Expanding the clinical spectrum of dermal hyperneury: report of nine new cases and a review of the literature

Abstract

Aims Dermal hyperneury is defined as the hypertrophy of small nerves in the dermis. It has been described in a variety of settings. We present a series of nine new cases with a distinctive clinical presentation and review the existing literature. The aim of the study was to summarise the clinical, histopathological and immunohistochemical findings in a case series of dermal hyperneury with unique clinical presentation. Methods and results Nine cases were identified from the referral practice of one of the authors. Clinical characteristics, including demographic details, were collated. The histopathological features and novel immunohistochemical findings were analysed. Four cases presented with multiple skin lesions. Clinical evaluation revealed no associated syndromic stigmata. The histology in all cases was that of dermal hyperneury. Immunohistochemistry for phosphatase and tensin homologue (PTEN) and RET was supportive of the lack of syndromic association. Conclusion The presentation of dermal hyperneury with multiple cutaneous lesions and no syndromic associations is distinctive, and no study with PTEN and RET immunohistochemistry has previously been reported. Comparisons with recent reports of multiple non‐syndromic mucocutaneous neuromas are discussed.

The Pathological Culprit of Neuropathic Skin Pain in Long COVID-19 Patients: A Case Series

“…The neuropathic chronic pain in post-acute COVID-19 patients has been recently described by Ieremia et al, who reported loss of dermal neurosensory fibers in nine patients [ 28 ]. Compared to our findings of hypertrophy, fiber loss and inflammation could be related to a later phase of the disease, in which chronic inflammation leads to atrophy.…”

Proceedings of Annual Congress Siapec Iap 2021

“…In two cases the neuro-vascular complexes showed a glomeruloid appearence. The overall apperance was that of dermal hyperneury, a condition known to occur in the context of different syndromes (e.g., MEN2a, MEN2b, PTEN hamartoma tumor syndrome and NF2) or in association with skin acquired disorders (e.g., Nodular Prurigo and Notalgia Paresthetica) 2 . SARS-CoV-2 could be involved in “burning skin” through a malfunction of the myelinated A-delta and unmyelinated C primary afferent neuronal fibres, due to the activation of the immune-mediated inflammatory response and host-related factors.…”

“…In two cases the neuro-vascular complexes showed a glomeruloid appearence. The overall apperance was that of dermal hyperneury, a condition known to occur in the context of different syndromes (e.g., MEN2a, MEN2b, PTEN hamartoma tumor syndrome and NF2) or in association with skin acquired disorders (e.g., Nodular Prurigo and Notalgia Paresthetica) 2 .…”