#ISDP #Olympics2024 Spot diagnosis Case 2 - Jose Candido ACQUIRED ELASTOTIC HEMANGIOMA •Proliferation of vascular channels surrounded and intertwined by intense solar elastosis. •Erythematous lesions in sun-exposed areas of elderly patients #pathology #medicine #derm

#ISDP #Olympics2024 Spot diagnosis Case 3 - Joyce Lee BAP1-INACTIVATED MELANOCYTOMA •Sporadic or germline •Intradermal •Large, epithelioid melanocytes •Abundant eosinophilic cytoplasm •Prominent nucleoli •IHC: loss of nuclear BAP1 expression #derm #path #dermpath

#ISDP #Olympics Spot diagnosis Case 4 - Jose Candido EXTRAMAMMARY PAGET DISEASE Intraepithelial proliferation of cells with vesicular nuclei and basophilic/amphophilic cytoplasm. Cells distributed in a solitary fashion or in nest/gland-like structures #derm #path #med

#ISDP #Olympics Spot diagnosis Case 5 - Joyce Lee SCLEROMYXEDEMA •Haphazard proliferation of fibroblasts within the reticular dermis •Fibrosis and skin thickening •Increased dermal mucin #dermatology #dermatopatology #dermapath #path

#ISDP #olympics Spot diagnosis Case 6 - Jose Candido GRANULAR CELL TUMOR •Benign neuroectodermal tumor •Large cells with abundant and granular cytoplasm •Synonym: Abrikossoff tumor •Pseudoepitheliomatous hyperplasia can be prominent #path #pathology #dermatology

#ISDP #Olympics Spot diagnosis Case 7 - Joyce Lee HAND, FOOT AND MOUTH DISEASE •Caused by coxsackievirus A16, enterovirus 71 •Intraepidermal blister •Ballooning and reticular degeneration •Epidermal necrosis •Neutrophils #Dermatology #derm #dempath #pathology

#ISDP #Olympics Spot diagnosis Case 8 - Jose Candido OCHRONOSIS •Clinical presentation: blue–black cutaneous pigmentation •Typical swollen, irregular, golden brown banana 🍌shaped, sickled or round ochronotic bodies #dermpath #dermatology #pathology #path

#ISDP #Olympics2024 Spot diagnosis Case 9 - Joyce Lee NECROTIZING INFUNDIBULAR CRYSTALLINE FOLLICULITIS •Folliculocentric crater •Eosinophilic filamentous material •Material likely derived from Malassezia yeasts, bacteria, and/or sebaceous lipids #path #dermatology

#ISDP #Olympics Spot diagnosis Case 10 - Jose Candido PSEUDOXANTHOMA ELASTICUM • degenerative disease of elastic tissue • autosomal dominant • Elastic fibers are basophilic and irregular, appearing as widely dispersed granular material. #Path #dermpath #derm

#ISDP #Olympics Spot diagnosis Case 11 - Joyce Lee NECROBIOTIC XANTHOGRANULOMA •Areas of necrobiosis •Xanthogranulomatousinflammation (foamy histiocytes, Touton giant cells) •Cholesterol clefts •Large, bizarre angulated giant cells with many nuclei #PathTwitter #derm

Join us for three days in Queenstown, New Zealand for insightful discussions, engaging presentations, and networking opportunities with leading experts and professionals in the field of Dermatopathology. #ISDP #Dermpath #path #pathology Jerad Gardner, MD Gerônimo Jr.

#ISDP #OlympicGames Spot diagnosis Case 12 - Jose Candido LANGERHANS CELL HISTIOCYTOSIS • Round/ovoid medium-sized cells with indented, lobulated or coffee-bean nuclei. • Abundant and eosinophilic cytoplasm •IHQ markers: CD1a, Langerin and S100 protein #derm #path

#ISDP #OlympicGames Spot diagnosis Case 13 - Joyce Lee ONYCHOMATRICOMA •Thickened nail plate •Wormwood-like or honeycomb-like cavities •Papillary digitate projections covered by matrix epithelium •V-shaped keratogenouszones •Fibrocellular stroma #path #dermatology

#ISDP #OlympicGames Spot diagnosis Case 14 - Jose Candido PARACOCCIDIOIDOMYCOSIS •Dimorphic fungi (mycelial in the environment and yeast in the host) •Granulomatous reaction pattern •Round yeast with single or multiple buds with narrow necks. #derm #path #pathology

#ISDP #OlympicGames Spot diagnosis Case 15 - Joyce Lee PLEVA: •Parakeratosis •Apoptotic keratinocytes •Basal vacuolar alteration •Dermal and intraepidermal hemorrhage •Wedge-shaped lymphohistiocytic infiltrate •+/- Lymphocytic vasculitis #derm #path #pathology

#ISDP #Olympics Spot diagnosis Case 16 - Jose Candido ELASTOFIBROMA •Benign soft tissue tumor characterized by abnormal elastic fibres and fibroblasts •Hypocellular tumor with fragmented and thickened to globular elastic fibres #Pathology #path #dermatology #derm

#ISDP #OlympicGames Spot diagnosis Case 17 - Joyce Lee CUTANEOUS ROSAI DORFMAN DISEASE •Non-Langerhans cell histiocytosis •Large histiocytes exhibiting emperipolesis (containing inflammatory cells) •CD68+, S100+, CD1a- •Lymphoplasmacytic infiltrate #Path #derm

#ISDP #OlympicGames Spot diagnosis Case 18 - Jose Candido SYRINGOCYSTADENOMA PAPILLIFERUM •It can occur in naevus sebaceus of Jadassohn •Endophytic crateriform lesion •Two layers of cells forming papillary and cystic structures • Numerous plasma cells #path #derm

#ISDP #Olympics Spot diagnosis Case 19 - Joyce Lee SEBACEOUS CARCINOMA • Periocular (75%) • Basophilic germinative sebaceous cells • Sebocytes with vacuolated cytoplasm • Nuclear pleomorphism • Increased and atypical mitoses • Necrosis #Path #derm #pathology

#ISDP #Olympics Spot diagnosis Case 20 - Jose Candido CHROMOBLASTOMYCOSIS •Pigmented (dematiaceous) fungi •Prominent pseudoepitheliomatous hyperplasia •Granulomatous infiltrates with round brownish Medlar bodies resembling copper pennies or coffee beans #path #derm