RESUMO
Steatocystoma multiplex (SM) is a rare condition characterized by multiple, small, asymptomatic dermal cysts. Treatment options are limited, with varying degrees of success; these include oral isotretinoin, surgical excision or drainage, and liquid nitrogen cryotherapy. The most effective method is excision, but cosmetic considerations, time, overall cost, and pain must be considered, because patients tend to have multiple cysts. Lasers, especially nonablative devices, have not frequently been used to treat SM. Herein, we present the case of a patient with isolated steatocystoma multiplex on the abdomen and lower chest with substantial clearance after two laser treatment sessions using two complementary lasers: a 1,450-nm diode laser to target the abnormal sebaceous glands and a 1,550-nm fractionated erbium-doped fiber laser to target the dermal cysts.
Assuntos
Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Paquioníquia Congênita/cirurgia , Adulto , Feminino , Humanos , Paquioníquia Congênita/patologia , Adulto JovemRESUMO
BACKGROUND: Actinic keratoses (AKs) are in situ epidermal tumors that may progress to invasive squamous cell carcinomas (SCCs). Aminolevulinic acid with photodynamic therapy (ALA PDT) is a field treatment for AK. OBJECTIVE: To evaluate the time to development of new non-melanoma skin cancers (NMSC) within one year of ALA-PDT treatment in immunocompetent patients with AK and a history of skin cancer. METHODS AND MATERIALS: One hundred forty anatomic sites in 114 patients were treated with topical ALA for a 1 to 3 hour incubation period followed by photodynamic therapy (PDT) with a blue light. All new NMSCs within the treatment areas were recorded over a 1-year observational period. RESULTS: Eighty-three anatomic sites (59%) did not develop new skin cancers within 1 year. Additionally, 92%, 78%, and 64% of anatomic sites were free of new skin cancers at 3, 6, and 9 months after treatment was initiated. Although approximately 41% of patients treated on both the scalp and face developed new skin cancers within 1 year of treatment, the average time to develop skin cancer was longer for the face (7.09 months) than for the scalp (5.34 months). CONCLUSION: In patients with a history of NMSC and multiple AKs, ALA PDT may be a valuable option for the prevention and delay of new NMSCs.
Assuntos
Ácido Aminolevulínico/administração & dosagem , Ceratose Actínica/tratamento farmacológico , Fotoquimioterapia/métodos , Neoplasias Cutâneas/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Faciais/prevenção & controle , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/prevenção & controle , Humanos , Ceratose Actínica/complicações , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/administração & dosagem , Fatores de TempoRESUMO
Nevus sebaceous of Jadassohn is a hamartoma with a combination of abnormalities of the epidermis, hair follicles, and sebaceous and apocrine glands. Herein, we discuss the results of an extensive literature review on the topic of nevus sebaceous with a particular focus on the debate about the necessity for prophylactic excision. We also focus on the documentation of associated malignant tumors that were reported to develop within NS. In addition to reporting the number and types of neoplasms, we documented the recommendations of all authors for therapeutic handling of these nevi.
Assuntos
Nevo Sebáceo de Jadassohn/patologia , Lesões Pré-Cancerosas/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Hamartoma/patologia , Hamartoma/cirurgia , Humanos , Nevo Sebáceo de Jadassohn/cirurgia , Lesões Pré-Cancerosas/cirurgia , Couro Cabeludo/cirurgia , Dermatopatias/patologia , Dermatopatias/cirurgia , Neoplasias Cutâneas/cirurgiaRESUMO
We report the unusual case of a young child who developed an idiopathic basal cell carcinoma (BCC). The patient was otherwise healthy, with no history of excessive sun or radiation exposure or any predisposing factors for nonmelanoma skin cancer. This is a rare case that exemplifies the need for pediatricians and dermatologists to be aware that BCC may occur in children, even if they have no predisposing factors.
Assuntos
Carcinoma Basocelular/patologia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/cirurgia , Criança , Humanos , Masculino , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoRESUMO
Several variants of psoriasis are seen in children, the most prevalent types include plaque, guttate, and psoriatic diaper rash; pustular and erythrodermic psoriasis are less frequently observed. Genetic susceptibility and environmental triggers are both involved in the development of this autoimmune disease. As well as improving symptoms, a treatment plan should strive to identify and eliminate precipitating factors. Topical medications are the first choice therapy for children with psoriasis. Systemic agents are used to treat more severe cases. Patient education and supportive care should be incorporated into the treatment plan.
Assuntos
Fármacos Dermatológicos/uso terapêutico , Educação de Pacientes como Assunto/métodos , Psoríase/tratamento farmacológico , Administração Cutânea , Adolescente , Idade de Início , Criança , Fármacos Dermatológicos/administração & dosagem , Exposição Ambiental , Predisposição Genética para Doença , Humanos , Psoríase/etiologia , Psoríase/patologiaRESUMO
BACKGROUND: A number of epidermal and papillary dermal skin conditions can be treated safely and effectively with fractional photothermolysis (FP). OBJECTIVE: We sought to evaluate the effectiveness of FP with a 1550-nm fractionated erbium-doped fiber laser for the treatment of facial actinic keratoses (AKs). METHODS: Fourteen men, ages 59 to 79 years, underwent 5 laser treatments (2- to 4-week intervals) at an energy fluence of 20 to 70 mJ and treatment level of 11 (8-10 passes), corresponding to 32% to 40% surface area coverage. AK counts and photographs were taken at baseline, before each treatment, and at 1-, 3-, and 6-month follow-ups after the last treatment. Biopsies were performed at baseline and at the 3-month follow-up. The clinical improvement of the actinic lesions was evaluated by a dermatologist using digital photography and lesion counts at all 3 follow-up visits. RESULTS: The AK count for each patient was reduced on average by 73.1% (67.5%-77.7%) at the 1-month, 66.2% (60.0%-71.5%) at the 3-month, and 55.6% (43.9%-64.8%) at the 6-month follow-up visit. Excluding two cases, all biopsy specimens (baseline and at the 3-month follow-up) were positive for histologic features of AK and/or squamous cell carcinoma. LIMITATIONS: This study is limited by a small number of patients; therefore further clinical studies are warranted. CONCLUSIONS: FP decreases the number of clinical AKs; however, posttreatment biopsy specimens indicate the histologic persistence of AKs (epidermal tumors). FP is not an adequate single-treatment modality for AKs.
Assuntos
Dermatoses Faciais/patologia , Dermatoses Faciais/radioterapia , Ceratose Actínica/patologia , Ceratose Actínica/radioterapia , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Idoso , Biópsia por Agulha , Intervalos de Confiança , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Medição de Risco , Estudos de Amostragem , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Nevus of Ota is a pigmented lesion that usually presents at birth. Due to a greater risk for complications, physicians have not always utilized laser therapy to treat these nevi in patients with darker skin types. OBJECTIVE: To evaluate the safety and efficacy of the 1,064-nm Q-switched neodymium-doped yttrium aluminium garnet (QS Nd:YAG) laser for the treatment of Nevus of Ota in two patients with Fitzpatrick skin type (FST) VI. RESULTS: After 4-13 treatment sessions with the 1,064-nm Q-switched Nd:YAG laser with a 4 mm spot size and fluence of 4-4.2 J/cm(2), two patients with FST VI noted substantial improvement in the appearance of the nevi. CONCLUSION: At conservative treatment settings, these two case reports have shown that the 1,064-nm QS Nd:YAG laser can be utilized to safely and effectively treat Nevus of Ota in individuals with FST IV-VI.
Assuntos
Lasers de Estado Sólido/uso terapêutico , Nevo de Ota/cirurgia , Neoplasias Cutâneas/cirurgia , Pigmentação da Pele , Adulto , Feminino , Humanos , Lactente , Nevo de Ota/diagnóstico , Neoplasias Cutâneas/diagnóstico , Resultado do TratamentoRESUMO
BACKGROUND: Pigmented lesions include solar lentigines, seborrheic keratoses, dermatosis papulosa nigra, ephelides, café-au-lait macules, nevus spilus, Becker's nevus, postinflammatory hyperpigmentation, melasma, nevocellular nevi, congenital nevi, junctional and compound melanocytic nevi, nevus of Ota and Ito, Hori's nevus, and blue nevi. Advances in laser technology have resulted in the ability to treat pigmented lesions with greater safety and efficacy. OBJECTIVE: To review the literature on the use of cutaneous laser treatments for pigmented lesions using Medline. RESULTS: The literature cited the use of various lasers to treat pigmented lesions, including argon, carbon dioxide, erbium-doped yttrium aluminum garnet, Q-switched, long-pulsed ruby, alexandrite, diode, and fractional lasers. For each lesion, we describe the efficacy of laser treatments, treatment intervals, and settings used for a variety of diagnoses. CONCLUSION: The treatment of pigmented lesions continues to evolve as new laser technology emerges and improvements in existing devices are made. The ability to treat pigmented lesions with greater efficacy and safety has resulted from recent advances in laser technology.
Assuntos
Terapia a Laser/métodos , Transtornos da Pigmentação/cirurgia , Humanos , Cuidados IntraoperatóriosRESUMO
Alcohol is a serious cause of morbidity and mortality in our society and is implicated in multiple health conditions, including hepatic failure, neurological damage, hematological disorders, and nutritional deficiencies, to name a few. Although alcohol induced cutaneous abnormalities can also cause significant morbidity, they tend to be overshadowed by the other disease states associated with alcohol use. In addition to the cutaneous stigmata linked to chronic alcoholic liver disease, alcohol can directly cause or exacerbate several skin conditions. In particular, alcohol misuse is implicated in the development of psoriasis and discoid eczema, as well as confers increased susceptibility to skin and systemic infections. Alcohol misuse might also exacerbate rosacea, porphyria cutanea tarda, and post adolescent acne. Herein, we review the evidence concerning the influences of alcohol in skin conditions with a focus on psoriasis.
Assuntos
Etanol/efeitos adversos , Psoríase/induzido quimicamente , HumanosRESUMO
The formation of hypergranulation tissue is an aberrant process that interferes with normal wound healing. Excessive granulation tissue results in the persistence of open wounds. It is resistant to currently available treatment modalities. We report a case series of patients with hypergranulation tissue on the scalp who were successfully treated with a 595 nm pulsed dye laser and hydrocolloid dressing.
Assuntos
Curativos Hidrocoloides , Tecido de Granulação/cirurgia , Lasers de Corante/uso terapêutico , Complicações Pós-Operatórias/cirurgia , Couro Cabeludo/cirurgia , Cicatrização , Idoso , Idoso de 80 Anos ou mais , Feminino , Tecido de Granulação/patologia , Humanos , Masculino , Complicações Pós-Operatórias/patologia , Couro Cabeludo/patologiaAssuntos
Doença de Bowen/tratamento farmacológico , Glicosídeos/uso terapêutico , Neoplasias Penianas/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Alcaloides de Solanáceas/uso terapêutico , Doença de Bowen/cirurgia , Terapia Combinada , Criocirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Penianas/cirurgia , Neoplasias Cutâneas/cirurgiaRESUMO
BACKGROUND: Odontogenic keratocysts of the jaw are a central feature of basal cell nevus syndrome (BCNS) and arise from the basal cell layer of the surface epithelium. Although they are benign, they tend to be aggressive, with local invasion of bony structures, extensive growth, and potential for substantial disfigurement and speech dysfunction. Complete surgical resection is the current standard of care; however, the procedures are often technically challenging and are followed by high recurrence rates. OBSERVATIONS: We report the case of a 55-year-old man with a long-standing history of BCNS. Over a 25-year period, this patient had been treated for many basal cell carcinomas (BCCs). He also had multiple large odontogenic keratocysts in the mandible that had previously been treated using surgical, chemotherapeutic, and radiation treatment techniques. He had also undergone a right inguinal lymph node dissection after BCC metastasis was diagnosed within a lymph node. Owing to the recalcitrant nature of his condition and his history of BCC metastasis, the patient was started on a daily regimen of a new oral drug, GDC-0449, which inhibits the hedgehog signaling pathway, a key genetic contributor in the oncogenesis of BCCs. In addition to complete resolution of all his BCCs at 12-week follow-up, nearly complete resolution of 3 odontogenic keratocysts was documented by serial dental radiographs after 2 years of therapy. CONCLUSIONS: We report the nearly complete regression of multiple BCNS-associated odontogenic keratocysts following nonsurgical treatment with GDC-0449. This novel drug, useful for the treatment of BCC, also appears to be effective for treatment of odontogenic keratocysts.