Correspondence |

Cutaneous Apocrine Carcinoma Masquerading as Head and Neck Cellulitis: An Ominous Sign

Aaron M. Secrest, PhD, MPH; Raja R. Seethala, MD; Laura K. Ferris, MD, PhD; Hakeem Sam, MD, PhD
Arch Dermatol. 2011;147(11):1335-1337. doi:10.1001/archdermatol.2011.349.
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Correspondence: Dr Sam, Department of Dermatology, University of Pittsburgh, 3601 Fifth Ave, Sixth Floor, Pittsburgh, PA 15213 (samh@upmc.edu).

Financial Disclosure: Dr Ferris has served as an investigator and consultant for Electro-Optical Science Inc and as an investigator for DermTech International.

Funding/Support: Dr Secrest was supported by training grant F30-DK082137 from the National Institute of Diabetes and Digestive and Kidney Diseases.

Additional Contributions: Philip Symes, MD, Conrad Stachelek, MD, PhD, and Robert Ferris, MD, PhD, provided valuable advice and expert clinical input, and Erin Deeb, BS, provided technical assistance.

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Figure 1. Patient presented with a poorly demarcated, erythematous plaque with firm woody edema involving the right cheek and anterior neck.

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Figure 2. Biopsy specimens from posterior side of patient's right neck. A, Skin with tumor composed of complex glandular structures (arrows) infiltrating the deep dermis (hematoxylin-eosin, original magnification ×4). B, Tubular formation with luminal secretions and cellular infiltrate with eosinophilic cytoplasm, pleomorphic nuclei, prominent nucleoli, and decapitation secretion (hematoxylin-eosin for both images, original magnification ×40 for the primary image and ×60 for the inset); the arrows in the inset indicate decapitation secretion. C, Under androgen receptor immunohistochemical staining, tumor cells show strong nuclear activity; seen in the top portion of the image as internal controls, normal sebaceous cells also show positive staining (original magnification ×20). D, Gross cystic disease fluid protein 15 immunohistochemical staining is strongly positive in tumor cells (original magnification ×20).




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