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Antonella Tosti - One of the best experts on this subject based on the ideXlab platform.

  • Nail lichen striatus: clinical features and long-term follow-up of five patients.
    Journal of the American Academy of Dermatology, 1997
    Co-Authors: Antonella Tosti, A. M. Peluso, Cosimo Misciali, Nortna Cameli
    Abstract:

    Background: Nail involvement in lichen striatus (LS) is uncommon and has always been reported in association with typical skin lesions. Objective: We attempted to characterize the clinical and pathologic features and the long-term prognosis of nail LS. Methods: Five cases of LS of the nail including three cases with exclusive nail involvement were evaluated and the literature reviewed. Results: Biopsy specimens showed a moderately dense bandlike lymphohistiocytic infiltrate affecting the proximal nailfold, the nail bed, and the nail matrix dermis. Exocytosis with slight spongiosis, focal Hypergranulosis, and dyskeratotic cells were detectable in the nail matrix epithelium. Spontaneous regression of the onychodystrophy occurred after 4 to 12 months from the time of diagnosis (mean, 8.4 months). Conclusion: Nail LS is not necessarily associated with skin lesions but can also be an isolated finding. The diagnosis of nail LS should be strongly suspected when a child or a young patient presents with lichen planus-like nail abnormalities localized to the lateral or medial portion of a single nail.

  • Oral manifestations of Darier's disease : a clinical and pathological study
    European Journal of Dermatology, 1996
    Co-Authors: Antonella Tosti, Pier Alessandro Fanti, Bianca Maria Piraccini, P. Paganini, Vincenzo Bettoli, G. Ghedini
    Abstract:

    Patients with Darier's disease may present oral lesions which occur in about 50% of affected patients. The palate, gingiva, buccal mucosa and the tongue are most commonly affected. This study reports the clinical and pathological features of the oral manifestations of Darier's disease. The pathology of early reddish spots reveals ortho-parakeratotic hyperkeratosis with focal Hypergranulosis and acanthosis. The pathology of established white papules shows the typical features of acantholytic dyskeratosis with suprabasal clefts containing acantholytic dyskeratotic keratinocytes. Our study indicates that although acantholytic dyskeratosis is a pathological marker of established oral lesions of Darier's disease, this pathological feature may not be detectable in early oral spots. The absence of acantholytic dyskeratosis in early lesions is not exclusive to mouth pathology, it has been descried in the early nail lesions of patients with Darier's disease. These findings indicate that the absence of acantholytic dyskeratosis should not be considered an absolute criterion for excluding a possible diagnosis of Darier's disease.

  • Nail Matrix Hypergranulosis
    The American Journal of dermatopathology, 1994
    Co-Authors: Pier Alessandro Fanti, Antonella Tosti, Norma Cameli, Claudio Varotti
    Abstract:

    Nail pathology shares some common features with skin pathology, but it also has its own peculiar aspects. The anatomical and physiological characteristics of the nail unit probably play a major role in determining these pathological differences. Although the presence of keratohyaline granules is a normal feature of the skin, there is no granular layer in the normal nail matrix. As a consequence, nail matrix Hypergranulosis should be considered a separate entity from skin Hypergranulosis. In our review of 150 longitudinal nail biopsy specimens, keratohyaline granules were seen in the nail matrix of 24 cases of lichen planus, 29 cases of spongiotic trachyonychia, 10 cases of psoriasis, and three cases of Hallopeau acrodermatitis. In all cases, the presence of keratohyaline granules was associated with the absence of the normal keratogenous zone. Similar nail matrix features were detectable in three cases of malignant melanoma, two cases of primary systemic amyloidosis, and one case of histiocytoid hemangioma compressing the nail matrix. Our data suggest that inflammatory and compressive insults to the nail matrix cause both disappearance of the keratogenous zone and matrix keratinization with the formation of keratohyaline granules. Skin Hypergranulosis reflects a hyperplasia of a normal skin component. In the nail matrix, however, Hypergranulosis represents the appearance of structures not normally present. Nail matrix Hypergranulosis should be considered a pattern of nail matrix reaction to different inflammatory insults. It is therefore more analogous to epidermal parakeratosis than to epidermal Hypergranulosis.

  • Nail changes of punctate keratoderma: a clinical and pathological study of two patients.
    Acta Dermato-venereologica, 1993
    Co-Authors: Antonella Tosti, Pier Alessandro Fanti, R. Morelli, Norma Cameli
    Abstract:

    : The pathological study of the nail changes of 2 patients affected by punctate keratoderma is described. Both patients presented nail abnormalities that were clinically suggestive of a nail psoriasis. Subungual hyperkeratosis was a prominent feature but onycholysis, splinter haemorrhages and pitting were also present. The pathology of the nail bed revealed sharply limited columns of hyperkeratosis associated with Hypergranulosis and depression of the underlying nail bed epidermis. Etretinate therapy produced a significant improvement in the palmoplantar keratoderma, but it was of no apparent value in treating nail keratoderma.

  • Lichen Planus Limited to the Nails in Childhood: Case Report and Literature Review
    Pediatric dermatology, 1993
    Co-Authors: Anna Maria Peluso, Antonella Tosti, Bianca Maria Piraccini, Norma Cameli
    Abstract:

    Although nail abnormalities have been reported to occur in 1% to 10% of patients with lichen planus, in children with lichen planus they are rarely mentioned in the literature. An 11-year-old boy had a two-month history of nail dystrophy affecting all the fingernails and the great toenails. The nail plates showed longitudinal ridging and thinning as well as onycholysis and distal splitting. There were no cutaneous or mucous membrane abnormalities. A nail biopsy specimen showed hyperkeratosis, Hypergranulosis, and acanthosis in the ventral portion of the proximal nail fold and in the nail matrix. A band-like lymphocytic infiltrate was present in the superficial dermis, and the basal layer showed vacuolar alterations. A diagnosis of lichen planus was made. Treatment was intramuscular triamcinolone 20 mg once a month for six months. Since 1969 only 13 proved pediatric cases of lichen planus limited to the nails have been reported, including two children with 20-nail dystrophy and four with idiopathic atrophy of the nails.

Norma Cameli - One of the best experts on this subject based on the ideXlab platform.

  • Nail Matrix Hypergranulosis
    The American Journal of dermatopathology, 1994
    Co-Authors: Pier Alessandro Fanti, Antonella Tosti, Norma Cameli, Claudio Varotti
    Abstract:

    Nail pathology shares some common features with skin pathology, but it also has its own peculiar aspects. The anatomical and physiological characteristics of the nail unit probably play a major role in determining these pathological differences. Although the presence of keratohyaline granules is a normal feature of the skin, there is no granular layer in the normal nail matrix. As a consequence, nail matrix Hypergranulosis should be considered a separate entity from skin Hypergranulosis. In our review of 150 longitudinal nail biopsy specimens, keratohyaline granules were seen in the nail matrix of 24 cases of lichen planus, 29 cases of spongiotic trachyonychia, 10 cases of psoriasis, and three cases of Hallopeau acrodermatitis. In all cases, the presence of keratohyaline granules was associated with the absence of the normal keratogenous zone. Similar nail matrix features were detectable in three cases of malignant melanoma, two cases of primary systemic amyloidosis, and one case of histiocytoid hemangioma compressing the nail matrix. Our data suggest that inflammatory and compressive insults to the nail matrix cause both disappearance of the keratogenous zone and matrix keratinization with the formation of keratohyaline granules. Skin Hypergranulosis reflects a hyperplasia of a normal skin component. In the nail matrix, however, Hypergranulosis represents the appearance of structures not normally present. Nail matrix Hypergranulosis should be considered a pattern of nail matrix reaction to different inflammatory insults. It is therefore more analogous to epidermal parakeratosis than to epidermal Hypergranulosis.

  • Nail changes of punctate keratoderma: a clinical and pathological study of two patients.
    Acta Dermato-venereologica, 1993
    Co-Authors: Antonella Tosti, Pier Alessandro Fanti, R. Morelli, Norma Cameli
    Abstract:

    : The pathological study of the nail changes of 2 patients affected by punctate keratoderma is described. Both patients presented nail abnormalities that were clinically suggestive of a nail psoriasis. Subungual hyperkeratosis was a prominent feature but onycholysis, splinter haemorrhages and pitting were also present. The pathology of the nail bed revealed sharply limited columns of hyperkeratosis associated with Hypergranulosis and depression of the underlying nail bed epidermis. Etretinate therapy produced a significant improvement in the palmoplantar keratoderma, but it was of no apparent value in treating nail keratoderma.

  • Lichen Planus Limited to the Nails in Childhood: Case Report and Literature Review
    Pediatric dermatology, 1993
    Co-Authors: Anna Maria Peluso, Antonella Tosti, Bianca Maria Piraccini, Norma Cameli
    Abstract:

    Although nail abnormalities have been reported to occur in 1% to 10% of patients with lichen planus, in children with lichen planus they are rarely mentioned in the literature. An 11-year-old boy had a two-month history of nail dystrophy affecting all the fingernails and the great toenails. The nail plates showed longitudinal ridging and thinning as well as onycholysis and distal splitting. There were no cutaneous or mucous membrane abnormalities. A nail biopsy specimen showed hyperkeratosis, Hypergranulosis, and acanthosis in the ventral portion of the proximal nail fold and in the nail matrix. A band-like lymphocytic infiltrate was present in the superficial dermis, and the basal layer showed vacuolar alterations. A diagnosis of lichen planus was made. Treatment was intramuscular triamcinolone 20 mg once a month for six months. Since 1969 only 13 proved pediatric cases of lichen planus limited to the nails have been reported, including two children with 20-nail dystrophy and four with idiopathic atrophy of the nails.

Hiroshi Shimizu - One of the best experts on this subject based on the ideXlab platform.

  • Erythrokeratoderma variabilis without connexin 31 or connexin 30.3 gene mutation: Immunohistological, ultrastructural and genetic studies
    Acta dermato-venereologica, 2003
    Co-Authors: Ken Arita, Takashi Onozuka, Yukiko Tsuji, Masashi Akiyama, Hiroshi Shimizu
    Abstract:

    Erythrokeratoderma variabilis, characterized by migrating erythema and fixed keratotic plaques, is a rare congenital disorder which has recently been connected with connexin (Cx)30.3 or Cx31 gene mutations. We present a 9-month-old Japanese girl who exhibited the typical clinical features of the disease, but carried no Cx30.3 or Cx31 gene mutations. Histopathologically, regular acanthosis with hyperkeratosis and Hypergranulosis was observed in her lesional skin. Upregulation of involucrin and loricrin expression, and a weak expression of Cx26 was immunohistochemically observed in the upper spinous and granular layers. Electron microscopy revealed no abnormality in the keratin filaments, cornified cell envelope or gap junctions. Direct sequencing revealed no pathogenetic mutations in the Cx26, Cx30.3, Cx31 or Cx31.1 genes in this patient. The results indicate that erythrokeratoderma variabilis is pathologically heterogeneous, and that abnormalities in keratinization other than Cx30.3 and 31 gene mutations may underlie some forms of this disease.

  • erythrokeratoderma variabilis without connexin 31 or connexin 30 3 gene mutation immunohistological ultrastructural and genetic studies
    Acta Dermato-venereologica, 2003
    Co-Authors: Ken Arita, Takashi Onozuka, Yukiko Tsuji, Masashi Akiyama, Hiroshi Shimizu
    Abstract:

    Erythrokeratoderma variabilis, characterized by migrating erythema and fixed keratotic plaques, is a rare congenital disorder which has recently been connected with connexin (Cx)30.3 or Cx31 gene mutations. We present a 9-month-old Japanese girl who exhibited the typical clinical features of the disease, but carried no Cx30.3 or Cx31 gene mutations. Histopathologically, regular acanthosis with hyperkeratosis and Hypergranulosis was observed in her lesional skin. Upregulation of involucrin and loricrin expression, and a weak expression of Cx26 was immunohistochemically observed in the upper spinous and granular layers. Electron microscopy revealed no abnormality in the keratin filaments, cornified cell envelope or gap junctions. Direct sequencing revealed no pathogenetic mutations in the Cx26, Cx30.3, Cx31 or Cx31.1 genes in this patient. The results indicate that erythrokeratoderma variabilis is pathologically heterogeneous, and that abnormalities in keratinization other than Cx30.3 and 31 gene mutations may underlie some forms of this disease. Key words: connexin 26; erythrokeratoderma; gap junction; loricrin.

Pier Alessandro Fanti - One of the best experts on this subject based on the ideXlab platform.

  • Oral manifestations of Darier's disease : a clinical and pathological study
    European Journal of Dermatology, 1996
    Co-Authors: Antonella Tosti, Pier Alessandro Fanti, Bianca Maria Piraccini, P. Paganini, Vincenzo Bettoli, G. Ghedini
    Abstract:

    Patients with Darier's disease may present oral lesions which occur in about 50% of affected patients. The palate, gingiva, buccal mucosa and the tongue are most commonly affected. This study reports the clinical and pathological features of the oral manifestations of Darier's disease. The pathology of early reddish spots reveals ortho-parakeratotic hyperkeratosis with focal Hypergranulosis and acanthosis. The pathology of established white papules shows the typical features of acantholytic dyskeratosis with suprabasal clefts containing acantholytic dyskeratotic keratinocytes. Our study indicates that although acantholytic dyskeratosis is a pathological marker of established oral lesions of Darier's disease, this pathological feature may not be detectable in early oral spots. The absence of acantholytic dyskeratosis in early lesions is not exclusive to mouth pathology, it has been descried in the early nail lesions of patients with Darier's disease. These findings indicate that the absence of acantholytic dyskeratosis should not be considered an absolute criterion for excluding a possible diagnosis of Darier's disease.

  • Nail Matrix Hypergranulosis
    The American Journal of dermatopathology, 1994
    Co-Authors: Pier Alessandro Fanti, Antonella Tosti, Norma Cameli, Claudio Varotti
    Abstract:

    Nail pathology shares some common features with skin pathology, but it also has its own peculiar aspects. The anatomical and physiological characteristics of the nail unit probably play a major role in determining these pathological differences. Although the presence of keratohyaline granules is a normal feature of the skin, there is no granular layer in the normal nail matrix. As a consequence, nail matrix Hypergranulosis should be considered a separate entity from skin Hypergranulosis. In our review of 150 longitudinal nail biopsy specimens, keratohyaline granules were seen in the nail matrix of 24 cases of lichen planus, 29 cases of spongiotic trachyonychia, 10 cases of psoriasis, and three cases of Hallopeau acrodermatitis. In all cases, the presence of keratohyaline granules was associated with the absence of the normal keratogenous zone. Similar nail matrix features were detectable in three cases of malignant melanoma, two cases of primary systemic amyloidosis, and one case of histiocytoid hemangioma compressing the nail matrix. Our data suggest that inflammatory and compressive insults to the nail matrix cause both disappearance of the keratogenous zone and matrix keratinization with the formation of keratohyaline granules. Skin Hypergranulosis reflects a hyperplasia of a normal skin component. In the nail matrix, however, Hypergranulosis represents the appearance of structures not normally present. Nail matrix Hypergranulosis should be considered a pattern of nail matrix reaction to different inflammatory insults. It is therefore more analogous to epidermal parakeratosis than to epidermal Hypergranulosis.

  • Nail changes of punctate keratoderma: a clinical and pathological study of two patients.
    Acta Dermato-venereologica, 1993
    Co-Authors: Antonella Tosti, Pier Alessandro Fanti, R. Morelli, Norma Cameli
    Abstract:

    : The pathological study of the nail changes of 2 patients affected by punctate keratoderma is described. Both patients presented nail abnormalities that were clinically suggestive of a nail psoriasis. Subungual hyperkeratosis was a prominent feature but onycholysis, splinter haemorrhages and pitting were also present. The pathology of the nail bed revealed sharply limited columns of hyperkeratosis associated with Hypergranulosis and depression of the underlying nail bed epidermis. Etretinate therapy produced a significant improvement in the palmoplantar keratoderma, but it was of no apparent value in treating nail keratoderma.

Mariya Miteva - One of the best experts on this subject based on the ideXlab platform.

  • Horizontal and vertical sections of scalp biopsy specimens from dermatomyositis patients with scalp involvement
    Journal of the American Academy of Dermatology, 2018
    Co-Authors: Julio Jasso-olivares, José Manuel Diaz-gonzalez, Mariya Miteva
    Abstract:

    Background The histologic findings of scalp involvement in dermatomyositis are not well characterized on account of a lack of large series. Objective To systematize the histologic features of scalp involvement in dermatomyositis on horizontal and vertical sections. Methods A descriptive, prospective, cross-sectional study recruited 31 patients with pathologically and serologically confirmed dermatomyositis in Mexico City, Mexico, from June 2014 to June 2015. A total of 36 scalp biopsy specimens from 20 patients with scalp involvement in dermatomyositis were processed as 20 vertical and 16 horizontal sections. Results Dilated capillaries and diffuse mucin deposition were detected in all biopsy specimens, followed by interface dermatitis. Partial or segmental thickening of the basement membrane, hyperkeratosis, atrophic epidermis, and acrosyringeal Hypergranulosis with hyperkeratosis were other very common findings. Preserved follicular architecture, with intact or slightly atrophic sebaceous glands, was present in most horizontal sections. There was decreased follicular density, with a terminal-to-vellus ratio of 4:1 and telogen count of 10.3%. Eosinophils were present in 15% and 25% of horizontal and vertical sections, respectively. Limitations No special stains performed. Conclusion Scalp involvement in dermatomyositis shows nonscarring pattern on horizontal sections that is consistent with chronic telogen effluvium. Telangiectasia and mucin are universal histologic features; eosinophils and acrosyringeal Hypergranulosis with hyperkeratosis are new findings.