Intraepithelial sebaceous carcinoma: a case report of an unusual occurrence.

Sebaceous carcinoma is a malignant neoplasm that occurs most commonly in the periorbital area, usually the eyelid. Its periocular location predisposes to smaller biopsies, thus complicating diagnosis. The neoplasm tends to exhibit aggressive local behavior, metastasizing to regional lymph nodes, and distant organs. Disease limited to the epithelium is rare, with less than 10 cases reported in the literature. We present the case of a 73-year-old woman who presented with left upper eyelid entropion and conjunctival erythema. Multiple punch biopsies showed an intraepithelial proliferation of atypical basaloid cells with enlarged and hyperchromatic nuclei intermingled with vacuolated cells containing bubbly cytoplasms and scalloped nuclei, consistent with a diagnosis of intraepithelial sebaceous carcinoma. After subsequent orbital exenteration and histological examination, a wide intraepithelial sebaceous component was identified; however, there was no invasive growth. This case highlights the rarity and the potential diagnostic pitfalls of intraepithelial sebaceous carcinoma.

Eczema prevalence in the United States: data from the 2003 National Survey of Children's Health.

Using the 2003 National Survey of Children's Health sponsored by the federal Maternal and Child Health Bureau, we calculated prevalence estimates of eczema nationally and for each state among a nationally representative sample of 102,353 children 17 years of age and under. Our objective was to determine the national prevalence of eczema/atopic dermatitis in the US pediatric population and to further examine geographic and demographic associations previously reported in other countries. Overall, 10.7% of children were reported to have a diagnosis of eczema in the past 12 months. Prevalence ranged from 8.7 to 18.1% between states and districts, with the highest prevalence reported in many of the East Coast states, as well as in Nevada, Utah, and Idaho. After adjusting for confounders, metropolitan living was found to be a significant factor in predicting a higher disease prevalence with an odds ratio of 1.67 (95% confidence interval of 1.19-2.35, P=0.008). Black race (odds ratio 1.70, P=0.005) and education level in the household greater than high school (odds ratio 1.61, P=0.004) were also significantly associated with a higher prevalence of eczema. The wide range of prevalence suggests that social or environmental factors may influence disease expression.