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Prognostic factors in cutaneous squamous cell carcinoma: is patient delay in hospital visit a predictor of survival? 皮肤鳞状细胞癌的预后因素:患者就诊延误是生存的预测因素吗?
Pub Date : 2011-01-01 Epub Date: 2011-11-14 DOI: 10.5402/2011/285289
Y Endo, M Tanioka, Y Miyachi

The patient's delay in the visit to a hospital seems to play an important role in prognosis in invasive cutaneous squamous cell carcinoma (SCC). This report explored prognostic factors of cutaneous SCC focusing on patient delay in hospital visit. Data of 117 Japanese patients who were treated for invasive cutaneous SCC in our facility between 2000 and 2010 were used for analysis. A multivariate Cox proportional-hazard modelling revealed that a pair of TNM stage (hazard ratio, 5.0; 95% CI, 1.8 to 13.9) and poorer histological differentiation (hazard ratio, 3.2; 95% CI, 0.93 to 10.3), and a pair of tumour size (hazard ratio, 1.02; 95% CI, 1.004 to 1.04) and rapid growth (hazard ratio, 8.25; 95% CI, 1.29 to 52.7) were a prognostic factor whereas patient delay in hospital visit was not. However, patient delay in hospital visit was correlated with larger tumour size.

在浸润性皮肤鳞状细胞癌(SCC)的预后中,患者的延迟就诊似乎起着重要的作用。本报告探讨了皮肤鳞状细胞癌的预后因素,重点是患者就诊延误。我们分析了2000年至2010年期间在我们医院接受侵袭性皮肤鳞状细胞癌治疗的117名日本患者的数据。多变量Cox比例风险模型显示,对TNM阶段(风险比,5.0;95% CI, 1.8 - 13.9)和较差的组织学分化(风险比,3.2;95% CI, 0.93 ~ 10.3)和肿瘤大小(风险比,1.02;95% CI, 1.004 ~ 1.04)和快速增长(风险比,8.25;95% CI(1.29 - 52.7)是影响预后的因素,而患者就诊延误则不是。然而,患者就诊延误与肿瘤大小有关。
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引用次数: 8
Photodynamic therapy for Basal cell carcinoma in recessive dystrophic epidermolysis bullosa. 隐性营养不良大疱性表皮松解性基底细胞癌的光动力治疗。
Pub Date : 2011-01-01 Epub Date: 2011-04-27 DOI: 10.5402/2011/346754
Myn Wee Lee, George Varigos, Peter Foley, Gayle Ross

A 22-year-old male with recessive dystrophic epidermolysis bullosa with a large superficial and nodular basal cell carcinoma on his right forehead was treated with photodynamic therapy. The treatment was well tolerated, and the site healed well. Patients with epidermolysis bullosa are at increased risk of developing skin cancers, particularly squamous cell carcinomas. However, basal cell carcinomas are rare in recessive dystrophic epidermolysis bullosa. As patients with epidermolysis bullosa have recurrent blistering and poor wound healing, surgery may not be the optimal choice in treating skin cancers. We present this case to highlight that photodynamic therapy may be a helpful and safe technique in the treatment of superficial skin cancers in patients with epidermolysis bullosa, as an alternative to more radical methods.

一例22岁男性隐性营养不良大疱性表皮松解伴大浅表性结节性基底细胞癌右前额患者接受光动力治疗。这种治疗耐受性很好,而且伤口愈合得很好。大疱性表皮松解症患者患皮肤癌的风险增加,尤其是鳞状细胞癌。然而,基底细胞癌在隐性营养不良大疱性表皮松解症中是罕见的。由于大疱性表皮松解症患者反复出现水泡和伤口愈合不良,手术可能不是治疗皮肤癌的最佳选择。我们提出这个病例是为了强调光动力疗法可能是治疗浅表性皮肤癌大疱性表皮松解症患者的一种有用和安全的技术,作为一种更激进的方法的替代方法。
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引用次数: 3
Incontinentia pigmenti and bipolar aphthosis: an unusual combination. 色素失禁和双相抑郁症:一个不寻常的组合。
Pub Date : 2011-01-01 Epub Date: 2011-03-07 DOI: 10.5402/2011/814186
G Márquez Balbás, M A González-Enseñat, A Vicente, L Creus-Vila, J Antón, P Umbert-Millet

Incontinentia pigmenti (IP) is an uncommon X-linked dominant multisystem disorder, lethal in the majority of affected males in utero and variably expressed in females. The cutaneous manifestations are diagnostic and classically occur in four stages: vesicular, verrucous, hyperpigmented, and atrophic. The skin lesions are typically spread along the lines of Blaschko, and they are usually present at birth. It may be variably accompanied by dental, ocular, neurologic, bones and joints, and development anomalies. The genes IP has been mapped to Xq28. Mutations in the NEMO/IKKγ gene, located at Xq28, have been found to cause expression of the disease. Behçets disease is a multisystem disorder consisting of recurrent oral aphtae, genital ulcers, pustular skin eruption, and uveitis. Occasionally there are other articular, neurological, intestinal, or vascular abnormalities. This disease is rare in children. Here, we report a case of a 16-year-old female with the rare combination of incontinentia pigmenti and an aphthosis bipolar, and we discuss the probably relationship between these two diseases.

色素失禁(IP)是一种罕见的x连锁显性多系统疾病,在大多数受影响的男性子宫内死亡,在女性中表达不同。皮肤表现是诊断性的,通常分为四个阶段:水泡、疣状、色素沉着和萎缩。皮肤损伤通常沿着布拉什科氏线扩散,通常在出生时就存在。它可能不同地伴有牙齿、眼部、神经系统、骨骼和关节以及发育异常。基因IP已被定位到Xq28。位于Xq28的NEMO/IKKγ基因的突变已被发现引起该疾病的表达。behets病是一种多系统疾病,包括复发性口腔溃疡、生殖器溃疡、皮肤脓疱和葡萄膜炎。偶尔也有其他关节、神经、肠道或血管异常。这种病在儿童中很少见。在这里,我们报告一个16岁的女性罕见的合并色素失禁和双相抑郁症的病例,并讨论这两种疾病之间可能的关系。
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引用次数: 4
Primary Cutaneous CD30-Positive Large T-Cell Lymphoma in an 80-Year-Old Man: A Case Report. 原发性皮肤cd30阳性大t细胞淋巴瘤1例80岁男性。
Pub Date : 2011-01-01 Epub Date: 2011-03-30 DOI: 10.5402/2011/634042
Rehan Hussain, Amir Bajoghli

Primary cutaneous CD30-positive large cell lymphoma (CD30+ PCLCL) is a rare subtype of cutaneous T-cell lymphoma (CTCL) that can present in a variety of ways. We report a patient with a three-month history of an enlarging, exophytic mass with two smaller satellite lesions on the left forearm. Biopsy of the skin stained positive for CD30, and, after thorough systemic evaluation, a diagnosis of CD30+ PCLCL was made. When PCLCL is suspected, it is important to perform immunohistological studies for CD30 types and conduct a thorough workup to rule out systemic LCL. These measures will reduce the use of unnecessarily aggressive chemotherapy regimens for CD30+ PCLCL, an indolent disease with a favorable prognosis.

原发性皮肤CD30阳性大细胞淋巴瘤(CD30+ PCLCL)是一种罕见的皮肤t细胞淋巴瘤(CTCL)亚型,其表现形式多种多样。我们报告一个病人三个月的历史扩大,外生性肿块和两个较小的卫星病变在左前臂。皮肤活检显示CD30阳性,经过全面的系统评估,诊断为CD30+ PCLCL。当怀疑PCLCL时,重要的是进行CD30类型的免疫组织学研究,并进行彻底的检查以排除全身性LCL。这些措施将减少对CD30+ PCLCL(一种预后良好的惰性疾病)不必要的积极化疗方案的使用。
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引用次数: 2
Antimicrobial active clothes display no adverse effects on the ecological balance of the healthy human skin microflora. 抗菌活性服装对健康人体皮肤菌群的生态平衡无不良影响。
Pub Date : 2011-01-01 Epub Date: 2011-04-04 DOI: 10.5402/2011/369603
Dirk Hoefer, Timo R Hammer

The progressive public use of antimicrobial clothes has raised issues concerning skin health. A placebo-controlled side-to-side study was run with antimicrobial clothes versus fabrics of similar structure but minus the antimicrobial activity, to evaluate possible adverse effects on the healthy skin microflora. Sixty volunteers were enrolled. Each participant received a set of form-fitting T-shirts constructed in 2 halves: an antibacterial half, displaying activities of 3-5 log-step reductions due to silver-finishes or silver-loaded fibres and a nonantibacterial control side. The microflora of the scapular skin was analyzed weekly for opportunistic and pathogenic microorganisms over six weeks. The antibacterial halves did not disturb the microflora in number or composition, whereas a silver-containing deodorant displayed a short-term disturbance. Furthermore, parameters of skin morphology and function (TEWL, pH, moisture) did not show any significant shifts. In summary, antimicrobial clothes did not show adverse effects on the ecological balance of the healthy skin microflora.

公众对抗菌衣物的逐渐使用引发了有关皮肤健康的问题。一项安慰剂对照的侧对侧研究将抗菌衣物与结构相似但抗菌活性较低的织物进行对比,以评估对健康皮肤微生物群可能产生的不利影响。60名志愿者被招募。每位参与者都收到了一套由两部分组成的合身t恤:抗菌的一半,显示了由于镀银或载银纤维而减少3-5步的活动,而非抗菌的对照组。在六周内,每周对肩胛骨皮肤的微生物区系进行机会性和致病性微生物分析。抗菌的那一半在数量或组成上不会干扰微生物群,而含银的除臭剂则会出现短期干扰。此外,皮肤形态和功能参数(TEWL、pH、水分)没有明显变化。综上所述,抗菌衣物并未对健康皮肤微生物群的生态平衡产生不利影响。
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引用次数: 33
Atypical steatocystoma multiplex with calcification. 不典型脂肪囊瘤合并钙化。
Pub Date : 2011-01-01 Epub Date: 2011-07-12 DOI: 10.5402/2011/381901
Muhammad Hasibur Rahman, Muhammad Saiful Islam, Nazma Parvin Ansari

A 60-year-old male reported to us with an atypical case of giant steatocystoma multiplex in the scrotum with calcification. There was no family history of similar lesions. Yellowish, creamy material was expressed from a nodule during punch biopsy. The diagnosis was based on clinical as well as histological findings. Successful surgical excision was done to cure the case without any complications.

一个60岁的男性报告了一个不典型的病例巨大脂肪囊瘤多发性阴囊钙化。没有类似病变的家族史。在穿孔活检中,从结节中表达出淡黄色的奶油状物质。诊断是基于临床和组织学结果。手术切除成功治愈,无并发症。
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引用次数: 6
Use of surgical sponge with running sutures for securing full-thickness skin grafts. 使用外科海绵和流动缝线固定全层皮肤移植物。
Pub Date : 2011-01-01 Epub Date: 2011-09-29 DOI: 10.5402/2011/470921
Stamatis Sapountzis, Achilleas Chantes, Ji Hoon Kim

One of the most common methods of skin defect repairing is the use of a skin graft. It is simple and reliable technique, although sometimes it is not totally successful due to hematoma and seroma formation between the skin graft and the recipient bed. Here in, we present a method to secure the skin grafts using a surgical sponge with two running sutures. This technique ensures high survival rate of the skin grafts, and in addition it is easy to be performed by the surgeon only.

修复皮肤缺损最常见的方法之一是使用皮肤移植。这是一种简单可靠的技术,尽管有时由于皮肤移植物和受体床之间形成血肿和血肿而不完全成功。在这里,我们提出了一种使用手术海绵和两条线来固定皮肤移植物的方法。该技术不仅保证了植皮成活率高,而且便于外科医生单独操作。
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引用次数: 2
A girl with cutaneous lesions, polyarthritis, and antinuclear antibodies positivity. 皮肤病变,多发性关节炎,抗核抗体阳性的女孩。
Pub Date : 2011-01-01 Epub Date: 2011-04-04 DOI: 10.5402/2011/657673
Jorge L Musuruana, Javier A Cavallasca

On October 1996, a 14-year-old girl was admitted to the hospital because cutaneous lesions, asthenia, and arthralgias. On examination, there was nonscarring hair thinning with a widened part over the frontal hairline, polymorphic papulosquamous rash on her face, neck, arms, and trunk, and livedo reticularis in her legs. Multiple aphtous ulcers were present on the buccal and nasal mucosa. There was polyarthritis involving the wrist, metacarpophalangeal joints, proximal interphalangeal joints, and metatarsophalangeal joints of both hands and feet. Skin biopsy of the face was compatible with subacute cutaneous lupus erythematosus. She started on prednisone 60 mg/d without improvement, and later hdroxhchloroquine (HCQ) 6 mg/kg/d was added for one year. Cutaneous lesions were almost healed, with just a hypopigmented macules left. Over the last 14 years, she has not shown any cutaneous or systemic manifestations.

1996年10月,一名14岁女孩因皮肤损伤、虚弱和关节痛而入院。检查发现,无瘢痕性毛发稀疏,额发际线上方部分变宽,面部、颈部、手臂和躯干出现多形态丘疹状鳞状皮疹,腿部出现网状活斑。口腔及鼻黏膜出现多处溃疡。多关节炎累及手腕、掌指关节、近端指间关节和手脚跖指关节。面部皮肤活检符合亚急性皮肤红斑狼疮。患者开始使用强的松60mg /d,未见改善,随后加用盐酸氯喹6mg /kg/d,连用一年。皮肤损伤几乎愈合,只剩下色素沉着的斑点。在过去的14年里,她没有表现出任何皮肤或全身症状。
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引用次数: 0
Tinea corporis gladiatorum presenting as a majocchi granuloma. 角斗士体癣表现为马约奇肉芽肿。
Pub Date : 2011-01-01 Epub Date: 2011-04-12 DOI: 10.5402/2011/767589
Anil Kurian, Richard M Haber

Background. Wrestlers are at increased risk of developing cutaneous infections, including fungal infections caused by dermatophytes. Erythematous lesions due to tinea infections can be mistakenly diagnosed as an inflammatory dermatitis and incorrectly treated with potent topical corticosteroid treatments which cause localized skin immunosuppression. This can eventuate in a Majocchi granuloma which then becomes refractory to topical antifungal therapy. To our knowledge, this is the first case of tinea corporis gladiatorum presenting as a Majocchi granuloma. Observations. A 20-year-old wrestler presented with a 4-year history of a large pruritic, scaly erythematous plaque with follicular papules, and pustules on his right forearm. The lesion had the clinical appearance of a Majocchi granuloma. He had been treated with potent topical corticosteroids and topical antifungal therapy. KOH and fungal culture of the lesion were negative. An erythematous scaly lesion in the scalp was cultured and grew Trichophyton tonsurans. Oral Terbinafine therapy was initiated and complete resolution of both lesions occurred within 6 weeks. Conclusion. The purpose of this report is to inform dermatologists that tinea corporis gladiatorum can present as a Majocchi granuloma and needs to be considered in the differential diagnosis of persistent skin lesions in wrestlers.

背景。摔跤运动员患皮肤感染的风险增加,包括由皮肤真菌引起的真菌感染。由于足癣感染引起的红斑病变可能被错误地诊断为炎症性皮炎,并错误地使用有效的局部皮质类固醇治疗,导致局部皮肤免疫抑制。这可能最终导致大黄基肉芽肿,然后对局部抗真菌治疗变得难治。据我们所知,这是第一例角斗士性体癣表现为马芝子肉芽肿。观察。一个20岁的摔跤运动员提出了4年的历史,一个大的瘙痒,鳞状红斑斑块与滤泡丘疹和脓疱在他的右前臂。病变临床表现为大黄骨性肉芽肿。他已经接受了有效的局部皮质类固醇和局部抗真菌治疗。KOH和真菌培养均为阴性。在头皮上培养了一个红斑鳞状病变,生长出了疣毛癣。开始口服特比萘芬治疗,两种病变在6周内完全消退。结论。本报告的目的是告知皮肤科医生,角斗士体癣可以表现为马氏肉芽肿,需要在摔跤运动员持续皮肤病变的鉴别诊断中加以考虑。
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引用次数: 19
Histocompatibility and long-term results of the follicular unit-like wigs after xenogeneic hair transplantation: an experimental study in rabbits. 异种毛发移植后毛囊样假发的组织相容性和远期效果:兔实验研究。
Pub Date : 2011-01-01 Epub Date: 2011-04-06 DOI: 10.5402/2011/134502
Yu Sun, Feng Lu, Ge Liu, Zhi-Dan Zhang, Zijie Zhang, Zhi-Qi Hu

Objective. This study was designed to observe the histocompatibility and long-term results of wigs after xenogeneic hair transplantation and to explore the possibility of industrial products in clinical application. Methods. The human hair and melted medical polypropylene were preceded into the follicular unit-like wigs according to the natural follicular unit by extrusion molding. 12 New Zealand rabbits were used as experimental animals for wigs transplantation. The histocompatibility of polypropylene and human hair was observed by H&E staining and scanning electron microscope. The loss rate of wigs was calculated to evaluate the long-term result after transplantation. Results. Mild infiltration by inflammatory cells around the polypropylene and human hair were seen during the early period after transplantation, accompanied with local epithelial cell proliferation. The inflammatory cells were decreased after 30 days with increased collagen fibers around the polypropylene and human hair. The follicular unit-like wigs maintained a good histocompatibility in one year. The degradation of hair was not significant. The loss rate of wigs was 4.1 ± 4.0% in one year. The appearance of hair was satisfactory. Conclusions. We successfully developed a follicular unit-like wigs, which were made of xenogeneic human hair with medical polypropylene, showing a good histocompatibility, a low loss rate, and satisfactory appearance in a year after transplantation. The follicular unit-like wigs may have prospective industrial products in clinical application.

目标。本研究旨在观察异种毛发移植后假发的组织相容性及远期效果,探讨其产业化临床应用的可能性。方法。将人的头发和熔融的医用聚丙烯按照天然毛囊单位,通过挤压成型制成类似毛囊单位的假发。12只新西兰兔作为假发移植实验动物。采用H&E染色和扫描电镜观察聚丙烯与人发的组织相容性。计算假发的损失率,评价移植后的远期效果。结果。移植后早期,聚丙烯和人发周围可见炎性细胞轻度浸润,伴局部上皮细胞增生。30 d后炎症细胞减少,聚丙烯纤维周围胶原纤维增多,人发纤维增多。滤泡单位样假发在一年内保持良好的组织相容性。毛发退化不显著。1年内假发的损失率为4.1±4.0%。头发的外观令人满意。结论。我们成功地研制了一种毛囊单位状假发,该假发由异种人发和医用聚丙烯制成,在移植后一年内具有良好的组织相容性、低损失率和令人满意的外观。该毛囊单位状假发在临床应用中具有较好的工业品前景。
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引用次数: 0
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ISRN Dermatology
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