Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 7 Articles
Dermoscopic patterns of basal cell carcinoma (BCC) are well defined, but the dynamics of dermoscopic changes in time were\r\napparently never described so far. In this paper, prominent changes were observed over a 8-week period, allowing to establish a\r\nclose connection between spoke wheel areas and maple leaf-like aspects, through progressive thickening of the former ones. A\r\nchronobiological phenomenon ruling synchronous apoptosis in some of the most superficial BCC nests is suggested, leading to a\r\nwax and wane process of millimetric crusts, taking part in the spontaneous BCC regression/progression process....
Clear cell sarcomas are aggressive, rare soft tissue tumors and their classification among melanoma or sarcoma is still undetermined\r\ndue to their clinical, pathologic, and molecular properties found in both types of tumors. This is a retrospective study of 52\r\npatients with CCS seen between April 1979 and April 2005 in two institutions. The EWS-ATF-1 fusion transcript was studied\r\nin 31 patients and an activating mutation of the BRAF or NRAS gene was researched in 22 patients. 30 men and 22 women,\r\nwith a mean age of 33 were studied. Forty-three tumors (82.69%) were located in the extremities, specially the foot (19 tumors).\r\nMedian initial tumor size was 4.8 cm (1 to 15 cm). Necrosis involving more than 50% of the tumor cells was found in 14 cases\r\n(26.92%). High mitotic rate (>10) was found in 25 cases (48.07%). The EWS/ATF-1 translocation was found in 28 (53.84%) of 31\r\npatients studied, and mutation of BRAF or NRAS was found in only 2 of 22 patients analyzed cases (3.84%). Among the tumorassociated\r\nparameters, only tumor size (>4 cm) emerged as a significant prognostic factor. Forty-nine patients had a localized\r\ndisease at diagnosis (94.23%) and underwent surgical resection immediately (90%) or after neoadjuvant chemotherapy (CT)\r\n(10%). Various CT regimens were used in 37 patients (71.15%) with no significant efficacy. The 5- and 10-year OS rates were 59%\r\nand 41%, respectively. Tumor size was the only emerging prognosis factor in our series. Complete surgical resection remains the\r\noptimal treatment for this aggressive chemoresistant tumor....
Ingrown toenails are one of the most frequent nail disorders of young persons. Theymay negatively influence daily activities, cause\r\ndiscomfort and pain. Since more than 1000 years, many different treatments have been proposed. Today, conservative and surgical\r\nmethods are available, which, when carried out with expertise, are able to cure the disease. Packing, taping, gutter treatment, and\r\nnail braces are options for relatively mild cases whereas surgery is exclusively done by physicians. Phenolisation of the lateral matrix\r\nhorn is now the safest, simplest, and most commonly performed method with the lowest recurrence rate. Wedge excisions can no\r\nlonger be recommended...
Aim. The aim of this paper is to report a novel intensive therapy of gynoid lipodystrophy (cellulite) based on a new hypothesis.\r\nMethods.Were evaluated in 10 patients with ages ranging between 25 and 59 years (mean 35.6 years) grade IV cellulite identified by\r\nclinical evaluation. Before initiating treatment, perimetry was performed at 5 cm intervals along both thighs, at the gluteal fold, 5,\r\n10, and 15 cm above the gluteal fold, at the navel, and 5 cmabove the navel. The patients were submitted to a 4-hour daily treatment\r\nsession that consisted of manual and mechanical lymph drainage and cervical stimulation by the Godoy & Godoy technique\r\nadapted for the treatment of cellulite. After 10 sessions over two weeks, the patients were again evaluated. The paired t-test was\r\nutilized for statistical analysis with an alpha error of 5% (P value < 0.05). A reduction was identified at all of the measurement\r\npoints (paired t-test; P value < 0.0001). Results. The mean reductions varied between 4.0 and 5.7 cm at the measurement points\r\nbut reductions of more than 10 cm in perimeter were achieved in some patients. Conclusion. This technique involving lymphatic\r\nsystem stimulation is efficacious in the treatment of cellulite....
Melanonychia, or melanin-derived brown-to-black nail pigmentation, is a diagnostic challenge for clinicians. The most serious\r\ndisease of the nail unit, melanoma, primarily presents with melanonychia. However, melanonychia most often occurs as a result of\r\nbenign etiologies such as nail matrix melanocytic activation, nail matrix melanocytic hyperplasia, and nail invasion by melaninproducing\r\npathogens. Regrettably, patients with nail apparatus melanoma are often initially misdiagnosed, and due to diagnostic\r\ndelays of an average of 2 years, melanoma of the nail unit carries a poor prognosis. Having a thorough knowledge of the various\r\ncauses of melanonychia and using a systematic approach when evaluating brown-to-black nail pigmentation may help prevent\r\nmisdiagnosis and thereby improve prognosis....
Contact dermatitis is produced by external skin exposure to an allergen, but sometimes a systemically administered allergen may\r\nreach the skin and remain concentrated there with the aid of the circulatory system, leading to the production of systemic contact\r\ndermatitis (SCD). Metals such as nickel, cobalt, chromium, and zinc are ubiquitous in our environment. Metal allergy may result\r\nin allergic contact dermatitis and also SCD. Systemic reactions, such as hand dermatitis or generalized eczematous reactions,\r\ncan occur due to dietary nickel or cobalt ingestion. Zinc-containing dental fillings can induce oral lichen planus, palmoplantar\r\npustulosis, and maculopapular rash. A diagnosis of sensitivity to metal is established by epicutaneous patch testing and oral metal\r\nchallenge with metals such as nickel, cobalt, chromium, and zinc. In vitro tests, such as the lymphocyte stimulating test (LST),\r\nhave some advantages over patch testing to diagnose allergic contact dermatitis. Additionally, the determination of the production\r\nof several cytokines by primary peripheral blood mononuclear cell cultures is a potentially promising in vitro method for the\r\ndiscrimination of metal allergies, including SCD, as compared with the LST....
Background: Psoriasis is associated with an atherogenic lipid profile but longitudinal changes in lipids around\r\ndisease onset are unknown. The purpose of our study is to examine the effect of psoriasis onset on serum lipid\r\nprofiles.\r\nMethods: We compared changes in lipid profiles in a population based incident cohort of 689 patients with\r\npsoriasis and 717 non-psoriasis subjects. All lipid measures performed 5 years before and after psoriasis incidence/\r\nindex date were abstracted. Random-effects models adjusting for age, sex and calendar year were used to examine\r\ntrends in lipid profiles.\r\nResults: There were significant declines in total cholesterol (TC) and low-density lipoprotein (LDL) levels during the\r\n5 years before and after psoriasis incidence/index date in both the psoriasis and the non-psoriasis cohorts, with a\r\ngreater decrease noted in the TC levels (p=0.022) and LDL (p=0.054) in the non-psoriasis cohort. High-density\r\nlipoprotein (HDL) levels increased significantly both before and after psoriasis incidence date in the psoriasis cohort.\r\nTriglyceride (TG) levels were significantly higher (p<0.001), and HDL levels significantly lower (p=0.013) in patients\r\nwith psoriasis compared to non-psoriasis subjects. There were no differences in prescriptions for lipid lowering\r\ndrugs between the two cohorts.\r\nConclusions: Patients with psoriasis had a significant decrease in TC and LDL levels during the 5 years before\r\npsoriasis incidence. Higher mean TG and lower mean HDL levels were noted in the 5 years before psoriasis\r\nincidence. These changes are unlikely to be caused by lipid lowering treatment alone and require further\r\nexploration....
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