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Silvija Gottesman MD
Ackerman Academy of Dermatopathology. Chair & . Founder . Tweets ≠ medical advice. Views mine.
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Silvija Gottesman MD 6h
It is so much more common to have a solitary wart with tricholemmal change like this and the patient will not have Cowden’s.
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Silvija Gottesman MD 7h
Very true, Dr Ackerman signed these out as verruca with tricholemmal differentiation. The lesion is papillomatous, there’s hypergranulosis, with dilated capillary loops in the superficial papillary dermis abutting the epidermis. Especially in the third photo.
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Silvija Gottesman MD 7h
🙏🏼
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Silvija Gottesman MD 7h
Very!
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Silvija Gottesman MD 21h
Me too🤣 We’ve all been there. Love love the honesty and the knowledge we share. Love you all, my Twitter ! 🙏🏼🥰
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Silvija Gottesman MD 24h
Incidental. I’ve seen it quite a few times on top of nevi too.🥰
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Silvija Gottesman MD Nov 23
👏🏻👏🏻
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Silvija Gottesman MD Nov 23
😍
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Silvija Gottesman MD retweeted
Melanie Bourgeau, MD Nov 23
Tricholemmoma: 👩‍⚕️ Small flesh-colored papule on nose, upper lip 👩‍⚕️ Multiple ➡️ a/w Cowden's syn (Tricholem-MOO-ma 🐄) 🔬 Lobules of squamoid/clear cells, attached to ED 🔬 Peripheral pallisading, thickened BM 🔬 Squamous eddies, pilar keratinization
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Silvija Gottesman MD Nov 23
Replying to @PhilippeCytoMD
You are so humerus!🥰😆
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Silvija Gottesman MD Nov 23
👏🏻👏🏻👏🏻 Yes, EDV on top of a fibrous papule🥰
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Silvija Gottesman MD Nov 23
Why yes it is🤩
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Silvija Gottesman MD Nov 23
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Silvija Gottesman MD Nov 23
One of my favorite quotes: “The mystery of the second diagnosis” - Ed Heilman, MD
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Silvija Gottesman MD Nov 23
😔
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Silvija Gottesman MD retweeted
Eduardo Alcaraz, MD PhD Nov 23
Polypoid (nodular) melanoma 😔. ▫️Vertical growth phase ⬇️. ▫️IV Clark's level. ▫️Breslow/thickness ↕️. ▫️⬆️⬆️⬆️ mitoses/mm2. ▫️Vascular invasion 🔀. ▫️Ulceration. ▫️Severe pleomorphism.
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Silvija Gottesman MD Nov 23
Yes, indeed. Patient already had several PG lesions and about 36hrs after placement of the PIV, new ones developed.
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Silvija Gottesman MD Nov 23
Pyoderma Gangrenosum -Pustules that progress to Painful ulcers -Rolled violaceous or hyperpigmented borders Pathergy -fascinating phenomenon (dermal injury, from PIV 3rd pic) Dx of exclusion: special stains, tissue cultures & deepers to exclude other causes
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Silvija Gottesman MD retweeted
Jisun Cha MD FAAD Nov 21
My favorite cells that resembles sunny side up 🍳
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Silvija Gottesman MD Nov 23
Replying to @forthejon
So neat! Love this! I saw something similar but in a solitary lesion. If the patient has multiple lesions then I vote for EHK in nevus comedonicus.
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