Cutaneous ciliated cyst: A case report

Cutaneous ciliated cyst are relatively rare benign lesions, found in the dermis or subcutis of the lower extremities of young females in their second and third decades. The cysts are typically lined by ciliated cuboidal to columnar epithelium, showing pseudostratified areas and focal squamous metaplasia is occasionally present. Immunohistochemical studies have demonstrated that the cysts can be PR and ER positive, similar to the epithelia of the fallopian tubes. The pathogenesis of the cyst is yet being studied, some hypotheses have been proposed including the Mullerian heterotopias, ciliated metaplasia of eccrine sweat glands, and embryonic remnants of the cloacal membrane. We report a cutaneous ciliated cyst over the right gluteus area in a 29 year old female. On histologic examination, the cyst was lined by ciliated columnar epithelium, showing occasional papillary projections.

BOTULINUM TOXIN EFFECTIVENESS IN PRIMARY HYPERHIDROSIS PATIENTS

Hyperhidrosis represents pathology of eccrine sweat glands and is manifested by the skin excessive sweating. For patients, living along with hyperhidrosis represents a big challenge, which has a significant impact on numerous aspects of everyday life, as well as on the social and professional lifestyle and psycho-emotional health.

Malignant Nodular Hidradenoma of the Fingertip: A Case Report

Malignant nodular hidradenoma (MNH) is an infrequent, highly malignant tumor derived from eccrine sweat glands. MNH usually occurs on the scalp, trunk, and proximal extremities, and rarely on the hand. A 55-year-old male patient visited clinics with a gradually enlarging painless mass at fingertip. It begins a year ago. Recently, it has grown rapidly and starts ulceration, and bleeding over the past 3 weeks. According to the biopsy report, it has focal necrosis, atypia, atypical mitoses, and nuclear pleomorphism suggested that the mass was MNH. After histological diagnosis, tiny bone erosion was observed in the re-read radiographic finding. For the oncologic evaluation, the patient was transferred to the cancer center. Radical amputation was performed to the residual tumor that might remain based on re-reading of radiographs. MNH of the finger is especially difficult to the diagnosis given its rarity and variable histology. When ulcerative skin lesion and radiographic bone erosion are observed, one should suspect malignancy and makes out a proper therapeutic plan after histologic biopsy.

Acquired Idiopathic Generalized Anhidrosis (AIGA) and Its Complications: Implications for AIGA as an Autoimmune Disease

Acquired idiopathic generalized anhidrosis (AIGA) is a rare disorder in which systemic anhidrosis/hypohidrosis occurs without causative dermatological, metabolic or neurological disorder. Most cases of AIGA have been reported in Asia, especially in Japan, but there have been only a few reports in Europe and the United States. Severe AIGA may result in heatstroke and can reduce quality of life due to restriction of exercise and outdoor works. AIGA is often accompanied by cholinergic urticaria (CholU), and it is thought that AIGA and CholU with anhidrosis/hypohidrosis belong to the same spectrum of the disease. However, the pathophysiology of AIGA has not yet been clarified. Decreased expression of cholinergic receptor M3 on the epithelial cells of eccrine sweat glands is often accompanied by T cell infiltration around eccrine apparatus, suggesting an immunological mechanism of disordered perspiration. AIGA is occasionally associated with various complications indicative of autoimmune disorders. The association of autoimmune complications further suggests that AIGA is an autoimmune disorder. Studies on complications may lead to a better understanding of the pathophysiology of AIGA.

Eccrine Sweat Gland and Its Regeneration: Current Status and Future Directions

Eccrine sweat glands (ESGs) play an important role in temperature regulation by secreting sweat. Insufficiency or dysfunction of ESGs in a hot environment or during exercise can lead to hyperthermia, heat exhaustion, heatstroke, and even death, but the ability of ESGs to repair and regenerate themselves is very weak and limited. Repairing the damaged ESGs and regenerating the lost or dysfunctional ESGs poses a challenge for dermatologists and bum surgeons. To promote and accelerate research on the repair and regeneration of ESGs, we summarized the development, structure and function of ESGs, and current strategies to repair and regenerate ESGs based on stem cells, scaffolds, and possible signaling pathways involved.

Notch1 down-regulation in lineage-restricted niches of mouse eccrine sweat glands

BackgroundEccrine sweat gland (SG) restrictedly exists in mouse foot pads indicating that mouse plantar dermis (PD) contains the SG lineage-restricted niches. However, it is still unclear how niches can affect stem cell fates.MethodsIn this study, we tried to find the key cues by which stem cells sense and interact with the SG lineage-specific niches. Briefly, we used transcriptomics RNA sequencing analysis to screen differentially expressed genes between SG cells and epidermal stem cells (ES), and then we used proteomic analysis to screen differentially expressed proteins between PD and dorsal dermis (DD).ResultsWe found that Notch1 is not only closely related to embryonic SG morphogenesis based on Gene Ontology enrichment analysis but also differentially down-regulated during SG formation in the levels of genes and proteins. Furthermore, immunochemistry and immunofluorescence staining verified that Notch1 was continuously down-regulated along with the process of SG morphogenesis. Especially, Notch1 positive cells almost disappeared neither in the emerging SG buds or in the newly-formed glandular structures.ConclusionHence, we speculated that Notch1 possibly acts as the role of “gatekeeper” during embryonic SG development and is the promising key cue that regulates the interactions between stem cells and the SG lineage-specific niches. Our attempts highlighted the role of Notch1 during embryonic SG organogenesis.Trial registration Not applicable.

SARS-CoV-2 and Skin: The Pathologist’s Point of View

The SARS-CoV-2 pandemic has dramatically changed our lives and habits. In just a few months, the most advanced and efficient health systems in the world have been overwhelmed by an infectious disease that has caused 3.26 million deaths and more than 156 million cases worldwide. Although the lung is the most frequently affected organ, the skin has also resulted in being a target body district, so much so as to suggest it may be a real “sentinel” of COVID-19 disease. Here we present 17 cases of skin manifestations studied and analyzed in recent months in our Department; immunohistochemical investigations were carried out on samples for the S1 spike-protein of SARS-CoV-2, as well as electron microscopy investigations showing evidence of virions within the constituent cells of the eccrine sweat glands and the endothelium of small blood vessels. Finally, we conduct a brief review of the COVID-related skin manifestations, confirmed by immunohistochemistry and/or electron microscopy, described in the literature.