James A. Ramirez

Thursday #dermpath special. 😆🔬 In my practice this kind of low-power look on H&E suggests BPDCN until proven otherwise (as it’s so common here), but this time it’s different and HP gives some morphologic clue! Cutaneous involvement by plasma cell myeloma See IHC/ISH below.

Primary cutaneous acral CD8-positive T-cell lymphoproliferative disorder➡️ 🩸Solitary red nodule 🩸Dense dermal medium-sized lymphocytic proliferation 🩸Extends into subcutis 🩸Characteristic Golgi dot-like pattern of CD68, unique to this entity #Hemepath #dermpath #PathTwitter

So cool when you read about something and then it pops up under your scope. This is a good example of the blue keratinocytes seen in epidermodysplasia verruciformis. #dermpath #dermatology #Pathtwitter #medtwitter

Classic example of a rare #dermpath entity. What is this? Answer: kikoxp.com/posts/11339. Short video: kikoxp.com/posts/11338. #pathology #pathologists #pathTwitter #dermatology #dermatologia #dermtwitter

Another Bluemor: Rapidly growing, ulcerated nodule on the chest of a 90 y/o #dermpath @HENRYY_MD @david_terrano @et565 @DiegoMoralesN @gonzadetoro @sgottesmanmd @redsnapperpath @alomaridermpath @vhnguyenmd

Epidermal inclusion cyst of the skull… might be a first for me. 🤷🏼‍♀️ #Neuropath

Young patient with history of recurrent GI bleeds presents with a small bowel obstruction and this finding ⬇️ What is the diagnosis? #GIBoards #GITwitter #MedTwitter #GIPearl

<1 year old. Enlarge “bruise”-like plaque. Arm.

Always a beauty! #dermpath

Nasal mucosal mass. Your diagnosis? Answer & more pics here: kikoxp.com/posts/5703. Many thanks to @sadiqamer for these incredible images! #pathology #pathologists #pathTwitter #dermpath #dermatology #dermatologia #dermtwitter #ENTpath #microbiology

20 YOF with symmetrical blue black patches on the face, shoulders, posterior trunk. Noticed in infancy. Dermal melanocytosis (Nevus of Ota and Ito) 🔬:Dendritic melanocytes and melanophages "flowing in a East-West" direction (found that description cool! #Dermpath #dermatology

My most favorite skin pathology quote is this. #dermpath #pathology #dermatology #dermatopathology

Middle aged man presents with progressive dysphagia, weight loss, cachexia and this finding on his feet. What is the diagnosis? #GIBoards #MedTwitter #GIPearl

Cool soft tissue lesion from the leg! #dermpath #pathology

Skin, face of older patient. 2 levels #Dermpath #pathresidents #Pathtwitter

"Cyst" on the trunk of an adult. Your diagnosis? (Hint: it's not a cyst!) Answer: kikoxp.com/posts/8892 Video: kikoxp.com/posts/4093 #pathology #pathologists #pathTwitter #dermpath #dermatology #dermatologia #dermtwitter #BSTpath

One of my all-time favorite cases!!! Deep nodule hand. Your diagnosis? Digital slide: kikoxp.com/posts/1782. PAS, GMS, Polarized pics: kikoxp.com/posts/9858. Answer & video: kikoxp.com/posts/4058 #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter

#ClinicalPearl. Watch the red dot blanch. What is it and what #diagnoses are likely?

65 YOF, shoulder - pretty bland on low power - some H&E shots with MelA #dermtwitter #dermpath #PathTwitter #dermatology