Assuntos
Cirurgia de Mohs/efeitos adversos , Rinoplastia/métodos , Transplante de Pele/métodos , Ferida Cirúrgica/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bandagens , Estética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/patologia , Nariz/cirurgia , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Estudos Prospectivos , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Fatores de Tempo , Resultado do TratamentoAssuntos
Proliferação de Células , Fibroblastos/patologia , Miofibroma/patologia , Neoplasias Cutâneas/patologia , Adolescente , Doenças Assintomáticas , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Feminino , Humanos , Miofibroblastos/patologia , Miofibroma/química , Miofibroma/genética , Neoplasias Cutâneas/química , Neoplasias Cutâneas/genéticaRESUMO
BACKGROUND: Mohs micrographic surgery (MMS) is the most reliable tissue-sparing technique in the management of cutaneous malignancies. Although the concept is simple, there is considerable variability in the mapping and processing techniques used by Mohs surgeons and histotechnicians. OBJECTIVE: This review article aims to examine the frozen-section tissue processing techniques. Existing variations will be discussed and pearls offered to optimize the frozen processing technique. METHODS: A PubMed search was performed for publications on methods of tissue processing in MMS. RESULTS: Our review highlights variations in debulking, embedding, processing adipose tissue, cartilage, and wedge resections. We offer pearls on how to avoid false-positive and false-negative margins and discuss advances in immunohistochemistry. CONCLUSION: Our article provides a how-to format on the different stages of tissue processing with pearls and techniques to optimize practice and improve accuracy.
Assuntos
Secções Congeladas/métodos , Cirurgia de Mohs/métodos , Neoplasias Cutâneas/cirurgia , Anticorpos/análise , Corantes , Procedimentos Cirúrgicos de Citorredução , Secções Congeladas/normas , Humanos , Imuno-Histoquímica/métodos , Queratinas/imunologia , Margens de Excisão , Cirurgia de Mohs/normas , Controle de Qualidade , Cloreto de TolônioRESUMO
OPINION STATEMENT: Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, infiltrative malignant tumour most commonly found on the head and neck. It often presents as a solitary skin-coloured or yellow papule, plaque or nodule. Ultraviolet radiation, immunosuppression and ionising radiation are possible risk factors. Clinical and histological differential diagnoses include morpheaform basal cell carcinoma and desmoplastic trichoepithelioma. The diagnosis is usually made by skin biopsy, and the characteristic features are small keratin-filled cysts with nests and cords which resemble ductal structures. Immunohistochemistry can assist in differentiating MAC from other tumours. The local aggressive nature of the tumour and its potential to infiltrate beyond the assessed clinical margins warrant complete excision with marginal control, and we recommend Mohs micrographic surgery. Wide local excision is widely performed but is associated with recurrence given its infiltrative nature and extensive subclinical extension. The role of radiotherapy in the management of MAC is unclear.
Assuntos
Neoplasias de Anexos e de Apêndices Cutâneos/diagnóstico , Neoplasias de Anexos e de Apêndices Cutâneos/terapia , Biópsia , Terapia Combinada , Diagnóstico Diferencial , Gerenciamento Clínico , Suscetibilidade a Doenças , Humanos , Imuno-Histoquímica , Incidência , Neoplasias de Anexos e de Apêndices Cutâneos/epidemiologia , Neoplasias de Anexos e de Apêndices Cutâneos/etiologia , Recidiva , Resultado do TratamentoAssuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Faciais/patologia , Neoplasias Cutâneas/patologia , Adulto , Biópsia por Agulha , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Terapia Combinada , Diagnóstico Diferencial , Neoplasias Faciais/radioterapia , Neoplasias Faciais/cirurgia , Humanos , Fatores de Risco , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoRESUMO
Melanoma-associated retinopathy is a rare paraneoplastic complication of metastatic cutaneous malignant melanoma. It may present years after the original diagnosis of melanoma. We describe a patient with this condition who presented with persistent visual symptoms.
Assuntos
Melanoma/complicações , Síndromes Paraneoplásicas Oculares/diagnóstico , Neoplasias da Retina/secundário , Neoplasias Cutâneas/complicações , Diagnóstico Diferencial , Eletrorretinografia , Humanos , Imageamento por Ressonância Magnética , Masculino , Melanoma/diagnóstico , Melanoma/secundário , Pessoa de Meia-Idade , Síndromes Paraneoplásicas Oculares/etiologia , Neoplasias da Retina/complicações , Neoplasias da Retina/diagnóstico , Neoplasias Cutâneas/patologia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Laser skin resurfacing was popularized for photoaged and scarred skin 2 decades ago. Since then, several technologic advancements have led to a new generation of delivery systems that produce excellent clinical outcomes with reduced treatment risks and faster recovery times. OBJECTIVES: To review the evolution of laser skin resurfacing from pulsed and scanned infrared laser technology to the latest techniques of nonablative and ablative fractional photothermolysis. MATERIALS AND METHODS: All published literature regarding laser skin resurfacing was analyzed and collated. RESULTS: A comprehensive review of laser skin resurfacing was outlined and future developments in the field of fractionated laser skin treatment were introduced. CONCLUSION: Laser skin resurfacing has evolved such that excellent clinical outcomes in photodamaged and scarred skin are achieved with rapid wound healing. As newer devices are developed, the applications of this technology will have a dramatic effect on the delivery of medical and aesthetic dermatology.
Assuntos
Procedimentos Cirúrgicos Dermatológicos/tendências , Terapia a Laser/tendências , Previsões , Humanos , Terapia a Laser/efeitos adversos , Fotoquimioterapia/tendências , RejuvenescimentoRESUMO
This article explores the current and emerging therapies for skin disease, with a particular focus on chronic plaque psoriasis and metastatic malignant melanoma. We discuss the current biological therapies used for psoriasis and those on the horizon, including small molecules and biosimilars. We also summarise the recent advances in the use of novel therapeutic agents in other dermatological diseases and outline the promise of translational research and stratified medicine approaches in dermatology. Better matching of patients with therapies is anticipated to have a major effect on both clinical practice and the development of new drugs and diagnostics.