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L Requena

Publications and source records attributed to L Requena.

At least 91 records · Page 5Linked to original sources
PubMed1997

Clear-cell porocarcinoma: another cutaneous marker of diabetes mellitus.

The relationship between clear-cell syringoma and diabetes mellitus is well established. We present a case of clear-cell porocarcinoma in a diabetic patient. The lesion consisted of a 5-cm nodule on the lateral aspect of the left leg. Histopathologically, the neoplasm was composed of irregular aggregations of neoplastic cells with striking clear-cell appearance, showing features of ductal differentiation. The clear-cell appearance of neoplastic cells was due to glycogen accumulation within their cytoplasm. Immunohistochemistry and ultrastructural studies also supported the diagnosis of a neoplasm with sweat ductal differentiation. Enzyme histochemical reactions for phosphorylase immunoreactivity on fresh, unfixed sections of the neoplasm demonstrated that this immunoreactivity was remarkably decreased. Some adnexal neoplasms of the skin mostly composed of clear cells may be cutaneous markers of diabetes mellitus. Phosphorylase activity deficiency in diabetic patients may be responsible for glycogen accumulation in neoplastic cells resulting in clear-cell appearance of these neoplasms.

Acrospiroma↗
PubMed1997

Oral pseudolymphoma: a report of two cases.

Although 2% to 10% of lymphomas present first in the oral cavity and lymphomas are the third most common oral malignancy, pseudolymphoma is a very infrequent problem within oral pathology. Two cases of oral pseudolymphoma are presented. Both were old persons with an infiltrative lesion on the oral mucosa that histologically showed a dense polymorphous infiltrate with some nuclear atypia that raised the problem of lymphoma versus pseudolymphoma. Both lesions disappeared with no relapse after 2-years' follow-up. Histologically, case 1 was mainly a lymphohistiocytic infiltrate whose histiocytic component showed nuclear features that mimicked Hodgkin's cells. In case 2, the infiltrate was mainly composed of histiocytes and eosinophils. The suspicion of malignancy here was a consequence of a high mitotic rate of histiocytes and of the large hyperchromatic nuclei of the intraepithelial lymphocytes. Similarities and differences with other pseudomalignant (lymphomatoid papulosis and atypical histiocytic granuloma) and inflammatory (traumatic ulcerative granuloma with stromal eosinophilia) disorders, as well as with some histiocytoses, are discussed. In the absence of a wider experience on this subject, an objective description of new cases seems appropriate.

Aged↗
PubMed1997

Clear-cell atypical fibroxanthoma: an uncommon histopathologic variant of atypical fibroxanthoma.

Atypical fibroxanthoma is a superficial variant of pleomorphic malignant fibrous histiocytoma. Histopathologically, it is characterized by a dermal nodule composed of bizarre cells arranged in a haphazard-to-fascicular pattern. These cells are spindle or rounded, pleomorphic and with numerous atypical mitotic figures. Some cells appear polygonal with ample and foamy cytoplasm. We recently encountered two elderly patients with atypical fibroxanthoma on their face. Histopathologically, one of the lesions was composed, almost entirely, of clear cells, whereas in the other one aggregations of clear cells constituted a half of the neoplasm. Atypical multinucleated cells with a Touton-like appearance were present. In addition to clear cells, areas of more conventional atypical spindle cells arranged in fascicles were seen, supporting the diagnosis of atypical fibroxanthoma. PAS staining failed to demonstrate glycogen in neoplastic cells. Immunohistochemistry revealed that neoplastic cells expressed positivity for vimentin, muscle-specific actin, and alpha smooth muscle actin, whereas cytokeratin, S-100 protein, EMA, CEA, and desmin were negative. Ultrastructural studies showed that neoplastic cells contained abundant rough endoplasmic reticulum, mitochondria, and numerous lipid vacuoles within the cytoplasm. Clear-cell atypical fibroxanthoma is a rare variant of atypical fibroxanthoma that should be differentiated from other clear-cell neoplasms of the skin.

Aged↗
PubMed1997

Dermatomyositis with a pityriasis rubra pilaris-like eruption: a little-known distinctive cutaneous manifestation of dermatomyositis.

A pityriasis rubra pilaris-like eruption has been described in patients with dermatomyositis. These patients showed generalized follicular hyperkeratosis and diffuse thickening of the palms and soles. Histopathological findings consisted of keratotic plugging of the follicular infundibulum and features of erector pili myositis. We report on an 18-year-old woman with dermatomyositis. The diagnosis was established by characteristic enzymatic alterations, electromyographic pattern of myositis and the findings in a muscle biopsy, although the patient had no evidence of muscular weakness during a follow-up of 14 years. She developed an erythematosus and squamous eruption associated with diffuse palmoplantar keratoderma. Histopathological features consisted of a papillomatous epidermis with spicules of compact eosinophilic hyperkeratosis over the tips of papillae that were not related to hair follicles. Pityriasis rubra pilaris-like eruption seems to be a characteristic although uncommon cutaneous manifestation in dermatomyositis.

Adolescent↗
PubMed1997

[Clinical significance of the isolation of rapidly growing mycobacteria].

BACKGROUND: To assess the clinical significance of the isolates of rapid-growing mycobacteria in a Universitary hospital from Madrid (Spain). PATIENTS AND METHODS: Review of medical records from patients with isolates of rapid-growing mycobacteria identified between 1979 and 1996 in the Microbiology department of the Fundación Jiménèz Díaz (Madrid, Spain). RESULTS: Rapid-growing mycobacteria were isolated from 28 patients during the study period (13 M. chelonae, 10 M. fortuitum, 2 M. mucogenicum, 1 M. marinum, 1 M. smegmatis and 1 M. flavascens). Clinical records of 26 patients were reviewed, being the isolate significative in 10 cases (5 soft tissue infections, 2 peritonitis in patients undergoing Continuous Ambulatory Peritoneal Dialysis [CAPD], 1 urinary tract infection, 1 osteomyelitis and 1 catheter-related soft-tissue infection). No patient was HIV+. All infections cured except 2 of them (the urinary tract infection and the osteomyelitis). Catheter withdrawal was needed in 3 cases (peritonitis in CAPD and catheter-related soft-tissue infection), apart from proper antimicrobial therapy. CONCLUSION: The most frequent rapid-growing mycobacteria isolated were those of the M. fortuitum complex. In our experience, isolation of rapid-growing mycobacteria from skin and soft-tissue samples was usually clinically significant, while isolates from respiratory tract, gut and blood cultures are always nonsignificant.

Adult↗
PubMed1996

Cutaneous metastases from prostatic carcinoma.

Cutaneous metastasis from carcinoma of the prostate is a rare phenomenon. When it occurs, metastases usually appear as multiple nodules involving the suprapubic area and the anterior aspect of the thighs. We report on two cases of cutaneous metastases from prostatic carcinoma, one of them presenting the stereotypical clinical and histopathological findings, whereas in the other one cutaneous metastasis consisted of a morphea-like plaque on the chest. Histopathologically, the later case revealed accumulations of neoplastic cells distributed in a folliculotropic pattern. In both examples immunohistochemical study with prostatic specific antigen (PSA) confirmed the prostatic origin of the metastases. We review the literature on this subject.

Aged↗
PubMed1996

Epidermotropically metastatic breast carcinomas. Rare histopathologic variants mimicking melanoma and Paget's disease.

Epidermotropic metastases from internal malignancies are exceedingly rare. We report two examples of epidermotropic metastatic breast carcinoma with striking intraepidermal involvement. The first case mimicked melanoma because the neoplastic cells contained melanin and were disposed both as single units and as nests at the dermoepidermal junction and throughout the epidermis. In the second case, the neoplastic cells were seen as isolated neoplastic cells with large, pale cytoplasm scattered throughout the epidermis, closely resembling extramammary Paget's disease. Immunohistochemical studies in both cases demonstrated the epithelial nature of intraepidermal neoplastic cells, which showed an immunophenotype identical to the neoplastic cells present in the dermis: positive staining with anti-cytokeratins, CEA, EMA, and GCDFP-15 and negative with anti-S-100 protein and HMB-45. These findings ruled out the possibility of a collision lesion, or simultaneous occurrence of melanoma and metastatic breast carcinoma. Pagetoid intraepidermal spread of metastatic breast carcinoma, as in our two cases, is exceptional. We also discuss the histogenetic similarities between our findings and those of mammary and extramammary Paget's disease, as well as the differential diagnosis of other cutaneous disorders characterized by pagetoid intraepidermal spread of neoplastic cells.

Aged↗
PubMed1996

Idiopathic palmoplantar hidradenitis.

Idiopathic plantar hidradenitis (IPH) is a recently described condition primarily affecting healthy children who develop tender lesions localized to the plantar or lateral aspects of the feet with histologic findings similar to those seen in neutrophilic eccrine hidradenitis (NEH), although with certain notable exceptions including the absence of syringosquamous metaplasia and the presence, in most cases, of neutrophilic abscesses adjacent to eccrine coils. Since its original description, three additional patients have been reported, one with palmoplantar lesions, extending the disease's clinical spectrum to include palmar as well as plantar surfaces. We report on a healthy 8-year-old girl with tender, erythematous nodules on palms and soles and review the literature on this subject.

Abscess↗
PubMed1996

Unilateral areolar sebaceous hyperplasia in a male.

We report a case of areolar sebaceous hyperplasia involving the right mammary areola in a 49-year-old male. Areolar sebaceous hyperplasia, an uncommon entity first described by Catalano and Ioannides in 1985, is characterized clinically by yellowish thickening of the areolae and histopathologically by large numbers of mature hyperplastic sebaceous lobules connected to the skin surface through short, hairless infundibular canals. Since its original description, only two additional reports have been published. To our knowledge, our patient is the first reported of areolar sebaceous hyperplasia in a male.

Humans↗
PubMed1996

Congenital nasal comedones--report of three cases.

We report on three patients with black or white comedones arranged along the nasal groove in the distal third of the nose between the alar and triangular cartilages. This peculiar disorder is probably more common than would appear from the small number of cases so far reported in the literature.

Acne Vulgaris↗
PubMed1996

Cutaneous adult myofibroma: a vascular neoplasm.

Infantile myofibromatosis is a distinctive type of fibromatosis that usually develops during the immediate perinatal period. There are variants with solitary and multiple tumors. Lesions confined to the skin, soft tissue, and bone carry a good prognosis, showing spontaneous regression. The prognosis, however, is much less favorable when visceral lesions are present and the outcome may be fatal. Only recently it became obvious that there is an adult counterpart of infantile myofibromatosis, characterized by solitary lesions that have a predilection for involve the dermis and show no tendency to regression, although they have an entirely benign biological behavior. These lesions have been named cutaneous myofibroma or solitary myofibroma of adults. We have studied the clinical, histopathological and immunohistochemical characteristics of 53 examples of cutaneous adult myofibroma. In addition, 2 cases were examined ultrastructurally. The patients were mostly adults with ages ranging from 6-83 years. The lesions presented as solitary, usually painless nodules of variable duration on the skin, usually located on the extremities. Histopathologically, four patterns were identified: nodular or cellular type, multinodular or biphasic type, leiomyoma-like or fascicular type, and vascular type. A correlation between the histopathologic pattern and the lesional age was observed: vascular type of cutaneous adult myofibroma in early lesions, nodular and multinodular lesions in fully developed lesions, and leiomyoma-like or fascicular type in late lesions. Immunohistochemically, the spindle cells were desmin negative, but expressed immunoreactivity for vimentin, pan-smooth muscle actin, and alpha-smooth muscle actin. Ultrastructurally, neoplastic cells showed characteristics of undifferentiated mesenchymal cells with features of fibroblasts, myofibroblasts and pericytes. Primitive vascular formations were seen in the form of irregular clefts between adjoining cells. We conclude that cutaneous adult myofibroma is a little-known benign vascular neoplasm probably derived from myopericytes.

Adolescent↗
PubMed1996

Pseudoatrophic macules: a variant of neurofibroma.

A 19-year-old man with neurofibromatosis type 1 showed a cutaneous plaque on the right scapular area with grayish coloration and atrophic appearance. Histopathologic examination demonstrated features of neurofibroma. Dermatologists should be aware of this uncommon clinical variant of neurofibroma in order to diagnose neurofibromatosis.

Adult↗
PubMed1996

Keloidal basal cell carcinoma. A new clinicopathological variant of basal cell carcinoma.

Basal cell carcinoma is the commonest malignant neoplasm of the skin. Clinical and histopathological variants are well known. We describe two patients with nodular lesions on the face, clinically suggestive of keloids, but with no previous history of injury at that site. Histopathological study, in both cases, demonstrated characteristic basaloid neoplastic aggregations of basal cell carcinoma, intermingled with thick, sclerotic, keloidal collagen bundles in the stroma. This peculiar stroma is responsible for the clinical and histopathological characteristics. We propose the name of keloidal basal cell carcinoma for this striking and distinctive variant of basal cell carcinoma.

Aged↗