1/17. 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 = 1keywords = physician (Clic here for more details about this article) |
2/17. Consequences of using escharotic agents as primary treatment for nonmelanoma skin cancer.BACKGROUND: The use of escharotic or caustic pastes to treat skin cancer is based on the centuries-old observation that selected minerals and plant extracts may be used to destroy certain skin lesions. zinc chloride and sanguinaria canadensis (bloodroot) are 2 agents that are used as part of the Mohs chemosurgery fixed-tissue technique. The use of escharotics without surgery has been discredited by allopathic medicine but persists and is promoted among alternative practitioners. patients may now purchase "herbal supplements" for the primary self-treatment of skin cancer, and physicians will see patients who elect this therapy for their skin cancers. OBSERVATIONS: We reviewed the history of escharotic use for skin disease and performed an internet search for the availability and current use of escharotics. Our search located numerous agents for purchase via the internet that are advertised as highly successful treatments for skin cancer. We report 4 cases from our practice in which escharotic agents were used by patients to treat basal cell carcinomas in lieu of the recommended conventional treatment. One patient had a complete clinical response, but had a residual tumor on follow-up biopsy. A second patient successfully eradicated all tumors, but severe scarring ensued. A third patient disagreed with us regarding his care and was lost to follow-up. One patient presented with a nasal basal cell carcinoma that "healed" for several years following treatment elsewhere with an escharotic agent but recurred deeply and required an extensive resection. The lesion has since metastasized. CONCLUSIONS: Escharotic agents are available as herbal supplements and are being used by patients for the treatment of skin cancer. The efficacy of these agents is unproven and their content is unregulated. Serious consequences may result from their use. Conventional medicine has an excellent track record in treating skin cancer. physicians should recommend against the use of escharotic agents for skin cancer, and the food and Drug Administration should be given the authority to regulate their production and distribution.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/17. Multiple basal cell carcinomas arising in a port-wine stain with a remote history of therapeutic irradiation.The coexistence of a basal cell carcinoma and a port-wine stain is a very rare condition that may be associated with previous treatments. We present a case of multiple basal cell carcinomas developing within the boundaries of a port-wine stain, which had been treated with a tholium X and argon laser. Our case suggests that port-wine stains which were previously treated with irradiation or argon laser should be examined carefully and regularly by both physician and patient, because they may hide basal cell carcinomas.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/17. 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 = 1keywords = physician (Clic here for more details about this article) |
5/17. Solitary basal cell carcinoma in a child.Basal cell carcinoma in children is rare. Its occurrence has been described in association with nevoid basal cell carcinoma syndrome, preexisting organoid nevus, and xeroderma pigmentosum. We present a case of solitary basal cell carcinoma in a 13-year-old boy with nonactive damaged skin or a genetically transmitted syndrome. The contribution of this case is to alert the physician to the possibility of basal cell carcinoma in children so that appropriate treatment may be initiated immediately and any delay avoided.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/17. dermatofibrosarcoma non-protuberans: description and report of five cases of a morpheaform variant of dermatofibrosarcoma.Five cases of dermatofibrosarcoma are reported. All showed features typical of dermatofibrosarcoma protuberans except that in four cases, and a portion of the fifth case, no protusion of the tumor was noted clinically despite the rather advanced stage of growth of the tumor. These lesions resembled morphea or a morpheaform basal cell carcinoma clinically but could be recognized as "dermatofibrosarcoma non-protuberans" by physicians who had observed a previous case.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/17. Cancer of the forehead and temple regions.Several characteristics inherent in tumors of the forehead and temple provide therapeutic challenges for the physician. These include spread along anatomic structures, a propensity toward aggressive growth patterns, the risk of nerve damage, and the preservation of important cosmetic landmarks. As a result of these problems, Mohs micrographic surgery is often indicated in the treatment of skin cancer of the forehead and temple. The high cure rates afforded by micrographic surgery, even for aggressive tumors, and tissue conservation are benefits to the patient. Although most BCCs and SCCs in this region can be handled by a dermatologic surgeon, patients may present with aggressive or neglected tumors exhibiting extensive invasion. These patients may require a cooperative approach between the dermatologic and head and neck surgeon to achieve complete tumor extirpation or appropriate reconstruction. In this article, we have tried to indicate the rationale behind the use of Mohs micrographic surgery for tumors of the forehead and temple. In selected tumors, a team approach between the micrographic and other surgeons will maximize both tumor excision and functional and cosmetic repair for the patient.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/17. Basal cell carcinoma: an infrequent pedal reality.The authors intend to present a more detailed look at the basal cell carcinoma, both clinically and histologically. An in-depth treatment approach, case presentation, and literature review is provided in order to aid the practicing physician to better understand and treat this cutaneous malignancy. Through describing the variety of appearances of the basal cell carcinoma, the practitioner, hopefully, will be made more aware of the very real possibility of carcinoma in the differential diagnosis of dermatologic lesions.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/17. Gorlin's basal cell nevus syndrome.A case report is used to illustrate the characteristics of Gorlin's syndrome and to emphasize the need for early recognition by the physician and for thorough lifetime follow-up by the patient to prevent severe sequelae.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/17. The sign of Leser-Trelat associated with primary lymphoma of the brain.The sign of Leser-Trelat has been defined as the sudden appearance of seborrheic keratoses in number and/or size in association with an underlying malignancy. There have been only thirty-two reported cases of the sign of Leser-Trelat since it was first described in 1984. This is the first known case of primary lymphoma of the brain associated with this sign. Until Dantzig's review of the literature in 1973, the only tumor type associated with this sign had been adenocarcinomas of the gastrointestinal tract and the genitourinary tract. Since that time there have been only nine cases reported that were not adenocarcinomas; of those, only four cases have been lymphoproliferative malignancies. We wish to emphasize the need for further reports of this sign to better characterize it and to make physicians more aware of the association between this dermatologic sign and an internal malignancy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
| | Next -> |