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Journal of Cutaneous Medicine and... 2017Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Terminal hair is not routinely removed for assessment of BCCs on the scalp and yet may obscure the...
BACKGROUND
Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Terminal hair is not routinely removed for assessment of BCCs on the scalp and yet may obscure the true size of scalp BCCs. This can compromise effective management.
OBJECTIVE
To underscore the importance of removing terminal hair on the scalp for an accurate assessment of clinical margins of BCC on the scalp.
METHODS
We report 2 cases of cutaneous BCC arising on the scalp. The size of the malignancies was underestimated because they were masked by hair growth.
RESULTS
Removing terminal hair allowed for a full assessment of the extent of the tumours on hair-bearing scalp, which had been underestimated by 73% to 80% prior to shaving.
CONCLUSION
Our cases highlight the importance of hair removal for complete assessment of cutaneous malignancy occurring on hair-bearing skin.
Topics: Adult; Carcinoma, Basal Cell; Hair; Hair Removal; Head and Neck Neoplasms; Humans; Male; Middle Aged; Scalp; Skin Neoplasms; Tumor Burden
PubMed: 27503748
DOI: 10.1177/1203475416664036 -
International Journal of STD & AIDS Jun 2019An atypical early primary syphilis case presentation with multiple umbilicated papular lesions on the penis and a nonreactive syphilis serology was misdiagnosed as...
An atypical early primary syphilis case presentation with multiple umbilicated papular lesions on the penis and a nonreactive syphilis serology was misdiagnosed as molluscum contagiosum. Over a period of eight weeks, prior to dermatologic consultation, the papules enlarged, ulcerated, and healed. New plaque and patch formation on the penis and scrotum led to a differential diagnosis of inverse psoriasis vs. syphilis. Histological examination of a shave biopsy specimen revealed numerous Treponema pallidum organisms and repeat syphilis serological test results confirmed a syphilis diagnosis. Lesions responded to treatment with benzathine penicillin. One must keep a high index of suspicion for syphilis in light of its diverse presentation and increasing incidence.
Topics: Biopsy; Chancre; Humans; Male; Penicillin G Benzathine; Penile Diseases; Penis; Scrotum; Skin; Skin Ulcer; Syphilis; Treponema pallidum; Young Adult
PubMed: 31112488
DOI: 10.1177/0956462418817636 -
Dermatology Online Journal Jan 2018A 12-month-old boy presented with three months of asymptomatic hypopigmented flat-topped papules on the suprapubic skin and lower abdomen. Emollients and topical... (Review)
Review
A 12-month-old boy presented with three months of asymptomatic hypopigmented flat-topped papules on the suprapubic skin and lower abdomen. Emollients and topical steroids offered no improvementand the patient was referred to the dermatology department. Shave biopsy revealed a papillated epidermis with scattered solitary mononuclearclear cells at all levels of the epidermis and an overlying basket weave orthokeratosis. The cells were epithelioid with increased amphophilic cytoplasm. Immunohistochemical staining was positive for CK7,CEA, and CAM5.2 and negative for S100, CD1a, and Mart-1. These findings were consistent with clear cell papulosis. No treatment was recommended as these lesions were asymptomatic. However, yearlyfollow up was recommended given the resemblance of these cells to those of Paget disease. Review of the literature demonstrates a total of 31 biopsy confirmed cases with AE1, CEA, and EMA positivity and S100negativity as the most consistent staining properties. A recent retrospective review of 19 cases documents long term follow-up of at least six years and up to 21 years. The results suggested a tendency toward selfresolution and an absence of malignant progression, supporting the benign nature of these lesions.
Topics: Abdomen; Female; Humans; Infant; Male; Sex Distribution; Skin; Skin Diseases, Papulosquamous
PubMed: 29469771
DOI: No ID Found -
Dermatologic Surgery : Official... Feb 2023Diagnosis and treatment of basal cell carcinoma (BCC) in the same visit by shave removal may decrease health care spending and promote patient satisfaction.
BACKGROUND
Diagnosis and treatment of basal cell carcinoma (BCC) in the same visit by shave removal may decrease health care spending and promote patient satisfaction.
OBJECTIVE
To prospectively evaluate deep shave removal of lesions clinically suspicious for low-risk BCC on the trunk or extremities in immunocompetent patients.
MATERIALS AND METHODS
Deep shave removal with the intent to remove the entire tumor was performed from January 2015 to June 2016, and patients were followed prospectively for clinical evidence of tumor recurrence.
RESULTS
Seventy-seven lesions were removed from 51 patients, including 29 (37%) superficial and nodular BCCs, 27 (35%) superficial BCCs, 16 (21%) nodular BCCs, and 5 (6%) non-BCCs. Fifteen BCCs (21%) had positive residual margins after deep shave removal, which was significantly more likely to occur in nodular compared with superficial BCCs (odds ratio = 7.8, 95% confidence interval = 1.4-43), and underwent re-excision. Fourteen specimens initially reported to have negative margins after deep shave underwent resectioning, which revealed positive margins in 4 specimens (28.6%). No BCCs have recurred clinically after an average follow-up of 50 months (SE 3.2).
CONCLUSION
Consider deep shave removal for low-risk BCCs on the trunk or extremities in immunocompetent patients hoping to avoid a second treatment visit.
Topics: Humans; Skin Neoplasms; Prospective Studies; Neoplasm Recurrence, Local; Carcinoma, Basal Cell; Margins of Excision
PubMed: 36728062
DOI: 10.1097/DSS.0000000000003680 -
Dermatologic Surgery : Official... Jul 2000Shave excision is an established surgical method for removing benign skin lesions for cosmetic and functional reasons. Usually superficial shave excision is performed...
BACKGROUND
Shave excision is an established surgical method for removing benign skin lesions for cosmetic and functional reasons. Usually superficial shave excision is performed with a common scalpel blade for the removal of papular nevi. However, there is little known about deep shave excision of macular melanocytic nevi with the razor blade technique.
OBJECTIVE
The present study was undertaken to evaluate the cosmetic outcome of deep shave excision of macular melanocytic nevi with the razor blade technique. Moreover, its potency for sufficient removal of these lesions was investigated.
METHODS
Within routine skin cancer screening 45 outpatients with a total of 77 macular melanocytic nevi were prospectively recruited. Deep shave excisions of these lesions were performed with a double-edged razor blade followed by chemical hemostasis. Histologically all specimens were processed and evaluated in a routine manner. After 6 months the physician and patients evaluated the shave sites for cosmetic outcome with a score graded from 1 to 4 (1 = excellent; 2 = good; 3 = moderate; 4 = poor).
RESULTS
Histologically 88% (68 of 77) of the melanocytic lesions were described as completely excised and 60% (46 of 77) were diagnosed as atypical melanocytic nevi; 12% (9 of 77) of the nevi were incompletely excised on the depth. On average, the deep margin of the specimens (n = 77) was 0.5 mm (range 0-1.8 mm) and the lateral margin was 2 mm (range 0.3-8.2 mm). After 6 months 56 shave sites could be reassessed. We observed mild hypopigmentation in 52% (29 of 56), hyperpigmentation in 32% (18 of 56), and erythema in 23% (13 of 56). Recurrent nevi occurred in 13% (7 of 56). The evaluation of the cosmetic outcome by the patients (mean score 1.7) achieved better results than the evaluation by the physician (mean score 2.5). The cosmetic results showed no significant (P >.05) differences in various anatomic sites.
CONCLUSION
Our data confirm that deep razor blade excision presents a highly useful and inexpensive method for the removal of macular melanocytic nevi that yields adequate specimens for pathologic interpretation. We consider that shave excision with the razor blade technique is potentially much less scarring than full-thickness scalpel excisions of nevi. In particular, this is of great significance for patients with multiple nevi, such as dysplastic nevi syndrome.
Topics: Adolescent; Adult; Biopsy; Female; Humans; Male; Middle Aged; Nevus, Pigmented; Postoperative Complications; Prospective Studies; Skin Neoplasms; Treatment Outcome
PubMed: 10886275
DOI: 10.1046/j.1524-4725.2000.00036.x -
Skinmed 2007A 41-year-old white man with Down syndrome presented with a slightly pruritic, papular eruption on bilateral forearms of several years' duration. Physical examination...
A 41-year-old white man with Down syndrome presented with a slightly pruritic, papular eruption on bilateral forearms of several years' duration. Physical examination revealed multiple 2- to 3-mm keratotic, umbilicated pink papules in an annular configuration distributed symmetrically on the flexural surfaces of the forearms (Figure 1). The skin surrounding these papules was noted to be hyperpigmented and somewhat atrophic. The remainder of his skin examination was unremarkable. A shave biopsy of 1 papule was performed and stained with hematoxylin-eosin. Hematoxylin-eosin-stained sections showed clumps of bright red fibers being extruded through an acanthotic epidermis with a central invagination (Figure 2). Verhoeff-van Gieson stain confirmed these fibers to be elastin (Figure 3). Elastosis perforans serpiginosa was diagnosed.
Topics: Adult; Down Syndrome; Elastic Tissue; Forearm; Humans; Male; Skin Diseases
PubMed: 17786109
DOI: 10.1111/j.1540-9740.2007.06438.x -
Journal of the American Academy of... Mar 2005
Topics: Biopsy; Humans; Skin
PubMed: 15761434
DOI: 10.1016/j.jaad.2004.10.016 -
Dermatologic Surgery : Official... Dec 2010
Topics: Biopsy, Needle; Humans; Skin Diseases
PubMed: 21040133
DOI: 10.1111/j.1524-4725.2010.01772.x -
Archives of Dermatology Nov 1991We prospectively studied 174 patients on whom 226 unsutured parallel incisional (shave) and 3-mm punch skin biopsies were performed. Two wound-care programs, occlusive... (Comparative Study)
Comparative Study
We prospectively studied 174 patients on whom 226 unsutured parallel incisional (shave) and 3-mm punch skin biopsies were performed. Two wound-care programs, occlusive dressing therapy and conventional therapy, were compared. The biopsy sites were evaluated after 1 or 2 weeks for healing, pain, and infection. We found that healing was unrelated to the indication for biopsy or the patients' age, gender, or race. Occlusive dressing therapy-treated shave biopsy sites were 3.83 times more likely to be healed than those treated with conventional therapy. Regardless of the treatment method, a facial shave biopsy site was 3.6 times more likely to be healed than a biopsy site in other locations. No punch biopsy site had healed after 1 week. At 2 weeks, only 7% and 36% of conventional therapy- and occlusive dressing therapy-treated punch biopsy sites, respectively, had healed. Pain at the biopsy site was six times more common in both shave and punch biopsy sites treated with conventional therapy. The absence of pain with occlusive dressing therapy was significant for both types of biopsy. One punch biopsy site treated with conventional therapy became infected, and one treated with occlusive dressing therapy was suspected of being infected. Forty patients, who had biopsy sites treated with both therapies, preferred occlusive dressing therapy over conventional therapy by a ratio of 3:1 because of ease of wound care and lack of pain. We conclude that occlusive dressing therapy may be the wound management of choice for shave biopsy sites. Since punch biopsy sites do not heal readily, it may be more appropriate to suture them, at least until therapies are developed that more effectively speed their healing.
Topics: Adult; Aged; Aged, 80 and over; Biopsy; Female; Follow-Up Studies; Humans; Logistic Models; Male; Middle Aged; Occlusive Dressings; Odds Ratio; Pain; Patient Satisfaction; Prospective Studies; Skin; Time Factors; Wound Healing
PubMed: 1952972
DOI: No ID Found -
American Journal of Obstetrics and... Apr 1958
Topics: Biopsy; Female; Humans; Nicotine; Skin; Uterine Cervical Neoplasms
PubMed: 13508782
DOI: 10.1016/0002-9378(58)90674-4