bromochloroacetic-acid and Focal-Epithelial-Hyperplasia

Heck's disease (focal or multifocal epithelial hyperplasia) is a benign, rare condition of the skin and mucous membranes induced by human papillomavirus (HPV) infection. Other entities that can induce large papillomatous lesions that involve the mucous membranes and skin include condyloma acuminatum, which is sexually transmitted, and white sponge nevus, often due to a mutation of cytokeratin 4 or 13. Six cases diagnosed as either Heck's disease (n = 2) or white sponge nevus (n = 4) and 6 oral condyloma were compared on histologic grounds and analyzed in situ for HPV DNA, including HPVs 6,11, and 13, as well as cytokeratins 4 and 13. Each case showed marked acanthosis, and para/hyperkeratosis. More variable histologic findings included rete ridge elongation, keratinocyte degeneration, and perinuclear halos. High copy HPV 13 DNA was evident in the squamous cells towards the surface in the two cases diagnosed as Heck's disease and in two cases diagnosed as white sponge nevus on clinical grounds. HPV 6/11 was found in each of the six condyloma. Marked decrease in either cytokeratin 4 or 13 was evident in the two cases diagnosed as white sponge nevus that were HPV DNA negative. It is concluded that in situ hybridization analyses including HPVs 6, 11, and 13 as well as immunohistochemistry for cytokeratins 4 and 13 can differentiate Heck's disease from condyloma and white sponge nevus, which can be difficult to differentiate on clinical and histologic grounds.

Topics: Adult; Biomarkers; Cell Differentiation; Condylomata Acuminata; DNA, Viral; Female; Focal Epithelial Hyperplasia; Humans; Hyperplasia; In Situ Hybridization; Keratins; Leukokeratosis, Hereditary Mucosal; Male; Middle Aged; Nevus; Papilloma; Papillomaviridae; Papillomavirus Infections; Skin

We present the clinicopathological findings after reviewing 52 patients affected by multifocal epithelial hyperplasia (MEH), previously known as focal epithelial hyperplasia and the results of an immunocytochemical study.. We reviewed the clinical files and microscopic slides from 52 MEH-affected patients and new slides were immunostained with a polyclonal antibody against high molecular weight cytokeratins.. More than 95% of the patients were in poverty (<200 dollars monthly family income). Females comprised 71.1% of the MEH patients, 69.3% were in the first and second decades and buccal mucosa, lips, and tongue were more frequently affected. Ninety-two percent of the patients had a direct relative with similar lesions. In hematoxylin and eosin-stained slides, prominent multiple nucleoli were observed. Immunocytochemical study showed differences in immunostaining between lesional and normal cells. Cells with strongly immunostained cytoplasm were seen in the prickle layer of the lesional epithelium as well as in the clinically normal neighboring epithelial tissue. Cytokeratin-negative mitosis-like cells and koilocytes were identified within the lesions.. The name "multifocal epithelial hyperplasia" is more accurate than those previously proposed designations, because it is more precise to describe the clinical and microscopic features of the disease. Also, our results suggest that mitosis-like cells and koilocytes are degenerated cells unable to synthesize cytokeratins and that cells with strongly immunostained cytoplasm represent epithelial cells showing an altered cytokeratin metabolic profile.

Topics: Adolescent; Adult; Age Factors; Aged; Cell Nucleolus; Child; Child, Preschool; Cytoplasm; Epithelial Cells; Female; Focal Epithelial Hyperplasia; Humans; Immunohistochemistry; Keratins; Lip Diseases; Male; Mexico; Middle Aged; Mitosis; Mouth Mucosa; Poverty; Retrospective Studies; Sex Factors; Social Class; Tongue Diseases

The double labeling technique using peroxidase and alkaline phosphatase for immunohistochemistry is well known, but must be adapted according to the antibodies used, fixation, and technical conditions. The technique allows identification on one slide of two antigens that are localized in the same or different cells of the same lesion. The aim of this paper is to describe the adaptation of this technique to cytokeratins of normal mammary tissue and proliferative lesions of the breast.

Topics: Animals; Antibodies; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Feasibility Studies; Focal Epithelial Hyperplasia; Humans; Immunohistochemistry; Keratins; Mammary Glands, Human; Staining and Labeling