Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
F026. Dermatopathology Case Challenge: Recognizing Mimics and Masqueraders
Description
In this session, Dr. Alex Flam presented dermatopathology case challenges, focusing on cases with mimics and masqueraders. The first case involved a 32-year-old female with a biopsy from her chin, initially suspected to be a pyogenic granuloma, wart, or non-melanoma skin cancer. Upon further examination, it was revealed to be a dental sinus with actinomycosis due to a chronic apical abscess. The case highlighted the importance of considering dental issues in similar presentations and the potential for actinomycosis as a coincidental finding. The second case concerned a 56-year-old male with stage 4B Hodgkin's lymphoma, presenting with red nodules on the leg, initially diagnosed as a possible Sweet’s syndrome or leukocytoclastic vasculitis. Ultimately, the diagnosis was Kaposi's sarcoma (KS), confirmed with HHV-8 staining. This case emphasized the need to consider KS in immunocompromised patients and its ability to mimic other conditions, including vasculitis. The presentation concluded with an exploration of the differential diagnoses for KS and discussion on treatment options.
View moreConclusions
- The first case presented was an actinomycosis occurring in a dental sinus rather than an expected pyogenic granuloma or other differential diagnoses.
- Actinomycosis is a common inhabitant of the oral cavity and can lead to chronic infections that manifest as sinus tracts.
- The appearance of a dental sinus can vary significantly, requiring careful clinical-pathological correlation to avoid misdiagnosis.
- The second case highlighted Kaposi's Sarcoma (KS) as a mimic of other neutrophilic processes such as Sweet's syndrome, especially in immunocompromised patients.
- Recognition of KS's characteristics, including the role of HHV-8 and its varied forms, is crucial for accurate diagnosis and treatment planning.
- Clinicians must maintain a high index of suspicion for KS in patients with a history of immunosuppression or malignancy.
- The use of topical imiquimod appeared beneficial for skin-limited Kaposi's Sarcoma, indicating a potential treatment avenue.
- Sammut et al ., BDJ, 2013
- Diagnostic Histopathology Volume 28, Issue 1, January 2022, Pages 38-52
- Wadee, R., & Grayson, W. (2021). Kaposi Sarcoma as a Cutaneous Vasculitis Mimic: Diagnosis and Treatment. Volume 41, pages 1357-1367.