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thus it is worthwhile to describe it in HS&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">An 88-year-old male patient sought the Dermatology Service complaining of an asymptomatic lesion in the right gluteal region&#44; with an unknown time of evolution&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">At the dermatological examination&#44; a slightly elevated pink plaque with irregular borders was evident&#44; but with a small area of exulceration &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Dermoscopy was able to show&#44; besides the exulceration&#44; several well-defined brown&#44; rounded structures&#44; surrounded by dotted vessels &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2 and 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">An incisional biopsy was performed with diagnostic hypotheses of seborrheic keratosis or Bowen&#39;s disease&#46; Histopathology showed basaloid clones without atypia&#44; in the middle of spinous cells &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Possibilities of HS and clonal SK were considered&#46; The expression of carcinoembryonic antigen &#40;CEA&#41; and epithelial membrane antigen &#40;EMA&#41; in the basaloid cells and in the ductal structures present in these cells at the immunohistochemical examination indicated the diagnosis of HS&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">In the early 20th century&#44; Borst and Jadassohn independently described neoplasms characterized by well-demarcated cell nests located in the epidermis&#46; Believing them to be a specific type of tumor&#44; the name intraepithelial epithelioma of Borst&#8211;Jadassohn was coined&#46; From the morphological and immunohistochemical studies&#44; the majority of the authors nowadays believe that this entity represents a morphological phenomenon&#44; rather than being specific to a certain neoplasia&#46; Therefore&#44; it is preferred to designate it as the Borst&#8211;Jadassohn phenomenon &#40;BJP&#41;&#46; This phenomenon is characterized as the presence of well-defined islands of epithelial cells&#44; typical or atypical&#44; within an acanthotic epidermis&#44; and can be evidenced in some benign or malignant conditions&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">One of the neoplasms where BJP is found is the hidroacanthoma simplex&#46; This neoplasm is considered the intraepidermal form of the eccrine poroma&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Despite its benign nature&#44; malignant transformations are reported in some cases&#44; leading to the discussion regarding whether its early excision should be mandatory&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Clinically&#44; it is often mistaken for SK&#46; This confusion may persist in histopathology and the initial diagnosis of clonal SK is not infrequent&#46; There is a well-circumscribed intraepithelial proliferation of rounded and basophilic cells&#44; very similar to what occurs in clonal SK that presents BJP&#46; In the immunohistochemistry&#44; the positivity for CEA and EMA in the cases of HS aid in the differentiation&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Shiiya C et al&#46; described four cases of HS and discussed the main dermatoscopic changes&#44; with the central aim of distinguishing it from Bowen&#39;s disease and SK&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> The authors concluded that findings of small black globules &#40;75&#37; of cases&#41; and fine scales distributed annularly &#40;100&#37;&#41; were characteristic&#46; In addition&#44; the absence of glomerular vessels would help in the differentiation of DB&#44; since such vessels found in a group are highly suggestive of the latter&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In the case reported&#44; dotted vessels distributed in circle around rounded brown structures were observed&#46; They represent&#44; in the correlation of dermatoscopy with histopathology&#44; proliferation of venules near the clonal cell blocks&#46; Dotted vessels&#44; when in non-melanocytic lesions&#44; are non-specific&#44; but the pattern found in the lesion described may be peculiar&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> The rounded structures represent the nests of melanocytic intraepidermal clonal cells&#44; corresponding to BJP&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Although hematoxylin and eosin staining did not show the presence of pigment&#44; when the Fontana-Masson staining was used&#44; a great amount of melanin was observed in the blocks &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; the present study contributes to review concepts of BJP to describe the dermatoscopic alterations of this phenomenon in HS&#44; one of the main tumors in which it develops&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Financial support</span><p id="par0085" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors&#8217; contribution</span><p id="par0065" class="elsevierStylePara elsevierViewall">Bruno de Castro e Souza&#58; Conception and planning of the study&#59; composition of the manuscript&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Maria Cl&#225;udia Alves Luce&#58; Composition of the manuscript&#59; critical review of the literature&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Thais do Amaral Carneiro Cunha&#58; Approval of the final version of the manuscript&#59; conception and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Neusa Yuriko Sakai Valente&#58; Participation in the design of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The Borst&#8211;Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic epidermis&#46; One of the neoplasms where this phenomenon is found is hidroacanthoma simplex&#46; This neoplasm is considered the intraepidermal form of the eccrine poroma&#46; Despite its benign nature&#44; malignant transformations are reported&#46; The present article reports a case of hidroacanthoma simplex and discusses the dermoscopy of this phenomenon&#46;</p></span>"
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Images in Dermatology
Dermatoscopy of the Borst–Jadassohn phenomenon in hidroacanthoma simplex
Bruno de Castro e Souzaa,
Corresponding author
brunocastro1990@hotmail.com

Corresponding author.
, Maria Cláudia Alves Luceb, Thais do Amaral Carneiro Cunhab,c, Neusa Yuriko Sakai Valenteb
a Department of Dermatology, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil
b Department of Dermatology, Instituto de Assistência Médica ao Servido Público Estadual, São Paulo, SP, Brazil
c Dermatology Residency Program, Instituto de Assistência Médica ao Servido Público Estadual, São Paulo, SP, Brazil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The Borst&#8211;Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic epidermis&#46; Some neoplasms&#44; whether malignant or benign&#44; may present this phenomenon&#44; like as clonal seborrheic keratosis &#40;SK&#41;&#44; clonal Bowen&#39;s disease &#40;BD&#41;&#44; Paget&#39;s disease&#44; porocarcinoma&#44; or hidroacanthoma simplex &#40;HS&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The distinction between these entities&#44; both clinically and histopathologically&#44; is sometimes a challenge&#46; This fact can have consequences since the approach of each one is different&#46; The dermatoscopy of the Borst&#8211;Jadassohn phenomenon has been little reported&#44; thus it is worthwhile to describe it in HS&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">An 88-year-old male patient sought the Dermatology Service complaining of an asymptomatic lesion in the right gluteal region&#44; with an unknown time of evolution&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">At the dermatological examination&#44; a slightly elevated pink plaque with irregular borders was evident&#44; but with a small area of exulceration &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Dermoscopy was able to show&#44; besides the exulceration&#44; several well-defined brown&#44; rounded structures&#44; surrounded by dotted vessels &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2 and 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">An incisional biopsy was performed with diagnostic hypotheses of seborrheic keratosis or Bowen&#39;s disease&#46; Histopathology showed basaloid clones without atypia&#44; in the middle of spinous cells &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Possibilities of HS and clonal SK were considered&#46; The expression of carcinoembryonic antigen &#40;CEA&#41; and epithelial membrane antigen &#40;EMA&#41; in the basaloid cells and in the ductal structures present in these cells at the immunohistochemical examination indicated the diagnosis of HS&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">In the early 20th century&#44; Borst and Jadassohn independently described neoplasms characterized by well-demarcated cell nests located in the epidermis&#46; Believing them to be a specific type of tumor&#44; the name intraepithelial epithelioma of Borst&#8211;Jadassohn was coined&#46; From the morphological and immunohistochemical studies&#44; the majority of the authors nowadays believe that this entity represents a morphological phenomenon&#44; rather than being specific to a certain neoplasia&#46; Therefore&#44; it is preferred to designate it as the Borst&#8211;Jadassohn phenomenon &#40;BJP&#41;&#46; This phenomenon is characterized as the presence of well-defined islands of epithelial cells&#44; typical or atypical&#44; within an acanthotic epidermis&#44; and can be evidenced in some benign or malignant conditions&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">One of the neoplasms where BJP is found is the hidroacanthoma simplex&#46; This neoplasm is considered the intraepidermal form of the eccrine poroma&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Despite its benign nature&#44; malignant transformations are reported in some cases&#44; leading to the discussion regarding whether its early excision should be mandatory&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Clinically&#44; it is often mistaken for SK&#46; This confusion may persist in histopathology and the initial diagnosis of clonal SK is not infrequent&#46; There is a well-circumscribed intraepithelial proliferation of rounded and basophilic cells&#44; very similar to what occurs in clonal SK that presents BJP&#46; In the immunohistochemistry&#44; the positivity for CEA and EMA in the cases of HS aid in the differentiation&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Shiiya C et al&#46; described four cases of HS and discussed the main dermatoscopic changes&#44; with the central aim of distinguishing it from Bowen&#39;s disease and SK&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> The authors concluded that findings of small black globules &#40;75&#37; of cases&#41; and fine scales distributed annularly &#40;100&#37;&#41; were characteristic&#46; In addition&#44; the absence of glomerular vessels would help in the differentiation of DB&#44; since such vessels found in a group are highly suggestive of the latter&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In the case reported&#44; dotted vessels distributed in circle around rounded brown structures were observed&#46; They represent&#44; in the correlation of dermatoscopy with histopathology&#44; proliferation of venules near the clonal cell blocks&#46; Dotted vessels&#44; when in non-melanocytic lesions&#44; are non-specific&#44; but the pattern found in the lesion described may be peculiar&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> The rounded structures represent the nests of melanocytic intraepidermal clonal cells&#44; corresponding to BJP&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Although hematoxylin and eosin staining did not show the presence of pigment&#44; when the Fontana-Masson staining was used&#44; a great amount of melanin was observed in the blocks &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; the present study contributes to review concepts of BJP to describe the dermatoscopic alterations of this phenomenon in HS&#44; one of the main tumors in which it develops&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Financial support</span><p id="par0085" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors&#8217; contribution</span><p id="par0065" class="elsevierStylePara elsevierViewall">Bruno de Castro e Souza&#58; Conception and planning of the study&#59; composition of the manuscript&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Maria Cl&#225;udia Alves Luce&#58; Composition of the manuscript&#59; critical review of the literature&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Thais do Amaral Carneiro Cunha&#58; Approval of the final version of the manuscript&#59; conception and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Neusa Yuriko Sakai Valente&#58; Participation in the design of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Panoramic image of the dermatoscopy showing several round&#44; brown&#44; well-delimited structures surrounded by dotted vessels&#46; The exulcerated area can be seen&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Detail of the same structures in dermoscopy&#46;</p>"
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Hematoxilin &#38; eosin&#44; &#40;Hematoxilin &#38; eosin&#44; &#215;200&#41; &#8211; well-circumscribed intraepithelial proliferation of rounded and basophilic cells&#46;</p>"
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Fontana-Masson&#44; &#40;Fontana-Masson&#44; &#215;200&#41; &#8211; a nest of basaloid cells with a considerable amount of melanin&#46; This phenomenon is observed in dermoscopy as the brown areas&#46;</p>"
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Article information
ISSN: 03650596
Original language: English
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