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Dermatopathology: Practical & Conceptual January - March 2006
>
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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25. Minimal deviation melanoma
Quotation from the 9th edition of Lever's:
"Recognized only by some authors, this lesion is referred to as 'borderline type' when it is limited to the papillary dermis and as 'minimal deviation type' when it extends into the reticular dermis. These tumors are considered to exhibit less cytological atypia than the common forms of melanoma, although the architectural characteristics of melanoma are usually present."
"Because of the resemblance to nevus cells, the term nevoid melanoma has also been used."
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA): None.
Statements contrary by ABA:
"Rather than admit uncertainty forthrightly, those who employ circumlocutions that we deplore, such as those under scrutiny here, resort to linguistic maneuvers that, at first blush, seem to have the cachet of scholarship (the jargon used being in keeping with a slew of other well-accepted, but equally bogus diagnoses in [dermato]pathology, among them being "minimal deviation melanoma," "borderline melanoma," "nevoid melanoma," "potentially low-grade melanocytic neoplasm," and "melanocytic proliferation of uncertain biologic potential"). All those terms and phrases are constructed in a manner designed to make them appear to convey unbridled confidence on the part of a histopathologist, rather than what they are in actuality, that is, a cover abjectly for tentativeness. Scrutiny of the lingo, in very abbreviated form, just catalogued reveals it to be devoid of content utterly."
Ackerman AB, Mones J "Atypical" blue nevus, "malignant" blue nevus, and "metastasizing" blue nevus.
Dermatopathology: Practical & Conceptual,
10(1);2004.
Other works of ABA in which the ideas contrary are expressed:
1. Ackerman AB, Cerroni L, Kerl H.
Pitfalls in Histopathologic Diagnosis of Malignant Melanoma.
Philadelphia: Lea & Febiger, 1994.
2. Ackerman AB, Cavegn BM, Casintahan MF, Robinson MJ.
Resolving Quandaries in Dermatology, Pathology and Dermatopathology.
Promethean Medical Press/Waverly, 1995.
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