RESUMO
Advancements within the field of veterinary surgical oncology are constantly presenting themselves, especially with continued development of comprehensive cancer programs. With the use of more advanced imaging techniques within veterinary medicine, tumor staging is improving and techniques novel to veterinary medicine are being evaluated for potential clinical application. Recommended tumor staging and treatment approach for apocrine gland anal sac adenocarcinoma in dogs has evolved, with the anticipation of good long-term patient outcomes. Preoperative staging for mast cell tumors and recommendations for surgical margins to obtain for wide surgical excision is being reassessed by surgeons.
Assuntos
Adenocarcinoma , Neoplasias das Glândulas Anais , Sacos Anais , Doenças do Cão , Oncologia Cirúrgica , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adenocarcinoma/veterinária , Neoplasias das Glândulas Anais/patologia , Neoplasias das Glândulas Anais/cirurgia , Sacos Anais/patologia , Sacos Anais/cirurgia , Animais , Glândulas Apócrinas/patologia , Glândulas Apócrinas/cirurgia , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Cães , Mastócitos/patologia , Estudos RetrospectivosRESUMO
BACKGROUND: Verneuil's disease is a chronic inflammatory skin disease of the follicles in apocrine glands rich area of the skin (axillary, inguinal, anogenital) and is associated with a deficient skin innate immunity. It is characterized by the occurrence of nodules, abscesses, fistulas, scars. Recently, vitamin D has been shown to stimulate skin innate immunity. OBJECTIVE: The primary objective of the study was to assess whether Verneuil's disease was associated with vitamin D deficiency. The secondary objective was to determine whether vitamin D supplementation could improve inflammatory lesions. METHODS: First, 25(OH) vitamin D3 serum levels in patients with Verneuil's disease followed at Nantes University Hospital were compared to those of healthy donors from the French Blood Bank. Then, a pilot study was conducted in 14 patients supplemented with vitamin D according to their vitamin D level at baseline at months 3 and 6. The endpoints at 6 months were decreased by at least 20% in the number of nodules and in the frequency of flare-ups. RESULTS: Twenty-two patients (100%) had vitamin D deficiency (level <30 ng/mL) of whom 36% were severely deficient (level <10 ng/mL), having correlation with the disease severity (P = 0.03268) vs. 20 controls with vitamin D deficiency (91%) of whom 14% were severely deficient. In 14 patients, the supplementation significantly decreased the number of nodules at 6 months (P = 0.01133), and the endpoints were achieved in 79% of these patients. A correlation between the therapeutic success and the importance of the increase in vitamin D level after supplementation was observed (P = 0.01099). CONCLUSION: Our study shows that Verneuil's disease is associated with a major vitamin D deficiency, correlated with the disease severity. It suggests that vitamin D could significantly improve the inflammatory nodules, probably by stimulating the skin innate immunity. A larger randomized study is needed to confirm these findings.
Assuntos
Glândulas Apócrinas/patologia , Hidradenite Supurativa/etiologia , Imunidade Inata , Deficiência de Vitamina D/complicações , Vitamina D/administração & dosagem , Adulto , Calcifediol/sangue , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Feminino , Hidradenite Supurativa/tratamento farmacológico , Hidradenite Supurativa/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/imunologia , Vitaminas/administração & dosagem , Adulto JovemRESUMO
La hidrosadenitis supurativa es una enfermedad inflamatoria crónica que afecta a las glándulas apocrinas. Al igual que en otras enfermedades inflamatorias crónicas de la piel pueden producirse cambios degenerativos. El carcinoma escamoso es la neoplasia maligna descrita con más frecuencia siendo excepcional el hallazgo de su variedad bien diferenciada denominado carcinoma verrucoso. Desde 1988, en nuestro hospital se han intervenido 44 pacientes diagnosticados de hidrosadenitis supurativa, de los cuales 15 presentaban una forma masiva de la enfermedad. Durante este periodo tan solo un paciente atendido en nuestra unidad de coloproctología por afectación perianal presentó degeneración maligna hacia un carcinoma verrucoso. Presentamos este caso y comentamos las peculiaridades clínicas y terapeúticas de esta situación tan poco frecuente (AU)
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Assuntos
Feminino , Pessoa de Meia-Idade , Humanos , Carcinoma Verrucoso/diagnóstico , Hidradenite/complicações , Neoplasias Cutâneas/diagnóstico , Carcinoma Verrucoso/complicações , Carcinoma Verrucoso/cirurgia , Carcinoma Verrucoso/patologia , Glândulas Apócrinas/patologia , Hidradenite/cirurgia , Hidradenite/diagnóstico , Diagnóstico Clínico , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/patologiaRESUMO
The authors describe a case of a sweat gland carcinoma that underwent complete remission after treatment with radiotherapy and hyperthermia. This sweat gland carcinoma had been thought to be unamenable to any therapeutic treatment. Based on this result, the authors feel that radiotherapy combined with hyperthermia may be effective for the treatment of a sweat gland carcinoma.