Comparing the application of various engineered xenografts for skin defects: A systematic review.

INTRODUCTION: Xenografts are a now a cornerstone in the management of wound dressings. Promising results were achieved since 1960 in the application of skin substitute for skin defects. OBJECTIVE: The objective of this study was to evaluate the efficacy of various xenografts. METHODS: A literature research was conducted using the following query: 'Porcine skin dermatology substitute', 'bovine skin dermatology substitute', 'xenograft skin substitute dermatology', 'xenografts skin defect', 'porcine skin defect', 'bovine skin defect'. RESULTS: The review yielded 35 articles pertaining to the topic. Main indications for porcine and bovine xenograft application were burn wounds and post-traumatic wounds, respectively. Mean discharge date or length of stay was at the 6th day after porcine application, and the time of graft healing was reported for 33.7% (n = 510) of patients. Promising results were seen with Matriderm and split-thickness skin graft. Most wounds achieved an excellent cosmetic result with full range of motion and a smooth contour appearance. A great variety of tissue substitutes exist, and the choice of graft application should depend on a patient's factors, product availability, wound type, size, and physician's factors. CONCLUSION: In summary, xenografts are more economic and affordable but have higher risk of infections compared to allografts.

Cutaneous adenosquamous carcinoma: a rare neoplasm with biphasic differentiation.

Cutaneous adenosquamous carcinoma (cASC) is an extremely rare malignant neoplasm. Due to its disputed pathophysiology, ambiguity of presentation, and lack of definitive clinical research, cASC is a commonly misdiagnosed skin lesion. Although it is not commonly encountered in clinical practice, it is essential for clinicians to correctly recognize and treat cASC because of its malignant and recurrent nature. The images provided in this case report depict classic and complete presentation of cASC. A review of the literature also was conducted to provide insight into this rare atypical lesion.

Patient presenting with left arm complaint has hidden melanoma on the sole.

Some insurance companies argue that complete skin examination is not justified if the presenting complaint can be fully visualized without having the patient disrobe. This might be especially true if such a patient is a member of a group at relatively lower risk for skin cancer. We present a case in which complete skin examination revealed a large melanoma in situ, indicating that skin examinations can be justified in such patients.

Two cases of acute generalized exanthematous pustulosis related to oral terbinafine and an analysis of the clinical reaction pattern.

Acute generalized exanthematous pustulosis (AGEP) is a clinical reaction pattern characterized by the rapid appearance of widespread sterile, nonfollicular pustules arising within edematous erythematous skin. This aseptic pustular eruption is commonly accompanied by leukocytosis and fever and usually follows recent administration of oral or parenteral drugs. We report two cases of terbinafine-induced AGEP in male patients. Both patients developed a generalized erythroderma with scaling and pruritic pustules 7 and 14 days following initiation of oral terbinafine. With immediate discontinuation of terbinafine and various treatment protocols, both patients demonstrated recovery followed by skin desquamation during the subsequent weeks. Terbinafine is the most frequently used systemic antimycotic and antifungal medication, reflecting its superior efficacy for dermatophyte infections. Despite the appealing drug profile, an awareness of terbinafine-induced AGEP is important given the 5 percent mortality associated with AGEP. Additionally, distinguishing the characteristics of AGEP from those associated with toxic epidermal necrolysis, Stevens-Johnson syndrome, and generalized pustular psoriasis allows for prompt dermatologic evaluation, accurate diagnosis, and appropriate treatment.

Cutaneous mixed tumor with extensive chondroid metaplasia: a potential mimic of cutaneous chondroma.

True cutaneous chondromas are extremely rare. Previously they have reportedly been confused with soft tissue chondromas and cartilaginous developmental anomalies. Monophasic mixed tumor could potentially also be mistakenly diagnosed as a true cutaneous chondroma. We report a cutaneous mixed tumor with massive chondroid metaplasia that mimicked a true cutaneous chondroma. We also propose that cutaneous mixed tumor with chondroid metaplasia may better explain the presence of primary cartilaginous tumors in the skin and true cutaneous chondroma may not be a real entity.

High expression of a cytokeratin-associated protein in many cancers.

We have described previously a cDNA library made from membrane-bound polysomal mRNA prepared from breast and prostate cancer cell lines. The library is highly enriched for cDNAs encoding membrane proteins, secreted proteins, and cytokeratins. To characterize this library, 25,277 cDNA clones were sequenced and aligned with various databases; 1,439 clones did not align with known genes. From this set of clones we identified a previously uncharacterized gene encoding a 334-aa protein. Although protein structural motif prediction programs indicate that the gene encodes a membrane protein comprising a signal sequence, a series of leucine-rich repeats, and a single transmembrane domain with a cytoplasmic tail, confocal microscopy of MCF7 breast cancer cells demonstrates that the protein is not directly associated with the plasma membrane or intracellular membranes but instead colocalizes with intermediate filaments and cytokeratins within the cell. Immunofluorescence studies also show that protein expression is increased greatly in mitotic MCF7 cells, and immunohistochemistry demonstrates its expression in human breast cancer cells. Analysis of mRNA levels in 25 different normal tissues by RT-PCR shows that this gene is expressed highly in normal prostate and salivary gland, very weakly in colon, pancreas, and intestine, and not at all in other tissues. RT-PCR studies on human cancer samples show that the RNA is expressed highly in many cancer cell lines and cancer specimens, including 26 of 33 human breast cancers, 3 of 3 prostate cancers, 3 of 3 colon cancers, and 3 of 3 pancreatic cancers. We name the protein CAPC, cytokeratin-associated protein in cancer.