Correspondence: Dr Sam, Department of Dermatology, University of Pittsburgh, 3601 Fifth Ave, Sixth Floor, Pittsburgh, PA 15213 (email@example.com).
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.
Figure 1. Patient presented with a poorly demarcated, erythematous plaque with firm woody edema involving the right cheek and anterior neck.
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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