
13. Follicular degeneration syndrome
14. Eccrine papillary adenoma
15. Degos’ disease
16. Dermatofibroma
17. Proliferating tricholemmal cyst
18. Erythema multiforme (dermal and epidermal types)
19. Lichen sclerosus et atrophicus vs. morphea
20. Malignant melanoma (classification)
21. Malignant melanoma—ABCD’s
22. Malignant melanoma—wide/deep excision
23. Sentinel node biopsy for melanoma
24. Malignant melanoma: nontumorigenic compartment of primary malignant melanoma (radial growth phase), tumorigenic compartment of primary malignant melanoma (vertical growth phase)
25. Minimal deviation melanoma
26. Nevoid melanoma
27. Malignant melanoma—in infancy and childhood
28. Malignant blue nevus
29. MELTUMP and SAMPUS
30. Bulge activation hypothesis
Conclusion
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17. Proliferating tricholemmal cyst
Quotation from the 9th edition of Lever's:
"There appears to be a spectrum of cases ranging from a proliferative trichilemmal cyst to a frankly malignant proliferating trichilemmal tumor. It has been proposed by some that proliferating trichilemmal cysts may be low-grade carcinomas."
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA): None.
Statements contrary by ABA:
"What has for decades been called "proliferating tricholemmal cyst" is not a cyst but a carcinoma that begins in a pre-existing follicular cyst. Both the cyst and the carcinoma that develops in it show differentiation toward the outer sheath at the isthmus (which, morphologically, is indistinguishable from the outer sheath as it involutes at a stage in catagen)."
Ackerman AB, Mones J. Proliferating tricholemmal cystic carcinoma (Revision of chapter XXV of the volume titled Neoplasms with Follicular Differentiation, 2nd edition by Ackerman, Reddy, and Soyer, Ardor Scribendi, Ltd., 2001.
Dermatopathology Pratical & Conceptual
9(2), 2003.
Other works of ABA in which the ideas contrary are expressed:
Ackerman AB, Mones J. Resolving Quandaries in Dermatology, Pathology and Dermatopathology. pp 306-311. New York: Ardor Scribendi, 2001.
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