Survey of 138 Conjunctival Tumors in the Dominican Republic.

PURPOSE: To report the frequency of conjunctival tumors in the Dominican Republic. METHODS: Retrospective noninterventional case series. One hundred thirty-eight consecutive patients with a conjunctival mass evaluated at two tertiary referral centers from 2010 to 2018. Main outcome measures were frequency of tumors by diagnosis and distribution of tumors relative to patients' age and gender. RESULTS: The mean age at presentation was 41.2 years (median, 42 years; range 10 days - 91 years). There were 83 male patients (60%) and 55 female patients (40%). The three most common specific diagnoses were junctional, compound, and subepithelial naevi (47 [34%]), squamous cell carcinoma (SCC) (26 [19%]) and conjunctival squamous intraepithelial neoplasia (CIN) (17 [12%]). The mean age at detection was 36.5 years for non-malignant tumors and 56.3 years for malignant tumors (p < .001), with a mean difference of 19.8 years at time of diagnosis (95% CI, 10.7-28.8). Benign tumors were more common in children and young adults; malignant and premalignant tumors were more common in mid and older adults (p = .009). Malignant tumors were more common in males (73%) than in females (27%) (p = .04). CONCLUSION: In the Dominican Republic, conjunctival tumors are benign (63%), premalignant (13%) and malignant (24%). Malignant tumors are more common in older adults and men.

Fibroadnexal hamartoma in the dog: retrospective epidemiological and histopathological study of 102 cases / Hamartoma fibroanexial em cão: estudo retrospectivo epidemiológico e histopatológico de 102 casos

Fibroadnexal hamartoma (FH), also called focal adnexal dysplasia, is the most common hamartomatous lesion in dogs. There are few retrospective studies about FH in dogs, which did not describe histopathological findings in detail. The main objective was to conduct a retrospective study and to describe the epidemiological and histopathological characteristics of a series of 102 FH cases in dogs. Descriptive statistics and Odds Ratio were used to analyze the data. The lesions were exophytic and measured on average 2.5 cm in diameter. The anatomic sites most affected were the limbs and digital region. The animals were on average 7 years of age and both sexes were equally affected. Doberman (OR: 4.15; P=0.0069) and Schnauzer (OR: 2.50; P=0.049) showed a higher risk for FH. Recurrence was not observed in any case. Four histopathological FH subtypes were identified: follicle-sebaceous (73.53%), sebaceous (16.66%), follicular (8.82%) and sebaceous-apocrine (0.98%). Diffuse and perianexial fibroplasia and inflammation were frequently seen. Chronic inflammation and mature adipocytes were seen in 71.6% and 7.8% of the cases, respectively.(AU)

Hamartoma fibroanexial (HF), também denominado displasia focal anexial, é a lesão hamartomatosa mais comum em cães. Existem poucos estudos retrospectivos sobre HF em cães, os quais não descrevem detalhadamente os achados histopatológicos. O objetivo principal foi realizar um estudo retrospectivo e descrever as características epidemiológicas e histopatológicas de uma série de 102 casos de HF em cães. A estatística descritiva e Odds Ratio foram utilizadas para a análise dos dados. As lesões foram exofíticas e mediram em média 2,5 cm de diâmetro. Os locais anatômicos mais acometidos foram os membros e dígitos. Os animais tinham em média 7 anos de idade e ambos os sexos foram igualmente acometidos. Doberman (OR: 4.15; P=0,0069) e Schnauzer (OR: 2,50; P=0,049) mostraram-se com maior risco para o HF. Não foi relatada recorrência para nenhum caso. Quatro subtipos histopatológicos de HF foram identificados: folículo-sebáceo (73,53%), sebáceo (16,66%), folicular (8,82%) e sebáceo-apócrino (0,98%). Fibroplasia difusa e perianexial e inflamação foram frequentemente observadas. Inflamação crônica e adipócitos maduros foram vistos em 71,6% e 7,8% dos casos, respectivamente.(AU)

Could a specific dietary intake be a risk factor for cutaneous melanoma?

The incidence of cutaneous melanoma (CM) has increased in the last decade. Some risk factors are well known, but there are other possible risk factors being studied, such as those involving nutrition. The objective of this case-control study was to assess the association between diet and CM. Classical risk factors, dietary intake, and body mass index were assessed. Binary logistic regression was used to study the association between dietary intake and the risk for CM. Classical risk factors associated with CM were confirmed. The findings suggest that some foods rich in vitamins A and D and phytochemicals may be related to CM.

Papular Epidermal Nevus with Skyline Basal Cell Layer (PENS): Three New Cases and Review of the Literature.

BACKGROUND/OBJECTIVE: Papular epidermal nevus with skyline basal cell layer (PENS) is a recently described type of epidermal nevus with characteristic histopathologic findings, mainly regular, rectangular acanthosis and a well-demarcated basal cell layer with clear palisading and separation between basal cell nuclei and the first row of Malpighian cell nuclei. Although the first reports described randomly distributed lesions appearing sporadically in otherwise healthy patients, cases of Blaschkoid distribution, lesions associated with extracutaneous manifestations, and familial cases have been reported. METHODS: We performed a review of the clinical charts of all patients with histologic diagnosis of PENS in our hospital. We evaluated epidemiologic, clinical, and histologic features. We then reviewed the literature with a particular emphasis on the presence or absence of extra-cutaneous associations. RESULTS: Three patients with PENS are described. One had a single lesion, one had three lesions, and one, a patient with mild developmental delay, a curved penis, and hypospadias, had multiple lesions. CONCLUSION: The probability of having extracutaneous manifestations is 6.3 times as great in individuals with more than four lesions. Therefore these patients may need closer follow-up.

Nevus-associated melanomas: clinicopathologic features.

OBJECTIVES: The clinical significance of nevus-associated melanoma compared with de novo melanomas remains controversial. It has been suggested that nevus-associated melanomas have a higher Breslow thickness and therefore worse prognosis. Over a 10-year period, this study evaluated the incidence of nevus-associated melanoma and its prognostic significance related to clinicopathologic features. METHODS: Cross-sectional study from 1995 through 2004 in a dermatopathology referral center. With available data, we evaluated sex, primary location, histologic subtype, Breslow thickness, Clark level, presence of ulceration, associated lesion, and histologic subtype of the associated lesion. RESULTS: Of 135,653 pathologic records from skin biopsy specimens over a 10-year period, 1,190 melanoma records were selected. Nevus-associated melanomas corresponded to 390 (32.8%) melanomas, with thin melanomas having a nevus 1.52 times the association observed with thick melanomas (>1.01 mm; 95% confidence interval, 1.16-1.99; P < .001). Superficial spreading melanoma was the most frequent, while no lentigo maligna melanoma was associated with nevi. The median Breslow thickness of nevus-associated melanomas was lower than that of de novo melanomas. CONCLUSIONS: Nevus-associated melanomas, which represent one-third of the melanomas in southeast Brazil, are associated with intermittent sun exposure, superficial spreading melanomas, and lower Breslow thickness. This is one of the largest series describing nevus-associated melanomas in Latin America.

Estudio epidemiológico de anatomopatología oral y maxilofacial en pacientes de un centro hospitalario / An epidemiological study of oral and maxillofacial anatomo-pathology in patients from an hospital center

Este trabajo epidemiológico está basado en el estudio estadístico de la patología biópsica del área maxilofacial hallada por el Servicio de Cirugía Maxilofacial de un centro hospitalario comunitario. En un total de 902 biopsias realizadas en 750 pacientes durante un período de 4 años (1998-2002). El objetivo de este trabajo es la determinación de resultados anatomopatológicos orofaciales relacionándolos con edad y sexo y la comparación con otros estudios, utilizados como métodos de diagnóstico (AU)

Epidermal nevus syndromes: clinical findings in 35 patients.

Of the patients with epidermal nevi, 10-18% may have disorders of the eye, nervous, and musculoskeletal systems. A predisposition to malignant neoplasms in ectodermal and mesodermal structures may also be found. There are six different epidermal nevus syndromes described so far: Proteus, congenital hemidysplasia with ichthyosiform nevus and limb defect syndrome, phakomatosis pigmentokeratotica, sebaceous nevus, Becker nevus, and nevus comedonicus. Thirty-five patients with epidermal nevus syndrome seen at the National Institute of Pediatrics in Mexico City during a 31-year period are described. This syndrome represented 7.9% of 443 patients with epidermal nevi; its relative frequency was 1 case per 11,928 pediatric patients and 1 case per 1080 dermatologic patients. Nine epidermal nevus syndrome patients (26%) had Proteus syndrome. Sebaceous nevus syndrome was found in six patients (17%), while the nevus comedonicus syndrome was found in three (8%). Two patients were diagnosed with phakomatosis pigmentokeratotica and one patient with congenital hemidysplasia with ichthyosiform nevus and limb defect syndrome. This is the first report of phakomatosis pigmentokeratotica and congenital hemidysplasia with ichthyosiform nevus and limb defect syndrome in Mexican patients. One patient had an inflammatory linear verrucous epidermal nevus with systemic involvement. Thirteen patients (37%) had keratinocytic nevi with systemic involvement. We propose the keratinocytic nevus syndrome to be defined as the association of a keratinocytic nevus with neuronal migration and/or musculoskeletal disorders in addition to a higher risk for mesodermal neoplasms.

Risks of congenital anomalies in large for gestational age infants.

OBJECTIVES: To evaluate the association between large for gestational age (LGA) and demographic and medical risk factors as well as specific types of congenital anomalies. STUDY DESIGN: A retrospective, case-control study on 2,149,617 consecutive births was conducted. LGA was defined as 1.64 SD above the mean weight for gestational age, adjusted by sex and altitude. Risk factor frequency distributions were compared between LGA and normal birth weight neonates. Associations between LGA and 41 infants with isolated congenital anomalies were evaluated. RESULTS: Of 31,897 neonates with congenital anomalies, 1800 were LGA. Five anomalies were associated with LGA: talipes calcaneovalgus, hydrocephaly, combined angiomatoses, hip subluxation, and non-brown-pigmented nevi. Multiparity, vaginal bleeding, diabetes, and delivery by cesarean section were more frequent in LGA than in appropriate for gestational age infants' mothers. Several maternal but no paternal factors were statistically associated with an increased risk for LGA infants. CONCLUSIONS: The clinical observation that nevi are more commonly observed in LGA patients was supported. The higher frequencies of hip subluxation and talipes calcaneovalgus among LGA neonates reinforces their pathogenesis as deformations, whereas those of combined angiomatoses and hydrocephaly could reflect increased fluid or body mass.

Detección de las dermatosis más frecuentes en edad escolar: estudio de 800 niños en la Provincia de Santa Fe / Detection of school-age dermatoses: a study

Durante los meses de noviembre de 1996 a marzo de 1997, en dos localidades del sur de la provincia de Santa Fe (Roldán y Casilda), se procedió al examen dermatológico de 800 niños sanos, entre 5 y 13 años. La entrevista y el examen físico se realizaron en las escuelas primarias de ambas localidades. El protocolo incluía: datos personales, características fenotípicas del individuo, antecedentes familiares y personales de dermatosis y enfermedades cutáneas detectadas. Todos los niños recibieron tratamiento y fueron citados a un nuevo control. Las dermatosis más frecuentemente detectadas fueron: pediculosis, pitiriasis alba fascie, prurigo, escabiosis, verrugas vulgares, impétigo y dermatoficias. Consideramos que este tipo de detección de patologías de piel es una acción preventiva de salud y que el mejor ámbito para la prevención masiva en salud es la escuela (AU)

Detección de las dermatosis más frecuentes en edad escolar: estudio de 800 niños en la Provincia de Santa Fe / Detection of school-age dermatoses: a study

Durante los meses de noviembre de 1996 a marzo de 1997, en dos localidades del sur de la provincia de Santa Fe (Roldán y Casilda), se procedió al examen dermatológico de 800 niños sanos, entre 5 y 13 años. La entrevista y el examen físico se realizaron en las escuelas primarias de ambas localidades. El protocolo incluía: datos personales, características fenotípicas del individuo, antecedentes familiares y personales de dermatosis y enfermedades cutáneas detectadas. Todos los niños recibieron tratamiento y fueron citados a un nuevo control. Las dermatosis más frecuentemente detectadas fueron: pediculosis, pitiriasis alba fascie, prurigo, escabiosis, verrugas vulgares, impétigo y dermatoficias. Consideramos que este tipo de detección de patologías de piel es una acción preventiva de salud y que el mejor ámbito para la prevención masiva en salud es la escuela

Nevo conjuntival / Conjunctival Nevi

El nevo conjuntival es una lesión frecuentemente vista en la clínica oftalmológica, de crecimiento lento y se suele iniciarse desde el nacimiento. Se origina de los melanocitos, tiene un curso benigno; pueden ser confundidos con los melanoma que tienen un origen similar pero con características malignas y alta mortalidad, por lo que resulta indispensable concoer las características histopatológicas de los nevos, y su clasificación, para abordarlos adecuadamente

Ultraviolet exposure and the development of banal and atypical naevi--a cross-sectional study on Curaçao and in The Netherlands.

The atypical naevus is both a risk factor for and a precursor lesion of melanoma. Sunlight is known to be an important aetiological factor for melanoma. Whether solar exposure is also involved in the initiation of (atypical) naevi is an issue of current interest. We performed a cross-sectional study among 270 inhabitants in the cloudy Netherlands and 282 white Dutch immigrants of the tropical island Curaçao to investigate whether solar exposure plays a role in the development of atypical naevi. All participants were interviewed and underwent total skin examination; banal melanocytic naevi and atypical naevi were counted. There was no significant difference in the mean number of melanocytic naevi > or = 2 mm or > or = 5 mm between Curaçao and the Netherlands. Furthermore, there was no significant difference in the mean crude and age standardized prevalence of atypical naevi between the Netherlands and Curaçao. In both groups individuals with atypical naevi had significantly more total naevi. Concerning the role of sun exposure in the development of naevi in the Netherlands, we found that the total naevus count had a significant association with cumulative sun exposure before the age of 12 as well as with two or more painful sunburns before the age of 12. In Curaçao these relationships were not observed. In contrast, however, on Curaçao the presence of atypical naevi showed an association (odds ratio = 2.6, 95% confidence interval 1.1-6.0) with the highest level of cumulative sun exposure and with painful sunburns before the age of 12 (odds ratio = 2.6, 95% confidence interval 1.2-5.5). In the Dutch group these associations were not significant. We hypothesize that in the development of banal naevi there is an association between the total number of naevi and sun exposure only at low exposure levels; however, after overstepping a critical threshold a further association between melanocytic naevi and sun exposure is lacking. Sunlight exposure before the age of 12 plays a complex role: only very high exposure levels seem to contribute to the development of atypical naevi.

A comparative study of atypical and melanocytic naevi on the tropical island Curaçao and in The Netherlands.

A cross-sectional study was undertaken in 270 inhabitants of The Netherlands (moderate maritime climate, latitude 51 degrees 5' N-53 degrees 3' N) with skin types I-III and 757 inhabitants of the tropical island Curaçao (latitude 12 degrees 2' N-12 degrees 23' N). The latter group consisted of 282 White individuals (mostly Dutch immigrants) and 475 people with non-White skin types IV, V and VI. All participants underwent total skin examination and melanocytic naevi (MN) and clinically atypical naevi (AN) were noted. There was no statistical difference in the mean number of naevi > or = 2 mm or > or = 5 mm between the Curaçao and The Netherlands White groups, but the mean number of naevi > or = 2 mm and > or = 5 mm was significantly lower in the Curaçao non-White group. We found no obvious differences in mean naevus counts between genders and the various comparable age groups. Furthermore, we found no significant difference in mean crude and mean age-standardized prevalence of (one or more) AN between Whites in The Netherlands and on Curaçao. The Mantel-Haenszel prevalence ratio weighted for age and gender differences of Curaçao Whites vs non-Whites was 5.93 (95% confidence interval 3.9-12.0), demonstrating that AN are significantly less prevalent in darker skin types. In all groups, people with AN had significantly more MN than people without AN. We found a generation-dependent difference in the expression of AN among White inhabitants of The Netherlands and on Curaçao, with a higher prevalence of AN in the younger generation.

Semana del lunar: 1a. campaña de detección del cáncer cutáneo. Parte ii: resultados epidemiológicos / The mole week: part ii: epidemiology

En la División Dermatología del Hospital de Clínicas "José de San Martín" se efectuó una campaña de prevención de cáncer de piel denominada "Semana del Lunar", que se realizó del 5 al 9 de octubre de 1992. Concurrieron 2004 pacientes y participaron la totalidad de los dermatólogos del Servicio. Los hallazgos clínicos preliminares fueron: 39 epiteliomas basocelulares, 6 epiteliomas espinocelulares y 11 melanomas malignos. Los datos estadísticos obtenidos motivan la publicación de este trabajo(AU)

Semana del lunar: 1a. campaña de detección del cáncer cutáneo. Parte ii: resultados epidemiológicos / The mole week: part ii: epidemiology

En la División Dermatología del Hospital de Clínicas "José de San Martín" se efectuó una campaña de prevención de cáncer de piel denominada "Semana del Lunar", que se realizó del 5 al 9 de octubre de 1992. Concurrieron 2004 pacientes y participaron la totalidad de los dermatólogos del Servicio. Los hallazgos clínicos preliminares fueron: 39 epiteliomas basocelulares, 6 epiteliomas espinocelulares y 11 melanomas malignos. Los datos estadísticos obtenidos motivan la publicación de este trabajo