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1.
Br J Dermatol ; 156(3): 440-7, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17300231

RESUMO

BACKGROUND: The incidence of malignant melanoma is increasing worldwide and patients are being diagnosed earlier with thinner primary lesions. Most patients with very thin melanoma (Breslow thickness < 0.76 mm) are cured by surgery but 2-18% relapse locally or with distant metastases. OBJECTIVES: The objective of this study was to establish potential new prognostic markers in very thin melanoma. METHODS: We identified a group of subjects with relapsing very thin primary cutaneous melanoma and a matched control group who had not relapsed. We investigated the expression of p16, Helix pomatia agglutinin (HPA), CD95 and CD95 ligand (CD95L) by immunohistochemistry on paraffin-embedded tissue sections from the subject group, their subsequent metastases and the control group. RESULTS: Reduced p16 expression was significantly associated with relapse in very thin melanoma (P = 0.0129). Loss of p16 expression was also found in 76% of metastases. There was no significant association between HPA, CD95 or CD95L expression and subsequent relapse. CONCLUSIONS: This work is the first to show a significant loss of p16 in relapsing very thin melanoma.


Assuntos
Biomarcadores Tumorais/metabolismo , Melanoma/metabolismo , Neoplasias Cutâneas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Proteína Ligante Fas/metabolismo , Feminino , Humanos , Lectinas/metabolismo , Masculino , Melanoma/patologia , Melanoma/secundário , Pessoa de Meia-Idade , Proteínas de Neoplasias/metabolismo , Índice de Gravidade de Doença , Neoplasias Cutâneas/patologia , Receptor fas/metabolismo
2.
Clin Exp Dermatol ; 26(8): 686-95, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11722458

RESUMO

In the UK the incidence of malignant melanoma is increasing and more patients with thinner primary lesions are diagnosed earlier. Most patients with very thin melanoma (< 0.76 mm Breslow thickness) are cured by surgical excision, however, 2-18% relapse over 0-11 years with local or distant metastatic disease and may die. There are still no recognized prognostic or predictive, clinical, serological or molecular markers that accurately determine which of these very thin melanoma will relapse: the Breslow thickness remains the single most important prognostic factor for melanoma in general. Improved prognostic indicators are therefore needed for this rare, but important, unusually aggressive group, to better direct new invasive and expensive investigations and treatment. This article reviews the clinical and histological aspects of relapsing very thin melanoma and discusses the findings of several recent studies, including our own. There is no clinical or biological evidence to support either wide surgical excision or sentinel node biopsy in these patients.


Assuntos
Melanoma/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias Cutâneas/patologia , Dorso , Humanos , Perna (Membro) , Melanoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Regressão Neoplásica Espontânea , Estadiamento de Neoplasias , Prognóstico , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/cirurgia
3.
Br J Dermatol ; 144(3): 561-6, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11260015

RESUMO

BACKGROUND: Cutaneous mastocytosis is considered a relatively benign and indolent form of mast cell disease, which either ultimately regresses, remains stable or is only slowly progressive. Previously, it has been purported that no more than 60% of adult patients with cutaneous mastocytosis will have occult bone marrow involvement. OBJECTIVES: To investigate the frequency of bone marrow involvement in patients with mastocytosis but without systemic symptoms. METHODS: Bone marrow aspirate and trephine biopsy were performed in 13 consecutive patients with cutaneous mastocytosis attending our department. RESULTS: All but one of these patients had evidence of bone marrow involvement. Bone marrow cytogenetic abnormalities have been found in patients with cutaneous mastocytosis: all our patients who were analysed showed a normal karyotype. CONCLUSIONS: Bone marrow involvement is common in adults with cutaneous mastocytosis.


Assuntos
Medula Óssea/patologia , Urticaria Pigmentosa/patologia , Adulto , Idoso , Biópsia , Feminino , Humanos , Cariotipagem , Masculino , Mastócitos/patologia , Pessoa de Meia-Idade , Urticaria Pigmentosa/genética
6.
Clin Exp Dermatol ; 25(1): 44-7, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10671972

RESUMO

We describe a patient who has familial cutaneous leiomyoma in association with a symplastic uterine leiomyoma. This association has not been described previously.


Assuntos
Leiomioma/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Cutâneas/patologia , Neoplasias Uterinas/patologia , Adulto , Feminino , Humanos , Leiomioma/genética , Neoplasias Primárias Múltiplas/genética , Linhagem , Neoplasias Cutâneas/genética , Neoplasias Uterinas/genética
7.
Br J Dermatol ; 141(2): 339-43, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10468813

RESUMO

A 33-year-old caucasian woman with pyoderma gangrenosum associated with Takayasu's arteritis responded to treatment with cyclosporin. This patient is unusual in that both ulcerative and vesiculopustular forms of pyoderma gangrenosum were present. This has not previously been reported with Takayasu's arteritis.


Assuntos
Ciclosporina/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Pioderma Gangrenoso/complicações , Arterite de Takayasu/complicações , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Pioderma Gangrenoso/tratamento farmacológico , Cicatrização
8.
Br J Dermatol ; 141(1): 3-11, 1999 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10417509

RESUMO

The predominant itchy folliculitis associated with human immunodeficiency virus (HIV) infection appears to be an eosinophilic folliculitis (EF). This is characterized by lytic degeneration of sebaceous glands and an inflammatory infiltrate in which eosinophils and CD8+ T lymphocytes predominate. All patients have low CD4 counts and present late on in their HIV disease. Lesional distribution is mainly truncal, with a significant proportion also having facial involvement. Our prospective survey has shown that it is impossible to differentiate clinically between infective folliculitis and EF, and we recommend therefore that all cases are biopsied. We review the clinicopathological and immunological aspects of HIV-associated itchy folliculitis, in particular HIV-associated EF as well as current theories on pathogenesis and treatment. We suggest that HIV-associated EF is an autoimmune disease with the sebocyte or some constituent of sebum acting as the autoantigen.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/patologia , Eosinofilia/patologia , Foliculite/patologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/etiologia , Doenças Autoimunes/patologia , Dermatomicoses/complicações , Dermatomicoses/patologia , Diagnóstico Diferencial , Eosinofilia/tratamento farmacológico , Eosinofilia/imunologia , Feminino , Foliculite/tratamento farmacológico , Foliculite/imunologia , Humanos , Hospedeiro Imunocomprometido , Malassezia , Masculino , Infestações por Ácaros/complicações , Infestações por Ácaros/patologia , Sebo/imunologia , Pele/microbiologia , Pele/parasitologia
9.
Clin Exp Dermatol ; 24(3): 189-92, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10354177

RESUMO

Apocrine acne, otherwise known as hidradenitis suppurativa, is a chronic inflammatory scarring disease affecting the apocrine gland-bearing skin. We present a case of a 34-year-old woman with severe vulval apocrine acne who was successfully treated initially with prednisolone and then maintained on long-term isotretinoin. This case indicates that long-term treatment with isotretinoin may be more successful than the usual 4-6 months treatment regime.


Assuntos
Anti-Inflamatórios/uso terapêutico , Hidradenite Supurativa/tratamento farmacológico , Ceratolíticos/uso terapêutico , Prednisolona/uso terapêutico , Tretinoína/uso terapêutico , Vulvite/tratamento farmacológico , Adulto , Antibacterianos/uso terapêutico , Quimioterapia Combinada , Eritromicina/uso terapêutico , Feminino , Humanos
10.
Sex Transm Infect ; 75(5): 291-3, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10616350

RESUMO

Eosinophilic folliculitis (EF) is a chronic, intensely pruritic condition of unknown pathogenesis that causes marked morbidity in those HIV patients whom it affects. There is a wide differential diagnosis of itchy skin conditions in HIV which are amenable to different treatments. It is therefore essential to take a biopsy of each suspected case and examine multiple sections of the biopsy to confirm or refute a diagnosis of EF. Treatment of EF can be difficult but we hope that by suggesting a rational approach to this and considering possible therapeutic options more patients may be helped with this troublesome dermatosis.


Assuntos
Eosinofilia/virologia , Foliculite/virologia , Infecções por HIV/complicações , Dermatopatias/virologia , Administração Tópica , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antifúngicos/uso terapêutico , Eosinofilia/patologia , Eosinofilia/terapia , Foliculite/patologia , Foliculite/terapia , Glucocorticoides , Infecções por HIV/patologia , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Humanos , Inseticidas/uso terapêutico , Isotretinoína/uso terapêutico , Itraconazol/uso terapêutico , Ceratolíticos/uso terapêutico , Metronidazol/uso terapêutico , Permetrina , Piretrinas/uso terapêutico , Dermatopatias/patologia , Dermatopatias/terapia , Terapia Ultravioleta
11.
Br J Dermatol ; 139(4): 708-12, 1998 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9892920

RESUMO

We report the case of a 44-year-old woman with Degos' disease who also had a lupus anticoagulant. Electron microscopy of the mature lesions showed interwoven tubular structures within the endothelial cells, as have been observed in previous cases of Degos' disease. Four years after her first cutaneous lesions, there is no evidence of involvement of other organs. Aspirin (300 mg daily) has arrested the cutaneous disease.


Assuntos
Dermatopatias Papuloescamosas/patologia , Adulto , Aspirina/uso terapêutico , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Inibidor de Coagulação do Lúpus/sangue , Microscopia de Fluorescência , Dermatopatias Papuloescamosas/imunologia
13.
Br J Dermatol ; 137(4): 620-2, 1997 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9390343

RESUMO

We report the first case of aquagenic urticaria in a patient with human immunodeficiency virus (HIV) infection. This is a rare physical urticaria not previously described in this context. The disorder proved unamenable to conventional treatment with antihistamines, but did respond dramatically to stanozolol, suggesting a novel indication for this anabolic steroid.


Assuntos
Infecções por HIV/complicações , Urticária/etiologia , Água/efeitos adversos , Adulto , Anabolizantes/uso terapêutico , Humanos , Masculino , Estanozolol/uso terapêutico , Urticária/tratamento farmacológico , Urticária/patologia
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