Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 18 de 18
Filtrar
1.
J Cosmet Laser Ther ; 20(1): 9-11, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28166444

RESUMO

Trichoepitheliomas are benign cutaneous tumours often occurring on the face and can lead to considerable psychological distress to its sufferers. Treatment is often difficult, and surgery is limited by the obvious scars and multiple numbers of lesions. Carbon dioxide laser ablation can be used safely with good cosmetic outcome and low recurrence rate, and in this article, we describe our experience in the treatment of these tumours with the carbon dioxide laser. This is the largest reported series in the literature.


Assuntos
Neoplasias Faciais/cirurgia , Lasers de Gás/uso terapêutico , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Cutâneas/cirurgia , Dióxido de Carbono , Feminino , Humanos , Lasers de Gás/efeitos adversos
4.
J Cosmet Laser Ther ; 18(4): 188-92, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26735085

RESUMO

Becker's naevus is a hamartoma that often appears during puberty. Clinically this presents with a pigmented and often hairy patch most often on the shoulders. Treatment has always been challenging and lasers are often used with mixed results. This article reviews the evidence of all the laser treatments used in Becker's naevus and analyses the findings from the published studies and trials.


Assuntos
Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Nevo/terapia , Neoplasias Cutâneas/terapia , Feminino , Humanos , Terapia a Laser/métodos , Masculino , Resultado do Tratamento
5.
J Cosmet Laser Ther ; 18(6): 335-8, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26962971

RESUMO

Sarcoid is a granulomatous disease that can affect the skin solely or as part of a systemic involvement. Cutaneous lesions of sarcoid may be difficult to treat and lasers are rarely used. In this article we report our case series and review the literature on the use of lasers in cutaneous sarcoid.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Sarcoidose/radioterapia , Dermatopatias/radioterapia , Feminino , Humanos , Masculino , Sarcoidose/terapia , Pele/efeitos da radiação , Dermatopatias/terapia
6.
J Cosmet Laser Ther ; 18(7): 372-375, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27331628

RESUMO

Angiofibromas are one of the dermatological hallmarks of tuberous sclerosis. Various ablative treatments have been trialled and more recently topical rapamycin has been proposed. We present our experience of treatment of angiofibromas using carbon dioxide (CO2) laser ablation and provide a timely literature review. Nine patients were retrospectively identified as being treated with CO2 laser between 2009 and 2015. Three patients were male, six were female, median age at first treatment was 28 (range 15-49) years and the median number of treatments was two (range 1-17). Four of these patients could be contacted for a post-treatment telephone interview. All reported an improvement in appearance of angiofibromas following treatment and that they would recommend CO2 laser ablation to others. Three of the four reported recurrence of some lesions following treatment. The only side effect reported by one patient was transient hyperpigmentation. CO2 laser ablation appears to be a well-tolerated, efficacious treatment for angiofibromas with few long-term side effects.


Assuntos
Angiofibroma/cirurgia , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Neoplasias Cutâneas/cirurgia , Adulto , Angiofibroma/patologia , Feminino , Seguimentos , Humanos , Hipopigmentação/etiologia , Hipopigmentação/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Resultado do Tratamento , Adulto Jovem
7.
Dermatol Surg ; 39(11): 1648-52, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24581313

RESUMO

BACKGROUND: Mohs micrographic surgery (MMS) is the preferred treatment modality for high-risk nonmelanoma skin cancer because of the high cure rates and tissue-sparing effect. Its outcome is highly dependent on the expertise and accuracy of the Mohs surgeon in the interpretation of frozen sections. OBJECTIVE: This retrospective study evaluated the level of concordance between Mohs surgeons and dermatopathologists in reading histology slides from MMS procedures. METHODS AND MATERIALS: A Mohs surgeon read 170 randomly selected slides for a quality assurance audit during excision, and then a dermatopathologist blindly read them at a separate time. Absence or presence of tumour and the final diagnosis were recorded on a standardized form. RESULTS: An overall concordance of 99.4% was demonstrated. True discordance was recorded in only one of 170 cases. Intraepidermal atypia was the most challenging scenario for Mohs surgeons. CONCLUSIONS: The high rate of agreement in this study confirms that adequately trained MMS surgeons have sufficient expertise and training for accurate and precise frozen sections interpretation.


Assuntos
Secções Congeladas , Cirurgia de Mohs , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Variações Dependentes do Observador , Patologia , Garantia da Qualidade dos Cuidados de Saúde , Estudos Retrospectivos
8.
Australas J Dermatol ; 53(2): 151-4, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22571569

RESUMO

Birt-Hogg-Dubé syndrome (BHDS) is an autosomal dominant condition caused by mutations in the gene which codes for folliculin (FLCN). It is characterised clinically by fibrofolliculomas, trichodiscomas, pulmonary cysts, spontaneous pneumothoraces and renal cancers. This case illustrates a patient with BHDS and a renal angiomyolipoma. Angiomyolipomas are not described as a feature of BHDS, but rather they can occur sporadically or in tuberous sclerosis complex (TSC). Recent studies suggest that clinical similarities between BHDS and TSC may be explained by FLCN and TSC proteins functioning on a common pathway, mammalian target of rapamycin. This case adds to the literature of cases with clinical similarities.


Assuntos
Angiomiolipoma/complicações , Síndrome de Birt-Hogg-Dubé/complicações , Neoplasias Renais/complicações , Esclerose Tuberosa/complicações , Adulto , Angiomiolipoma/diagnóstico por imagem , Síndrome de Birt-Hogg-Dubé/genética , Síndrome de Birt-Hogg-Dubé/patologia , Dermatoses Faciais/complicações , Dermatoses Faciais/genética , Dermatoses Faciais/patologia , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Proteínas Proto-Oncogênicas/genética , Radiografia , Proteínas Supressoras de Tumor/genética , Ultrassonografia
12.
Am J Dermatopathol ; 31(3): 297-300, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19384074

RESUMO

Gastrointestinal stromal tumors (GISTs) rarely metastasize to the skin. We describe 5 patients with GIST with subcutaneous and cutaneous metastases. The mean age at metastasis was 54 years (range 30-68 years) with a male predominance (4:1). Primary tumors occurred in the stomach (n = 3), small bowel (n = 1), and abdomen, not otherwise specified (n = 1). The average time from primary tumor resection to the resection of skin metastases was 59 months (range 11-155 months). The metastases occurred in the scalp (n = 2), cheek (n = 1), and abdomen (n = 2) with 3 patients presenting with solitary nodules and 2 patients with multiple nodules. The average size was 2 cm (range 0.6-4 cm). Histologically, 2 cases were spindled and 3 cases demonstrated mixed epithelioid and spindle cell morphology. All were confirmed to have CD117 reactivity. KIT genotyping was performed in 4 of 5 cases. Two cases harbored a mutation in exon 11, and the remaining 2 cases were wild type in exons 9, 11, 13, and 17. All 5 patients had multiple concurrent or subsequent abdominal and/or hepatic metastases. In 4 patients with an average follow-up of 32 months (range 6-75 months), after the resection of the metastases, 2 were alive with disease and 2 died of disease. Cutaneous metastases seem to be a late complication of GIST, but their presence does not necessarily herald a rapid demise of the patient.


Assuntos
Tumores do Estroma Gastrointestinal/patologia , Proteínas Proto-Oncogênicas c-kit , Neoplasias Cutâneas/secundário , Neoplasias de Tecidos Moles/secundário , Tela Subcutânea/patologia , Adulto , Idoso , Análise Mutacional de DNA , Éxons , Feminino , Tumores do Estroma Gastrointestinal/genética , Tumores do Estroma Gastrointestinal/imunologia , Tumores do Estroma Gastrointestinal/mortalidade , Tumores do Estroma Gastrointestinal/cirurgia , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Mutação , Proteínas Proto-Oncogênicas c-kit/análise , Proteínas Proto-Oncogênicas c-kit/genética , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/cirurgia , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/imunologia , Neoplasias de Tecidos Moles/mortalidade , Neoplasias de Tecidos Moles/cirurgia , Tela Subcutânea/imunologia , Tela Subcutânea/cirurgia , Fatores de Tempo , Resultado do Tratamento
13.
Matrix Biol Plus ; 4: 100016, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33543013

RESUMO

Following wound damage to the skin, the scarring spectrum is wide-ranging, from a manageable normal scar through to pathological keloids. The question remains whether these fibrotic lesions represent simply a quantitative extreme, or alternatively, whether they are qualitatively distinct. A three-way comparison of the extracellular matrix (ECM) composition of normal skin, normal scar and keloids was performed using quantitative discovery-based proteomics. This approach identified 40 proteins that were significantly altered in keloids compared to normal scars, and strikingly, 23 keloid-unique proteins. The major alterations in keloids, when functionally grouped, showed many changes in proteins involved in ECM assembly and fibrillogenesis, but also a keloid-associated loss of proteases, and a unique cartilage-like composition, which was also evident histologically. The presence of Aggrecan and Collagen II in keloids suggest greater plasticity and mis-differentiation of the constituent cells. This study characterises the ECM of both scar types to a depth previously underappreciated. This thorough molecular description of keloid lesions relative to normal scars is an essential step towards our understanding of this debilitating clinical problem, and how best to treat it.

14.
Dermatol Surg ; 34(11): 1520-6, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18811716

RESUMO

BACKGROUND: Distinguishing sun-induced melanocyte atypia from residual melanoma in situ (MIS) can be challenging, particularly when working with frozen sections. Immunostains such as melanoma-associated antigen recognized by T cells (MART-1) can assist, but paraffin sections provide an optimal means of analyzing melanocyte morphology. OBJECTIVE: To verify the effectiveness of a 2-hour paraffin processing technique that uses microwave technology in the preparation of MIS sections. METHODS: Twelve MIS debulk specimens were divided into 4 pieces with each piece processed 1 of 4 ways: our 2-hour paraffin technique with hematoxylin and eosin (H&E), conventional 24-hour paraffin processing with H&E, frozen sections with H&E, and frozen sections with MART-1 immunostaining. A Mohs surgeon and a dermatopathologist compared all specimens in a blinded fashion using a 3-point ranking scale to assess ease of visualizing normal melanocytes, ease of visualizing abnormal melanocytes, and overall ability to adequately visualize epidermal and dermal structures. RESULTS: A nonparametric signed rank test indicated no significant differences between our microwave technique and conventional paraffin processing in all 3 criteria (p=.29, .63, .75, respectively). Our microwave technique was significantly better than frozen H&E sections for all 3 criteria (p=.046, .004, .005, respectively). CONCLUSION: This rapid microwave tissue processing technique is comparable with conventional paraffin section processing.


Assuntos
Melanoma/patologia , Melanoma/cirurgia , Cirurgia de Mohs , Inclusão em Parafina/métodos , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Humanos , Projetos Piloto , Estudos Prospectivos , Fatores de Tempo
15.
J Cutan Aesthet Surg ; 10(3): 157-159, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29403188

RESUMO

Full-thickness skin grafts (FTSGs) are frequently used to treat patients with burn injuries and to repair defects rendered by excisional (including Mohs) surgery. The evidence for corrective laser surgery after scar formation is well established. With regard to laser treatment of FTSG, the evidence is sparse. Laser treatment after FTSG is a novel concept, with minimal literature. We present a case series, one of the first to our knowledge, of the treatment of FTSG with fractional CO2 laser in five patients after Mohs surgery.

16.
J Cutan Aesthet Surg ; 8(2): 88-91, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26157307

RESUMO

INTRODUCTION: Basal cell carcinoma is a common cutaneous malignant tumour. Surgical excision is the "gold standard" treatment for most subtypes, with Mohs micrographic surgery (MMS) offering the highest cure rate. Other treatment modalities used include photodynamic therapy (PDT). BACKGROUND: We aimed to study the efficacy of combining MMS with PDT to see whether this would reduce the number of stages and final defect size when compared with MMS alone. MATERIALS AND METHODS: Our study was a single-centre, single-blinded, randomised and controlled pilot study involving a total of 19 patients. Nine patients were randomised to pre-treatment with PDT followed by MMS of whom two withdrew; the remaining 10 patients were randomised to the MMS alone. Follow-up visits were arranged at 3 and 6 months post-surgery. RESULTS: In the PDT arm, five out of the seven treated patients (71%) had their initial tumour size decreased following PDT treatment prior to MMS. The average number of stages in the PDT arm was 1.85, compared to 2.5 in the MMS arm. The average number of sections in the PDT arm was 4.2, in comparison to 5.2 in the MMS arm. CONCLUSION: Our pilot study showed a promising but limited role for PDT as an adjunct in MMS in the treatment of selected cases of basal cell carcinomas. Larger trials, preferably multi-centred are required to further examine the role of this combination therapy.

17.
F1000Res ; 3: 25, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25075285

RESUMO

Lentigo maligna is a lentiginous proliferation of atypical melanocytes confined to the epidermis, typically on chronically sun-damaged skin. Following biopsy and exclusion of invasive disease, therapy may involve Mohs surgery, topical treatment or radiotherapy. However, lentigo maligna often involves adnexal structures, creating histological difficulty in distinguishing these foci from invasive melanoma. We present a case in which, during Mohs excision, a nodule of severely atypical melanocytes appeared to lie within the dermis, potentially altering treatment and prognosis. The use of laminin-5 provided a means of resolving this diagnostic dilemma, facilitating continuation of Mohs surgery until tumour clearance was achieved.

SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa