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Squamous Cell Carcinoma Arising From Keratoacanthoma: An Evaluation by RT-PCR.

and squamous eddies. The pathophysiology behind FI in the various previously reported associations is unclear. In general, the prevailing theory is that there is a release of cytokines from mesenchymal tissue that induce epidermal differentiation of adnexal structures. Induction of other adnexal structures, particularly sebaceous differentiation, is very common in association with dermatofibromas. Park et al recently summarized the spectrum of etiologies that have been proposed to date for induction of follicular differentiation in the assorted observed cutaneous pathologies. Interestingly, a recent study suggests that, although the normal embryologic development of hair follicles is dependent on molecular crosstalk between the dermis and epidermis, FI is triggered by an initial epidermal signal. It is unclear how epidermal signaling and regeneration change in the setting of abnormal, dermal cellular proliferations such as dermatofibromas and other intradermal tumors. In the case of an intradermal melanocytic nevus, it is possible that there are some unidentified characteristics that melanocytes, as normal epidermal cells, possess that may result in an ability to induce the molecular crosstalk to enable follicular differentiation. The association of an intradermal nevus with overlying FI has not previously been reported in the literature. The present case calls into question the mechanism of FI and the role of melanocytes in the molecular crosstalk between the epidermis and dermis in the differentiation of adnexal structures. Many authors have also called into question whether tumor of FI might represent a spectrum of reactive changes associated with other tumors (as nearly 25% of cases occur in association with other neoplasms). Additionally, dermatopathologists should consider follicular differentiation overlying intradermal nevi in the differential diagnosis of collision lesion of nevus with basal cell carcinoma or follicular tumors.