RESUMEN
BACKGROUND: Although melanoma accounts for only 4% to 5% of all skin cancers in the United States, it causes most skin cancer-related deaths. We describe a unique group of African-American patients with multiple primary acral lentiginous melanomas (ALMs). OBJECTIVE: The purpose of this study was to review the case histories and management of a cohort of patients in the Mohs practice of our dermatologic surgeon with multiple primary ALM. METHODS: This is a case series of patients with multiple ALM identified by chart review from 2000 to 2005. A thorough review of the literature was performed. RESULTS: Four patients, all African-American, were identified with multiple ALM. All patients were managed with excision or Mohs micrographic surgery utilizing permanent sections. None of the patients with ALM had melanomas at nonacral sites or other types of skin cancer. Several had acral melanosis. Information in the literature on patients with multiple primary acral melanomas was insufficient. CONCLUSION: Patients with multiple acral melanomas have not, to our knowledge, been reported thus far. It can be extrapolated from current literature, however, that appropriate management of these patients, including staging work and surgical intervention, is to be determined by the individual characteristics of the melanoma and the patient's concomitant risk factors, if any.
Asunto(s)
Negro o Afroamericano , Enfermedades del Pie/etnología , Enfermedades del Pie/patología , Melanoma/etnología , Melanoma/patología , Neoplasias Cutáneas/etnología , Neoplasias Cutáneas/patología , Anciano , Estudios de Cohortes , Femenino , Enfermedades del Pie/cirugía , Humanos , Masculino , Melanoma/cirugía , Persona de Mediana Edad , Cirugía de Mohs , Estadificación de Neoplasias , Neoplasias Cutáneas/cirugía , Resultado del TratamientoAsunto(s)
Infecciones por Mycobacterium no Tuberculosas/etiología , Enfermedades Cutáneas Bacterianas/etiología , Neoplasias Cutáneas/cirugía , Infección de la Herida Quirúrgica/etiología , Anciano , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Infecciones por Mycobacterium no Tuberculosas/terapia , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedades Cutáneas Bacterianas/terapia , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/terapiaRESUMEN
Uncommon histologic variants of basal cell carcinoma (BCC) can present a diagnostic challenge. In this case series, we describe 3 patients with unusual BCCs encountered in a dermatologic surgical unit over a 1-year period from September 2003 to September 2004. The formalin-fixed, paraffin-embedded histologic specimens were initially examined microscopically after staining with hematoxylin and eosin. Additional stains, including diastase periodic acid-Schiff, colloidal iron, carcinoembryonic antigen, and cytokeratin-20, were subsequently performed as appropriate. Of the 3 lesions, one exhibited apocrine differentiation and two demonstrated a trabecular growth pattern. Although BCCs demonstrating apocrine differentiation have previously been described, a trabecular growth pattern, to our knowledge, has not been previously reported for BCC.
Asunto(s)
Carcinoma Basocelular/patología , Neoplasias Cutáneas/patología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Subcutaneous granuloma annulare (SGA) is a benign inflammatory disorder that may be alarming in its presentation because of its rapid growth and extensive differential diagnosis. The purpose of our study was to improve the appropriate evaluation and management of pediatric patients with subcutaneous scalp nodules. This article presents the clinical presentation, histopathologic data, evaluation, and management of a patient with subcutaneous scalp nodules diagnosed as SGA. Additionally, the clinical data of all other cases of SGA diagnosed at our institution over a 9-year period were reviewed. The majority (72%) of SGA patients encountered at our facility were children. Most of the SGA lesions were located on the extremities; however, all of the lesions located on the scalp were in children. This article reviews the differential diagnosis and workup of scalp nodules. In evaluating the patient with subcutaneous scalp nodules, we conclude that SGA should be added to the differential diagnosis.
Asunto(s)
Granuloma Anular/diagnóstico , Dermatosis del Cuero Cabelludo/diagnóstico , Adulto , Anciano , Biopsia , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Granuloma Anular/patología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Dermatosis del Cuero Cabelludo/patologíaRESUMEN
BACKGROUND: Epidermolytic hyperkeratosis (EH) and focal acantholytic dyskeratosis (FAD) are distinct histologic patterns that have been observed incidentally in a variety of benign and malignant skin lesions, including melanocytic lesions. OBJECTIVE: Our motivation for this study was to determine whether FAD and/or EH was significantly associated with atypical melanocytic lesions. METHODS: Skin biopsy specimens of melanocytic lesions diagnosed at our facility over a 3-month period were examined for the occurrence of FAD and EH. RESULTS: Whereas both FAD and EH are uncommon findings, FAD was statistically increased in atypical melanocytic lesions (P =.0172). EH was not found to differ significantly in common acquired melanocytic nevi vs atypical melanocytic lesions. CONCLUSIONS: Although both can be found in association with nonneoplastic skin diseases, as well as cutaneous neoplasms, FAD, but not EH, might serve as a marker for melanocytic atypia. Taken together with findings in the literature, FAD might serve as marker for atypical cutaneous proliferations as a whole.