Premalignant and Malignant Skin Lesions in Two Recipients of Vascularized Composite Tissue Allografts (Face, Hands)

Figure 1

(a) Patient 1. Pigmented nodule on the left temple. (b) Histological examination shows a nodular-pigmented basal cell carcinoma, that is, a dermal proliferation of deeply basophilic nodules separated from the surrounding dermis by clefts. Melanin deposits (accounting for the clinically pigmented aspect of the tumour) are seen within the tumour (haematoxylin-eosin-saffron stain, ×100). (c) Patient 2. A 5 mm keratotic annular lesion of the leg. (d) Histological examination shows typical features of porokeratosis, that is, two vertical stacks of parakeratotic corneocytes (arrows) in the horny layer (cornoid lamella) corresponding to the edges of the lesion shown in (c). (e) (Inset) Cornoid lamella shown on the left of panel (d). A vertical stack of parakeratotic corneocytes is seated on a shallow depression of the epidermis; the latter is devoid of granular layer and contains apoptotic eosinophilic keratinocytes (haematoxylin-eosin-saffron stain, (d) ×100, (e) ×250).