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  Vol. 136 No. 10, October 2000 TABLE OF CONTENTS
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Occult Neurofibroma and Increased S100 Protein in the Skin of Patients With Neurofibromatosis Type 1

New Insight to the Etiopathomechanism of Neurofibromas

Seija-Liisa Karvonen, MD, PhD; Matti Kallioinen, MD, PhD; Heli Ylä-Outinen, MD; Minna Pöyhönen, MD, PhD; Aarne Oikarinen, MD, PhD; Juha Peltonen, MD, PhD

Arch Dermatol. 2000;136:1207-1209.

Background  Neurofibromas represent proliferation of the connective tissue cells of peripheral nerves and deposition of collagenous extracellular matrix. There is evidence that the appearance and growth of neurofibromas may be associated with prior or ongoing mechanical trauma in patients with neurofibromatosis type 1 (NF1).

Objective  To study the histologic characteristics of apparently healthy skin of patients with NF1.

Design  The histologic features of healthy-looking skin of patients with NF1 were analyzed.

Setting  University hospital.

Patients  Ten patients who fulfilled the criteria for NF1.

Interventions  Punch biopsy specimens of healthy-looking skin of the forearm from 9 volunteer patients and of the upper eyelid during cosmetic operation from 1 volunteer patient were obtained.

Main Outcome Measures  The main outcomes were not predicted, and the hypothesis was formulated during data collection.

Results  Apparently unaffected skin of 5 patients with NF1 was studied by routine histologic testing with respect to expression of S100 protein. Unexpectedly, analysis of the samples revealed the presence of a small neurofibroma tumor in one of the samples. The tumor was located in deep dermis around a hair follicle. In addition, neurofibromatous tissue not large enough to be called a tumor was found on the same anatomical location in another patient. In further studies, 10 punch biopsy specimens of apparently healthy skin from patients with NF1 were similarly sectioned and analyzed. No tumors were found in these additional samples. In 4 patients, however, abundant S100 protein–positive cells were located within collagenous extracellular matrix surrounding hair follicles.

Conclusions  The skin of patients with NF1 might be more widely affected than previously thought and occult neurofibromas are not rare.


From the Departments of Dermatology (Drs Karvonen and Oikarinen) and Pathology (Dr Kallioinen), University Hospital of Oulu, and Department of Anatomy and Cell Biology, University of Oulu (Drs Karvonen, Ylä-Outinen, and Peltonen), Oulu, Finland; Department of Dermatology, University Hospital of Tampere, Tampere, Finland (Dr Karvonen); and Department of Medical Genetics, Family Federation of Finland, Helsinki (Dr Pöyhönen).


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Of Mass and Men: Neurofibromas and Histogenesis
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Archives of Dermatology Reader's Choice: Continuing Medical Education
Arch Dermatol. 2000;136(10):1284-1285.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

What Causes Neurofibromas?
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Of Mass and Men: Neurofibromas and Histogenesis
Riccardi
Arch Dermatol 2000;136:1257-1258.
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