Chronic exposure to ultraviolet radiation (UVR) induces skin tumors in hairless mice. Daily oral ... more Chronic exposure to ultraviolet radiation (UVR) induces skin tumors in hairless mice. Daily oral administration of a Polypodium leucotomos (PL) extract significantly delayed tumor development in PL-treated versus non-PL-treated mice. UVR and/or PL treatment modified several oxidative stress markers. In all irradiated mice, erythrocytic glutathione S-transferase (GST) activity and glutathione disulphide (GSSG) content increased and in all PL-treated mice GSSG content decreased, specially in non-irradiated animals, and total plasma anti-oxidant capacity (ORAC) increased. In dorsolateral non-tumoral skin of all irradiated mice, glutathione reductase (GR) and glutathione peroxidase (GPx) activities increased and GSSG decreased in non-irradiated PL-treated animals. UVR induced a steep increase of p53 expression in epidermal cells. In non-tumoral skin, this increase was significantly higher in PL-treated animals than in non-treated mice and can contribute in delaying tumor development, ei...
Reflectance-mode confocal microscopy (RCM) is a novel, laser-based technique that enables a non-i... more Reflectance-mode confocal microscopy (RCM) is a novel, laser-based technique that enables a non-invasive diagnosis of the skin. Despite a relatively lack of depth, its use is taking off due to its ease of use, reproducibility and lack of invasiveness. Good correlation with the gold standard in diagnosis of skin diseases, which is conventional histology, validates the technique. Recent reports have focused on this crucial aspect for different pathologies as well as non-diseased, physiological skin. Particular attention has been pointed to the diagnosis of different types of cancer, e.g. squamous and basal cell carcinoma and melanoma. In vivo assays have revealed that RCM displays good sensitivity and accuracy for the diagnosis of BCC and melanoma. Furthermore, RCM has also been used to delimit the edges of suspected tumors before surgery and also to image the response of the skin to different treatments. This review summarizes the current state of the art in terms of available RCM units, diagnosis both in vivo and ex vivo and current applications of the technique.
The American Journal of Surgical Pathology, Feb 1, 2002
The clinicopathologic characteristics of 69 cases of eccrine porocarcinoma (EP) have been studied... more The clinicopathologic characteristics of 69 cases of eccrine porocarcinoma (EP) have been studied. Seven cases of purely in situ disease are included. Forty patients were female, 29 male with ages ranging from 29 to 91 years (mean 73 years). The lower extremity represented the single most common site (44%). Other common sites were the trunk (15 cases, 24%) and head (11 cases, 18%). The histologic diagnosis of EP was predicated on the basis of an irregular tumor at least partly formed of characteristic poromatous basaloid epithelial cells displaying ductal differentiation, and significant cytologic atypia. Forty-seven tumors (68%) contained mature well-formed eccrine ducts having an eosinophilic luminal cuticle, with the remaining tumors containing small ill-formed ducts and/or intracytoplasmic lumina. All ducts were discernible via light microscopy and in 49 cases were highlighted with DPAS stain and/or CEA/EMA immunocytochemistry. A variant with a broad pushing tumor margin and marked nuclear pleomorphism showed some resemblance to proliferative bowenoid dysplasia. In 11 cases (18%) the tumors appeared to arise in continuity with a benign preexistent poroma. A variety of histologic patterns were displayed including clear, squamous, and spindle cell differentiation, mucus cell metaplasia, and colonization by melanocytes. Lymphovascular invasion was present in 9 cases (15%). Three cases showed pagetoid extension of malignant cells (epidermotropism) and appeared to be multifocal. Follow-up was available in 54 patients (78%) with 9 (17%) experiencing local recurrence, 10 developing lymph node metastases (19%), and 6 (11%) experiencing distant metastases or death. Mitoses, the presence of lymphovascular invasion, and tumor depth >7 mm were associated with a poorer prognosis. Dividing tumors into those with a “pushing” or “infiltrating” advancing margin was also predictive of outcome with the latter having an increased risk of local recurrence. This report, the largest series of EP to date, suggests that the incidence of aggressive behavior is less than popularly believed. Furthermore, EP can display a wide variety of histologic patterns that may lead to diagnostic error in the unwary. The large number of cases in this series enables a reliable evaluation of prognostic parameters. A more aggressive clinical course may be indicated by more than 14 mitoses per high power field (hazard ratio [HR] for death 17.0, 95% confidence interval [CI] 2.71–107), lymphovascular invasion by tumor (HR 4.41, CI 1.13–17.2), and depth >7 mm (HR 5.49, CI 1.0–30.3). Thus, mitoses, lymphovascular invasion, and tumor depth should be evaluated in these tumors. We also suggest that tumors presenting an “infiltrative” advancing margin are particularly prone to local recurrence and require wide excision with close attention to the surgical margins by the reporting pathologist.
Mammary Paget disease and extramammary Paget disease (EMPD) have different prognoses. Because the... more Mammary Paget disease and extramammary Paget disease (EMPD) have different prognoses. Because they are indistinguishable on histopathological grounds, they must be distinguished on a topographical basis. To study cases of Paget disease of the breast, which show similarities to EMPD. Cases were selected by 2 different approaches: (1) those with an exceptionally good evolution and no evidence of subjacent tumor and (2) those expressing MUC5AC. Five cases were collected. All cases showed an indolent behavior with a known long clinical history in 2 cases (9 and 25 years, respectively) and a long follow-up in all cases but one (4-8 years). In all cases but one, surgery was performed, and no parenchymal tumor was found (either intraductal or infiltrating). All cases expressed cytokeratin 7 and MUC5AC without expression of MUC2, S100, or p40. The short number of cases is a limitation of this study. In addition, case 5 is recent, so we have a very short follow-up. Some cases of mammary Page...
Cutaneous regeneration, fractional laser, medical device, cellular proliferation cutaneous change... more Cutaneous regeneration, fractional laser, medical device, cellular proliferation cutaneous changes linked to photoaging are currently treated with physical treatments, such as fractional laser, which may induce epidermal alteration. To determine the efficacy and safety of a regenerative serum (Matricium® , Laboratoire Bioderma, France) after laser procedure. Prospective, double-blind, controlled, and randomized study in subjects with photoaged skin. The regenerative serum of treatment was used after a fractional laser session twice daily for 2 months on 1 side of the face and the placebo on the other side. The main variable to determine efficacy was the improvement of clinical signs and histological and immunological results. A superior quality of epidermal regeneration on the treated side compared to the placebo side was observed. Likewise, a superior and faster clinical improvement on static wrinkles was observed on the hemiface on which the regenerative serum was used. After 60 d...
Scalp actinic keratoses (AKs) are common, particularly in elderly bald males. Cryotherapy and 5-f... more Scalp actinic keratoses (AKs) are common, particularly in elderly bald males. Cryotherapy and 5-fluorouracil are effective for localized AKs but are limited in extensive disease. Topical 5-aminolaevulinic acid photodynamic therapy (5-ALA PDT) is an alternative. We treated four patients with extensive scalp AKs with low light dose, low dose-rate topical 5-ALA PDT using a broad-spectrum visible light source. Three patients cleared and one showed significant improvement. Remission lasted 6 months.
We describe the clinical and histopathological results of plaque psoriasis in eleven adult patien... more We describe the clinical and histopathological results of plaque psoriasis in eleven adult patients with knee osteoarthritis and long-standing, moderate to severe psoriasis resistant to conventional therapy treated with chondroitin sulfate. Patients received 800 mg per day of chondroitin sulfate for 2 months. Skin biopsies were obtained before and after treatment. All patients but one presented a dramatic improvement of the condition of the skin, with a reduction of swelling, redness, flaking, and itching (clearance of psoriasis in one patient), increase in the hydration and softening of the skin, and amelioration of scaling. Histopathologically, there was a statistically significant decrease in epidermal thickness, a decrease in the thickness between the stratum basale and the stratum granulosum, a significant improvement of the degree of psoriasis activity, and a decrease in the number of keratinocytes stained with Ki-67. The confirmation of these serendipitous findings in controlled prospective studies could represent an important advance in the therapeutic armamentarium for patients with psoriasis given the excellent safety profile of chondroitin sulfate.
We report a case of purpuric gloves and socks syndrome, with evidence, by serologic test and by d... more We report a case of purpuric gloves and socks syndrome, with evidence, by serologic test and by deteccion of the PVB19 genome (PCR), of primary infection with parvovirus B19. We provide a gastroscopic study that indicates the possibility of the esophagic involvement in this syndrome, that we have not found documented to previously. We emphasize the finding of leucocitoclastic vasculitis in the histologic study of the skin lesions, scarcely refered in others patients with this syndrome.
Journal of the American Academy of Dermatology, 2015
Fig 2. Frontal fibrosing alopecia. Histopathologic findings of a biopsy from a depressed frontal ... more Fig 2. Frontal fibrosing alopecia. Histopathologic findings of a biopsy from a depressed frontal vein in a patient with frontal fibrosing alopecia. Panoramic view: intense dermal atrophy and dermal fibrosis with a dilated vascular structure in the subcutaneous tissue corresponding to the frontal vein. An erector pili muscle can be observed in the dermis. (Hematoxylin-eosin stain.) J AM ACAD DERMATOL VOLUME 72, NUMBER 6 Letters 1087
Chronic exposure to ultraviolet radiation (UVR) induces skin tumors in hairless mice. Daily oral ... more Chronic exposure to ultraviolet radiation (UVR) induces skin tumors in hairless mice. Daily oral administration of a Polypodium leucotomos (PL) extract significantly delayed tumor development in PL-treated versus non-PL-treated mice. UVR and/or PL treatment modified several oxidative stress markers. In all irradiated mice, erythrocytic glutathione S-transferase (GST) activity and glutathione disulphide (GSSG) content increased and in all PL-treated mice GSSG content decreased, specially in non-irradiated animals, and total plasma anti-oxidant capacity (ORAC) increased. In dorsolateral non-tumoral skin of all irradiated mice, glutathione reductase (GR) and glutathione peroxidase (GPx) activities increased and GSSG decreased in non-irradiated PL-treated animals. UVR induced a steep increase of p53 expression in epidermal cells. In non-tumoral skin, this increase was significantly higher in PL-treated animals than in non-treated mice and can contribute in delaying tumor development, ei...
Reflectance-mode confocal microscopy (RCM) is a novel, laser-based technique that enables a non-i... more Reflectance-mode confocal microscopy (RCM) is a novel, laser-based technique that enables a non-invasive diagnosis of the skin. Despite a relatively lack of depth, its use is taking off due to its ease of use, reproducibility and lack of invasiveness. Good correlation with the gold standard in diagnosis of skin diseases, which is conventional histology, validates the technique. Recent reports have focused on this crucial aspect for different pathologies as well as non-diseased, physiological skin. Particular attention has been pointed to the diagnosis of different types of cancer, e.g. squamous and basal cell carcinoma and melanoma. In vivo assays have revealed that RCM displays good sensitivity and accuracy for the diagnosis of BCC and melanoma. Furthermore, RCM has also been used to delimit the edges of suspected tumors before surgery and also to image the response of the skin to different treatments. This review summarizes the current state of the art in terms of available RCM units, diagnosis both in vivo and ex vivo and current applications of the technique.
The American Journal of Surgical Pathology, Feb 1, 2002
The clinicopathologic characteristics of 69 cases of eccrine porocarcinoma (EP) have been studied... more The clinicopathologic characteristics of 69 cases of eccrine porocarcinoma (EP) have been studied. Seven cases of purely in situ disease are included. Forty patients were female, 29 male with ages ranging from 29 to 91 years (mean 73 years). The lower extremity represented the single most common site (44%). Other common sites were the trunk (15 cases, 24%) and head (11 cases, 18%). The histologic diagnosis of EP was predicated on the basis of an irregular tumor at least partly formed of characteristic poromatous basaloid epithelial cells displaying ductal differentiation, and significant cytologic atypia. Forty-seven tumors (68%) contained mature well-formed eccrine ducts having an eosinophilic luminal cuticle, with the remaining tumors containing small ill-formed ducts and/or intracytoplasmic lumina. All ducts were discernible via light microscopy and in 49 cases were highlighted with DPAS stain and/or CEA/EMA immunocytochemistry. A variant with a broad pushing tumor margin and marked nuclear pleomorphism showed some resemblance to proliferative bowenoid dysplasia. In 11 cases (18%) the tumors appeared to arise in continuity with a benign preexistent poroma. A variety of histologic patterns were displayed including clear, squamous, and spindle cell differentiation, mucus cell metaplasia, and colonization by melanocytes. Lymphovascular invasion was present in 9 cases (15%). Three cases showed pagetoid extension of malignant cells (epidermotropism) and appeared to be multifocal. Follow-up was available in 54 patients (78%) with 9 (17%) experiencing local recurrence, 10 developing lymph node metastases (19%), and 6 (11%) experiencing distant metastases or death. Mitoses, the presence of lymphovascular invasion, and tumor depth >7 mm were associated with a poorer prognosis. Dividing tumors into those with a “pushing” or “infiltrating” advancing margin was also predictive of outcome with the latter having an increased risk of local recurrence. This report, the largest series of EP to date, suggests that the incidence of aggressive behavior is less than popularly believed. Furthermore, EP can display a wide variety of histologic patterns that may lead to diagnostic error in the unwary. The large number of cases in this series enables a reliable evaluation of prognostic parameters. A more aggressive clinical course may be indicated by more than 14 mitoses per high power field (hazard ratio [HR] for death 17.0, 95% confidence interval [CI] 2.71–107), lymphovascular invasion by tumor (HR 4.41, CI 1.13–17.2), and depth >7 mm (HR 5.49, CI 1.0–30.3). Thus, mitoses, lymphovascular invasion, and tumor depth should be evaluated in these tumors. We also suggest that tumors presenting an “infiltrative” advancing margin are particularly prone to local recurrence and require wide excision with close attention to the surgical margins by the reporting pathologist.
Mammary Paget disease and extramammary Paget disease (EMPD) have different prognoses. Because the... more Mammary Paget disease and extramammary Paget disease (EMPD) have different prognoses. Because they are indistinguishable on histopathological grounds, they must be distinguished on a topographical basis. To study cases of Paget disease of the breast, which show similarities to EMPD. Cases were selected by 2 different approaches: (1) those with an exceptionally good evolution and no evidence of subjacent tumor and (2) those expressing MUC5AC. Five cases were collected. All cases showed an indolent behavior with a known long clinical history in 2 cases (9 and 25 years, respectively) and a long follow-up in all cases but one (4-8 years). In all cases but one, surgery was performed, and no parenchymal tumor was found (either intraductal or infiltrating). All cases expressed cytokeratin 7 and MUC5AC without expression of MUC2, S100, or p40. The short number of cases is a limitation of this study. In addition, case 5 is recent, so we have a very short follow-up. Some cases of mammary Page...
Cutaneous regeneration, fractional laser, medical device, cellular proliferation cutaneous change... more Cutaneous regeneration, fractional laser, medical device, cellular proliferation cutaneous changes linked to photoaging are currently treated with physical treatments, such as fractional laser, which may induce epidermal alteration. To determine the efficacy and safety of a regenerative serum (Matricium® , Laboratoire Bioderma, France) after laser procedure. Prospective, double-blind, controlled, and randomized study in subjects with photoaged skin. The regenerative serum of treatment was used after a fractional laser session twice daily for 2 months on 1 side of the face and the placebo on the other side. The main variable to determine efficacy was the improvement of clinical signs and histological and immunological results. A superior quality of epidermal regeneration on the treated side compared to the placebo side was observed. Likewise, a superior and faster clinical improvement on static wrinkles was observed on the hemiface on which the regenerative serum was used. After 60 d...
Scalp actinic keratoses (AKs) are common, particularly in elderly bald males. Cryotherapy and 5-f... more Scalp actinic keratoses (AKs) are common, particularly in elderly bald males. Cryotherapy and 5-fluorouracil are effective for localized AKs but are limited in extensive disease. Topical 5-aminolaevulinic acid photodynamic therapy (5-ALA PDT) is an alternative. We treated four patients with extensive scalp AKs with low light dose, low dose-rate topical 5-ALA PDT using a broad-spectrum visible light source. Three patients cleared and one showed significant improvement. Remission lasted 6 months.
We describe the clinical and histopathological results of plaque psoriasis in eleven adult patien... more We describe the clinical and histopathological results of plaque psoriasis in eleven adult patients with knee osteoarthritis and long-standing, moderate to severe psoriasis resistant to conventional therapy treated with chondroitin sulfate. Patients received 800 mg per day of chondroitin sulfate for 2 months. Skin biopsies were obtained before and after treatment. All patients but one presented a dramatic improvement of the condition of the skin, with a reduction of swelling, redness, flaking, and itching (clearance of psoriasis in one patient), increase in the hydration and softening of the skin, and amelioration of scaling. Histopathologically, there was a statistically significant decrease in epidermal thickness, a decrease in the thickness between the stratum basale and the stratum granulosum, a significant improvement of the degree of psoriasis activity, and a decrease in the number of keratinocytes stained with Ki-67. The confirmation of these serendipitous findings in controlled prospective studies could represent an important advance in the therapeutic armamentarium for patients with psoriasis given the excellent safety profile of chondroitin sulfate.
We report a case of purpuric gloves and socks syndrome, with evidence, by serologic test and by d... more We report a case of purpuric gloves and socks syndrome, with evidence, by serologic test and by deteccion of the PVB19 genome (PCR), of primary infection with parvovirus B19. We provide a gastroscopic study that indicates the possibility of the esophagic involvement in this syndrome, that we have not found documented to previously. We emphasize the finding of leucocitoclastic vasculitis in the histologic study of the skin lesions, scarcely refered in others patients with this syndrome.
Journal of the American Academy of Dermatology, 2015
Fig 2. Frontal fibrosing alopecia. Histopathologic findings of a biopsy from a depressed frontal ... more Fig 2. Frontal fibrosing alopecia. Histopathologic findings of a biopsy from a depressed frontal vein in a patient with frontal fibrosing alopecia. Panoramic view: intense dermal atrophy and dermal fibrosis with a dilated vascular structure in the subcutaneous tissue corresponding to the frontal vein. An erector pili muscle can be observed in the dermis. (Hematoxylin-eosin stain.) J AM ACAD DERMATOL VOLUME 72, NUMBER 6 Letters 1087
Uploads
Papers by Jesús Cuevas