Presence of Incipient Fungal Infection in Atypical Squamous Lesions of the Lip
| Autor: | Brandie Firetag, Diego S Ambrosio, Johanna B Moore, Surget V. Cox, Kurt Lundquist |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Fungal growth Antifungal Agents Biopsy Hyphae Dermatology medicine.disease_cause Pathology and Forensic Medicine Diagnosis Differential 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Dermis Predictive Value of Tests medicine Atypia Neoplasm Humans Parakeratosis Aged Cell Proliferation Aged 80 and over business.industry Actinic cheilitis Fungi General Medicine Middle Aged medicine.disease medicine.anatomical_structure Treatment Outcome Cheilitis Mycoses Superinfection Host-Pathogen Interactions Lip Neoplasms Female medicine.symptom business Precancerous Conditions Fungal hyphae |
| Zdroj: | The American Journal of dermatopathology. 43(7) |
| ISSN: | 1533-0311 |
| Popis: | Epidermal barrier disruption caused by atypical squamous proliferations of the lip (SOL) creates an ideal environment for fungal growth. Histologic features of SOL include parakeratosis overlying partial- or full-thickness keratinocyte atypia with or without invasion of the dermis, dermal solar elastosis, and scattered inflammatory cells which are predominantly lymphocytes. Histologic features of SOL with fungal superinfections overlap those seen in primary fungal cheilitis with reactive atypia, creating a diagnostic challenge. One-hundred seventy SOL cases were examined for the presence of fungal elements, and the histological features associated with superinfection were identified. Cases diagnosed as actinic cheilitis with fungal superinfection were carefully examined to rule out the possibility of misdiagnosed primary fungal cheilitis with reactive atypia. Histopathological characteristics commonly present with fungal hyphae included intraepidermal or intradermal neutrophils, bacterial colonies, and erosion or ulceration. Medical record review of those patients treated conservatively with topical antifungals revealed persistent clinical neoplasm and histological evidence of residual SOL on repeat biopsy. Thus, when biopsies exhibit histological overlap between these 2 entities, clinicians should keep a high index of suspicion for underlying SOL and carefully follow these patients if conservative antifungal therapy is initially trialed. |
| Databáze: | OpenAIRE |
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