RESUMO
BACKGROUND: Although permanent tattoos are becoming increasingly commonplace, there is a paucity of epidemiological data on adverse tattoo reactions. Several European studies have indicated that tattoo reactions may be relatively common, although the extent of this phenomenon in the United States is largely unknown. OBJECTIVES: To provide insights into the prevalence and nature of adverse tattoo reactions. PATIENTS/MATERIALS/METHODS: We administered a survey about adverse tattoo reactions to 300 randomly selected tattooed people in Central Park, New York City. RESULTS: Of 300 participants, 31 (10.3%) reported experiencing an adverse tattoo reaction, 13 (4.3%) reported acute reactions, and 18 (6.0%) suffered from a chronic reaction involving a specific colour lasting for >4 months. Forty-four per cent of colour-specific reactions were to red ink, which was only slightly higher than the frequency of red ink in the sampled population (36%). Twenty-five per cent of chronic reactions were to black ink, which was less than expected based on the number of respondents with black tattoos (90.3%). Study participants with chronic, colour-specific reactions had more tattoo colours than those without reactions. CONCLUSIONS: This study shows that tattoo reactions are relatively common, and that further investigation into the underlying causes is merited.
Assuntos
Dermatite Alérgica de Contato/epidemiologia , Tinta , Tatuagem/efeitos adversos , Adolescente , Adulto , Idoso , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Prevalência , Autorrelato , Adulto JovemRESUMO
Leukemia cutis and facial nerve palsy are rare presenting symptoms of leukemia. This report describes a case of acute T-cell lymphoblastic leukemia (ALL) presenting with only these two symptoms, a presentation of ALL that, to our knowledge, has not been previously described. It serves to alert physicians to look for underlying malignancy in the setting of cutaneous findings associated with facial nerve palsy.
Assuntos
Doenças dos Nervos Cranianos/etiologia , Doenças dos Nervos Cranianos/patologia , Infiltração Leucêmica/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Pele/patologia , Criança , Nervo Facial/patologia , Humanos , Masculino , Couro Cabeludo/patologiaRESUMO
UNLABELLED: Recent whole genome melanoma sequencing studies have identified recurrent mutations in the gene encoding the catalytic subunit of serine/threonine phosphatase 6 (PPP6C/PP6C). However, the biochemical, functional, and clinical ramifications of these mutations are unknown. Sequencing PP6C from patients with melanoma (233 primary and 77 metastatic specimens) with extended prospective clinical outcome revealed a large number of hotspot mutations in patients with both primary and metastatic melanoma. Despite minimal association between stage and presence of PP6C mutations in patients with primary melanoma, a subpopulation of cells within each tumor did contain PP6C mutations, suggesting PP6C mutation is an early, but non-tumor-initiating event in melanoma. Among patients with primary melanoma with PP6C mutations, patients with stop mutations had significantly shorter recurrence-free survival compared with patients without stop mutations. In addition, PP6C mutations were independent of commonly observed BRAF and NRAS mutations. Biochemically, PP6C mutations could be classified as those that interact with PP6C regulatory subunits and those that do not. Mutations that did not bind to PP6C regulatory subunits were associated with increased phosphorylation of Aurora kinase, a PP6C substrate, and mitotic defects. However, both classes of PP6C mutations led to increased sensitivity to Aurora kinase inhibition. Together, these data support for the first time that PP6C mutations are molecularly, biochemically, and clinically heterogeneous. IMPLICATIONS: PP6C mutations have distinct functional and clinical consequences in melanoma, and confer sensitivity to Aurora A kinase inhibitors.
Assuntos
Aurora Quinases/antagonistas & inibidores , Melanoma/enzimologia , Melanoma/genética , Mutação , Fosfoproteínas Fosfatases/genética , Neoplasias Cutâneas/enzimologia , Neoplasias Cutâneas/genética , Aurora Quinases/metabolismo , Inibidores Enzimáticos/farmacologia , Humanos , Masculino , Melanoma/tratamento farmacológico , Melanoma/patologia , Estadiamento de Neoplasias , Fosfoproteínas Fosfatases/antagonistas & inibidores , Fosfoproteínas Fosfatases/metabolismo , Prognóstico , Inibidores de Proteínas Quinases , Subunidades Proteicas , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologiaRESUMO
Silicone injections have been used for cosmetic soft tissue augmentation for over five decades with documented consequences both systemic and dermatologic. We present a case of extensive filler migration causing bilateral lower extremity woody induration in a 53 year old Hispanic woman. She presented with a multi-year history of progressive joint stiffening at the knees, accompanied by induration and pain of the bilateral lower extremities. The patient had received two injections of an unknown substance placed into her bilateral gluteals 11 years prior. MRI indicated an infiltrative process of both lower extremities and pathology was consistent with migration of injected tissue augmentation material, most likely silicone. Due to the extent of involvement the patient was started on a trial of doxycycline 100 mg PO BID.
Assuntos
Artralgia/etiologia , Técnicas Cosméticas/efeitos adversos , Migração de Corpo Estranho/complicações , Silicones/efeitos adversos , Anti-Inflamatórios/uso terapêutico , Artralgia/tratamento farmacológico , Nádegas/patologia , Doxiciclina/uso terapêutico , Feminino , Humanos , Injeções , Extremidade Inferior/patologia , Pessoa de Meia-Idade , Dor/etiologia , Silicones/administração & dosagemRESUMO
OBJECTIVES: Age is an understudied factor when considering treatment options for melanoma. Here, we examine the impact of age on primary melanoma treatment in a prospective cohort of patients. METHODS: We used logistic regression models to examine the associations between age and initial treatment, using recurrence and melanoma-specific survival as endpoints. RESULTS: 444 primary melanoma patients were categorized into three groups by age at diagnosis: 19-45 years (24.3%), 46-70 (50.2%), and 71-95 (25.5%). In multivariate models, older patients experienced a higher risk of recurrence (hazard ratio 3.34, 95% confidence interval, CI, 1.53-7.25; p < 0.01). No significant differences were observed in positive biopsy margin rates or extent of surgical margins across age groups. Patients in the middle age group were more likely to receive adjuvant therapy than those in the older group (odds ratio 2.78, 95% CI 1.19-6.45; p = 0.02) and showed a trend to longer disease-free survival when receiving adjuvant therapy (p = 0.09). CONCLUSION: Our data support age as an independent negative prognostic factor in melanoma. Our data suggest that age does not affect primary surgical treatment but may affect decisions of whether or not patients receive postoperative treatment(s). Further work is needed to better understand the biological variables affecting treatment decisions and efficacy in older patients.