1/6. White sponge nevus of the tongue.To my knowledge, this is the fifth case of white sponge nevus of the tongue to be reported. This lesion is probably much more common than has been reported in the past. The disorder is benign and almost always asymptomatic. The recognition of this disorder is important in that it must be differentiated from other congenital or familial disorders of more widespread clinical significance. It is important for any physician, and especially for dermatologists, to do a thorough examination of the oral mucous membranes as a part of any physical examination.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/6. Spontaneous regression of subcutaneous metastasis of cutaneous melanoma.A case is presented of a 44-year-old Caucasian man who was operated on in October of 1988 for a cutaneous melanoma in his trunk and who in the space of 1 year manifested a single subcutaneous nodule compatible with a metastasis of melanoma by fine-needle aspiration biopsy. No other abnormal findings were revealed by physical and instrumental examinations. During the subsequent hospitalization, we witnessed (in conjunction with the occurrence of painful symptoms in the hands of an inflammatory nature) the total, progressive, spontaneous regression of the metastasis, which was confirmed by the clinic and the tests. After 15 months of follow-up, the patient has not shown any further signs of illness.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/6. A patient with extensive blue rubber bleb nevi associated with multiple congenital anomalies: an overlap or a new syndrome?We report a case of a 13 year old boy with non-familial, multiple blue rubber bleb nevi (BRBN). He also had additional dysmorphic anomalies including a low hairline, low set ears, narrow nares, ptosis, hypotelorism, a high arched palate and downward slanting of the outer canthi. Skeletal deformities included a short, slightly webbed neck, kyphosis, cubitus valgus, non-traumatic luxation of the head of the right radius and a short left little and index fingers. He had no evidence of gastrointestinal lesions or bleeding, congenital heart or renal disease or enchondromata. The boy was mentally slow compared to his peers. He had normal chromosomes. The absence of gastrointestinal bleeding or iron deficiency anaemia is inconsistent with Bean's syndrome and the lack of enchondromata in this patient militates against the diagnosis of classical Maffucci syndrome. Some of his physical features are obviously similar to those observed in a Noonan's syndrome yet the presence of extensive BRBN would be an extremely unusual finding. Since the overall picture does not fit into any of the classical categories mentioned above, the constellation of his features has yet to find a specific syndrome. It may, however, represent an overlap between them or, possibly, a new syndrome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/6. Atypical compound nevus arising in mature cystic ovarian teratoma.BACKGROUND: Mature cystic ovarian teratoma (MCOT) is the most common primary ovarian tumor. Rarely, MCOT may undergo malignant transformation. Melanoma arising primarily in MCOT is a rare event. Melanocytic nevi have also rarely been reported in MCOT. CASE REPORT: A 28 year-old female presented with a palpable, 4.6 cm, right pelvic mass on physical examination. Histologically, the cystic neoplasm demonstrated epidermis with numerous pilosebaceous units and respiratory-type epithelium (endoderm) surrounded by adipose tissue and cartilage (mesoderm). A 2.0 x 1.0 cm pigmented area corresponded to a nevus with architectural and cytologic features of the so-called "dysplastic nevus," including variable-sized nests of nevomelanocytes irregularly distributed on distorted rete ridges, bridging of nests between rete ridges, fibroplasia around rete ridges, and junctional shouldering beyond the dermal nevus. The nevomelanocytes demonstrated moderate cytologic atypia. Diagnostic criteria of melanoma were not identified. CONCLUSIONS: Herein, we report, to the best of our knowledge, the first case of an atypical ("dysplastic") nevus, arising in a MCOT. No features of melanoma were present and the patient is disease-free at one-year follow-up. Rarely, melanocytic nevi and melanomas arise from the ectodermal component of MCOTs. Moreover, melanomas may arise de novo or in association with a nevus. Distinction between a melanocytic nevus, as in our case, and a primary melanoma is critical for determining the patient's prognosis and need for additional therapy. As primary ovarian melanomas, like their skin counterpart, may arise from a precursor lesion, removal of a melanocytic nevus, such as this atypical nevus, could theoretically prevent melanoma transformation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/6. Rounds in podiatric dermatology.Dr. Port presents six cases, which he refers to as "zebras," with clinical descriptions and discussions that typify his excellent teaching style. He also alludes to the fact that podiatrists need to be thorough in their history and physical evaluations. After a lesion has been treated appropriately and does not respond, additional investigation is in order. These cases are interesting to read but, most importantly, any one of these atypical patients could be seen in our offices tomorrow.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/6. Segmental arrangement of multiple, partly congenital and partly acquired melanocytic nevi.A 15 year-old girl presented with numerous congenital melanocytic nevi, occasionally hairy, with a segmental distribution at the left pre-auricular region. On the left side of the back of the neck there were multiple melanocytic nevi with a warty appearance, which had started to appear when she was 5 and which had remained stable from the time she was 10. These lesions had a distribution reminiscent of an epidermal nevus with a pattern similar to Blaschko's lines. On general physical examination there was a moderate degree of idiopathic scoliosis, with a left lumbar curvature. Biopsies were taken from both types of nevus which were diagnosed as congenital compound melanocytic nevus and acquired compound melanocytic nevus respectively. We consider that the segmental distribution of the melanocytic nevi of this patient supports the theory that a genetic defect determined the appearance of both these congenital and acquired lesions.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |