An 11‐year‐old Korean girl presented with a 2‐year history of asymptomatic multiple punctiform, hypopigmented and achromic spots predominantly on the outer aspect of her right forearm. She had been treated for segmental vitiligo on her right forearm with topical PUVA six times a week for 4 years at a local clinic. The lesions were very distinct, round hypopigmented macules 1–2 mm in diameter, predominantly in nonfollicular distribution (Fig. 1). Not only the site where topical psolaren had been applied but also areas on her right forearm where UVA was exposed for a long time for treatment of vitiligo developed multiple punctiform hypopigmented spots. She also had PUVA lentigenes on her right forearm. Laboratory studies including complete blood cell count, biochemistry, and endocrinologic studies were all within normal limits. There was no history of inflammatory lesions antedating the hypopigmentation. Skin biopsy was taken from punctiform hypopigmented macules. There were no specific findings in the hematoxylin‐eosin stained sections. However, marked reduction of melanin and melanocytes was noted with the Fontana‐Masson stain (Fig. 2) and the S‐100 stain (Fig. 3). With these clinical and histological findings the patient was diagnosed as having leukoderma punctata. 1 Multiple, hypopigmented, and achromic spots on the right forearm 2 Microscopic examination of a hypopigmented macule showing marked reduction of melanin (Fontana‐Masson stain, ×200) 3 S‐100 stain showing marked reduction of melanocytes in the basal layer (S‐100 stain, ×200)
Glomangiosarcomas, or malignant glomus tumors, are very rare, cutaneous, soft tissue tumors. Despite having histologic features of malignancy, these tumors usually do not metastasize. We describe a 74-year-old woman with a glomangiosarcoma on her hand and review the literature. The woman presented with a five month history of a painful mass on the right palm. An excisional biopsy of the mass was undertaken. Histologically, the tumor was composed of uniform, round cells and numerous vascular components. The tumor cells were pleomorphic and had large nucleoli. Frequent mitotic figures were identified. Immunohistochemical stains showed strong positivity for vimentin and weak, focal positivity for smooth muscle actin. Ultrastructurally, the tumor cells were characterized by pinocytic vesicles, well formed basal lamina, and scattered junctional complex of the plasma membrane.
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