Five-year pattern of adnexal tumors of the skin in Ethiopia.

BACKGROUND: Adnexal tumors of the skin are rare neoplasms that encompass a wide range of dermatologic entities. Here, we investigated the pattern of adnexal tumors of the skin in the All African Leprosy and Tuberculosis Rehabilitation and Training Center (ALERT) hospital retrospectively. METHODS: A hospital-based retrospective study was conducted at ALERT from histopathology records in the Armauer Hansen Research Institute (AHRI) pathology laboratory of patients diagnosed with any of the skin adnexal tumors during the time period January 2017 to December 2021. A structured data extraction sheet was used. Data entry was done using EpiData 4.6.0.6. Data were analyzed using SPSS version 25. RESULT: A total of 146 skin adnexal tumors were identified making the magnitude 2.8% of total biopsies. The 3rd decade of life was found to be the most common age group. Male-to-female ratio was 1 : 1.05. Majority of the tumors were benign (82.2%) and had sweat gland differentiation at 48.6%. Poroma (10.9%) was the most frequent tumor, whereas porocarcinoma (6.8%) made up the most frequent malignant tumor. The most common site was the head and neck region (48.6%). Only 21.2% of the tumors were correctly identified clinically. CONCLUSION: The magnitude of skin adnexal tumors is found to be slightly higher than other similar studies which could be because it was carried out in the largest dermatologic center in the country. The most common skin adnexal tumors identified, their localizations, and lines of differentiation are all in line with other studies. Histopathologic examination is mandatory for the accurate diagnosis of these tumors.

[Creation, implementation and objectives of CARADERM, a national network for rare skin carcinomas - Adnexal neoplasm part]. / Développement, mise en œuvre et objectifs de CARADERM, réseau national cancers cutanés rares ­ partie carcinomes annexiels.

INTRODUCTION: CARADERM is a French national network that includes patients with rare skin adnexal neoplasms. The present paper describes only the adnexal neoplasm part of this network. The primary objective of CARADERM is to improve medical care for malignant skin adnexal neoplasms. A multidisciplinary review group and a centralized pathological review group have been set up. PATIENTS AND METHODS: A dual network of clinicians and pathologists has been set up. Data are recorded in a secure database. RESULTS: The CARADERM network comprises of 38 clinical centres and 22 pathology centres. Between 2014 and 2017, 1598 patients with an adnexal neoplasm were included. Data of interest were documented in 80% of cases. Median patient age was 72 years. Major histological subtypes were sweat gland carcinomas (50%), hair follicle carcinomas (37.7%), and sebaceous gland carcinomas (9.8%). Surgery was the first-line treatment for 81% of patients, including 76.9% with standard surgical margin analysis, and 5.5% with exhaustive margin analysis. 920 patients (57.6%) underwent a national pathology review process. DISCUSSION: The CARADERM network aims at providing assistance in difficult situations concerning diagnosis and care in skin adnexal neoplasms. Analysis of the CARADERM data should allow the creation of a prognostic classification of these rare neoplasms together with recommendations. A national multidisciplinary consensus exists. Translational and therapeutic research is ongoing. CONCLUSION: The CARADERM network is currently recruiting and more data should lead to improved knowledge of these tumours in the coming years.

Hydrochlorothiazide use and risk for Merkel cell carcinoma and malignant adnexal skin tumors: A nationwide case-control study.

BACKGROUND: Hydrochlorothiazide use has been associated with markedly increased risk for squamous cell carcinoma. No previous studies have investigated the association between hydrochlorothiazide use and the risk for Merkel cell carcinoma (MCC) and malignant adnexal skin tumors (MAST). OBJECTIVE: To examine the association between hydrochlorothiazide use and the risk for MCC and MAST. METHODS: Using Danish nationwide health registries, we identified all patients with incident MCC or MAST during 2004-2015 and matched the cases individually to cancer-free population controls by risk set sampling. Using conditional logistic regression, we estimated the odds ratios (ORs) and confidence intervals (CIs) associated with cumulative use of hydrochlorothiazide. RESULTS: The adjusted ORs for MCC and MAST associated with high use (≥50,000 mg) of hydrochlorothiazide was 2.3 (95% CI 1.1-4.8) and 3.6 (95% CI 1.9-7.0), respectively, which increased to 3.3 (95% CI 1.3-8.3) and 5.6 (95% CI 2.4-13.3), respectively, with highest use (≥100,000 mg). We found no increased risk for these tumors in analyses of drugs with similar indications as hydrochlorothiazide, except there was a tendency toward an increased risk for MCC associated with the use of furosemide (OR 1.9, 95% CI 0.9-4.0). LIMITATIONS: No data on sun exposure was available. CONCLUSION: Hydrochlorothiazide use is associated with an increased risk for MCC and MAST.

Microcystic Adnexal Carcinoma and a Summary of Other Rare Malignant Adnexal Tumours.

OPINION STATEMENT: Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, infiltrative malignant tumour most commonly found on the head and neck. It often presents as a solitary skin-coloured or yellow papule, plaque or nodule. Ultraviolet radiation, immunosuppression and ionising radiation are possible risk factors. Clinical and histological differential diagnoses include morpheaform basal cell carcinoma and desmoplastic trichoepithelioma. The diagnosis is usually made by skin biopsy, and the characteristic features are small keratin-filled cysts with nests and cords which resemble ductal structures. Immunohistochemistry can assist in differentiating MAC from other tumours. The local aggressive nature of the tumour and its potential to infiltrate beyond the assessed clinical margins warrant complete excision with marginal control, and we recommend Mohs micrographic surgery. Wide local excision is widely performed but is associated with recurrence given its infiltrative nature and extensive subclinical extension. The role of radiotherapy in the management of MAC is unclear.

Incidence and Clinical Features of Rare Cutaneous Malignancies in Olmsted County, Minnesota, 2000 to 2010.

BACKGROUND: The incidence of rare cutaneous malignancies is unknown. Current estimates of rare cutaneous malignancy incidences are based on broad epidemiologic data or single institution experiences, not population-based data. OBJECTIVE: To determine the incidence of several rare nonmelanoma skin cancers. MATERIALS AND METHODS: The authors conducted a retrospective chart review of a population-based cohort between the years 2000 and 2010. Residents of Olmsted County, Minnesota, who were diagnosed with a biopsy-proven nonmelanoma skin cancer-excluding basal cell carcinoma and squamous cell carcinoma-were included in this study. The primary outcome was tumor incidence. Additionally, the authors extracted patient demographics, tumor characteristics, treatment modalities, and outcomes. RESULTS: The age-adjusted and sex-adjusted incidences per 100,000 persons of multiple rare cutaneous malignancies were: atypical fibroxanthoma (1.8), sebaceous carcinoma (0.8), dermatofibrosarcoma protuberans (0.4), microcystic adnexal carcinoma (0.7), eccrine carcinoma (0.4), eccrine porocarcinoma (0.2), and leiomyosarcoma (0.2). CONCLUSION: The authors report population-based incidences and clinical characteristics for these rare cutaneous malignancies. The immune status and smoking status of patients and the treatment and outcomes of these tumors are reported. Additional studies in a broader population are needed to further define the epidemiology and outcomes of these malignancies.

Risk of malignancy index validity assessment in premenopausal and postmenopausal women with adnexal tumors.

OBJECTIVE: The aim of this study was to investigate the validity of the risk of malignancy index (RMI) in premenopausal and postmenopausal patients with adnexal masses. MATERIALS AND METHODS: The study involved all women treated for adnexal tumors throughout an 18-month period in the Clinic for Gynecology and Obstetrics, Clinical Center of Serbia (Belgrade, Serbia). On admission, detailed anamnestic and laboratory data were obtained and an expert ultrasound scan was performed. The RMI was calculated for all patients and the obtained data were related to histopathological findings of the tumors. For statistical analysis, we used descriptive and analytical statistics methods and an SPSS computer program. RESULTS: From a total number of 540 women, 85 women had malignant tumors; 20 women, borderline tumors; and 435 women, benign adnexal tumors. The RMI was reliable in 84.6% of all patients; in 77% of premenopausal patients, and in 81.1% of postmenopausal patients. The sensitivity of the RMI in the overall population was 83.81%; the specificity was 77.24%; the positive predictive value (PPV) was 47.06%, and the negative predictive value (NPV) was 95.18%. In premenopausal women, the RMI sensitivity was 83.87%; specificity, 80.31%; PPV, 28.89%; and NPV, 98.12%. In postmenopausal women the RMI sensitivity was 83.78%; specificity, 68.18%; PPV, 63.92%; and NPV, 74.71%. CONCLUSION: The RMI was a reliable factor for differentiating benign from malignant adnexal masses in premenopausal and postmenopausal patients.

Estudio clínico y epidemiológico de los tumores anexiales en la cátedra de Dermatología de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción: Paraguay, 2002-2008 / Clinical and epidemiological study of adnexal tumours at the Dermatology of the Facultad de Ciencias Médicas of the Universidad Nacional de Asunción: Paraguay, 2002-2008

Introducción: los tumores anexiales constituyen un grupo de entidades relativamente infrecuentes y de difícil diagnóstico. Objetivos: describir la prevalencia y las características clínicas de los casos de tumores cutáneos anexiales en la cátedra de Dermatología del Hospital de Clínicas. FCM-UNA. Clasificar los tumores de acuerdo a la estructura anexialde la cual derivan. Determinar la correlación entre la apreciación clínica y el diagnóstico dermatopatológico. Determinar la prevalencia de tumores anexiales cutáneos benignos y malignos. Material y métodos: estudio descriptivo de serie de casos de 2.637 diagnósticos dermatopatológicos de la cátedra de Dermatología del Hospital de Clínicas en el periodo 2002-2008. Resultados: se encontraron 36 pacientes con tumores cutáneos anexiales representando una prevalencia del 1.4%. El diagnóstico fue más frecuente en mujeresy el 53% de pacientes era mayor de 40 años. Los tumores resultaron ser benignos en 33 casos (92%) y malignos en tres (80/0E). El mayor número de diagnósticos histopatológicos correspondió al grupo de tumores anexiales originados en las glándulas sudoríparas (ecrinas y apocrinas) con 19 casos (53%). Se realizó correlación clínico-patológica en un 14% de 105 pacientes, siendo el diagnóstico definitivo histopatológico en más del 50% de los casos. Conclusiones: los tumores anexiales cutáneos se diagnostican con una frecuencia baja y son difíciles de diferenciar por la clínica, lo que se corrobora por la escasa correspondencia entre ésta y la dermatopatología. La incidencia de tumores anexiales malignos es baja.

Background: adnexal skin tumors are, agroup of relatively rare diseases, difficult to diagnose. Aims: to describe the prevalence and clinical characteristics of adnexal skin tumors in the Dermatology Department, Clínicas Hospital. FCM-UNA. To classify tumors according to the adnexal structure from which they derive. To determine the correlation between clinical assessment and dermatopathological diagnosis. To determine the prevalence of benign and malígnant adnexal skin tumours. Methods: descriptive case series study of 2.637 dermatopathological cases from the Dermatology Department, at Clínicas Hospital in the period 2002-2008. Results: there were 36 patients with adnexal skin tumors, prevalence of 1.4%. These diagnoses were more common in women and 53% of patients were older than 40 years. The tumors were benign in 33 cases (92%) and malignant in 3 cases (8%). The highest number of his to pathological diagnoses corresponded to the group of adnexal tumors arising in sweat glands (eccrine and apocrine) with 19 cases(53%). There was a clinicopathological correlation in 14% of patients, and in histopathological diagnosis by more than 50% of cases. Conclusions: cutaneous adnexal tumors are diagnosed with low frequency and are difficult to distinguish by just the clinical aspects, which is corroborated by the low correspondence between them and the dermatopathology aspects. The incidence of malignant adnexal tumors is low.

Rare skin cancer: a population-based cancer registry descriptive study of 151 consecutive cases diagnosed between 1980 and 2004.

BACKGROUND: There are few epidemiological data available on rare skin cancer, including Merkel cell carcinoma, Paget's disease, adnexal carcinoma, and sarcoma. We conducted this study to investigate the epidemiology of rare skin cancer diagnosed in the department of Doubs from 1980 to 2004. METHODS: Data were collected from a population-based cancer registry from 1980 to 2004. Diagnosis was based on the 3(rd) edition of the International Classification of Diseases for Oncology. The incidence rates were standardized on world population. RESULTS: One hundred and fifty one patients were investigated (88 women and 63 men). Median age for the diagnosed disease was 63 years. The standardized incidence rate was 0.82/100 000 person-year (95% CI = 0.68-0.96) and increased from 0.25 in 1980-1984 to 1.50 in 2000-2004. Fifty nine cases (39%) were sarcomas, 35 (23%) adnexal carcinomas, 27 (18%) Merkel cell carcinoma and 27 (18%) Paget's disease. The standardized incidence rates were 0.37/100 000 (0.27-0.47) for sarcomas, 0.16 (0.10-0.22) for adnexal tumors, 0.13 (0.08-0.18) for Merkel cell carcinoma, and 0.15 (0.09-0.21) for Paget's disease. CONCLUSIONS: Our results based on a population-based cancer registry showed an increase of the standardized incidence rate for all types of rare skin tumors. These results may be useful when considering the growing interest in rare diseases in identifying risk factors and planning scientific research programmes.

Incidence of cutaneous sebaceous carcinoma and risk of associated neoplasms: insight into Muir-Torre syndrome.

BACKGROUND: Sebaceous tumors of the skin occurring in association with an internal malignancy characterize Muir-Torre syndrome (MTS), a variant of hereditary nonpolyposis colon cancer (Lynch syndrome). To the authors' knowledge, only limited information exists regarding incidence patterns of sebaceous carcinoma (SC), and no prior study has quantified risks of associated cancers. METHODS: The authors calculated cutaneous SC incidence rates (IRs) and IR ratios in 9 US Surveillance, Epidemiology, and End Results program registries (1973-2003). Indirectly standardized incidence ratios and 95% confidence intervals (95% CIs) were calculated for subsequent cancers among 2-month survivors of SC and for subsequent SC after other primary cancers. RESULTS: Among 664 cases of cutaneous SC, nearly 90% were diagnosed among whites (IR, 0.11 per 100,000 person-years), with significantly lower IR noted among blacks (IR, 0.04). Whereas eyelid SC IRs demonstrated no sex differences and stabilized in recent years, IRs of noneyelid SC predominated in men and rose steadily over time. Survivors of SC had a 43% (95% CI, 15%-76%) increased risk of subsequent cancer, and risk of SC was elevated by 52% (95% CI, 24%-84%) among survivors of other cancers. Whether before or after SC, the significant excesses of other primary cancers were limited to noneyelid SC. Patterns suggestive of genetic predisposition included >20-fold risks for early-onset (diagnosed in patients aged <50 years) SC associated with colon, pancreatic, ovarian, or uterine corpus cancers, whereas late-onset SC (diagnosed in patients aged > or =50 years) predisposed to ureter cancer. CONCLUSIONS: This population-based study of cutaneous SC revealed an association with a spectrum of early-onset cancers consistent with MTS. Etiologic heterogeneity was suggested by differences between eyelid and noneyelid SC in incidence patterns and associated cancer risks.

Adnexal skin tumors in Zaria, Nigeria.

BACKGROUND: Adnexal skin tumors share many features in common and differentiate along one line. Their detailed morphological classification is difficult because of the variety of tissue elements and patterns seen. They may be clinically confused with other cutaneous tumors. The aim of this report is to review and classify all adnexal tumors seen in a pathology department over a 16-year period. METHOD: A 16-year retrospective analysis of all adnexal skin tumors seen in a large University Teaching Hospital in Nigeria from January 1991- December 2006. All tissue specimens were fixed in 10% formalin, processed in paraffin wax and stained with Haematoxylin and Eosin. Histology slides were retrieved, studied and lesions characterized. RESULTS: Fifty-two adnexal tumors were seen, accounting for 0.9% of all cutaneous tumors seen within the same period. The median age was 33 years (range: 4 days-70 years). Clinical presentations varied from discreet swellings and nodules to ulcerated masses. Five patients presented with recurrent lesions. Only two cases had a clinical diagnosis of adnexal tumor. Twenty-four (46%) of the lesions were distributed in the head and neck region. Duration of symptoms was 2 months to 15 years (median: 12 months). Tumours of the sweat gland were the commonest--41 (78.8%); they comprised predominantly eccrine acrospiroma (17), characterized histologically by solid nests of round to polygonal cells with clear to eosinophilic cytoplasm, forming tubules in areas. Tumours of sebaceous gland were 7 (13.5%); they comprised mainly Nevus sebaceous of Jadassohn (6), composed of immature sebaceous glands and pilar structures microscopically and a solitary sebaceous adenoma. Tumours of hair follicle were 4 (7.7%) and included trichoepithelioma, characterized microscopically by multiple horn cysts and epithelial tracts connecting abortive pilar structures and a trichofolliculoma. Forty-six lesions (88.5%) were benign and six (11.5%) malignant. CONCLUSION: Adnexal skin tumors have distinct histological patterns which differentiates them from other cutaneous tumors. They are commonly distributed in the head, neck and trunk. The commonest variants are those of eccrine sweat gland origin. Malignant adnexal tumors are uncommon in our setting.

No evidence for an association of ocular adnexal lymphoma with Chlamydia psittaci in a cohort of patients from the Netherlands.

Extra-nodal marginal zone B cell lymphomas (MZBCLs) of the mucosa-associated lymphoid tissues (MALT) arise at sites of chronic antigenic stimulation due to organ-specific autoimmunity or infections, like Helicobacter pylori-associated chronic gastritis and Borrelia burgdorferi dermatitis. Recently, conflicting data have been published regarding a possible association between Chlamydia psittaci and ocular adnexal MZBCL. In the present study, we analyzed a cohort of ocular adnexal MZBLs from the Netherlands for the presence of C. psittaci DNA. We found no evidence for the presence of C. psittaci DNA in any of the tumor samples studied. Our data do not support a role for C. psittaci in the pathogenesis of ocular adnexal lymphomas in patients from the Netherlands.

Incidencia de tumores cutáneos anexiales en el Hospital Barros Luco-Trudeau / Incidence of cutaneous adnexal tumor in Barros Luco-Trudeau Hospital

Los tumores anexiales, derivados de las glándulas sebáceas, sudoríparas o de los folículos pilosos, son poco frecuentes y de difícil diagnóstico en Dermatología, correspondiendo la mayoría de ellos a hallazgos histopatológicos. Con objeto de determinar la incidencia de este tipo de tumores en pacientes de edad adulta, se realizó una revisión total de protocolos de biopsias del Servicio de Anatomía Patológica del Hospital Barros Luco-Trudeau. De 3.589 enviadas por el Servicio de Dermatología, 124 de éstas correspondieron a tumores anexiales, lo que da una incidencia de alrededor del 3,5 por ciento. La mayoría de los casos con diagnósticos de tumor anexial correspondieron a pacientes del sexo femenino (65 por ciento). Respecto a la edad de presentación, la mayor parte de los pacientes en quienes se diagnosticó este tipo de tumor cutáneo sobrepasaba los 40 años de edad (68,5 por ciento). Los tumores anexiales más frecuentes son los de origen piloso, seguidos por los originados por las glándulas sudoríparas. De acuerdo a nuestros resultados, es posible plantear que existe una correlación entre edad de presentación y tipo de tumor y entre sexo y tipo de tumor. Un porcentaje importante de estos tumores correspondió a un hallazgo histopatológico (55 por ciento), lo que confirma la dificultad en el diagnóstico clínico, y a su vez explicaría el bajo número de antecedentes bibliográficos existentes a nivel de literatura mundial.