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Clinics in Dermatology 2020Neoplastic cells originating from a primary cancer can uncommonly spread to the skin, where they suggest a poor prognosis for the patient. In women, melanoma, breast,... (Review)
Review
Neoplastic cells originating from a primary cancer can uncommonly spread to the skin, where they suggest a poor prognosis for the patient. In women, melanoma, breast, ovarian, oral cavity, and lung are the most common primary sources; in men, melanoma, lung, colon, and squamous cell carcinoma of the head and neck predominate. The classic presentation of cutaneous metastases is a firm, painless, flesh-colored to an erythematous dermal nodule (or nodules); however, several other presentations, including inflammatory, cicatricial, and bullous lesions, have been reported. Cutaneous metastases may also mimic benign conditions such as lipomas, hemangiomas, or cellulitis. A high degree of clinical suspicion is necessary, and the diagnosis is confirmed by biopsy, which may also be used to establish the primary malignancy if unknown, as the histopathologic appearance of the metastatic tissue may mimic the primary tumor. Treatments include excision of the metastases, chemotherapy, immunotherapy, radiation, and/or palliative care.
Topics: Biopsy; Diagnosis, Differential; Female; Humans; Male; Skin; Skin Neoplasms
PubMed: 32513401
DOI: 10.1016/j.clindermatol.2019.10.004 -
Annals of the Royal College of Surgeons... Feb 2018We describe the largest reported case of pilomatrixoma in the literature. While pilomatrixomas typically present as small soft-tissue nodules of the head, neck and upper...
We describe the largest reported case of pilomatrixoma in the literature. While pilomatrixomas typically present as small soft-tissue nodules of the head, neck and upper extremities, they can also present as much larger masses in atypical locations. When they present in their usual size, pilomatrixomas have typical imaging features and can be correctly diagnosed with imaging studies before histological confirmation. Their clinical and imaging diagnosis become challenging when they are very large, as in our case. A giant pilomatrixoma should also be considered for paediatric patients presenting with a large subcutaneous soft-tissue mass.
Topics: Adolescent; Back; Hair Diseases; Humans; Male; Pilomatrixoma; Skin; Skin Neoplasms
PubMed: 29182000
DOI: 10.1308/rcsann.2017.0196 -
Seminars in Oncology Apr 2022According to the literature, skin metastases affect 0.7%-10.4% of patients with malignant neoplasms of internal organs and may be 1 presentation of systemic spread of... (Review)
Review
According to the literature, skin metastases affect 0.7%-10.4% of patients with malignant neoplasms of internal organs and may be 1 presentation of systemic spread of the cancer. Skin metastases may be the first sign of relapse after treatment and about 30% of cases of skin metastases are diagnosed before the diagnosis of internal organ cancer. Cutaneous metastases most often come from breast cancer and melanoma. They can present synchronous or metachronous. Adequate vigilance, combined with knowledge of the clinical picture and epidemiology, can contribute to accurate diagnosis and treatment. Clinically, skin metastases occur in the form of atypical solitary, painless nodules, or tumors. Lumps or infiltrating foci do not show clinical features that help in making a diagnosis. Skin changes are more accessible during physical examination, and it is easier to do a biopsy and provide histological assessment. Dermoscopy, a useful initial tool for the assessment of skin metastases, can lead to a rapid accurate diagnosis and treatment. Ultimately, the diagnosis of a metastatic malignancy is confirmed by histopathological examination.
Topics: Biopsy; Dermoscopy; Humans; Melanoma; Skin; Skin Neoplasms
PubMed: 35589424
DOI: 10.1053/j.seminoncol.2022.04.005 -
JAMA Dermatology Jan 2020
Topics: Biopsy; Dairying; Dermatitis, Occupational; Farmers; Hand Dermatoses; Humans; Male; Poxviridae; Poxviridae Infections; Skin; Skin Diseases, Viral; Young Adult
PubMed: 31642868
DOI: 10.1001/jamadermatol.2019.3248 -
Dermatologic Clinics Jul 2015Rheumatoid nodules are a common manifestation of rheumatoid arthritis. These lesions are often easily identified based on typical diagnostic features and characteristic... (Review)
Review
Rheumatoid nodules are a common manifestation of rheumatoid arthritis. These lesions are often easily identified based on typical diagnostic features and characteristic locations. When biopsied, nodules have a characteristic histologic appearance. Uncommonly, rheumatoid nodules can occur in systemic locations. There is no evidence that systemic therapy treats underlying rheumatoid nodules. Paradoxically, methotrexate and possibly tumor necrosis factor inhibitors can increase nodule development. Treatment of rheumatoid nodules is often not necessary, unless patients are experiencing pain or there is interference of mechanical function. This review outlines the available data on and associations of rheumatoid nodules.
Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Diagnosis, Differential; Humans; Lung Neoplasms; Methotrexate; Multiple Pulmonary Nodules; Rheumatoid Nodule; Skin
PubMed: 26143419
DOI: 10.1016/j.det.2015.03.004 -
Frontiers in Cellular and Infection... 2019Post-kala-azar dermal leishmaniasis (PKDL) follows visceral leishmaniasis (VL, kala-azar) in 10-60% of cases. It is characterized by an asymptomatic skin rash, usually... (Review)
Review
Post-kala-azar dermal leishmaniasis (PKDL) follows visceral leishmaniasis (VL, kala-azar) in 10-60% of cases. It is characterized by an asymptomatic skin rash, usually starting in the face and consisting of macules, papules, or nodules. Diagnosis is difficult in the field and is often made clinically. There is an extensive differential diagnosis, and parasitological confirmation is preferred particularly when drug treatment is considered. The response to treatment is difficult to assess as this may be slow and lesions take long to heal, thus possibly exposing patients unnecessarily to prolonged drug treatment. Biomarkers are needed; these may be parasitological (from microscopy, PCR), serological (from blood, or from the lesion), immunological (from blood, tissue), pathological (from cytology in a smear, histology in a biopsy), repeated clinical assessment (grading, photography), or combinations. In this paper, we will review evidence for currently used biomarkers and discuss promising developments.
Topics: Biomarkers; Biopsy; Humans; Leishmaniasis, Cutaneous; Leishmaniasis, Visceral; Parasitology; Skin
PubMed: 31417876
DOI: 10.3389/fcimb.2019.00228 -
Dermatology Online Journal Dec 2015We present a 28-year-old man with a one-year history of cutaneous lesions in old scars and tattoos with concomitant subcutaneous nodules and myopathy. A skin biopsy...
We present a 28-year-old man with a one-year history of cutaneous lesions in old scars and tattoos with concomitant subcutaneous nodules and myopathy. A skin biopsy specimen showed cutaneous sarcoidosis. We discuss the multiple aspects of this case, which represent unique presentations of this systemic disease as well as review isomorphic and isotopic responses.
Topics: Adult; Diagnosis, Differential; Humans; Male; Sarcoidosis; Skin; Skin Diseases
PubMed: 26990326
DOI: No ID Found -
Current Problems in Dermatology 2022Cosmetic tattooing and medical tattooing of the face share basic principles and to some degree types and spectrum of technical and clinical complications known from... (Review)
Review
Cosmetic tattooing and medical tattooing of the face share basic principles and to some degree types and spectrum of technical and clinical complications known from decorative tattooing of other parts of the body. Cosmetic tattoos recently have grown exponentially in popularity in industrialized countries all over the world. The different complications and their clinical symptoms, pathophysiology, diagnosis, treatment, and prevention are analyzed versus culprit pigments and updated. Eyeliner tattooing is associated with special complications because of the subtle anatomy and the closeness to the eye, and the risk of meibomian gland damage. The spectrum of cosmetic tattoo complications includes early-onset complications (infections particularly with herpes simplex, healing issues, aesthetic and technical mistakes with regret), and late-onset complications (color fading and color shift, "blowout" pigment escape to surrounding skin, papules, nodules, granulomas associated with sarcoidosis, allergic reactions in lip tattoos with lichenoid dermatitis, eye irritation, and fibrosis and scaring especially after microblading); miscellaneous complications include severe burn sensation in tattoos during magnetic resonance imaging later in life. Corneal tattooing and subconjunctival/episcleral tattooing performed on medical indication by ophthalmologists, and for decoration by tattooists carry special risk of intraocular complications. It is recommended for the purpose of research harmonization that terms and diagnostic classification of tattoo adverse events follow the system introduced by the Tattoo Clinic of Copenhagen and already accepted in specialized tattoo clinics in other centers.
Topics: Humans; Tattooing; Skin Diseases; Skin; Herpes Simplex; Hypersensitivity
PubMed: 37263217
DOI: 10.1159/000526048 -
Clinics in Dermatology 2019Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon... (Review)
Review
Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon form of extrapulmonary TB, cutaneous TB is complicated in its clinical manifestation, pathogenesis, and classification. Cutaneous TB can be divided into two major categories, true cutaneous TB and tuberculid, depending on the source of infection, the route of transmission, the amount of bacteria, and the immune state of the host. Clinical manifestations may include patches and plaques (lupus vulgaris, TB verrucosa cutis), macules and papules (acute miliary TB, papulonecrotid tuberculid, lichen scrofulosorum), nodules, and abscesses (erythema induratum of Bazin, tuberculous gumma), erosions, and ulcers (tuberculous chancre, orificial TB, scrofuloderma), mimicking diverse skin diseases. Uncommon localizations such as external genitalia, unusual presentations such as nodular granulomatous phlebitis, and coexistence with other morbidities such as Behçet disease and acne inversa or hidradenitis suppurativa deserve special attention. Treatment of both true and tuberculid cutaneous TB follows the same drug regimens of the World Health Organization's recommendation for treatment of new cases of pulmonary TB. Erythema induratum of Bazin may need longer treatment duration and adjuvants such as dapsone, potassium iodide, doxycycline, and corticosteroids to tackle inflammation. Misdiagnosis and undertreatment in daily practice are likely, and contemplation of this classic great imitator in dermatology is warranted.
Topics: Adolescent; Adrenal Cortex Hormones; Adult; Antitubercular Agents; Child; Dapsone; Diagnosis, Differential; Diagnostic Errors; Doxycycline; Drug Therapy, Combination; Female; HIV Infections; Humans; Male; Mycobacterium tuberculosis; Potassium Iodide; Skin; Tuberculosis, Cutaneous; Young Adult
PubMed: 31178102
DOI: 10.1016/j.clindermatol.2019.01.008 -
The Journal of Investigative Dermatology Feb 2022Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by the formation of nodules, abscesses, and fistulae at intertriginous sites. The... (Observational Study)
Observational Study
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by the formation of nodules, abscesses, and fistulae at intertriginous sites. The skin-gut axis is an area of emerging research in inflammatory skin disease and is a potential contributory factor to the pathogenesis of HS. A total of 59 patients with HS provided fecal samples and nasal and skin swabs of affected sites for analysis. A total of 30 healthy controls provided fecal samples, and 20 healthy controls provided nasal and skin swabs. We performed bacterial 16S ribosomal RNA gene amplicon sequencing on total DNA derived from the samples. Microbiome alpha diversity was significantly lower in the fecal, skin, and nasal samples of individuals with HS, which may be secondary to disease biology or related to antibiotic usage. Ruminococcus gnavus was more abundant in the fecal microbiome of individuals with HS, which is also reported in Crohn's disease, suggesting comorbidity due to shared gut microbiota alterations. Finegoldia magna was overabundant in HS skin samples relative to that in the healthy controls. It is possible that local inflammation is driven by F. magna by promoting the formation of neutrophil extracellular traps. These alterations in both the gut and skin microbiome in HS warrant further exploration, and therapeutic strategies, including fecal microbiota transplant or bacteriotherapy, could be of benefit.
Topics: Adult; Aged; Case-Control Studies; Clostridiales; Extracellular Traps; Fecal Microbiota Transplantation; Feces; Female; Firmicutes; Gastrointestinal Microbiome; Hidradenitis Suppurativa; Humans; Male; Middle Aged; Skin; Young Adult
PubMed: 34364884
DOI: 10.1016/j.jid.2021.05.036