RESUMO
BACKGROUND/AIM: Acral lentiginous melanoma (ALM) is a rare entity on the foot. This study aimed to reveal its clinical presentations, histopathology and treatment options. MATERIALS AND METHODS: Seven cases of ALM involving foot were treated in our Institute in a 3-year period. RESULTS: The patients' age ranged from 38 to 84 years, with a mean of 65. The ratios of males to females and white to non-white were 4:3 and 5:2, respectively. Clinically, ALM presented as asymmetric, irregular shaped, black-brown, variegatedly discolored, papular, verrucoid, ulcerated or nodular lesions with or without pain. All ALMs were treated with either wide local excision (WLE) or toe amputation. Histologically, ALM was characterized by multiple single and nested atypical melanocytes growing along the dermal-epidermal junction, and extending into dermal layer in nodular growth pattern. CONCLUSION: ALM is a rare, asymmetric, irregularly bordered, variegatedly pigmented lesion. WLE or toe amputation is the standard treatment option.
Assuntos
Tornozelo/patologia , Doenças do Pé/patologia , Melanoma/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Tornozelo/cirurgia , Feminino , Seguimentos , Doenças do Pé/cirurgia , Humanos , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Nevo/cirurgia , Prognóstico , Neoplasias Cutâneas/cirurgia , Melanoma Maligno CutâneoRESUMO
This article presents an up-to-date review of the literature on hormone augmentation in the elderly to help primary care physicians better evaluate and utilize hormone replacement and optimization strategies to benefit their patients. The scientific literature suggests that hormone supplementation with estrogen, progesterone, testosterone, growth hormone, and thyroid hormone has the potential to improve quality of life and to prevent, or reverse, the many symptoms and conditions associated with aging, including fatigue, depression, weight gain,frailty, osteoporosis, loss of libido, and heart disease. Possible long-term side effects are also considered.
Assuntos
Envelhecimento/efeitos dos fármacos , Estrogênios/farmacologia , Geriatria/métodos , Terapia de Reposição Hormonal/métodos , Progesterona/farmacologia , Testosterona/farmacologia , Hormônios Tireóideos/farmacologia , Humanos , PrognósticoRESUMO
The data reviewed herein show that hormone replacement therapies improve some conditions associated with aging. Additionally, some of the long-held fears of significant side effects associated with hormone supplementation may be overstated, especially when providing patients with individualized care and optimal monitoring. We encourage clinicians to consider such interventions based on the evidence presented.More long-term studies are needed to further quantify and substantiate the risks and benefits associated with the use of such therapies.
Assuntos
Envelhecimento/efeitos dos fármacos , Estrogênios/farmacologia , Geriatria/tendências , Terapia de Reposição Hormonal/métodos , Progesterona/farmacologia , Testosterona/farmacologia , Hormônios Tireóideos/farmacologia , Humanos , Prognóstico , Inquéritos e QuestionáriosRESUMO
Confusion and controversy surround the use of estrogen, progesterone, testosterone, growth hormone, and thyroid hormones. This article discusses age-related hormone loss and supplementation therapies for age-related hormonal deficiencies as possible first-line therapeutic modalities to be considered in our search to improve quality of life, prevent chronic illnesses, and maintain wellness. The well-informed use of hormones in wellness and disease prevention will result in symptomatic improvement and should be considered an integral part in the armamentarium of options we offer our patients.