From the Guidelines
To confirm a diagnosis of pleomorphic dermal sarcoma, immunohistochemical staining rather than immunizations is required. The diagnosis typically involves a panel of immunohistochemical markers including CD10, p63, cytokeratins (CK), S100, desmin, smooth muscle actin (SMA), and CD34, as stated in the general guidelines for cancer diagnosis and treatment 1. These markers help differentiate pleomorphic dermal sarcoma from other malignancies with similar histological appearances.
Key Diagnostic Markers
- CD10
- p63
- Cytokeratins (CK)
- S100
- Desmin
- Smooth muscle actin (SMA)
- CD34 The pathologist will look for specific staining patterns - typically pleomorphic dermal sarcoma shows negative results for cytokeratins, S100, and desmin, which helps rule out carcinoma, melanoma, and muscle tumors respectively.
Diagnostic Approach
- Histopathological examination of tissue obtained through biopsy
- Pleomorphic spindle cells with atypical mitoses and invasion into the dermis and subcutaneous tissue The diagnosis is primarily based on histopathological examination of tissue obtained through biopsy, showing pleomorphic spindle cells with atypical mitoses and invasion into the dermis and subcutaneous tissue. Complete surgical excision with clear margins is the standard treatment, followed by close monitoring for recurrence or metastasis. Immunohistochemistry is crucial for accurate diagnosis as pleomorphic dermal sarcoma can be mistaken for other aggressive skin tumors. Vaccination recommendations for patients with cancer, as outlined in the NCCN Guidelines 1, are important for preventing infections but are not relevant to the diagnosis of pleomorphic dermal sarcoma.
From the Research
Immunisations for Pleomorphic Dermal Sarcoma
There is limited information available on the specific immunisations required to confirm pleomorphic dermal sarcoma. However, the available studies provide some insights into the treatment and management of the disease:
- The studies do not specifically mention immunisations for confirming pleomorphic dermal sarcoma 2, 3, 4.
- Some studies discuss the treatment options for pleomorphic dermal sarcoma, including immune checkpoint inhibitors 2 and surgical excision 4.
- Other studies focus on the immunogenicity of pneumococcal vaccines in older adults and those at increased risk of pneumococcal disease 5, 6, but do not provide direct information on immunisations for pleomorphic dermal sarcoma.
Treatment and Management
The treatment and management of pleomorphic dermal sarcoma may involve:
- Immune checkpoint inhibitors, such as anti-PD-1 therapy 2.
- Surgical excision, with adequate margins to prevent recurrence 4.
- Radiotherapy, although its role is not well defined 4.
Immunogenicity and Vaccination
The available studies on immunogenicity and vaccination do not provide direct information on immunisations for pleomorphic dermal sarcoma:
- The studies discuss the immunogenicity of pneumococcal vaccines in older adults and those at increased risk of pneumococcal disease 5, 6.
- The results suggest that immune responses to repeat vaccination with PPSV23 or sequential PCV/PPSV23 vaccination are robust, without evidence of hyporesponsiveness 5.
- Coadministration of PCV13 and QIV in adults previously immunized with PPSV23 is safe and noninferior to each vaccine given alone 6.