RESUMO
BACKGROUND: The etiology of cheilitis includes endogenous, irritant, and allergic dermatitis; lichenoid and granulomatous disorders; infection; trauma; and actinic damage. Patch testing is indicated for refractory cases (other than actinic cheilitis). OBJECTIVE: The aim of the study was to review demographics and allergens in patients patch tested for cheilitis at 2 sites in Sydney, Australia. METHODS: Records for patients patch tested for a 10-year period from 2007 to 2017 were reviewed. Baseline characteristics and patch test results were compared for patients with and without cheilitis. CONCLUSIONS: There were 1584 patients including 91 with cheilitis. Patients with cheilitis were more likely to be female, younger, and atopic and have concurrent eyelid involvement than those presenting with other dermatoses. Seventeen percent of patients with cheilitis had a post-patch test diagnosis of allergic contact cheilitis, and the most frequent relevant reactions were to patients' own products, fragrances, and sunscreens. Those with cheilitis had more positive reactions to sunscreens, especially benzophenones, compared with those without cheilitis (P < 0.001). This is an important finding in Australia where high rates of melanoma and nonmelanoma skin cancer necessitate promotion of strict sun protection measures.
Assuntos
Queilite/diagnóstico , Dermatite Alérgica de Contato/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alérgenos/efeitos adversos , Queilite/induzido quimicamente , Criança , Pré-Escolar , Cosméticos/efeitos adversos , Cosméticos/química , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Estudos Retrospectivos , Protetores Solares/efeitos adversos , Protetores Solares/química , Cremes Dentais/efeitos adversos , Cremes Dentais/química , Adulto JovemRESUMO
We report a case of a 71-year-old male who presented with a small skin-coloured plaque on his cheek. Histopathology demonstrated an intraepidermal carcinoma with follicular involvement. No evidence of dermal invasion was seen. Immunohistochemical studies showed areas of positive staining for CK20, EMA and synaptophysin. Histopathology findings were found to be most consistent with a diagnosis of intraepidermal carcinoma with features of Merkel cell carcinoma in situ, in combination with a squamous cell carcinoma in situ, with follicular involvement. Recent advances and findings suggest Merkel cell polyomavirus MCPyV-positive Merkel cell carcinoma and MCPyV-negative Merkel cell carcinoma have different cells of origin from different germ layers.
