Assuntos
Perna (Membro)/patologia , Neoplasias de Bainha Neural/patologia , Nervos Periféricos/patologia , Doenças do Sistema Nervoso Periférico/patologia , Neoplasias Cutâneas/patologia , Idoso , Dermoscopia/métodos , Humanos , Imuno-Histoquímica/métodos , Perna (Membro)/inervação , Masculino , Mucina-1/imunologia , Neoplasias de Bainha Neural/imunologia , Neoplasias de Bainha Neural/cirurgia , Nervos Periféricos/imunologia , Nervos Periféricos/cirurgia , Doenças do Sistema Nervoso Periférico/imunologia , Doenças do Sistema Nervoso Periférico/cirurgia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/cirurgiaRESUMO
BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is increasing in incidence but mortality rates are low. Identifying high-risk tumours is important when rationalizing clinical review for patients with cSCC. OBJECTIVES: To assess the accuracy of death certification in cases of reported fatal cSCC and to identify risk factors for fatal cSCC. METHODS: A retrospective, observational study of cases of fatal cSCC over 11 years (1993-2004) in Leeds, identified in cancer registry and death certification data. RESULTS: Fifty-eight patients were recorded by the registry as having fatal cSCC in this period. Review of case notes and pathology specimens, where available (34 cases), confirmed that 21/34 patients had died of cSCC. Five were on the ear and none on the lip. Four patients had been treated for leukaemia or lymphoma and one was a renal transplant recipient. On pathology review five patients proved to have had malignant adnexal tumours rather than cSCC, and one a melanoma. In addition, three patients had disease of the ear canal or vulva. CONCLUSIONS: A proportion of deaths were falsely attributed to cSCC as a result of inaccurate histological diagnosis. Some fatalities were related to tumours in sites known to be at higher risk, and a significant proportion was postulated to be related to immunosuppression. In those cases attributed to cSCC in which this could be assessed, the majority were American Joint Committee on Cancer stage 2 and only 24% were in high-risk sites.
Assuntos
Carcinoma de Células Escamosas/mortalidade , Neoplasias Cutâneas/mortalidade , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Atestado de Óbito , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos , Neoplasias Cutâneas/patologiaRESUMO
Calciphylaxis is a rare and potentially life-threatening condition. It is thought to result from arterial calcification causing complete vascular occlusion and subsequent cutaneous infarction. Most often, it is a complication of end-stage renal failure or hyperparathyroidism; without either of these associated conditions, it is extremely rare. We report a case of calciphylaxis in a 58-year-old white British man, who had received long-term oral prednisolone for asthma control, with prophylactic calcium supplementation. There was no history of renal failure, and the patient's parathyroid function was normal. He was found to be heterozygous for the Factor V Leiden mutation. The acute presentation was seemingly precipitated by an episode of trauma and subsequent compression bandaging. The patient responded promptly to intravenous sodium thiosulfate. To our knowledge, this is the first case with no history of renal failure and normal parathyroid function, precipitated by compression bandaging and with an associated Factor V Leiden mutation.
Assuntos
Antioxidantes/administração & dosagem , Calciofilaxia/tratamento farmacológico , Quelantes/administração & dosagem , Tiossulfatos/administração & dosagem , Humanos , Injeções Intravenosas , Rim/fisiologia , Perna (Membro) , Masculino , Pessoa de Meia-IdadeRESUMO
Acquired port-wine stains (PWSs) are rare but well recognized, and have often been reported in association with localized trauma. Various drugs have also been implicated as aetiological factors. We report the case of a 71-year-old man with an extensive congenital PWS affecting the left side of the face, upper chest and upper back. At the age of 69 years, he began to develop similar areas on his right hand and forearm, left hand and left knee. This corresponded temporally to being started on simvastatin and metformin, both of which may promote angiogenesis.
Assuntos
Anticolesterolemiantes/efeitos adversos , Hipoglicemiantes/efeitos adversos , Mancha Vinho do Porto/induzido quimicamente , Idoso , Biópsia , Diagnóstico Diferencial , Humanos , Masculino , Mancha Vinho do Porto/patologiaRESUMO
Although keratoacanthomas are common and spontaneous resolution well recognized, case reports with photographic documentation of resolution are few. The subtype of giant keratoacanthoma (GKA) can give rise to severe cosmetic destruction because of their size and their predilection for cosmetically sensitive areas (nose and eyelids). Spontaneous resolution of GKAs has not been widely reported. We present an impressive series of clinical photographs documenting the spontaneous resolution of a GKS on the nose of a 56-year-old patient.
Assuntos
Ceratoacantoma/patologia , Doenças Nasais/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Remissão EspontâneaRESUMO
A 62-year-old woman presented with a skin-coloured indurated asymptomatic plaque, 150 mm in diameter on the knee. Histological analysis of a skin biopsy taken from the lesion showed haphazardly arranged bundles of smooth muscle in the deep dermis, characteristic of a pilar leiomyoma. Cutaneous pilar leiomyomas are rare, benign smooth muscle tumours arising from the arrector pili muscle, which usually appear as red or brown papules < 15 mm in diameter. This case is unusual in its clinical appearance and size, being at least 10 times larger than the largest previously documented cutaneous pilar leiomyoma. Similar lesions have also been previously reported under the term 'acquired smooth muscle hamartoma' (ASMH). These cases are also rare and have no known consistent clinical features. Histologically it is difficult to differentiate between ASMH and leiomyomas, and some authors would consider this case as a new report of ASMH. We feel, however, that as the lesion is composed of only one element and has grown out of proportion with the growth of the limb, it is more in keeping with a true tumour rather than a hamartoma. We suggest the term 'diffuse pilar leiomyoma' may be more appropriate in this case, representing a new clinical variant of cutaneous pilar leiomyoma.
Assuntos
Hamartoma/diagnóstico , Leiomioma/diagnóstico , Doenças Musculares/diagnóstico , Neoplasias Cutâneas/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Perna (Membro) , Leiomioma/patologia , Pessoa de Meia-Idade , Músculo Liso , Neoplasias Cutâneas/patologiaRESUMO
Milia en plaque is a term used to describe an aggregation of milia occurring on an erythematous base usually localized in the retroauricular area. In most reported cases, no aetiological factors have been identified. We report the first case of milia en plaque associated with discoid lupus erythematosus occurring in the retroauricular site.
Assuntos
Lúpus Eritematoso Sistêmico/patologia , Pele/patologia , Complemento C3/análise , Orelha Externa , Feminino , Humanos , Lúpus Eritematoso Sistêmico/imunologia , Pessoa de Meia-Idade , Pele/imunologiaAssuntos
Carcinoma/diagnóstico , Carcinoma/etiologia , Nevo Pigmentado/complicações , Nevo Pigmentado/diagnóstico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/etiologia , Adulto , Biópsia , Carcinoma/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Nevo Pigmentado/patologia , Pele/patologia , Neoplasias Cutâneas/patologiaRESUMO
We describe the case of a cutaneous symplastic leiomyoma in a 37-year-old woman who presented with a 4-year history of a painful slow growing lesion on the left upper arm. The lesion was excised and subjected to histological examination. A poorly circumscribed lesion was seen in the dermis composed of spindle shaped cells with marked nuclear pleomorphism. No mitotic figures or necrosis were seen. The cells stained strongly positive with desmin and smooth muscle actin, and negative with S100, melan A, MNF116 a mouse monoclonal antibody to cytokeratin and CK5/6. The diagnosis was felt to be in keeping with a cutaneous symplastic leiomyoma, a rarely reported variant of the pilar leiomyoma. Histologically, it shows features similar to the symplastic variant of uterine leiomyoma with cytological atypia, nuclear pleomorphism and minimal mitotic activity. Although the long-term outlook is probably benign, the presence of cytological atypia and mitoses in any spindle cell tumor is generally a concerning feature and warrants long-term follow up.
Assuntos
Leiomioma/patologia , Neoplasias Cutâneas/patologia , Actinas/análise , Adulto , Biomarcadores Tumorais/análise , Núcleo Celular/patologia , Desmina/análise , Feminino , Humanos , Leiomioma/química , Leiomioma/cirurgia , Neoplasias Cutâneas/química , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoAssuntos
Angiomiolipoma/patologia , Neoplasias Cutâneas/patologia , Neoplasias de Tecidos Moles/patologia , Adolescente , Adulto , Angiomiolipoma/diagnóstico , Angiomiolipoma/metabolismo , Feminino , Humanos , Extremidade Inferior , Linfangioleiomiomatose/diagnóstico , Linfangioleiomiomatose/metabolismo , Linfangioleiomiomatose/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/metabolismo , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/metabolismoRESUMO
Trichoepitheliomas are benign epidermal appendage tumours that present most commonly as solitary lesions, and less often as multiple, symmetrically distributed lesions on the face, scalp, neck and trunk. Only a few patients have been reported in whom trichoepitheliomas were found as unusually configured linear or plaque-like confluent lesions, all of which occurred in patients with skin types V or VI. We describe a white girl with a hemifacial plaque of confluent naevoid trichoepitheliomas, the first report of such lesions in a white patient.
Assuntos
Neoplasias Faciais/patologia , Neoplasia de Células Basais/patologia , Neoplasias Cutâneas/patologia , Criança , Feminino , HumanosRESUMO
Pustular vasculitis of the hands is a distinctive clinical entity. It has recently been proposed by some authors to rename pustular vasculitis of the hands as 'neutrophilic dermatosis of the hands' to reflect its histological resemblance to the neutrophilic dermatoses. We report the case of a 66-year-old woman who presented with clinical appearances resembling pustular vasculitis of the hands associated with palmo-plantar pustulosis due to Streptococcus-induced 'pustular vasculitis'.
Assuntos
Dermatoses da Mão/microbiologia , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Vasculares/microbiologia , Infecções Estreptocócicas/diagnóstico , Vasculite/microbiologia , Idoso , Feminino , Dermatoses da Mão/patologia , Humanos , Dermatopatias Bacterianas/patologia , Dermatopatias Vasculares/patologia , Infecções Estreptocócicas/patologia , Vasculite/patologiaRESUMO
Pseudo-inflammatory tumours are a poorly defined group of tumours, with indeterminate malignant potential, which can occur at almost any site of the body. The optimal treatment of inflammatory pseudo-tumours is yet to be elucidated. Surgical excision has been the most frequently reported treatment in the literature. We report a case of solitary cutaneous inflammatory pseudo-tumour.
Assuntos
Granuloma de Células Plasmáticas/patologia , Dermatopatias/patologia , Adulto , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Glucocorticoides/uso terapêutico , Granuloma de Células Plasmáticas/tratamento farmacológico , Humanos , Masculino , Ombro , Dermatopatias/tratamento farmacológicoRESUMO
This paper reports the exceedingly rare occurrence of oral Kaposi's sarcoma in a non-HIV Caucasian White male. The lesion presented as a 8 mm vascular nodule on the buccal mucosa on the left. He was homosexual. The lesion was removed and histological examination confirmed Kaposi's sarcoma. The patient has been tested on 10 occasions for HIV from December 1998 to March 2004 and has been negative. The patient remains alive and well with no evidence of recurrence.