Relationship between food intake and cutaneous solar elastosis adjacent to basal cell carcinoma.

BACKGROUND/OBJECTIVE: Studies suggest that diet may influence in skin ageing and skin appearance. However, the effect of diet in the elastotic changes of dermis, which is the main histological sign of ageing, has not been studied previously. The objective was to investigate if the dietary habits influence the dermal elastosis observed in BCCs. MATERIALS AND METHODS: The 136 patients with facial BCCs, who underwent surgery, were interviewed to assess the consumption of fruit, vegetables, fat, red meat, coffee and tea. We reviewed 136 specimens of BCC to identify the presence of solar elastosis. We also analysed clinical variables such as gender, age, phototype and smoking. RESULTS: Severe solar elastosis was found in 22 patients (16%), middle reticular dermis in 37 (27 %) and 77 patients (57%) had abscence or light elastosis. Fat consumption was reported by most of participants from our sample, while fruit and tea consumption was less common. Intakes of fat, vegetables and coffee were not associated with the grade of elastosis whereas Vitamin E and C-rich fruits and tea were correlated with less risk of elastosis. Smokers showed higher grades of elastosis than non-smokers. CONCLUSION: Our study provides evidence that the presence of dermal elastosis and cutaneous ageing may be influenced by the type of food intake: Vitamin E and C-rich fruit and tea are positively associated with less elastosis.

"Eruptive" facial syringomas: an inflammatory skin reaction?

A 26-year-old woman exhibited multiple, 1- to 3-mm eruptive asymptomatic papules, symmetrically distributed on the face. None of her family members had similar lesions. The papules first appeared in 2006 and gradually increased in number, particularly during her first pregnancy. She stated that the development of lesions was preceded by dermatitis. Physical examination revealed many flesh-colored or slightly reddish, smooth-surfaced papules around the eyes, both cheeks, and temples (Figure 1 and Figure 2). The differential diagnosis included syringomas in an atypical location, cutaneous sarcoidosis, and periorificial dermatitis. Histopathologic examinations revealed aggregation of small tubular structures lined by two rows of epithelial cells, most of which were characterized by comma-like tails, giving them a tadpole shape. They were embedded in a fibrous connective tissue stroma in the dermis. These histopathologic findings were consistent with syringoma (Figure 3).

Assessment of incompletely excised basal cell carcinomas in six facial areas: influence of elastosis.

BACKGROUND: Incomplete excision of non-melanoma skin cancer is a clinical indicator of surgical care. With most basal cell carcinomas arising on the face and considering the cosmetic and functional structures involved, it is interesting to identify what are the areas within the face with more likelihood of incomplete excision and the factors implicated. The aim of this study was to identify those areas and possible predictive factors. Six anatomical regions were considered and studied selectively. METHOD: A monocentric study was performed reviewing all facial basal cell carcinomas excised at our center during 2010. Data were analyzed using SPSS software. RESULTS: 202 lesions from 202 subjects were studied. The percentage of incomplete excision was 17.07%. CONCLUSION: Lesions located in the orbitopalpebral and auricular areas and those with moderate to severe grade of associated elastosis are more likely to be incompletely excised. Wider surgical margins are observed in frontal, malar and labial areas which are distant from functional structures. The following tumor features were found to be a risk factor for incomplete resection: morpheic or superficial histology, large lesions (>20 mm) and thick lesions (>6 mm).

Annular erythematous papules in the neckline.

A 45-year-old woman with personal history of hypertension presented with an erythematous lesion in the neckline for a year and with a progressive growth. A physical examination revealed an annular lesion with erythematous papules in the edge. Histological exam showed phagocytosis of elastic fibers by multinucleated cells compatible with annular elastolytic giant-cell granuloma. The patient did not present any other associated systemic manifestation. Treatment with tacrolimus 0.1 percent ointment was prescribed with a very good response after two months.

A 5-year-old boy with comedo-like lesions on the right buttock.

A healthy, 5-year-old boy presented with cutaneous lesions on the right buttock, evident at birth. A physical examination revealed plugged pores in a linear distribution with the appearance of comedones and scar areas. Histopathological exam revealed multiple atrophic cystically dilated hair follicles containing abundant keratinous debris and small projections of epithelial cells extending from the wall of the cyst into the surrounding dermis, compatible with nevus comedonicus.

Cutaneous metastasis as first clinical manifestation of signet ring cell gastric carcinoma.

Cutaneous metastases from signet ring cell gastric carcinoma are uncommon. A 69-year-old man presented with a 15-day history of an asymptomatic indurated scar-like lesion. The biopsy revealed an infiltrating signet ring cell carcinoma consistent with gastric metastasis. Gastroscopy and biopsy showed gastric carcinoma with signet ring cells; subsequent computed tomography revealed metastatic nodules in the liver, mesentery, and retroperitoneal and peripancreatic lymph nodes. A review of the 10 cases of cutaneous metastasis from signet ring cell carcinoma in the literature revealed that cutaneous metastases of gastric origin usually appear at earlier ages than in our patient and that the primary tumor is unknown at the time of skin biopsy in 64 percent of cases. The present report describes the unusual clinical-diagnostic sequence of a patient diagnosed with cutaneous metastasis before detection of his gastric carcinoma.

Nevus azul con área central despigmentada / Blue naevus with central depigmented area

El nevus azul es una lesión benigna papular o nodular con coloración que varía desde el azul-oscuro al azulnegruzco. Las localizaciones más comunes son el dorso de las manos y pies, brazos, piernas, cara y cuero cabelludo. Se presenta el caso de una mujer de 60 años con una lesión sobreelevada en el cuero cabelludo de más de 30 años de evolución, en cuyo centro apareció un área central despigmentada. Tras la toma de biopsia y posterior extirpación completa de la lesión, fue diagnosticada de nevus azul celular. La aparición de dicha área central despigmentada posiblemente está relacionada con un traumatismo continuado y repetitivo por la acción del cepillado del pelo. (AU)

Expresión inmunohistoquímica de glicoproteína P como factor pronóstico en sarcomas óseos / Immunohistochemical expression of glycoprotein P as a prognostic factor in bone sarcomas

Se presenta un estudio inmunohistoquímico de expresión de glicoproteína P en 44 tumores óseos malignos (32 osteosarcomas y 12 condrosarcomas) con el propósito de analizar la inmunorreactividad por estirpe histológico y su valor pronóstico potencial. El principio del procedimiento es la determinación de la molécula de glicoproteína P mediante un método inmunohistoquímico que emplea un cóctel de anticuerpos monoclonales específicos (JSB1 y MRK16) prediluidos y el procedimiento estándar de la fosfatasa-antifosfatasa alcalina, con incubación doble de anticuerpo secundario y ese complejo. Las muestras de tejido fueron obtenidas antes de la quimioterapia. La inmunoexpresión se clasificó en seis grados según una escala semicuantitativa de positividad celular.Hay que destacar la expresión intensa y constante de glicoproteína P en la membrana celular de los condrosarcomas (positividad del 100 por ciento y puntuación semicuantitativa de 3,83ñ 1,03). En los osteosarcomas la tinción fue menos constante (positividad del 59,37 por ciento y puntuación semicuantitativa de 2,79 ñ 1,81). Los pacientes con osteosarcomas localizados de alto grado (IIB) y que expresaban glicoproteína P tenían una menor supervivencia (log rank; p < 0,05) e intervalo libre de enfermedad (log rank; p < 0,001). Los hallazgos sustentan a la expresión de glicoproteína P como factor pronóstico en el osteosarcoma (AU)

Endocervical polyp with pseudosarcomatous pattern and cytoplasmic inclusions: an electron microscopic study.

A case of endocervical polyp with atypical stromal cells in a 32-year-old woman is reported. Light microscopy showed atypical stromal cells with eosinophilic cytoplasmic inclusions which, by electron microscopy, were nonmembrane-bound, compact fibrillary structures in close relationship with the cytoplasmic microfibrils. The ultrastructural features demonstrated a fibroblastic nature of bizarre cells. These inclusions are similar to those of infantile digital fibromatosis. These findings have not been reported previously.