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Merkel cells and sclerosing epithelial neoplasms
E Abesamis-Cubillan1, L El-Shabrawi-Caelen, P E LeBoit
1Department of Dermatology, University of California, San Francisco 94115, USA.
The American Journal of Dermatopathology
|August 19, 2000
Summary
Merkel cells are key indicators in diagnosing skin neoplasms. Their presence in desmoplastic trichoepithelioma (DTE) distinguishes it from other sclerosing lesions like basal cell carcinoma (BCC), syringoma, and microcystic adnexal carcinoma (MAC).
Area of Science:
- Dermatopathology
- Sclerosing Neoplasms
- Immunohistochemistry
Background:
- Merkel cells are normal epidermal and follicular epithelium components.
- They are found in benign neoplasms with follicular differentiation but absent in basal cell carcinomas (BCCs).
- Distinguishing sclerosing epithelial neoplasms is challenging, especially with small biopsies.
Purpose of the Study:
- To assess the presence of Merkel cells in desmoplastic trichoepithelioma (DTE), syringoma, morpheiform BCC, and microcystic adnexal carcinoma (MAC).
- To evaluate the utility of Merkel cell identification in differentiating these cutaneous neoplasms.
Main Methods:
- Immunohistochemical staining for cytokeratin 20 was employed.
- The study analyzed 14 DTE, 12 syringoma, 11 morpheiform BCC, and 8 MAC specimens.
- Presence of Merkel cells was assessed in association with each neoplasm type.
Main Results:
- Merkel cells were identified in all 14 DTE specimens.
- Merkel cells were found in 1 of 11 morpheiform BCC cases (p < 0.005).
- No Merkel cells were detected in any syringoma or MAC specimens.
Conclusions:
- Merkel cells are associated with benign, follicular germinative origin cutaneous neoplasms.
- Absence of Merkel cells in MAC supports its malignant nature, despite potential follicular differentiation.
- Identifying Merkel cells in sclerosing epithelial neoplasms strongly suggests desmoplastic trichoepithelioma (DTE) as the diagnosis.