Document Detail

p75 Neurotrophin receptor differentiates between morphoeic basal cell carcinoma and desmoplastic trichoepithelioma: insights into the histogenesis of adnexal tumours based on embryology and hair follicle biology.
MedLine Citation:
PMID:  20184585     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Tumour development is frequently described in the basic pathology literature as a recapitulation of embryogenesis. However, a link between the embryology of the skin and the histogenesis of adnexal tumours has been largely overlooked. The low-affinity p75 neurotrophin receptor (p75NTR) has a profound role in hair follicle biology. We therefore speculated that it is involved in the histogenesis of follicular adnexal tumours. One of the most challenging diagnoses in dermatopathology is differentiating morphoeic basal cell carcinoma from desmoplastic trichoepithelioma.
OBJECTIVES: To describe the expression pattern of p75NTR during cutaneous embryogenesis, in the adult hair follicle and in morphoeic basal cell carcinoma and desmoplastic trichoepithelioma.
METHODS: Evaluation of the staining pattern for p75NTR was performed using standard immunohistochemical techniques. For comparison, we examined staining for cytokeratin 20 which highlights Merkel cells.
RESULTS: All 17 desmoplastic trichoepitheliomas were immunoreactive with > 80% of the cells stained, whereas 12 of the 14 (86%) morphoeic basal cell carcinomas were p75NTR negative. In the two positive cases of morphoeic basal cell carcinoma < 30% of cells were labelled. In the late bulbous hair peg stage and in the postnatal anagen hair follicle p75NTR highlights the outer root sheath.
CONCLUSIONS: Our results support the classification of desmoplastic trichoepithelioma as a follicular hamartoma mimicking the outer root sheath. In contrast, the lack of p75NTR expression in morphoeic basal cell carcinoma favours a concept of this tumour as a more primitive follicular lesion with the characteristics of a carcinoma and not a hamartoma. We suggest including p75NTR as a tool in the differential diagnosis between morphoeic basal cell carcinoma and desmoplastic trichoepithelioma.
D Krahl; K Sellheyer
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Publication Detail:
Type:  Journal Article     Date:  2010-02-22
Journal Detail:
Title:  The British journal of dermatology     Volume:  163     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-21     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  138-45     Citation Subset:  IM    
Institut für Dermatohistologie, Heidelberg, Germany.
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MeSH Terms
Aged, 80 and over
Carcinoma, Basal Cell / embryology,  metabolism*,  pathology
Diagnosis, Differential
Hair Follicle / metabolism*
Merkel Cells / metabolism
Middle Aged
Neoplasms, Adnexal and Skin Appendage / embryology,  metabolism*,  pathology
Receptor, Nerve Growth Factor / metabolism*
Skin / embryology,  metabolism
Skin Neoplasms / embryology,  metabolism*,  pathology
Tumor Markers, Biological / metabolism*
Reg. No./Substance:
0/Receptor, Nerve Growth Factor; 0/Tumor Markers, Biological

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