RESUMEN
BACKGROUND: Pigmented lesions on the nipple and areola concern patients and physicians as melanoma and pigmented mammary Paget's disease must be considered in the differential diagnoses. There have been only six case reports of melanosis of the nipple and areola in the medical literature yet five cases presented to our department in a 26-month period. METHOD: Five women aged between 26 and 34 years presented with pigmentation of the areola and/or nipple. Two patients were pregnant and one also had vitiligo. All lesions were solitary, eccentrically located with a sharp but irregular contour, and homogeneous pigmentation. Dermoscopy was performed and reassuring features included light to dark brown cobblestone pigmentation with ring-like structures and reticulation. Blue-white veil and irregular centred black dots were not seen. Histology confirmed melanosis of the nipple and areola. CONCLUSION: Melanosis of the nipple and areola is probably significantly underreported in the medical literature and, based on our experience, is likely to be the most common cause of pigmentation at this site. Considering this, benign condition on clinical and dermoscopic features should lead to biopsy rather than excision to confirm the diagnosis. Further reports of the dermoscopic features will help to define this condition further.
Asunto(s)
Enfermedades de la Mama/patología , Neoplasias de la Mama/patología , Melanoma/patología , Melanosis/patología , Pezones , Adulto , Diagnóstico Diferencial , Femenino , HumanosRESUMEN
BACKGROUND: Skin cancer screening aims to detect potentially metastasizing skin cancers at an early and surgically curable stage. This may take the form of mass screening, as currently occurs in Germany, or of targeted screening of those at greatest risk. OBJECTIVE: To develop a model to identify patients at high risk of developing skin cancer who would benefit from regular skin cancer screening. METHODS: This was an open prospective point-prevalence study of consecutive patients presenting to dermatologists for a total skin check. Demographic and skin cancer risk factors were recorded and, for the first time, histology of skin lesions was documented. Results were analysed by univariate and multivariate analyses and, after logistic regression with stepwise forward selection, a risk-group model was developed. RESULTS: The results of 108,281 total skin examinations were available for analysis. 142 definite melanomas, 108 severely dysplastic naevi/cannot-exclude-melanoma, 491 basal cell carcinomas (BCC) and 93 squamous cell carcinomas (SCC) were excised. A risk model was developed for melanoma and SCC based on mathematical e-functions. The model had >92% sensitivity for melanoma and SCC and an overall 67.24% specificity for melanoma, SCC and BCC. This targeted risk model identified one-third of the study population as being at risk for the development of melanoma and SCC. CONCLUSIONS: Using the risk calculator developed from this study, targeted screening of the identified at-risk population reduces the numbers needed to be screened regularly by 50%, yet has better sensitivity for melanoma and similar sensitivity for SCC compared to the current mass screening programme in Germany.
Asunto(s)
Examen Físico , Neoplasias Cutáneas/diagnóstico , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Factores de RiesgoRESUMEN
Gunpowder may no longer be a recommended treatment for warts, but most of the therapies used in 1950 are still used to some extent now. The problems, now as then, are the multiplicity of treatment options and the lack of a cure. Several treatments popular in the past decade are discussed.
Asunto(s)
Enfermedades de la Piel/historia , Enfermedades de la Piel/terapia , Verrugas/historia , Verrugas/terapia , Historia del Siglo XX , Humanos , PronósticoRESUMEN
The use of intralesional bleomycin to treat Bowen's disease of the palm affecting a motor mechanic is presented. Bleomycin in 1% lignocaine was injected at 3-6 week intervals to a cumulative total of 6.35 U. Follow-up at 18 months showed no local recurrence and no long-term adverse events.
Asunto(s)
Antibióticos Antineoplásicos/uso terapéutico , Bleomicina/uso terapéutico , Enfermedad de Bowen/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Enfermedad de Bowen/diagnóstico , Supervivencia sin Enfermedad , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Neoplasias Cutáneas/diagnósticoRESUMEN
Melasma of the forearms seems to be a relatively common sign which is, to our knowledge, not reported in the literature. It seems that it may be more common in older patients and especially in postmenopausal women on supplementary oestrogen. The pigmentary change is macular and may be confluent or speckled. Like facial chloasma there is a sharp line of demarcation at the margins. In some, there seems to be an element of erythema.
Asunto(s)
Brazo , Melanosis/diagnóstico , Adulto , Distribución por Edad , Anciano , Femenino , Humanos , Incidencia , Masculino , Melanosis/epidemiología , Melanosis/fisiopatología , Persona de Mediana Edad , Factores de RiesgoRESUMEN
An indian woman presented with crateriform and pearly papules along the lines of transgredience of the hands and feet. Her father and an older sister are similarly affected. Histology showed hyperkeratosis and elastorrhexis. The differential diagnosis of acrokeratoelastoidosis includes focal acral hyperkeratosis. The current classification of marginal papular acrokeratodermas is discussed.
Asunto(s)
Acrodermatitis/diagnóstico , Queratodermia Palmoplantar/diagnóstico , Enfermedades Cutáneas Papuloescamosas/diagnóstico , Acrodermatitis/genética , Diagnóstico Diferencial , Femenino , Humanos , Queratodermia Palmoplantar/genética , Persona de Mediana Edad , Enfermedades Cutáneas Papuloescamosas/genéticaAsunto(s)
Alopecia Areata/etiología , Ciclosporina/uso terapéutico , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Trasplante de Riñón , Alopecia Areata/diagnóstico , Ciclosporina/administración & dosificación , Femenino , Humanos , Inmunosupresores/uso terapéutico , Trasplante de Riñón/inmunología , Persona de Mediana EdadRESUMEN
A five year old boy is presented with bilateral congenital malalignment of the great toenails. This disorder is due to lateral deviation of the nail matrix and can be complicated by hemionychogryphosis or ingrowing of the nail at a young age.
Asunto(s)
Enfermedades de la Uña , Uñas Malformadas , Preescolar , Diagnóstico Diferencial , Humanos , Masculino , Enfermedades de la Uña/congénito , Enfermedades de la Uña/diagnóstico , Dedos del PieRESUMEN
An elderly man presented with a longstanding, tender lesion on the sole of the foot. Clinically this was a cutaneous horn but biopsy revealed the features of a viral wart. The cytopathic effects of cutaneous human papillomaviruses are discussed.
Asunto(s)
Enfermedades de la Piel/patología , Verrugas/patología , Anciano , Efecto Citopatogénico Viral , Humanos , Masculino , Papillomaviridae/aislamiento & purificación , Enfermedades de la Piel/virología , Verrugas/virologíaRESUMEN
Four hundred and seventy-four Nova Scotian renal transplant recipients were screened, using the records of the Nova Scotia Cancer Registry and the Victoria General Hospital, in a retrospective study, for the development of cutaneous malignancies. Sixteen patients developed a total of 60 squamous cell carcinomas (SCC) and 14 developed 28 basal cell carcinomas (BCC). The survival curve shows that within 10 years of transplant, less than 10% will develop SCC. This is a 16-fold increase above the rate of SCC in the general population of Nova Scotia, Canada. Age at time of transplantation appears to be a significant determinant of subsequent skin cancer risk. None of the previously reported HLA associations was found to hold in this small study. The role of ultraviolet radiation, due to both geographic and lifestyle exposure, is discussed when comparing to other transplant studies.
Asunto(s)
Carcinoma Basocelular/epidemiología , Carcinoma de Células Escamosas/epidemiología , Trasplante de Riñón , Neoplasias Cutáneas/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/inmunología , Carcinoma de Células Escamosas/inmunología , Niño , Preescolar , Femenino , Antígenos HLA , Humanos , Incidencia , Lactante , Trasplante de Riñón/inmunología , Masculino , Persona de Mediana Edad , Nueva Escocia/epidemiología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Cutáneas/inmunología , Luz Solar/efectos adversos , Análisis de Supervivencia , Factores de TiempoRESUMEN
A young woman presented with a persistent unilateral erosive and pustular plaque of the forearm. Repeated biopsy was required to make the diagnosis of a fungal cause for her eosinophilic pustular folliculitis.
Asunto(s)
Dermatomicosis/patología , Eosinofilia/patología , Foliculitis/patología , Adulto , Dermatomicosis/tratamiento farmacológico , Eosinofilia/tratamiento farmacológico , Femenino , Foliculitis/tratamiento farmacológico , Griseofulvina/uso terapéutico , Humanos , Piel/patologíaRESUMEN
A male infant with the features of Adams-Oliver syndrome is described. These features included severe aplasia cutis congenita (ACC) of the scalp involving both skin and cranium, a shortened right foot with talipes equinovarus, extensive cutis marmorata telangiectatica congenita and also haemangiomas and ulceration of the abdominal skin. Exposure of the dural membrane was associated with infection, hyponatraemia and finally localised necrosis with herniation of brain and fatal cerebral haemorrhage.
Asunto(s)
Deformidades Congénitas del Pie , Hemangioma/congénito , Dermatosis del Cuero Cabelludo/congénito , Anomalías Cutáneas , Neoplasias Cutáneas/congénito , Úlcera Cutánea/congénito , Telangiectasia/congénito , Humanos , Recién Nacido , Masculino , Piel/irrigación sanguínea , SíndromeAsunto(s)
Síndrome Antifosfolípido/patología , Histiocitoma Fibroso Benigno/patología , Neoplasias Cutáneas/patología , Piel/patología , Adulto , Anticuerpos Anticardiolipina/metabolismo , Síndrome Antifosfolípido/complicaciones , Femenino , Histiocitoma Fibroso Benigno/etiología , Humanos , Neoplasias Cutáneas/etiologíaRESUMEN
Three neonates with numerous cutaneous hemangiomas are presented. Although all three had serious medical problems, in none of these three could visceral hemangiomas be demonstrated. Neonatal hemangiomas can be restricted to the skin.
Asunto(s)
Hemangioma , Neoplasias Primarias Múltiples , Neoplasias Cutáneas , Preescolar , Femenino , Hemangioma/patología , Humanos , Lactante , Recién Nacido , Masculino , Neoplasias Primarias Múltiples/patología , Neoplasias Cutáneas/patologíaRESUMEN
An association between HLA DR7 and the development of multiple non-melanoma skin cancer was detected in immunosuppressed patients in southern Australia. The relative risk was 2.6 which was lower than for immunocompetent patients with the same skin cancers. HLA frequencies of renal transplant recipients with multiple skin cancers were determined. The types HLA B27 and HLA Dr7 were found in significantly higher frequency, and there was no absence of HLA A11.
Asunto(s)
Carcinoma Basocelular/inmunología , Carcinoma de Células Escamosas/inmunología , Antígenos HLA/análisis , Trasplante de Riñón/efectos adversos , Neoplasias Cutáneas/inmunología , Adulto , Anciano , Femenino , Antígeno HLA-B27/análisis , Antígeno HLA-DR7/análisis , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Subcutaneous fat necrosis of the newborn is an uncommon but distinctive condition which appears in the first six weeks of life, associated with variable degrees of hypercalcaemia and which resolves spontaneously over months. We report a case of subcutaneous fat necrosis of the newborn following perinatal distress and complicated by thrombocytopenia and hypercalcaemia.