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1.
Dermatol Online J ; 26(3)2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609447

RESUMO

A widespread form of eruptive collagenomas in a 12-year-old man is presented for the impressive iconography, challenging differential diagnosis, and histopathological considerations associated with such rare connective tissue disorders. Syndromic forms should be carefully investigated for the different course and prognosis. Treatment is a major unsolved issue as aesthetic concerns are significant, especially in young adults.


Assuntos
Doenças do Tecido Conjuntivo/patologia , Derme/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Dorso/patologia , Biópsia/métodos , Corantes , Fibroblastos/patologia , Humanos , Masculino , Adulto Jovem
2.
Orv Hetil ; 161(15): 563-574, 2020 04 01.
Artigo em Húngaro | MEDLINE | ID: mdl-32320191

RESUMO

Our purpose is to summarize the actual knowledge about melanocytic lesions of the ocular surface (conjunctival nevus, primary acquired melanosis and conjunctival melanoma),especially their clinical appearance, differential diagnosis and treatment. Conjunctival nevus is the most common benign, conjunctival melanocytic lesion. Primary acquired melanosis mainly presents in middle-aged or elderly individuals, characterized by proliferation of melanocytes of the conjunctival epithelial layer. Conjunctival melanoma is a rare tumor, it is the second most common malignant ocular surface tumor after ocular surface squamous neoplasia and the third most common ocular malignancy following choroideal malignant melanoma and ocular surface squamous neoplasia. Early recognition and proper management of conjunctival melanoma is indispensable due to its high malignant and metastatic potential. Due to frequent recurrences, the knowledge and use of intra- and postoperative adjuvant treatment modalities, and regular follow-up are necessary. Orv Hetil. 2020; 161(15): 563­574.


Assuntos
Neoplasias da Túnica Conjuntiva/patologia , Melanócitos/patologia , Melanoma/patologia , Nevo Pigmentado/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Idoso , Diagnóstico Diferencial , Humanos , Pessoa de Meia-Idade
3.
N Z Med J ; 133(1509): 17-27, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32027635

RESUMO

AIM: Waitemata District Health Board has implemented a new approach to the management of skin cancers by triaging lesions to specialist-trained general practitioners (GPSI) with the aim of reducing patient wait times and treatment costs. The primary outcome was to determine positive margin rates for the GP surgeons, with secondary outcome being infection rates. METHOD: A retrospective audit was conducted on all excisions (n=2,705) performed between 1 January 2016 and 31 December 2016 by the 13 WDHB GPSIs. Electronic patient records were accessed to review data. Each lesion was classified into benign, in-situ (pre-malignant) and malignant categories. Surgical margins were analysed for non-melanotic skin cancers (NMSC) and determined as positive, close or negative. Infection rates determined by microbiology results and prescribing information and time to treat analyses were conducted. RESULTS: WDHB GPSIs performed 2,705 excisions, 1,887 (69.8%) of which were malignant lesions. Among the 1,486 NMSC excised, a positive surgical margin was observed in 51 (3.4%). There were 294 (10.9%) cases of infection in 2,705 excisions. Median time to treat was 31 days across all lesions. New Zealand papers from the last two decades estimate the NMSC positive margin rate among primary care physicians varies between 16-31%; most recent papers have published rates 6.8-9.5%.European publications describe positive margin rates ranging between 13.9-33.5%. CONCLUSION: This study validates the use of surgically trained GP surgeons and shows their integral role in managing the high volume of skin cancer in New Zealand.


Assuntos
Assistência à Saúde , Medicina Geral/métodos , Clínicos Gerais/educação , Neoplasias Cutâneas/cirurgia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Ceratoacantoma/patologia , Ceratoacantoma/cirurgia , Ceratose Actínica/patologia , Ceratose Actínica/cirurgia , Ceratose Seborreica/patologia , Ceratose Seborreica/cirurgia , Margens de Excisão , Auditoria Médica , Melanoma/patologia , Melanoma/cirurgia , Nevo/patologia , Nevo/cirurgia , Nova Zelândia , Garantia da Qualidade dos Cuidados de Saúde , Qualidade da Assistência à Saúde , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Infecção da Ferida Cirúrgica/epidemiologia , Tempo para o Tratamento/estatística & dados numéricos
4.
Surg Clin North Am ; 100(1): 43-59, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31753115

RESUMO

Melanoma is an aggressive malignancy arising from melanocytes in the skin and rarely in extracutaneous sites. The understanding of pathology of melanoma has evolved over the years, with the initial classifications based on the clinical and microscopic features to the current use of immunohistochemistry and genetic sequencing. The depth of invasion and lymph node metastasis are still the most important prognostic features of melanoma. Other important prognostic features include ulceration, lymphovascular invasion, mitosis, and tumor-infiltrating lymphocytes. This article reviews the pathology of melanoma and its precursor lesions, along with the recent advances in pathologic diagnosis of melanoma.


Assuntos
Carcinoma in Situ/patologia , Melanoma/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Biópsia , Humanos , Metástase Linfática , Estadiamento de Neoplasias , Biópsia de Linfonodo Sentinela
5.
Anticancer Res ; 39(11): 6175-6181, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704845

RESUMO

BACKGROUND/AIM: Acral lentiginous melanoma (ALM) is a rare entity on the foot. This study aimed to reveal its clinical presentations, histopathology and treatment options. MATERIALS AND METHODS: Seven cases of ALM involving foot were treated in our Institute in a 3-year period. RESULTS: The patients' age ranged from 38 to 84 years, with a mean of 65. The ratios of males to females and white to non-white were 4:3 and 5:2, respectively. Clinically, ALM presented as asymmetric, irregular shaped, black-brown, variegatedly discolored, papular, verrucoid, ulcerated or nodular lesions with or without pain. All ALMs were treated with either wide local excision (WLE) or toe amputation. Histologically, ALM was characterized by multiple single and nested atypical melanocytes growing along the dermal-epidermal junction, and extending into dermal layer in nodular growth pattern. CONCLUSION: ALM is a rare, asymmetric, irregularly bordered, variegatedly pigmented lesion. WLE or toe amputation is the standard treatment option.


Assuntos
Tornozelo/patologia , Doenças do Pé/patologia , Melanoma/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Tornozelo/cirurgia , Feminino , Seguimentos , Doenças do Pé/cirurgia , Humanos , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Nevo/cirurgia , Prognóstico , Neoplasias Cutâneas/cirurgia
6.
Ned Tijdschr Geneeskd ; 1632019 10 02.
Artigo em Holandês | MEDLINE | ID: mdl-31580030

RESUMO

A 52-year-old woman was referred to a dermatologist with a changed yellowish lesion on her scalp. Histological features were those of a sebaceous naevus with secondary malignant differentiation into superficial and solid basal cell carcinoma. A sebaceous naevus is a benign, congenital, hamartomatous lesion. In adulthood, secondary neoplasms may develop within them.


Assuntos
Carcinoma Basocelular/patologia , Neoplasias de Cabeça e Pescoço/patologia , Nevo/patologia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias Cutâneas/patologia , Feminino , Hamartoma/patologia , Humanos , Pessoa de Meia-Idade , Couro Cabeludo/patologia
7.
G Ital Dermatol Venereol ; 154(5): 519-522, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31638350

RESUMO

BACKGROUND: In Italy, the incidence of new cases of melanoma is roughly 10,000 cases per year, with an average rate of mortality of 5-6 per 100,000 population per year respectively. The objective of this retrospective study was to evaluate the epidemiological incidence of primitive melanoma, including the incidence of multiple melanomas occurring in the same patient. Furthermore, we studied all histological different types of melanoma focusing on the presence of an association nevus-melanoma. METHODS: A clinical epidemiologic retrospective study from January 2010 to March 2015 was recorded. For each lesion, mitotic rate, Breslow's index, ulceration, presence of regression, vascular and perineural invasion, lymphocytic infiltrate, microsatellitosis and presence of pre-existencing nevus were also studied. RESULTS: Five hundred eighty primitive cutaneous melanomas (CMs) were removed from 525 patients with an incidence of 18-20 new melanomas/100,000 habitants/year. Eighty percent of these were at stage T0-1. Among other melanomas, SSM was the predominant subtype (85% of cases). Only 18 cases had lymph node metastases and 13 (2%) lymph node and/or distant metastases (stage IV) at time of diagnosis. Mitotic figures were present in 25% of cases (143 cases out of 580) without significant gender differences. CONCLUSIONS: The incidence of new melanomas founded is close to the CM's incidence in US population in 2016 with a high percentage of superficial melanomas highlighting the importance of prevention campaigns. The presence of melanoma on a preexisting nevus in only 16% of cases allow to conclude that this association is overestimated in literature. On the contrary the high incidence of a second melanoma in the 7% of cases in a relatively short period of survey leads to the conclusion that this data is underestimated.


Assuntos
Melanoma/epidemiologia , Nevo/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Itália/epidemiologia , Metástase Linfática , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Nevo/patologia , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Adulto Jovem
9.
Ann Diagn Pathol ; 43: 151402, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31473371

RESUMO

Heck's disease (focal or multifocal epithelial hyperplasia) is a benign, rare condition of the skin and mucous membranes induced by human papillomavirus (HPV) infection. Other entities that can induce large papillomatous lesions that involve the mucous membranes and skin include condyloma acuminatum, which is sexually transmitted, and white sponge nevus, often due to a mutation of cytokeratin 4 or 13. Six cases diagnosed as either Heck's disease (n = 2) or white sponge nevus (n = 4) and 6 oral condyloma were compared on histologic grounds and analyzed in situ for HPV DNA, including HPVs 6,11, and 13, as well as cytokeratins 4 and 13. Each case showed marked acanthosis, and para/hyperkeratosis. More variable histologic findings included rete ridge elongation, keratinocyte degeneration, and perinuclear halos. High copy HPV 13 DNA was evident in the squamous cells towards the surface in the two cases diagnosed as Heck's disease and in two cases diagnosed as white sponge nevus on clinical grounds. HPV 6/11 was found in each of the six condyloma. Marked decrease in either cytokeratin 4 or 13 was evident in the two cases diagnosed as white sponge nevus that were HPV DNA negative. It is concluded that in situ hybridization analyses including HPVs 6, 11, and 13 as well as immunohistochemistry for cytokeratins 4 and 13 can differentiate Heck's disease from condyloma and white sponge nevus, which can be difficult to differentiate on clinical and histologic grounds.


Assuntos
Condiloma Acuminado/patologia , Leucoceratose da Mucosa Hereditária/patologia , Nevo/patologia , Pele/patologia , Adulto , Biomarcadores/metabolismo , Diferenciação Celular , Condiloma Acuminado/virologia , DNA Viral/genética , Feminino , Hiperplasia Epitelial Focal/patologia , Humanos , Hiperplasia/patologia , Hibridização In Situ , Queratinas/metabolismo , Leucoceratose da Mucosa Hereditária/genética , Leucoceratose da Mucosa Hereditária/virologia , Masculino , Pessoa de Meia-Idade , Nevo/virologia , Papiloma/patologia , Papillomaviridae/genética , Infecções por Papillomavirus/patologia
10.
Pediatr Dermatol ; 36(6): 997-998, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31469926

RESUMO

Fibroblastic connective tissue nevus (FCTN) is a benign cutaneous mesenchymal lesion characterized by proliferation of CD34-positive fibroblastic/myofibroblastic spindle-shaped cells. We report a case of agminated FCTN on the right lower abdomen of a 1-year-old boy.


Assuntos
Fibroblastos/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Abdome , Humanos , Lactente , Masculino
11.
J Cutan Pathol ; 46(12): 898-904, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31373032

RESUMO

BACKGROUND: Melanocytic acral nevi have a series of distinguishing features, including their location, patient age at onset, clinical progression, and histological findings. In particular, histopathological analysis often reveals a melanocytic acral nevus with intraepidermal ascent of cells (MANIAC nevus), which in some cases can be mistaken for atypia or malignancy. AIM: This study describes the clinicopathological characteristics of acral nevi in patients under 18 years old and contrasts the clinical and histological features between MANIAC vs non-MANIAC nevi. METHODS: This was a retrospective observational study, performed in our department in the decade between January 2007 and January 2017. We included patients younger than 18 years of age who were subjected to the removal of melanocytic acral nevi. RESULTS: A total of 70 patients were studied. 54.2% (38/70) were females and 45.8% (32/70) were males. With regard to the type of nevus, 34 were compound, 27 were junctional, and 9 were predominantly intradermal lesions. We identified a total of 41 MANIAC nevi and 29 non-MANIAC nevi. Statistically significant differences between these two groups were identified in nevus size (larger in MANIAC) and the frequency of compound nevi (higher in the MANIAC group), but not in the remainder of the histological parameters studied.


Assuntos
Melanoma/patologia , Nevo Intradérmico/patologia , Nevo Pigmentado/patologia , Nevo/patologia , Adolescente , Assistência ao Convalescente , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Doenças do Pé/patologia , Humanos , Masculino , Nevo Pigmentado/epidemiologia , Nevo Pigmentado/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/patologia
14.
Actas Dermosifiliogr ; 110(9): 710-727, 2019 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31171301

RESUMO

The skin is the largest and most exposed organ in the human body and the ideal place to look for signs that aid in the early diagnosis of systemic diseases with cutaneous effects. As the concepts that underpin our understanding of many of these diseases have evolved or expanded in recent years, there have also been changes in the criteria we use for early diagnosis, including our approaches to skin biopsy and dermatopathologic evaluation. This review focuses on some of the systemic processes with skin manifestations for which our basic understanding has changed most in recent decades.


Assuntos
Dermatopatias/patologia , Pele/patologia , Doenças Autoimunes/patologia , Biópsia , Doenças do Sistema Digestório/patologia , Síndrome do Hamartoma Múltiplo/patologia , Linfadenite Histiocítica Necrosante/patologia , Humanos , Doença Relacionada a Imunoglobulina G4/patologia , Nefropatias/patologia , Lúpus Eritematoso Sistêmico/patologia , Síndrome de Muir-Torre/patologia , Nevo/genética , Nevo/patologia , Sarcoidose/patologia , Doença de Still de Início Tardio/patologia , Síndrome de Sweet/patologia , Proteínas Supressoras de Tumor/genética , Ubiquitina Tiolesterase/genética
15.
Skinmed ; 17(2): 100-104, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31145059

RESUMO

Nevus depigmentosus, a disorder of hypopigmentation, occurs in both sexes and all races. It most commonly presents in early infancy and childhood as a nonprogressive hypomelanotic macule. It is considered a form of cutaneous mosaicism due to somatic mutation in pigmentary genes, which results in functional impairment of melanocytes. Clinical forms include localized, segmental, and systemized. Rare cases of nevus depigmentosus may be associated with systemic features. Treatment is usually not required, although certain techniques such as suction-blister grafting, excimer laser, and cosmetic camouflage have been tried with variable results. Counseling of parents plays a significant role to allay apprehension and anxiety.


Assuntos
Hipopigmentação/diagnóstico , Nevo/diagnóstico , Neoplasias Cutâneas/diagnóstico , Humanos , Hipopigmentação/genética , Hipopigmentação/patologia , Hipopigmentação/terapia , Mosaicismo , Nevo/genética , Nevo/patologia , Nevo/terapia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia
17.
PLoS One ; 14(5): e0217293, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31112591

RESUMO

Skin cancer is one of most deadly diseases in humans. According to the high similarity between melanoma and nevus lesions, physicians take much more time to investigate these lesions. The automated classification of skin lesions will save effort, time and human life. The purpose of this paper is to present an automatic skin lesions classification system with higher classification rate using the theory of transfer learning and the pre-trained deep neural network. The transfer learning has been applied to the Alex-net in different ways, including fine-tuning the weights of the architecture, replacing the classification layer with a softmax layer that works with two or three kinds of skin lesions, and augmenting dataset by fixed and random rotation angles. The new softmax layer has the ability to classify the segmented color image lesions into melanoma and nevus or into melanoma, seborrheic keratosis, and nevus. The three well-known datasets, MED-NODE, Derm (IS & Quest) and ISIC, are used in testing and verifying the proposed method. The proposed DCNN weights have been fine-tuned using the training and testing dataset from ISIC in addition to 10-fold cross validation for MED-NODE and DermIS-DermQuest. The accuracy, sensitivity, specificity, and precision measures are used to evaluate the performance of the proposed method and the existing methods. For the datasets, MED-NODE, Derm (IS & Quest) and ISIC, the proposed method has achieved accuracy percentages of 96.86%, 97.70%, and 95.91% respectively. The performance of the proposed method has outperformed the performance of the existing classification methods of skin cancer.


Assuntos
Diagnóstico por Computador/métodos , Melanoma/classificação , Melanoma/diagnóstico por imagem , Nevo/classificação , Nevo/diagnóstico por imagem , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/diagnóstico por imagem , Cor , Bases de Dados Factuais/estatística & dados numéricos , Aprendizado Profundo , Diagnóstico por Computador/estatística & dados numéricos , Humanos , Melanoma/patologia , Redes Neurais de Computação , Nevo/patologia , Neoplasias Cutâneas/patologia
19.
Pediatr Dermatol ; 36(4): 554-555, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30983034

RESUMO

We present a 4-year-old developmentally appropriate boy with short stature and widespread expanding epidermal nevus with features of acanthosis nigricans. He was found to have a mosaic mutation in FGFR3, the R248C variant. Despite several therapies, he continued to have growth, fissuring, and bleeding of the affected skin. Ultimately, topical sirolimus was attempted and found to improve thickness and overall symptoms.


Assuntos
Acantose Nigricans/patologia , Nevo/tratamento farmacológico , Nevo/genética , Receptor Tipo 3 de Fator de Crescimento de Fibroblastos/genética , Sirolimo/uso terapêutico , Acantose Nigricans/genética , Administração Tópica , Pré-Escolar , Diagnóstico Diferencial , Regulação da Expressão Gênica , Humanos , Masculino , Mutação , Nevo/patologia , Medição de Risco , Resultado do Tratamento
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