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Cranial fasciitis.
Arch Dermatol. 1989 May; 125(5):674-8.AD

Abstract

We present the clinical, roentgenographic, light-microscopic, immunohistochemical, and ultrastructural findings in two children with cranial fasciitis. A 7-year-old boy and a 3-year-old girl presented with rapidly expanding masses on the scalp. Roentgenographic studies showed erosion of the underlying cranium in one case. Both lesions showed proliferations of elongated spindle cells in a focally myxoid matrix, together with areas of hemorrhage, vascular proliferation, and chronic inflammation. Occasional cells with atypical nuclei were observed, but mitotic figures were uncommon. Immunoperoxidase studies showed negative or equivocal staining for desmin, factor VIII-associated antigen, S100 protein, and macrophage antigen. In one lesion there was focal positivity for alpha 1-antichymotrypsin, and in another lesion, some cells stained positively for smooth-muscle actin. Electron microscopy showed cells with dilated endoplasmic reticulum, bundles of microfilaments, pinocytotic vesicles, and focal external membrane material, features of myofibroblasts. Both lesions were excised and there has been no recurrence in 7 years in one case and 1 year in the other case. Cranial fasciitis is closely related to nodular fasciitis, but it has a predilection for the scalp of children. Despite its rapid growth, it has a benign clinical course and is cured by excision with or without curettage of the underlying bone. Our immunohistochemical and ultrastructural observations indicate that, like nodular fasciitis, cranial fasciitis represents a proliferation of fibroblasts and myofibroblasts.

Authors+Show Affiliations

Department of Pathology, Medical College of Virginia, Richmond.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

2653227

Citation

Patterson, J W., et al. "Cranial Fasciitis." Archives of Dermatology, vol. 125, no. 5, 1989, pp. 674-8.
Patterson JW, Moran SL, Konerding H. Cranial fasciitis. Arch Dermatol. 1989;125(5):674-8.
Patterson, J. W., Moran, S. L., & Konerding, H. (1989). Cranial fasciitis. Archives of Dermatology, 125(5), 674-8.
Patterson JW, Moran SL, Konerding H. Cranial Fasciitis. Arch Dermatol. 1989;125(5):674-8. PubMed PMID: 2653227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cranial fasciitis. AU - Patterson,J W, AU - Moran,S L, AU - Konerding,H, PY - 1989/5/1/pubmed PY - 1989/5/1/medline PY - 1989/5/1/entrez SP - 674 EP - 8 JF - Archives of dermatology JO - Arch Dermatol VL - 125 IS - 5 N2 - We present the clinical, roentgenographic, light-microscopic, immunohistochemical, and ultrastructural findings in two children with cranial fasciitis. A 7-year-old boy and a 3-year-old girl presented with rapidly expanding masses on the scalp. Roentgenographic studies showed erosion of the underlying cranium in one case. Both lesions showed proliferations of elongated spindle cells in a focally myxoid matrix, together with areas of hemorrhage, vascular proliferation, and chronic inflammation. Occasional cells with atypical nuclei were observed, but mitotic figures were uncommon. Immunoperoxidase studies showed negative or equivocal staining for desmin, factor VIII-associated antigen, S100 protein, and macrophage antigen. In one lesion there was focal positivity for alpha 1-antichymotrypsin, and in another lesion, some cells stained positively for smooth-muscle actin. Electron microscopy showed cells with dilated endoplasmic reticulum, bundles of microfilaments, pinocytotic vesicles, and focal external membrane material, features of myofibroblasts. Both lesions were excised and there has been no recurrence in 7 years in one case and 1 year in the other case. Cranial fasciitis is closely related to nodular fasciitis, but it has a predilection for the scalp of children. Despite its rapid growth, it has a benign clinical course and is cured by excision with or without curettage of the underlying bone. Our immunohistochemical and ultrastructural observations indicate that, like nodular fasciitis, cranial fasciitis represents a proliferation of fibroblasts and myofibroblasts. SN - 0003-987X UR - https://www.unboundmedicine.com/medline/citation/2653227/Cranial_fasciitis_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/vol/125/pg/674 DB - PRIME DP - Unbound Medicine ER -