1/18. Systemic sarcoidosis presenting with multiple tattoo granulomas and an extra-tattoo cutaneous granuloma.We describe a 29 year old Caucasian man who developed cutaneous sarcoidosis manifesting itself as a tumour at the left outer canthus clinically mimicking a basal cell carcinoma and nine tattoo granulomas. Subsequent investigation revealed that the patient was also suffering from systemic sarcoidosis.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
2/18. Temporoparietal fascial flap in orbital reconstruction.OBJECTIVE: To evaluate the success of the temporoparietal fascial flap (TPFF) in the primary or secondary reconstruction of difficult orbital defects and to review the surgical techniques. DESIGN: Retrospective analysis. SETTING: Tertiary medical center. patients: Nine patients with diverse orbital cavity or periorbital soft tissue and bony defects due to trauma, benign or malignant neoplasms, and radiation treatment. INTERVENTIONS: Temporoparietal fascial flap anatomy and techniques of harvest and inset are reviewed in detail. Four cases are presented to illustrate possible variables in orbital reconstruction. Variables examined include the location of defects, the success of flap survival in orbital cavities after primary or secondary reconstruction, the effects of prior irradiation on flap survival, and the possibility of concurrent osteointegrated implant placement with TPFF reconstruction. MAIN OUTCOME MEASURES: Functional and aesthetic outcomes were determined by physical examination and preoperative and postoperative photographs. RESULTS: All patients had successful transfer of TPFF grafts without flap compromise. Temporoparietal fascial flap was a viable option for subtle orbital and malar contour defects. In chronically inflamed wounds such as with osteoradionecrosis and orbitoantral fistula, TPFF successfully restored vascularity, obliterated the defects, and enabled the placement of osteointegrated implants. The TPFF also supported the concurrent placement of a free calvarial bone graft. Finally, split-thickness skin grafted onto a pedicled TPFF showed 100% survival. CONCLUSIONS: The TPFF is one of the most reliable and versatile regional flaps in the head and neck for orbital reconstruction. This study presents the use of TPFF in a variety of orbital defects, from lateral bony rim defects to total exenteration. Timing of repair in this study spans from immediate reconstruction to reconstruction delayed more than 50 years after the initial injury. In all cases, reconstruction with TPFF resulted in improved bony and soft tissue contours, and incurred minimal morbidity.- - - - - - - - - - ranking = 1.373291015625keywords = physical (Clic here for more details about this article) |
3/18. Non-ulcerative basal cell carcinoma arising on the genitalia.We report two cases of basal cell carcinoma (BCC) arising on the genitalia. The first case was a 49-year-old male who became aware of a dull erythematous plaque with a keratotic surface on his scrotal skin, and the second case was a 44-year-old female suffering from a keratotic plaque on her right vulvar region. Neither lesion was ulcerative. Both were resected under local anesthesia following a clinical diagnosis of angiokeratoma for the former and seborrheic keratosis or BCC for the latter lesion. Histopathological study revealed that both lesions were BCC. Many questions regarding the pathogenesis of BCC still remain to be clarified. Because most of the reported cases have been ulcerative lesions and the genital region is an uncommon site for BCCs, caution should be taken in cases in whom a clinically non-ulcerative tumor suspected to be angiokeratoma or seborrheic keratosis arises in this region.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
4/18. skin cancer screening.BACKGROUND: skin cancer is the most common malignancy occurring in humans, affecting 1 in 5 Americans at some time during their lives. Early detection of cancerous lesions is important for reducing morbidity and mortality. CASE DESCRIPTION: The patient was a 79-year-old woman who was receiving physical therapy for cervical stenosis. The physical therapist identified a mole with suspicious characteristics, using the ABCD checklist for skin cancer screening. The patient was referred to her primary care physician, and the lesion was removed and identified as basal cell carcinoma. OUTCOMES: Early detection of this lesion allowed for complete excision, with no further treatment of the area warranted. DISCUSSION: physical therapists can aid in detection of suspect lesions with knowledge of the basic screening techniques for skin cancer, which may help reduce the morbidity and mortality caused by these lesions.- - - - - - - - - - ranking = 2.74658203125keywords = physical (Clic here for more details about this article) |
5/18. Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid: a case report.BACKGROUND: Syringocystadenoma papilliferum is an unusual benign tumor most commonly located on the scalp or face, which frequently arises from a nevus sebaceous. Transition of SP to basal cell carcinoma and, rarely, to metastatic adenocarcinoma may occur. CASE REPORT: A 28-year-old female patient had been suffering from a pinkish, painless nodule for 25 years. physical examination revealed a pinkish, non-tender, painless nodule, 5mm in diameter, on the lower eyelid. The nodular lesion was excised, and the lower eyelid was reconstructed with V-Y advancement flap. Histopathologic examination revealed hyperkeratosis with papillomatosis of epidermis. The dermis showed several cystic invaginations extending downwards from the epidermis. One year later, the postoperative result was cosmetically and functionally acceptable. CONCLUSON: Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid is of interest, since there were scanty skin appendages. Our paper considers the issue of differentiating between SP and BCC, since SP is asymptomatic and may have similar appearance. We believe that SP may be a transitional step from nevus sebaceous to basal cell carcinoma, since molecular studies show PTCH gene in all three lesions, the origins of SP are still debatable, and both SP and BCC can arise in nevus sebaceous of Jadassohn.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
6/18. Bilateral basal cell carcinoma symmetrically appearing on lower eyelids: a case report.Basal cell carcinoma is the most common skin malignancy and is found in skin exposed to the sun. It is rarely seen bilaterally in ears, ankles or breasts. There has been no literature about bilateral basal cell carcinoma of lower eyelids symmetrically. A 68-year-old male patient had been suffering from two lesions on his lower eyelids for two years. The first lesion appeared on the right lower eyelid two years ago and got larger. Then the second lesion occurred on the left lower eyelid a year and a half ago. The patient had worked as a farmer for fifteen years. physical examination revealed ulcerated lesions, with surrounding hyperemia, 12 x 6 mm in size, on both lower eyelids. Both lesions were excised and repaired with lateral malar flap mucosal graft. One year later, there no evidence of recurrence, and postoperative scars were functionally and cosmetically acceptable. We present a case of bilateral basal cell carcinoma involving both lower eyelids symmetrically, reviewing the literature.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
7/18. The use of imiquimod 5% cream for the treatment of basal cell carcinoma as observed in Gorlin's syndrome.Gorlin's syndrome (naevoid basal cell carcinoma) is an autosomal dominant tumour-predisposition syndrome. It typically consists of multiple basal cell carcinomas (BCCs) of the skin, odontogenic keratocysts of the jaw, various skeletal abnormalities and lamellar falx calcifications. Four patients with multiple facial and trunk BCCs (superficial and nodular) consistent with Gorlin's syndrome are reported. Imiquimod 5% cream was topically applied to the lesions 3-5 times a week for 8-14 weeks. Two of the patients suffered mild to severe erythema and developed superficial erosions but did not discontinue treatment. Imiquimod 5% cream successfully treated 13 out of 17 BCCs in these patients with Gorlin's syndrome, with no patient suffering a relapse at the follow-up visit.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
8/18. Treatment of an extensive superficial basal cell carcinoma of the face with imiquimod 5% cream.The efficacy and safety of imiquimod, an immune-response modifier approved for the treatment of anogenital warts that has antiviral and antitumor activity, in the management of an extensive superficial basal cell carcinoma (sBCC) of the face as an alternative to surgical treatment was evaluated in a 75-year-old male with a 4-year history of a progressively enlarging lesion located on the right temporal region. Imiquimod 5% cream was applied daily until clinical resolution. Histopathological confirmation of clinical diagnosis and of tumor clearance were performed before starting treatment and at the end of treatment, respectively. Moreover, monthly post-treatment follow-up visits were planned. At physical examination, an ovalar, erythematous and slightly infiltrated plaque of 5 x 4 cm in size (approximately 20 cm2), partly eroded and crusted, with a sharp, raised, pearly edge, was evident on the right temporal region of the patient. Histopathological examination of a biopsy specimen showed the typical features of sBCC. Imiquimod 5% cream applied daily for 5 months produced complete clinical and histological clearance. No adverse events but considerable irritation were reported during treatment and no relapses were clinically observed at the 6-month follow-up visit. Our findings confirm current reports from the literature showing imiquimod 5% cream to be an effective treatment for sBCC that is especially valuable in avoiding disfigurement in cases of single large lesions located on the face or in those patients who may not be surgical candidates.- - - - - - - - - - ranking = 1.373291015625keywords = physical (Clic here for more details about this article) |
9/18. Vulvar basal cell carcinoma misdiagnosed for 4 years.Vulvar basal cell carcinoma is a rare cutaneous neoplasm occurring mainly in white postmenopausal females. It can be misdiagnosed due to its nonspecific physical appearance. Here, we report a 59-year-old white female who had vulvar basal cell carcinoma misdiagnosed for 4 years.- - - - - - - - - - ranking = 1.373291015625keywords = physical (Clic here for more details about this article) |
10/18. muir-torre syndrome: a case of this uncommon entity.A 69-year-old Hispanic woman presented for the evaluation of nodules on the head and back. In the past, she had been treated for basal cell carcinoma (BCC) of the face; the referring physician was concerned that the new lesions might also be BCC. The patient had an extensive past medical history. In addition to BCC, she had been treated for breast cancer, colon cancer, and cervical cancer prior to emigrating to the USA. Her colonic malignancy had been localized proximal to the splenic flexure. She also had a history of colonic polyps and distal colonic villous adenoma. She denied ever being treated with radiation. Further details of her medical history and cancer staging were not available. Her family history was significant for a sister with colon cancer and transitional cell carcinoma of the urinary bladder. In addition, she had a great aunt with oral cancer and a great uncle with lung cancer. Neither the patient or her relatives had any history of tobacco use. On physical examination, in addition to scars from a radical mastectomy and midline abdominal laparotomy, four skin lesions were noted: two on the scalp, one on the tragus, and one on the mid-back. The first lesion on the vertex of the scalp was a yellow-brown waxy papule measuring 0.6 x 0.5 cm. This lesion was similar to that on the mid-back, except in size. The lesion on the back measured 1.2 x 1.0 cm. The second lesion on the frontal scalp measured 0.8 x 0.6 cm and was red-brown with a pearly appearance and some central hyperkeratosis. The tragus lesion was similar in appearance to that on the frontal scalp. Shave biopsies of all lesions were obtained. The lesions on the scalp and mid-back revealed lobules of sebaceous cells in the dermis with a minority of surrounding basaloid cells, consistent with a diagnosis of sebaceous adenoma (Fig. 1). Although the lesion on the frontal scalp also showed sebaceous differentiation, there were a greater number of basaloid cells, some with hyperchromatic nuclei and mitotic figures; this was consistent with a diagnosis of sebaceous epithelioma (Fig. 2). The final lesion (tragus) was histologically consistent with a keratotic BCC. No further treatment was required for these benign sebaceous tumors, but their presence defined our patient's condition as muir-torre syndrome. Mohs' micrographic surgery was performed on the tragus BCC and the margins were tumor free in one stage. The patient returned 1 year later with a lesion anterior to the left axilla which was biopsied to rule out BCC (Fig. 3). Histologically, this lesion was also consistent with sebaceous epithelioma.- - - - - - - - - - ranking = 1.373291015625keywords = physical (Clic here for more details about this article) |
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