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Secondary lymphangioma (lymphangiectasis) has been reported as a consequence of lymphatic damage. No specific histological criteria can be used to differentiate primary lymphangioma circumscriptum from lymphangiectasis. We describe a woman who developed lymphangiectases on both non-lymphoedematous upper thighs after hysterectomy and radiation therapy for carcinoma of the cervix. This case differs from the secondary lymphangiomas reported previously in that the vascular channels appeared in newly formed adventitial dermis without histological changes in the epidermis.

To discuss the relation between solitary keratoacanthoma (KA) and crateriform squamous cell carcinoma (cSCC), the clinical and histologic features of cutaneous crateriform squamous cell proliferations were studied. Two hundred twenty cases of wholly excised crateriform squamous cell proliferations were studied both clinically (age, sex, location, and duration) and histologically (hematoxylin-eosin-stained sections). For comparison, we studied 100 consecutive cases of wholly excised noncrateriform squamous cell carcinoma (ncSCC). One hundred forty-four of the 220 cases of crateriform squamous cell proliferations were histologically classified as KA. In 47 other cases, a relatively large area of the KA showed frank histologic and cytologic malignant transformation (mKA); this event could happen during every stage of the KA. Twenty-nine lesions were cSCCs without remnants of KA. The patients in the KA group were significantly younger (p = 0.000) than those in the other three groups. The ages of the patients in these three groups were not significantly different (p = 1.0). More KAs (16%) were located in areas that are not usually exposed to the sun than was the case with the other groups of neoplasms considered (2%, 3%, and 3%, respectively), and this difference was statistically significant (p = 0.001). Regarding the duration of the lesion, only the differences between KA and cSCC, KA and ncSCC, and mKA and ncSCC were statistically significant. Not every cutaneous crateriform squamous cell proliferation is a KA; in KA, the crater must be multilocular, the "lips" must be perforated, and the cornified contents do not usually project out of the "mouth." At least a quarter of KAs undergo malignant transformation, which occurs more frequently in older patients and photoexposed areas. This transformation is a focal event and may happen at any stage of KA development. Consequently, a suspected KA must be wholly excised and studied in serial paraffin blocks so as to disclose any focus of malignant transformation.

Arteriovenous malformations (AVM) are vascular anomalies containing a communication between an artery and a vein without an intervening capillary bed. In 1990, Klippel and Trenaunay reported a patient with limb overgrowth, cutaneous angiomata and varicose veins. In 1918, Parkes Weber mentioned the additional feature of AVM terming the condition 'hemangiectatic hypertrophy'. Most authors now consider both the Klippel-Trenaunay syndrome and the syndrome of multiple congenital arteriovenous fistulae to be two forms of Parkes Weber's hemangiectatic hypertrophy. Clinical and histological 'Kaposi sarcoma'-like lesions in the Klippel-Trenauny-Weber syndrome are well documented. We report an additional case appearing after minor trauma.

We report an aggressive keratoacanthoma of the upper eyelid that recurred at the site of a previously excised keratoacanthoma. The diagnosis was confirmed by biopsy. Because the surgery required would be extensive, medical therapy was tried first. The tumor was treated with intralesional injections of 5-fluorouracil and radiotherapy. Despite this therapy, the orbital computed tomogram showed tumor extension into the orbit, and an orbital exenteration was performed. Histopathology of the excised tumor was consistent with squamous cell carcinoma. We discuss the topic of malignant transformation of the keratoacanthoma.

A patient with angiolymphoid hyperplasia with eosinophilia is described. This is, to our knowledge, the first case report in which the lesions were located on the vulva.

Clear-cell syringoma is a histologic variant of syringoma that is otherwise clinically indistinguishable from ordinary syringoma. This variant is formed by cells that have pale or clear cytoplasm as a result of glycogen accumulation. There is a high association of clear-cell syringoma and diabetes mellitus. A case of clear-cell syringoma associated with diabetes mellitus is described. Electron microscopic examination revealed that periluminal cells showed intra- and extracytoplasmic multivesicular bodies that may be characteristic of the clear-cell variant. Immunohistochemistry for carcinoembryonic antigen (CEA) showed ordinary syringomas as in the presence of CEA within and surrounding duct-like spaces.