Biomedical subjects
A B Ackerman
Publications and source records attributed to A B Ackerman.
Some observations, reflections, and questions about dysplastic nevi.
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Melanosis of the vulva. A clinical simulator of malignant melanoma.
Eight patients with melanosis of the vulva are presented in order to illustrate the characteristic clinical and histopathologic features of the condition. Despite clinical features that may be indistinguishable from those of malignant melanoma, the patchy pigmentation of melanosis that is seen mostly on the vulva, but also on the penis, shows wholly different histologic changes than those of melanoma, namely, a slightly increased number of typical melanocytes arranged as solitary units at the dermal-epidermal junction of a hyperpigmented epidermis. It is important to identify melanosis of the vulva for what it is, because overdiagnosis of it as malignant melanoma may result in needless radical surgery.
A combined variant of Spitz's nevi. How to differentiate them from malignant melanomas.
In the past several years we have studied 22 lesions of what we believe are combined variants of Spitz's nevi. Almost all of the patients were young adults. These combined melanocytic nevi have the architectural pattern of benign lesions, i.e., they are relatively symmetrical and well circumscribed. Each was characterized by the presence of at least two populations of nevus cells, one relatively banal with small nuclei and scant cytoplasm, the other with large nuclei and abundant cytoplasm. The latter are indistinguishable from cuboidal (epithelioid) cells of Spitz's nevus. The banal and the large nevus cells were intermingled in some of the lesions, but were segregated in others. Because these combined nevi differ from conventional Spitz's nevi and because the large nevus cells often fail to show maturation with progressive descent into the dermis, they are commonly misdiagnosed histologically as malignant melanomas.
Mitotic figures may be seen in cells of banal melanocytic nevi.
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Intraepidermal epithelioma of Borst-Jadassohn.
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Civility among colleagues should be reciprocal.
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Are there too many dermatopathologists?
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Criteria for histologic differentiation of desmoplastic trichoepithelioma (sclerosing epithelial hamartoma) from morphea-like basal-cell carcinoma.
Histological differentiation between desmoplastic trichoepithelioma and morphea-like basal-cell carcinoma may be exceedingly difficult. Because the criteria for this differentiation published to date have not proved satisfactory to us, we undertook a study with the aim of formulating repeatable and reliable criteria for distinguishing between these two conditions of wholly different biological potential. We believe that the 26 sets of criteria listed here will permit reliable differentiation of desmoplastic trichoepitheliomas from morphea-like basal-cell carcinomas, even in biopsy specimens taken by shave and punch techniques.
The myth of the "born" teacher.
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Making chronic nonspecific dermatitis specific. How to make precise diagnoses of superficial perivascular dermatitides devoid of epidermal involvement.
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Mammary and extramammary Paget's disease.
Ten cases of mammary Paget's disease and 10 cases of extramammary Paget's disease were studied for differences of histologic features in them. Based on the epidermal changes alone, Paget cells in 90% of specimens from lesions of extramammary Paget's disease had abundant mucin that stained well, whereas Paget cells in only 40% of specimens from mammary Paget's disease stained for mucin and faintly at that. In 60% they did not stain at all. The conclusion derived from these observations is that the mucin in Paget cells of extramammary Paget's disease is different from that found in cells of mammary Paget's disease. The Paget cells in these two conditions seem to have different origins, i.e., those of mammary Paget's disease ascend to the epidermis from lactiferous ducts, whereas those of extramammary Paget's disease originate in the epidermis itself.
Remembering Hermann Pinkus.
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"Handouts". Doctors on a dole.
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Cutaneous pathology of the toxic shock syndrome.
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Remembering Hermann Pinkus.
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Malignant melanoma in situ: the flat, curable stage of malignant melanoma.
Malignant melanoma can be diagnosed clinically and histologically when it is small, flat, and confined to the epidermis. The criteria for the diagnosis are described. The application of these criteria can lead to simple excision of the lesion and the prevention of the malignant melanoma from evolving into a neoplasm with the potential for metastasis.
Follicular mucinosis. A reaction pattern in follicular epithelium.
Follicular mucinosis is a histologic term for a reaction pattern in follicular epithelium. Although it is the sine qua non for alopecia mucinosa as a disease sui generis, it may occur in a variety of unrelated conditions, which may be inflammatory, hamartomatous, hyperplastic, or neoplastic. Follicular mucinosis is rare in plaque and nodular lesions of mycosis fungoides, but when it occurs, the malignant lymphoma is not related to the condition known as alopecia mucinosa. In short, alopecia mucinosa is a wholly benign condition and is not premonitory or an early aspect of mycosis fungoides. Follicular mucinosis is not synonymous with alopecia mucinosa but is analogous to other histologic reaction patterns of cutaneous epithelium such as epidermolytic hyperkeratosis, focal acantholytic dyskeratosis, and cornoid lamellation.