Melanomas arising in blue nevi exhibit absence of TERT promoter mutations, low tumor mutational burden, and high frequency of distant metastases and disease-related mortality: a clinicopathologic and ... Melanoma arising in blue nevus (MBN) is a rare melanoma subtype with distinct molecular characteristics and biological behaviors compared to other cutaneous melanomas. However, limited data exists on ...

🚨 Hot off the press! What a timely delivery during #USCAP2026. This is one of the very first molecular characterizations of true MBNs in one of the largest cohorts ever studied. Open access. Check it out if you love #dermpath & #molepath! 😆🔬🧬 #MDACCPath

link.springer.com/article/10.1...

My very 1st USCAP meeting was 9 years ago in San Antonio, and it opened my eyes to the possibility of a career in academic #pathology.

Residents, please attend #USCAP2026 if at all possible. It could truly change your career path! #dermpath #MDACCPath

Bonus: what do you 👀?

Melanoma With RNF11::BRAF Fusion: A Novel Fusion Previously Undescribed in Melanoma - PubMed B-Raf Proto-Oncogene ( BRAF ) fusions are rare in melanomas. We present a case of cutaneous melanoma with a Ring Finger Protein 11 ( RNF11 ) ::BRAF fusion in a 63-year-old man with a history of stage IB melanoma on the right upper back (pT2apN0cM0; nonulcerated with a Breslow thickness of 1.2 mm). D …

The presence of a gene fusion doesn’t always indicate a Spitz melanocytic neoplasm. Here’s our example featuring the new RNF11::BRAF fusion in non-Spitz melanoma. Check it out if you love #dermpath and #molepath! 😆🔬🧬

#MDACCPath

pubmed.ncbi.nlm.nih.gov/40036483/

RAC9366: IHC for "malignant spindle tumour on H-CSD skin: CD10 = 60%, S100-, a pan-keratin- & p63- not shown. I don't do other markers unless clues. Do p16, p53 & Ki67 as here when lesions are indolent as in this case. Thoughts? #Dermpath @rishiagrawal.bsky.social

RAC9366 M70s. Scalp Vertex. ?SCC #dermpath @rishiagrawal.bsky.social

What a pleasant surprise! Our article has been selected as the front cover of this month’s issue of JPTM. I’m glad that the editorial team was impressed by the comprehensiveness of our review article and its high-quality images. 😆🔬

#dermpath #MDACCpath

jpatholtm.org/journal/view...

RAC9365. F80ish. Pre-auricular ?BCC. #Dermpath @rishiagrawal.bsky.social

INSM1: A highly sensitive marker for primary and metastatic Merkel cell carcinoma, superior to SOX11, pancytokeratin, and CK20 - PubMed Detection of Merkel cell carcinoma (MCC) micrometastases in sentinel lymph nodes (SLNs) often necessitates immunohistochemical studies like pancytokeratin (panCK) or CK20. However, panCK can label non-epithelial cells, particularly dendritic reticulum cells, complicating interpretation, while CK20 i …

Want to maximize Merkel cell carcinoma detection in sentinel lymph nodes? Go with panCK + INSM1 or panCK + SOX11. CK20’s sensitivity is just too low; its expression can be absent in up to 24% of MCCs. Check it out if you love #dermpath and #IHCpath. 😆🔬

#MDACCPath

pubmed.ncbi.nlm.nih.gov/40505699/

Next up with the CSDP! Fellows Series! 📣📣📣📣
#dermpath #pathresidents #dermatology #pathology #CSDP #Zoominar - please join us this week and next for these 2 excellent talks !

RAC9364 M70 ish. Upper chest. 30 x 20mm keratotic nodule ?SCC. #Dermpath @rishiagrawal.bsky.social

Subcutaneous Panniculitis-Like T-Cell Lymphoma With Increased γδ T Cells: A Potential Diagnostic Pitfall - PubMed Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare primary cutaneous T-cell lymphoma with adipotropism characterized by infiltration of CD8 + T cells exhibiting a cytotoxic and αβ phenotype. Although SPTCL is typically indolent, distinguishing it from more aggressive cutaneous lymphoma …

A striking increase in gamma/delta T-cells in subcutaneous panniculitis-like T-cell lymphoma (SPTCL) can be a major diagnostic pitfall. Recognizing this pitfall is crucial to avoid misclassification. A must-read for fellow #dermpath and #hemepath enthusiasts! 😆🔬

pubmed.ncbi.nlm.nih.gov/40532089/

#USCAP2026 in TX is just around the corner! 😆🔬🤠

Excited to connect with incredible pathologists and #pathology trainees and to see the latest studies in #dermpath.

As a bonus, here’s a special stain that turned into a bit of pareidolia. 👀
What do you see in it? #MDACCPath

Atypical Spitz Tumor/Spitz Melanocytoma Revealing a VIM::NTRK3 Gene Fusion: Clinicopathological Correlation of a Unique Molecular Finding - PubMed Spitz tumors are a heterogeneous group of melanocytic neoplasms ranging from benign Spitz nevi to malignant Spitz melanomas, with atypical Spitz tumors/Spitz melanocytoma occupying an intermediate position within this biological spectrum. A hallmark of all these lesions is the presence of specific g …

Bit late in sharing this, but excited nonetheless! Here’s a report featuring another novel fusion, VIM::NTRK3, in a Spitz neoplasm.

An educational case for anyone into #dermpath & #molepath combos! 😄🔬🧬

pubmed.ncbi.nlm.nih.gov/40591913/

NSD3::FGFR1 : A Novel Gene Fusion First to Be Described in Merkel Cell Carcinoma - PubMed Merkel cell carcinomas (MCCs) exhibit diverse molecular profiles, often categorized by their association with Merkel cell polyoma virus (MCPyV). MCPyV-associated MCCs typically display a low tumor mutational burden (TMB), lacking both somatic mutations and ultraviolet signature. By contrast, MCPyV-n …

When was the last time you encountered a gene fusion in Merkel cell carcinoma?

Here is the first documented case of MCPyV-positive MCC harboring a novel NSD3::FGFR1 gene fusion. Check it out if you love #dermpath and #molepath! 😆🔬🧬

#MDACCPath

pubmed.ncbi.nlm.nih.gov/40036479/

<em>JEADV Clinical Practice</em> | Clinical Dermatology and Venereology Journal | Wiley Online Library Click on the article title to read more.

Endocrine mucin-producing sweat gland carcinomas presenting as blue-gray papules, as reported by Likki et al. 😆🔬

#dermpath #dermatology #pathology #MDACCPath

onlinelibrary.wiley.com/doi/10.1002/...

Diffuse cutaneous ALK-immunoreactive histiocytosis with MEF2C::FLT3 fusion - PubMed Diffuse cutaneous ALK-immunoreactive histiocytosis with MEF2C::FLT3 fusion

We share our experience with an unusual, diffuse cutaneous ALK-immunoreactive histiocytosis with a MEF2C::FLT3 fusion. Check it out if you love the #dermpath and #molepath combination. 😆🔬🧬

#MDACCPath

pubmed.ncbi.nlm.nih.gov/41211348/

The evolving role of TRPS1 in dermatopathology: insights from the past 4 years - PubMed Over the past 4 years, trichorhinophalangeal syndrome type 1 (TRPS1) has rapidly gained attention among practicing pathologists, with numerous studies emerging that both support and question its diagnostic utility. Initially regarded as a highly specific marker for tumors of mammary origin, TRPS1 is …

Lastly, when in doubt, read this most comprehensive review on TRPS1 #IHCPath, which incorporates our extensive experience with this marker over the past 4–5 years in #dermpath. Free access! 😆🔬

#MDACCPath

pubmed.ncbi.nlm.nih.gov/41605620/

TRPS1 expression in primary and secondary extramammary Paget diseases: An immunohistochemical analysis of 93 cases - PubMed Extramammary Paget disease (EMPD) predominantly manifests de novo as primary EMPD, with less than 30 % of cases associated with underlying internal malignancy (secondary EMPD). Differentiating primary from secondary EMPDs based solely on histopathology poses challenges, often necessitating supplemen …

And this was by far the largest study on this topic, including more than 90 cases of EMPD, and it was the first to demonstrate that primary perianal EMPDs lack TRPS1 expression, an important diagnostic pitfall. 😆🔬

#MDACCPath #dermpath

pubmed.ncbi.nlm.nih.gov/38000676/

Immunohistochemical expression of TRPS1 in mammary Paget disease, extramammary Paget disease, and their close histopathologic mimics - PubMed TRPS1 may be useful to distinguish MPDs/EMPDs from MISs, but its utility is limited in distinguishing them from other pagetoid intraepidermal neoplasms such as SCCISs.

This was the very first study on this topic by #MDACCPath #dermpath published in 2023. 😆🔬

pubmed.ncbi.nlm.nih.gov/36808637/

Here is another study supporting the role of TRPS1 #IHCPath in MPDs/EMPDs, which my initial studies proposed 2–3 years ago. Despite the major pushback and rejection from the #dermpath community at the time, I am glad to see more and more studies confirming our initial impression. 😆🔬

RAC9358. M40s Bilateral giant pigmented lesion. Biopsy from chest. #Dermpath @rishiagrawal.bsky.social

Tomorrow with the CSDP ! #CME #dermpath #dermatology #pathology #Zoominar #CSDP #melanoma

RAC9356. M60s. Re-excision of thin melanoma (7 weeks from prior excision). What's going on? @rishiagrawal.bsky.social #dermpath

RAC9355 F60s. Lower back. ?BCC for opinions please. Also what type of giant cell? @rishiagrawal.bsky.social #Dermpath

Please join us for our next ZOOMinar with the CSDP! #dermpath #pathology #CME #pathresidents #pathboards #dermatology @heatedrivalryfan.bsky.social

RAC9352. M70s. Cheek. BCC excised. Adjacent lesion. #dermpath @iyengarish.bsky.social

#TooCloseToDiagnose? 🧐
A. Verruca vulgaris
B. Myrmecia
C. Epidermodysplasia verruciformis
#Pathology #DermPath

#TooFarToDiagnose? 🧐
A. Perniosis
B. Erythema Annulare Centrifugum
C. Tumid Lupus Erythematosus
D. Granuloma Annulare

#Pathology #Dermatology #Dermatopathology #DermPath

#TooCloseToDiagnose? 🧐
Painful subcutaneous nodule.
A. Myopericytoma
B. Angioleiomyoma
C. Glomangioma
D. Hidradenoma
#Pathology #Dermatology #Dermatopathology #DermPath

#TooCloseToDiagnose? 🧐
A. Clear Cell Acanthoma
B. Trichilemmoma
C. Bowen's Disease
D. Paget's Disease
#Pathology #Dermatology #Dermatopathology #DermPath