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1.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(2): 58-60, abr.-jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-ET2-5380

RESUMO

Las úlceras genitales constituyen un motivo frecuente de consulta en urgencias, especialmente en ginecología. Sin embargo, debido a la baja frecuencia de algunas de ellas, junto con el amplio diagnóstico diferencial que puede plantear cada caso, hacen que el diagnóstico de dichas lesiones, en ocasiones, sea difícil o erróneo. Presentamos el caso de una paciente menopáusica que consultó por una úlcera genital, cuyo diagnóstico fue de carcinoma basocelular. El conocimiento de esta entidad y sus hallazgos clínicos característicos, junto con una correcta anamnesis, permitirán realizar un apropiado diagnóstico de sospecha, facilitando el manejo de estas pacientes y evitando exploraciones innecesarias


Genital ulcers are a common reason for consultation in the emergency department, especially in Gynaecology. However, due to the low frequency of some of them, together with the wide differential diagnosis that can arise in each case, the diagnosis of these lesions can sometimes be difficult or erroneous. We present the case of a menopausal patient that consulted due to a genital ulcer, and was diagnosed with of basal cell carcinoma. The knowledge of this entity and its characteristic clinical findings, together with a correct anamnesis, will lead to an appropriate diagnostic suspicion, facilitating the management of these patients, and avoiding unnecessary examinations


Assuntos
Humanos , Feminino , Idoso , Vulva/lesões , Úlcera/diagnóstico , Doenças da Vulva/etiologia , Carcinoma Basocelular/diagnóstico , Vulva/patologia , Prurido Vulvar/complicações , Úlcera/etiologia , Úlcera/patologia , Doenças da Vulva/patologia , Doenças da Vulva/terapia , Diagnóstico Diferencial
2.
Hautarzt ; 71(8): 580-587, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32533202

RESUMO

Basal cell carcinoma is the most common type of cancer in Central Europe and has a high medical relevance. Due to its high tendency of recurrence, an important parameter in the planning of therapy is the risk of recurrence. After clinical and histological diagnosis, the majority of tumors are treated surgically, although radiation and topical procedures are also possible therapeutic alternatives in certain constellations. Hedgehog inhibitors, a completely new class of substances, have recently been approved for rare metastatic and locally advanced diseases, thus significantly expanding the range of treatments. This article provides an overview of the current guideline-based diagnosis and therapy of basal cell carcinomas in Germany.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Procedimentos Cirúrgicos Dermatológicos/métodos , Guias de Prática Clínica como Assunto , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Carcinoma Basocelular/patologia , Europa (Continente) , Alemanha , Proteínas Hedgehog , Humanos , Recidiva Local de Neoplasia/prevenção & controle , Neoplasias Cutâneas/patologia
3.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(2): 58-60, abr.-jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-191315

RESUMO

Las úlceras genitales constituyen un motivo frecuente de consulta en urgencias, especialmente en ginecología. Sin embargo, debido a la baja frecuencia de algunas de ellas, junto con el amplio diagnóstico diferencial que puede plantear cada caso, hacen que el diagnóstico de dichas lesiones, en ocasiones, sea difícil o erróneo. Presentamos el caso de una paciente menopáusica que consultó por una úlcera genital, cuyo diagnóstico fue de carcinoma basocelular. El conocimiento de esta entidad y sus hallazgos clínicos característicos, junto con una correcta anamnesis, permitirán realizar un apropiado diagnóstico de sospecha, facilitando el manejo de estas pacientes y evitando exploraciones innecesarias


Genital ulcers are a common reason for consultation in the emergency department, especially in Gynaecology. However, due to the low frequency of some of them, together with the wide differential diagnosis that can arise in each case, the diagnosis of these lesions can sometimes be difficult or erroneous. We present the case of a menopausal patient that consulted due to a genital ulcer, and was diagnosed with of basal cell carcinoma. The knowledge of this entity and its characteristic clinical findings, together with a correct anamnesis, will lead to an appropriate diagnostic suspicion, facilitating the management of these patients, and avoiding unnecessary examinations


Assuntos
Humanos , Feminino , Idoso , Vulva/lesões , Úlcera/diagnóstico , Doenças da Vulva/etiologia , Carcinoma Basocelular/diagnóstico , Vulva/patologia , Prurido Vulvar/complicações , Úlcera/etiologia , Úlcera/patologia , Doenças da Vulva/patologia , Doenças da Vulva/terapia , Diagnóstico Diferencial
4.
Surg Clin North Am ; 100(3): 629-634, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32402305

RESUMO

Anal cancer is a rare cancer, comprising less than 5% of gastrointestinal tract malignancies. Diagnosis of anal canal cancer can be difficult given that presenting symptoms are similar to those of benign anorectal diseases. General surgeons who encounter suspected anal canal cancer need to have a good understanding of the anatomy of the anal canal, high index of suspicion for malignancy, and low threshold to biopsy lesions when indicated. This article discusses the most commonly encountered anal canal tumors, the evaluation of these tumors, and their management. The foundation for successful therapy includes timely diagnosis, accurate staging, and routine surveillance.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias do Ânus/cirurgia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Melanoma/cirurgia , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Canal Anal/patologia , Canal Anal/cirurgia , Neoplasias do Ânus/diagnóstico , Neoplasias do Ânus/patologia , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Quimiorradioterapia , Diagnóstico Diferencial , Seguimentos , Metástase Linfática/patologia , Metástase Linfática/terapia , Melanoma/diagnóstico , Melanoma/patologia , Estadiamento de Neoplasias , Proctoscopia , Prognóstico
5.
Nat Med ; 26(6): 900-908, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32424212

RESUMO

Skin conditions affect 1.9 billion people. Because of a shortage of dermatologists, most cases are seen instead by general practitioners with lower diagnostic accuracy. We present a deep learning system (DLS) to provide a differential diagnosis of skin conditions using 16,114 de-identified cases (photographs and clinical data) from a teledermatology practice serving 17 sites. The DLS distinguishes between 26 common skin conditions, representing 80% of cases seen in primary care, while also providing a secondary prediction covering 419 skin conditions. On 963 validation cases, where a rotating panel of three board-certified dermatologists defined the reference standard, the DLS was non-inferior to six other dermatologists and superior to six primary care physicians (PCPs) and six nurse practitioners (NPs) (top-1 accuracy: 0.66 DLS, 0.63 dermatologists, 0.44 PCPs and 0.40 NPs). These results highlight the potential of the DLS to assist general practitioners in diagnosing skin conditions.


Assuntos
Aprendizado Profundo , Diagnóstico Diferencial , Dermatopatias/diagnóstico , Acne Vulgar/diagnóstico , Adulto , Afro-Americanos , Nativos do Alasca , Americanos Asiáticos , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Dermatite Seborreica/diagnóstico , Dermatologistas , Eczema/diagnóstico , Grupo com Ancestrais do Continente Europeu , Feminino , Foliculite/diagnóstico , Hispano-Americanos , Humanos , Índios Norte-Americanos , Ceratose Seborreica/diagnóstico , Masculino , Melanoma/diagnóstico , Pessoa de Meia-Idade , Profissionais de Enfermagem , Grupo com Ancestrais Oceânicos , Fotografação , Médicos de Atenção Primária , Psoríase/diagnóstico , Neoplasias Cutâneas/diagnóstico , Telemedicina , Verrugas/diagnóstico
8.
Klin Monbl Augenheilkd ; 237(1): 46-56, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31968366

RESUMO

INTRODUCTION: Skin malignancies are typically localised in areas of the head that are exposed to the sun. Basal cell carcinomas (BCC) are the most frequent malignancies on the facial skin. Their incidence is raising - due to demographic changes. As regards strategies for resection and reconstruction, the eyelids and the periorbital region are extremely complex and have to be treated in an interdisciplinary context. The aim of the present investigation was to analyse the results of interdisciplinary treatment of periorbital and eyelid non-melanotic malignoma. MATERIALS AND METHODS: All treated non-melanotic malignancies of the eyelid/periorbital region were analysed in a pilot study from September 2017 until July 2019. Patients were treated by an ophthalmologist and a maxillofacial plastic surgeon. The clinical and pathological parameters were collected in a databank. In all interdisciplinary cases, the tumour localisation, histology, R-status and the reconstructive strategy were analysed. RESULTS: Out of 349 patients, 14 were analysed as they were treated with an interdisciplinary approach. The youngest was 12, the oldest 98 years old. There were 6 women (average age 80.3 years) and 8 men (average age 65.3 years). BCC (n = 10) were the most frequent malignancy; 3 patients suffered from squamous cell carcinoma. Actinic keratosis was diagnosed in one case. In all patients, complete resection (R0) was certified by histopathological examination. The reconstruction was performed immediately in 6 cases, and the reconstruction strategy was accomplished after definitive histology (at least two step procedures) in 8 cases. Only one patient had three resections before starting the reconstruction procedure. DISCUSSION: Surgical treatment of malignancies of the eyelid or periorbital non-melanotic malignancies can be an interdisciplinary challenge. BCC is the most frequent entity. These critically localised BCC present with extremely deep infiltration, followed by subtotal or total eyelid resection, often including bony structures. The reconstruction is extremely complex in such cases and requires the whole plastic reconstructive repertoire of both medical disciplines.


Assuntos
Carcinoma Basocelular , Neoplasias Palpebrais , Procedimentos Cirúrgicos Reconstrutivos , Neoplasias Cutâneas , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/cirurgia , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/cirurgia , Pálpebras/cirurgia , Feminino , Humanos , Masculino , Projetos Piloto , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia
9.
J Cutan Pathol ; 47(1): 36-46, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31361351

RESUMO

We report two cases of combined cutaneous tumors composed of melanoma and carcinoma. The first tumor presented as a 5-mm pink-blue macule over the right zygomatic arch in an 85-year-old man. Shave biopsy and immunohistochemical studies revealed that the tumor was composed of melanoma (highlighted by SOX10 and MART-1, with high Ki-67 proliferative index) intermixed with nodular basal cell carcinoma (highlighted by pan-cytokeratin and Ber-EP4). The neoplastic melanocytes were confined to the basal cell carcinoma nodules, and a diagnosis of combined melanoma in situ and basal cell carcinoma was rendered. After therapeutic excision, the patient was disease-free at 9 months after the initial diagnosis. The second tumor presented as a 6-mm pink-brown crusted papule on the right forehead in an 89-year-old man. Shave biopsy and immunohistochemical studies revealed that the tumor was composed of malignant melanoma (MM) (highlighted by S100 and MART-1) intermixed with squamous cell carcinoma (SCC) (highlighted by cytokeratin and p63), and a diagnosis of combined MM-SCC was rendered. These two cases highlight the importance of recognizing these rare types of melanocytic-epithelial cutaneous neoplasms to arrive at an accurate diagnosis that may inform appropriate disease stage and therapy.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma Basocelular , Melanoma , Proteínas de Neoplasias/metabolismo , Segunda Neoplasia Primária , Neoplasias Cutâneas , Idoso de 80 Anos ou mais , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/metabolismo , Carcinoma Basocelular/patologia , Diagnóstico Diferencial , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/metabolismo , Melanoma/patologia , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/metabolismo , Segunda Neoplasia Primária/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia
11.
Lasers Med Sci ; 35(5): 1141-1151, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31853808

RESUMO

The differences in the biochemistry of normal and cancerous tissue could be better exploited by Raman spectroscopy when the spectral information from normal tissue is subtracted from the abnormal tissues. In this study, we evaluated the use of the normal-subtracted spectra to evidence the biochemical differences in the pre-cancerous and cancerous skin tissues compared with normal skin, and to discriminate the groups with altered tissues with respect to the normal sites. Raman spectra from skin tissues [normal (Normal), benign (dermatitis-BEN), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and actinic keratosis (KER)] were obtained in vivo (Silveira et al., 2015, doi: https://doi.org/10.1002/lsm.22318) and used to develop the spectral model. The mean spectrum of the normal sites (circumjacent to each lesion) from each subject was calculated and subtracted from each individual spectrum of that particular subject independently of the group (Normal, BEN, BCC, SCC, KERAT). The mean spectra of each altered group and the mean spectra of the differences were firstly evaluated in terms of biochemical contribution or differentiation comparing the normal site. Then, the normal-subtracted spectra were submitted to discriminant models based on partial least squares and principal components regression (PLS-DA and PCR-DA), and the discrimination were compared with the model using non-subtracted spectra. Results showed that the peaks of nucleic acids, lipids (triolein) and proteins (elastin and collagens I, III, and IV) were significantly different in the lesions, higher for the pre- and neoplastic lesions compared with normal and benign. The PLS-DA showed that the groups could be discriminated with 90.3% accuracy when the mean-subtracted spectra were used, contrasting with 75.1% accuracy when the non-subtracted spectra were used. Also, when discriminating non-neoplastic tissue (Normal + BEN) from pre- and neoplastic sites (BCC + SCC + KERAT), the accuracy increases to 92.5% for the normal-subtracted compared with 85.3% for the non-subtracted. The subtraction of the mean normal spectrum from the subject obtained circumjacent to each lesion could significantly increase the diagnostic capability of the Raman-based discrimination algorithm.


Assuntos
Algoritmos , Ceratose Actínica/diagnóstico , Neoplasias Cutâneas/diagnóstico , Pele/diagnóstico por imagem , Pele/patologia , Análise Espectral Raman , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/diagnóstico por imagem , Análise Discriminante , Humanos , Análise dos Mínimos Quadrados , Análise de Componente Principal
12.
BMJ Case Rep ; 12(12)2019 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-31818896

RESUMO

A 62-year-old woman came to our hospital with complaints of painless gradual increase in dark coloured mass along inner canthus of the right eye. The surface of the mass was rough with a well-defined margin. No other systemic abnormality was detected. Wide margin excision was done and the excised mass was sent for histopathological examination. No skin grafting was done and the raw area was left for self-healing. In the next 3 weeks, skin growth over the raw area was observed and it was cosmetically acceptable. Histopathological examination revealed well-circumscribed tissue composed of aggregation of basaloid cells suggestive of trichoblastoma. Immunohistochemistry revealed positive staining of CD34 and CD10. Trichoblastoma is a rare entity seen in our clinical practice. Hence, a patient presenting with darker masses trichoblastoma can be considered as differential diagnosis.


Assuntos
Carcinoma Basocelular/diagnóstico , Neoplasias Palpebrais/diagnóstico , Folículo Piloso/patologia , Antígenos CD34/análise , Biomarcadores Tumorais/análise , Diagnóstico Diferencial , Neoplasias Palpebrais/patologia , Neoplasias Palpebrais/cirurgia , Feminino , Folículo Piloso/cirurgia , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Neprilisina/análise , Resultado do Tratamento
14.
An Sist Sanit Navar ; 42(3): 303-307, 2019 Dec 05.
Artigo em Espanhol | MEDLINE | ID: mdl-31859267

RESUMO

BACKGROUND: To describe the dermoscopic features in superficial basal cell carcinoma that are associated with a poor therapeutic response to imiquimod treatment. METHOD: Clinical and dermatoscopic photographs of 56 superficial basal cell carcinomas of different patients were compared retrospectively, assessed in our office for five years and treated with topic 5% imiquimod five days a week for six weeks. The different dermatoscopic signs of the lesions were identified and the association of each of them with the response to treatment was assessed. RESULTS: A total response to treatment was achieved by 69.5% of the lesions of patients treated with imiquimod. Dermatoscopy of responding lesions showed a higher frequency of lesions with in focus gray dots (43.6%) and multiple erosions of less than 2 mm (61.5%), without observing statistically significant differences. Within the group with poor response to treatment, a greater number of lesions were found with the presence of arborizing telangiectasias (58.8%), blue-gray ovoid nests (41.1%), ulceration (58.8%), shiny white-red structureless areas (82.2%) and chrysalis (41.2%). The areas in blue-white veil areas (23.5%) and rainbow pattern (23.5%) were only observed in non-responding lesions. Both groups were similar regarding age, sex, diameter of lesions and frequency of some dermatoscopic signs: fine short telangiectasias, gray blue globules, arc-leaf areas and cart-wheel structures. CONCLUSION: The study identified dermatoscopic criteria that are significantly associated with a worse response to treatment with imiquimod. In contrast, we found no dermatoscopic signs that correlate specifically to a complete response to treatment.


Assuntos
Antineoplásicos/administração & dosagem , Carcinoma Basocelular/tratamento farmacológico , Imiquimode/administração & dosagem , Neoplasias Cutâneas/tratamento farmacológico , Administração Cutânea , Idoso , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Dermoscopia/métodos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Resultado do Tratamento
15.
Pan Afr Med J ; 34: 8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762877

RESUMO

We report here a case of simultaneous cutaneous and visceral manifestations due to Leishmania L. infantum diagnosed in an immunocompetent adult. We describe a 74-year-old woman from Tunis, Tunisia, who presented a biologically confirmed visceral leishmaniasis infection concomitant with arm ulceration which appeared 2 years before. Leishmania DNA was detected by ITS PCR in both buffy coat and dermal scrapping of the arm lesion. Sequencing revealed that the 2 isolated strains corresponded to L. infantum and were 100% identical. The symptoms of visceral leishmaniasis responded to amphotericin B with rapid healing. However, the skin lesion did not improve although Leishmania PCR on dermal sample became negative. This location is probably secondarily to lymphatic or blood dissemination during the systemic visceral leishmaniasis infection. It would be favored by the inflammatory environment induced by the basal cell carcinoma subsequently diagnosed.


Assuntos
Carcinoma Basocelular/diagnóstico , Leishmaniose Cutânea/diagnóstico , Leishmaniose Visceral/diagnóstico , Neoplasias Cutâneas/diagnóstico , Idoso , Anfotericina B/administração & dosagem , Antiprotozoários/administração & dosagem , Carcinoma Basocelular/patologia , Feminino , Humanos , Leishmania infantum/isolamento & purificação , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Visceral/tratamento farmacológico , Reação em Cadeia da Polimerase , Neoplasias Cutâneas/patologia , Tunísia
16.
Pan Afr Med J ; 34: 43, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31762910

RESUMO

Basal cell carcinoma is the most common skin cancer. It occurs in young adults older than 50 years and it is often caused by chronic exposure to solar rays, which explains why it often affects the face. In patient who are not treated immediately, the tumour develops slowly, with locoregional extension, but it rarely metastasizes. We here report a very rare case of bilateral cystic basal cell carcinoma in an albino young adult aged 36 years. The patient had terebrant left brachial ulcero-budding infiltrating mass with bone erosion (pathological fracture of the humerus) evolving over the last 7 years as well as ulcero-budding secondarily infected mass in the cervicodorsal junction evolving over the last 6 months. During his 1 month stay in our hospital, he underwent transfusion of 6 units of isogroup isoRh 450cc and boric acid dressings were applied as a complement to antibiotic therapy and iron therapy. Given the poor general health of the patient (cachexia, chronic anemia, development of the cancerous lesions), amputation of the left upper member and cervicodorsal mass excision were controindicated. Multidisciplinary team opted for second line treatment, including chemotherapy and/or radiotherapy. Given the lack technical equipment, the patient was transferred out to Lusaka.


Assuntos
Albinismo , Carcinoma Basocelular/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Carcinoma Basocelular/patologia , Carcinoma Basocelular/terapia , Humanos , Masculino , Equipe de Assistência ao Paciente/organização & administração , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia
17.
Pan Afr Med J ; 34: 64, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31762928

RESUMO

Introduction: Dermatoscopy is an innovative non-invasive technique for clinical morphology of pigmented lesions and skin tumor. The purpose of our study was to highlight the morphological and dermoscopic features of basal cell carcinoma (CBC) in our study population. Methods: We conducted a prospective unicentric study over a period of 2 years. We used dermoscopy in all patients with BCC. Statistical analysis was performed using SPSS software version 17. Results: The study included 100 patients with BCC, the average age of patients was 51.87 years, with a sex ratio F/M = 0.6. BCC most commonly occurred in the face and most patients were prototype III and IV. We established conventional and non-conventional dermatoscopic criteria. Our study showed that there is a significant relationship between prototype and the degree of BCC pigmentation. Conclusion: This study highlighted the key role of dermoscopy in detecting small-sized BCC and in facilitating the diagnosis of pigmented BCC.


Assuntos
Carcinoma Basocelular/diagnóstico , Dermoscopia/métodos , Neoplasias Cutâneas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos , Pigmentação , Estudos Prospectivos , Neoplasias Cutâneas/patologia , Adulto Jovem
18.
Int J Mol Sci ; 20(22)2019 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-31744230

RESUMO

Skin cancer is the most common type of cancer worldwide. Ozone depletion and climate changes might cause a further increase in the incidence rate in the future. Although the early detection of skin cancer enables it to be treated successfully, some tumours can evolve and become more aggressive, especially in the case of melanoma. Therefore, good diagnostic and prognostic markers are needed to ensure correct detection and treatment. Transcription factor p63, a member of the p53 family of proteins, plays an essential role in the development of stratified epithelia such as skin. In this paper, we conduct a comprehensive review of p63 expression in different types of skin cancer and discuss its possible use in the diagnosis and prognosis of cutaneous tumours.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Fatores de Transcrição/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Carcinoma Basocelular/metabolismo , Carcinoma de Células Escamosas/metabolismo , Humanos , Imuno-Histoquímica , Melanoma/metabolismo , Prognóstico , Neoplasias Cutâneas/metabolismo
19.
Dermatol Surg ; 45 Suppl 2: S118-S128, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31764297

RESUMO

BACKGROUND: Mohs micrographic surgeons should be adept in identifying and managing perineural invasion (PNI), lymphovascular invasion (LVI), and single-cell spread (SCS), features denoting high-risk behavior of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and microcystic adnexal carcinoma (MAC). OBJECTIVE: The purpose of this article is to review the literature and guidelines regarding the diagnosis of PNI, LVI, and SCS in BCC, cSCC, and MAC and examine the role of advanced diagnostic studies, adjuvant therapy, and reconstructive techniques of these high-risk tumors. MATERIALS AND METHODS: We performed a literature search including the following terms: PNI, LVI, SCS, BCC, cSCC, keratinocyte carcinoma, MAC, sentinel lymph node biopsy, radiation, chemotherapy, and staging. Relevant studies, case reports, and review articles were included, as well as National Comprehensive Cancer Network guidelines. RESULTS: Pancytokeratin immunohistochemistry may aid in the diagnosis of high-risk features of BCC and cSCC. Reconstruction of the Mohs defect should be carefully considered to allow for thorough inspection. Radiation therapy should be considered as an adjuvant treatment option for high-risk cSCC and BCC. Close surveillance for recurrence is warranted. CONCLUSION: The Mohs surgeon should be competent in identification of high-risk tumors and to understand how best to manage, further treat, and follow these tumors.


Assuntos
Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Cirurgia de Mohs , Neoplasias de Anexos e de Apêndices Cutâneos/cirurgia , Neoplasias Cutâneas/cirurgia , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Humanos , Metástase Linfática , Invasividade Neoplásica , Neoplasias de Anexos e de Apêndices Cutâneos/diagnóstico , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Radioterapia Adjuvante , Procedimentos Cirúrgicos Reconstrutivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia
20.
Cutis ; 104(2): 114-116, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31603954

RESUMO

Linear basal cell carcinoma (LBCC) is a rare morphologic variant of basal cell carcinoma. We report a case of a patient with a recurrent linear lesion on the supraclavicular neck with prior repeated mild trauma to the area. The patient was diagnosed with recurrent LBCC after a prior excision of an LBCC in the same area. A review of the literature was performed, and the demographics, anatomic location, histologic subtype, treatment methods, and frequency of recurrence for all reported cases of LBCC were summarized. Because of the likelihood of subclinical spread, LBCC should be regarded as a high-risk subtype. As such, Mohs micrographic surgery or excision with complete circumferential peripheral and deep margin assessment is recommended as first-line treatment.


Assuntos
Carcinoma Basocelular/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias Cutâneas/diagnóstico , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia de Mohs , Recidiva Local de Neoplasia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
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