{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:57:26Z","timestamp":1747184246747,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Floating Sign is a histopathologic clue to the diagnosis of autoimmune sclerosing skin disorders such as morphea and interstitial granulomatous dermatitis (IGD). On the other hand, the \u201cfree\u2010floating\u201d sign has been associated with neoplasms, for example, dermatofibroma and interstitial mycosis fungoides. Herein, we report the Free Sign in sclerosing skin disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a case\u2010control study, we applied detailed histopathologic definitions of Floating Sign and Free Sign to assess their presence in morphea, IGD, and other sclerosing disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Free Sign was present in most cases of morphea (46\/55, 84%) and IGD (7\/13, 54%) but not necrobiosis lipoidica (NL) (6\/14, 42.8%) or sclerodermoid graft versus host disease (SGVHD) (2\/7, 28.5%). The sensitivity and specificity of Free Sign for morphea versus other disorders was 84% and 56%, respectively. Floating Sign was not identified in most cases: NL (3\/14, 21.4%), SGVHD (1\/7, 14.2%), morphea (5\/55, 9%), IGD (1\/13, 7.7%). The diagnostic sensitivity of Floating Sign in morphea was 9%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Free Sign was present in most cases of morphea in our series and may represent a clue to the presence of evolving sclerosis. Free Sign may be seen in other sclerosing disorders. Technical artifact is a potential cause of a false\u2010positive Free Sign.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cup.14421","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T12:22:08Z","timestamp":1680006128000},"page":"58-62","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Free Sign in morphea and other sclerosing disorders: A clue to the presence of early sclerosis?"],"prefix":"10.1111","volume":"51","author":[{"given":"Maria Fernanda","family":"Ortega\u2010Springall","sequence":"first","affiliation":[{"name":"Department of Dermatology University of California, Davis  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Yang","sequence":"additional","affiliation":[{"name":"Stanford\u2010O'Connor Family Medicine Residency Program  San Jose California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-7325","authenticated-orcid":false,"given":"Anupam","family":"Mitra","sequence":"additional","affiliation":[{"name":"Department Pathology and Laboratory Medicine University of California, Davis  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-8257","authenticated-orcid":false,"given":"Maxwell A.","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of California, Davis  Sacramento California USA"},{"name":"Department Pathology and Laboratory Medicine University of California, Davis  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm\u201020\u20106222"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.05.045"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000000758"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001662"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001177"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/IJPM.IJPM_67_20"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000000758"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e3182924f0a"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.2011.10727.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17010"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2003.90"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e3181b876d7"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000679"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.14421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T08:29:30Z","timestamp":1703579370000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.14421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,28]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/cup.14421"],"URL":"https:\/\/doi.org\/10.1111\/cup.14421","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"type":"print","value":"0303-6987"},{"type":"electronic","value":"1600-0560"}],"subject":[],"published":{"date-parts":[[2023,3,28]]},"assertion":[{"value":"2022-10-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}