《美国皮肤病理学杂志》对最新的诊断方法和实验室技术以及对当代社会、法律和伦理问题的见解进行了出色的报道。每期都有关于临床、技术和基础科学进展的评论文章以及富有启发性的详细病例报告。通过《美国皮肤病理学杂志》，您将能够：- 逐步涵盖新的或难以-诊断从最早的组织病理学症状到确认性免疫组织化学和分子研究的疾病。-立即将最新的基础科学发现和临床方法应用于您的工作。-通过同行评审的原创文章，利用您在世界各地的同行和同事的技能和专业知识、“特殊病例报告”、实用指南的覆盖范围和图形演示。-通过期刊的创意论坛来扩展您的视野，讨论有争议的问题并向杰出的研究人员和临床医生学习

The American Journal of Dermatopathology provides in-depth coverage of the latest diagnostic methods and laboratory techniques, while also addressing contemporary social, legal, and ethical issues. Each issue features review articles on clinical, technical, and basic science advancements, as well as detailed case reports. Through the American Journal of Dermatopathology, you will be able to: - Gradually master new or challenging diagnoses, from the earliest histopathological symptoms to confirmatory immunohistochemistry and molecular studies. - Immediately apply the latest basic science discoveries and clinical methods to your work. - Leverage the skills and expertise of your peers and colleagues worldwide through peer-reviewed original articles, as well as a wealth of information from 'special case reports' and practical guidelines. - Expand your horizons through the journal's creative forum, discussing controversial issues and learning from outstanding researchers and clinicians.

《美国皮肤病理学杂志》对最新的诊断方法和实验室技术进行了深入的报道，同时也探讨了当代社会、法律和伦理问题。每期都包含关于临床、技术和基础科学进展的评论文章，以及详细的病例报告。通过《美国皮肤病理学杂志》，您将能够：- 逐步掌握新的或难以诊断的疾病，从最早的组织病理学症状到确认性的免疫组织化学和分子研究。- 立即将最新的基础科学发现和临床方法应用于您的工作。- 通过同行评审的原创文章，利用来自世界各地同行和同事的技能与专业知识，获取“特殊病例报告”和实用指南的丰富信息。- 通过期刊的创意论坛扩展视野，讨论有争议的问题，并向杰出的研究人员和临床医生学习。

American Journal of Dermatopathology

Nevus depigmentosus is a congenital disorder characterized by a nonprogressive hypopigmented lesion, which may not be apparent at birth. Thus, it is sometimes difficult to differentiate vitiligo from nevus depigmentosus only by clinical features. We postulated that the histologic changes in lesional and perilesional skin might be different in the 2 conditions. We took biopsies from both lesional and perilesional skin of 100 cases of vitiligo to assess the number of melanocytes, the amount of melanin, dermal inflammatory infiltrate, and other changes. We compared them with 30 cases of nevus depigmentosus. Histologically, lesions of vitiligo showed more basal hypopigmentation and dermal inflammation than perilesional normal skin. With Fontana-Masson staining, 16% of cases of vitiligo showed the presence of melanin. The ratio of pigmented area to epidermal area was 0.06% in vitiligo, whereas 17% in perilesional normal skin and 8.9% in nevus depigmentosus. In NKI/beteb staining, 12% of vitiligo showed the presence of melanocytes, and their average number was 7.68 per square millimeter. The number of melanocytes was also decreased in nevus depigmentosus but not as much as in vitiligo. We also confirmed the presence of melanocytes in 1 of 3 cases of vitiligo by electron microscopy. In conclusion, there are a few melanocytes and melanin in some cases of vitiligo. Therefore, the diagnosis of vitiligo should be made considering these points.

You Chan Kim

Yun Jeon Kim

Hee Young Kang

Seonghyang Sohn

Eun-So Lee

Histopathologic Features in Vitiligo

白癜风组织病理学特征

Background: Cutaneous arteriovenous malformations (AVMs) of stage I may mimic port-wine stains (PWSs) clinicopathologically; therefore, it may be misdiagnosed and mistreated as being PWS. Objective: To suggest the clinicopathological differential clues between early AVMs and PWSs. Methods: A set of 10 radiologically proven AVMs of stage I was selected in conjunction with a set of 10 age-/sex-matched PWSs as a control. Their clinical features, hematoxylin and eosin, CD31, and smooth muscle actin immunohistochemistry were then compared. Results: Four pathological clues for differential diagnosis with statistical significance (P < 0.05) were found: the vessel density (CD31), presence of vascular luminal red blood cells, elongation and haphazard branching of vessels, and thickened vessel walls highlighted by smooth muscle actin. Conclusion: Therefore, 4 differential clues with respect to stage I AVM and PWS in their earlier developmental stages have been proposed.

Seok-Jong Lee

Ho Youn Kim

Byung Soo Kim

Do Won Kim

Ho Yun Chung

Jong Min Lee

Seung Huh

Han Ik Bae

Capillary Malformation of Port-Wine Stain

葡萄酒色痣的毛细血管畸形

Syphilis has plagued mankind for centuries and is currently resurgent in the Western hemisphere. Although there has been a significant reduction of tertiary disease and recognition of facilitative interactions with human immunodeficiency virus infection, the natural history of syphilis has remained largely unchanged; thus, new strategies are required to more effectively combat this pathogen. The immunopathologic features of experimental syphilis in the rabbit; the course, stages, and pathology of human syphilis; and a comparison of human syphilis with leprosy suggest that the clinical course of syphilis and its tissue manifestations are determined by the balance between delayed-type hypersensitivity (DTH) and humoral immunity to the causative agent, Treponema pallidum. A strong DTH response is associated with clearance of the infecting organisms in a well-developed chancre, whereas a cytotoxic T-cell response or strong humoral antibody response is associated with prolonged infection and progression to tertiary disease. Many of the protean symptoms/appearances of secondary and tertiary human syphilis are manifestations of immune reactions that fail to clear the organism, due to a lack of recruitment and, more importantly, activation of macrophages by sensitized CD4 T cells. The Bacillus Calmette-Guerin vaccination can enhance DTH and has been shown to produce a low, but measurable, beneficial effect in the prevention of leprosy, a disease that shows a disease spectrum with characteristics in common with syphilis. In the prevention of syphilis, a potential vaccine protective against syphilis should be designed to augment the DTH response.

J Andrew Carlson

Ganary Dabiri

Bernard Cribier

Stewart Sell

The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity

梅毒的免疫病理生物学：梅毒的表现和病程由迟发型超敏反应水平决定

Tumor necrosis factor (TNF)-α inhibitors (anti-TNF-α biologic drugs), currently used to treat different autoimmune conditions, may be associated with cutaneous drug reactions. New onset or worsening of psoriasis and psoriasis-like reactions have been reported in these patients. However, not much is known about the different histopathologic patterns of such skin lesions. The aim of this study was to evaluate the pathologic spectrum of clinically papulosquamous to pustular "psoriasiform" lesions in this setting. Sixteen biopsies from 9 patients on anti-TNF-α therapy for rheumatoid arthritis (n = 7), Crohn disease (n = 1), and Behçet disease (n = 1) who developed a "psoriasiform" skin rash during treatment were included in this study. None of the patients had history of psoriasis. Five patients (10 biopsies) showed a psoriasis-like pattern that varied from that seen in guttate lesions (4 biopsies), to well-established plaques (3 biopsies) to pustular psoriasis (3 biopsies). Three patients (4 biopsies) showed an interface/lichenoid dermatitis mimicking lichen planus. Two patients (2 biopsies) showed features of pustular folliculitis. Eosinophils varied from none (2 biopsies) to scattered (7 biopsies) to numerous (7 biopsies). Plasma cells were present in most cases. All pustular lesions had negative cultures. In conclusion, anti-TNF drugs elicit a spectrum of cutaneous reactions that go beyond the classical eosinophilic-rich hypersensitivity reaction and may closely mimic primary dermatitis. In addition to psoriasis-like lesions, lichen planus-like dermatitis and sterile pustular folliculitis should be included in the list of anti-TNF-α-related drug reactions. Because the different histopathologic findings may be subtle, clinical correlation is crucial to make the diagnosis.

Alvaro C Laga

Ruth A Vleugels

Abrar A Qureshi

Elsa F Velazquez

Histopathologic Spectrum of Psoriasiform Skin Reactions Associated With Tumor Necrosis Factor-α Inhibitor Therapy. A Study of 16 Biopsies

肿瘤坏死因子-α抑制剂治疗相关银屑样皮肤反应的组织病理学谱：16例活检研究

Background: The pathogenesis of melasma remains unclear. Interleukin (IL)-17, a proinflammatory mediator, disturbs barrier function. Filaggrin (FLG) is a protein involved in epidermal barrier homeostasis and may be affected by IL-17 and IL-33. Objective: To evaluate epidermal barrier function in malar melasma and its association with the expression of FLG, IL-17, and IL-33. Methods: Twenty patients with malar melasma were included in this study. Colorimetric and transepidermal water loss (TEWL) was measured in lesional and adjacent unaffected skin at baseline and 30 minutes after barrier disruption using the tape-stripping test. Biopsies from melasma and perilesional skin were performed to evaluate the presence of FLG by immunohistochemistry, and profilaggrin, IL-17, and IL-33 expression were analyzed by reverse transcription–qualitative polymerase chain reaction. Results: After the stripping test, the erythema and TEWL values were higher in the melasma than in the unaffected skin ( P = 0.01). Thirty minutes later, TEWL diminished, but it remained higher than in the perilesional skin. Profilaggrin increased as TEWL gradually decreased (R = −0.68, P = 0.04). FLG and IL-17 were higher in the melasma than in the perilesional skin ( P = 0.003). IL-17 and profilaggrin expression were positively associated (R = 0.60, P = 0.04). IL-33 expression was higher in the adjacent normal skin than in the melasma ( P = 0.01). Conclusion: This study found subclinical inflammation in the skin adjacent to the melasma, dysfunction of the epidermal barrier in lesions associated with chronic inflammation, and an abnormal differentiation process promoting an increase in FLG. These findings highlight the need to preserve the integrity of the facial stratum corneum in these patients.

Juan Pablo Castanedo-Cázares

Juan Diego Cortés-García

Gabriela Pérez-Coronado

Diana Hernández-Blanco

Bertha Torres-Alvarez

Skin Barrier Function and Its Relationship With IL-17, IL-33, and Filaggrin in Malar Melasma

Abbreviation	Am. J. Dermatopathol.
Journal Impact	1.29
Quartiles(Global)	DERMATOLOGY(Q4)

ISSN	0193-1091, 1533-0311
h-index	81

Publication Information	Publisher: Lippincott Williams and Wilkins，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1979，Proportion of original research papers: 85.57%，Self Citation Rate:9.10%， Gold OA Rate: 1.45%
Average review cycle	网友分享经验：偏慢,4-8周
Average recruitment ratio	网友分享经验：容易

American Journal of Dermatopathology

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Histopathologic Features in Vitiligo

Capillary Malformation of Port-Wine Stain

The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity

Histopathologic Spectrum of Psoriasiform Skin Reactions Associated With Tumor Necrosis Factor-α Inhibitor Therapy. A Study of 16 Biopsies

Skin Barrier Function and Its Relationship With IL-17, IL-33, and Filaggrin in Malar Melasma

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