ABSTRACT
BACKGROUND: Differences in immune profile between actinic cheilitis (AC), a precursor of lip squamous cell carcinoma, and normal lip vermillion (NL) have not been elucidated. OBJECTIVES: To compare density, distribution, and ratios of CD8+ and FoxP3+ cells between AC and NL and assess their associations with clinicopathologic variables. METHODS: Samples of AC and NL obtained between 2001 and 2013 at the College of Dentistry of the University of Concepcion, Chile, were retrospectively analyzed for immunohistochemical detection of CD8+ and FoxP3+ cells. Differences between groups were tested by Mann-Whitney U and Fisher's exact tests. Independent effects of cell densities and CD8/FoxP3 ratio with AC were assessed by multiple logistic regression analysis after adjustment for potential confounding. RESULTS: A total of 62 AC and 24 NL biopsies were included. Densities of CD8+ and FoxP3+ cells in AC were significantly higher than in NL. Conversely, the CD8+/FoxP3+ ratio was significantly lower in AC as compared to NL. After adjustment for sun exposure, age, gender, and smoking status, a stromal FoxP3+ cell density higher than 0.35 cells/field was significantly associated with increased odds of AC (odds ratio [OR] = 5.01, 95% confidence interval [CI]: 1.18-21.31), while a stromal CD8+/FoxP3+ ratio higher than 5.91 was associated with decreased odds of AC (OR = 0.29, 95% CI: 0.08-1.08). CONCLUSIONS: AC is characterized by increased FoxP3+ cell infiltration and a reduced CD8/FoxP3 ratio as compared to NL. Therefore, increased infiltration of FoxP3+ cells relative to CD8+ cells may contribute to the transition from normal to preneoplastic stages in lip carcinogenesis.
Subject(s)
CD8-Positive T-Lymphocytes/immunology , Carcinoma, Squamous Cell/immunology , Cheilitis/immunology , Forkhead Transcription Factors/analysis , Lip Neoplasms/immunology , Precancerous Conditions/immunology , Adult , Aged , Aged, 80 and over , Case-Control Studies , Cell Transformation, Neoplastic/immunology , Cheilitis/pathology , Female , Humans , Lip/immunology , Lymphocyte Count , Male , Middle Aged , Precancerous Conditions/pathology , Retrospective Studies , T-Lymphocytes/chemistry , T-Lymphocytes/immunology , Young AdultABSTRACT
La epidermodisplasia verruciforme (EV) es una genodermatosis rara, caracterizada por el desarrollo de verrugas planas y lesiones similares a pitiriasis versicolor, asociada a infección crónica por Virus Papiloma Humano. Se reporta el caso de EV. Mujer de 49 años con múltiples lesiones verrucosas de larga evolución distribuidas en las cuatro extremidades y antecedente familiar de cuadro similar. Biopsia a los 19 años evidenció verrugas sin atipia. Nuevo estudio histológico informó carcinoma escamoso, decidiéndose extirpación de lesiones. La clínica inicia en edades tempranas, con elevado riesgo de transformación maligna. No existe tratamiento específico. Es esencial la fotoprotección estricta y manejo precoz de lesiones para prevención de progresión a carcinoma.
Epidermodysplasia verruciformis (EV) is a rare genodermatosis, characterized by the development of plane warts and pityriasis versicolor-like lesions, associated with chronic infection caused by the Human Papilloma virus. An EV case is reported. 49 year-old woman with multiple long standing warty lesions distributed on the four limbs and family background of similar cases. Biopsy at 19 years old evidenced warts without atypia. New histological study reported squamous cell carcinoma, deciding the removal of the lesions. The clinic begins at early age, with high risk of malignant transformation. There is no specific treatment. Strict photoprotection and early management of the lesions is essential to prevent the progression to carcinoma.
Subject(s)
Humans , Female , Middle Aged , Epidermodysplasia Verruciformis/diagnosis , Epidermodysplasia Verruciformis/virology , Papillomavirus Infections/complications , Epidermodysplasia Verruciformis/pathology , Chronic Disease , Disease Progression , Papillomavirus Infections/virology , Diagnosis, DifferentialABSTRACT
El melanoma anorrectal es infrecuente, su clínica inespecífica y su diagnóstico tardío, acompañándose de pronóstico ominoso. Se reporta el caso de melanoma anorrectal. Mujer de 62 años con historia de baja de peso y masa rectal, estudio histológico evidencia melanoma anorrectal, realizándose cirugía respectiva y posterior radioterapia hipofraccionada. La clínica del melanoma anorrectal dificulta el diagnóstico, presentándose en edades propias de patologías más frecuentes y benignas como hemorroides. El tratamiento de elección es quirúrgico. Se recomienda un elevado índice de sospecha para manejo oportuno.
Anorrectal melanoma is rare, his clinic is unspecific and his diagnostic is late, accompanied by ominous prognosis. The case of anorrectal melanoma is reported. A 62 year old female presented weight loss and rectal mass, histology study showed melanoma anorrectal, resection surgery and radiotherapy hypofractionated were performed. Anorrectal melanoma clinical is a difficult diagnosis, this appears in ages where others diseases benign are more frequent, such as hemorrhoids. The treatment of choice is surgical. A high index of suspicion for timely management is recommended.
Subject(s)
Humans , Female , Middle Aged , Anus Neoplasms/pathology , Rectal Neoplasms/pathology , Skin Neoplasms/pathology , Melanoma/pathology , Anus Neoplasms/surgery , Rectal Diseases/surgery , Skin Neoplasms/surgery , Biopsy , Melanoma/surgeryABSTRACT
La Hidrosadenitis Supurativa (HS) es una enfermedad inflamatoria,folicular, crónica, recurrente y debilitante de la piel, caracterizadapor la presencia de abscesos y/o nódulos recurrentes, formación de fístulas y cicatrices. Las lesiones inflamatorias son dolorosas profundas y se localizan en zonas del cuerpo que poseen glándulas sudoríparas apocrinas, principalmente en la región axilar, inguinal y anogenital. Es una patología que presenta gran retraso en laconsulta y diagnóstico, ya que la mayoría de los casos leves sonreportados tardíamente. La resolución espontánea es poco probable y la discapacidad progresiva es comúnmente experimentada. Hay gran compromiso de la calidad de vida el que se correlaciona con la gravedad de la enfermedad. En esta segunda parte revisaremos las enfermedades asociadas a HS, complicaciones y alternativas terapéuticas de tipo médico y quirúrgico.
Hidradenitis suppurativa (Hs) is a chronic inflammatory, follicular,recurrent and debilitating disease characterized by painful and recurrent nodules forming extensive, fibrous anddisfigured scars. Inflammatory lesions are painful and affect primarily the axillae, inguinal and anogenital areas. Is a late disease in being diagnosed because of late consultation andreport. Spontaneous resolution is very rare and progressive disable is common. There is great quality of life involvementand related with the severity of the disease. In this second Part associated diseases, complications, and medical and surgery treatments are discussed.
Subject(s)
Humans , Hidradenitis Suppurativa/complications , Hidradenitis Suppurativa/therapyABSTRACT
El reporte de la II Encuesta Nacional sobre Prevención y Consumo de Drogas 2002 (DEVIDA, 2003) señala como dato restaltante el incremento del consumo de estupefacientes en la población femenina. Es así como el Centro de Orientación de la Unifé, con el fin de aplicar estrategias de prevención consideró necesario analizar las componentes personales de las ingresantes que juegan un factor de riesgo y las que presentan un factor protector en el consumo de sustancias psicoactivas relacionadas con características individuales. Se escogió para este fin el Test de Inteligencia Emocional ICE Bar-On, considerando los componentes relacionados con factores de riesgo y protección para el consumo de sustancias.