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World Journal of Clinical Cases Mar 2024Eccrine porocarcinoma (EPC) is a rare skin tumor that mainly affects the elderly population. Tumors often present with slow growth and a good prognosis. EPCs are usually...
BACKGROUND
Eccrine porocarcinoma (EPC) is a rare skin tumor that mainly affects the elderly population. Tumors often present with slow growth and a good prognosis. EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry. However, surgical management alone may be inadequate if the tumor has metastasized. However, currently, surgical resection is the most commonly used treatment modality.
CASE SUMMARY
A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area, with no obvious itching or pain, for more than four months. Histopathological examination showed small columnar and short spindle-shaped cells; thus, basal cell carcinoma was suspected. However, immunohistochemical analysis revealed the expression of cytokeratin 5/6, p63 protein, p16 protein, and Ki-67 antigen (40%), and EPC was taken into consideration. The skin biopsy was repeated, and hematoxylin and eosin staining revealed ductal differentiation in some cells. Finally, the patient was diagnosed with EPC, and Mohs micrographic surgery was performed. We adapted follow-up visits in a year and not found any recurrence of nodules.
CONCLUSION
This case report emphasizes the diagnosis and differentiation of EPC.
PubMed: 38576807
DOI: 10.12998/wjcc.v12.i8.1523 -
Cureus Mar 2024Introduction Acne vulgaris is one of the most common skin problems encountered in the dermatology department. It is a chronic, inflammatory disease of the pilosebaceous...
Introduction Acne vulgaris is one of the most common skin problems encountered in the dermatology department. It is a chronic, inflammatory disease of the pilosebaceous unit, clinically presenting with comedones, papules, pustules, nodules, and cysts. With its particularly high prevalence in the younger population, it has significant adverse sequelae on patient's quality of life. At present, due to an enhanced understanding of the pathogenesis of acne, various therapeutic modalities are available. The current management strategies generally follow a systematic treatment escalation based on disease severity and treatment response. However meticulous choice of appropriate anti-acne medicine for the acne type is the key to the management plan. Starting with mild to moderate types of acne as per the Leeds photometric grading scale, the most useful topical agents include topical retinoids, benzoyl peroxide, and topical antibiotics while systemic therapies such as oral antibiotics or isotretinoin are generally reserved for moderate to severe acne treatment. The skin of color (SOC) population is a relatively neglected group concerning the optimum and safe management strategies in different dermatological conditions and acne is no different, where there remains a need for comparing the available topical modalities for appropriate drug selection in the treatment of mild to moderate acne in SOC population. Objective The objective of this study was to compare the efficacy of topical 4% benzoyl peroxide versus topical 0.1% adapalene in the treatment of acne vulgaris in the SOC population. Methods The participants were divided into two groups, groups A and B. A total of 64 patients of both genders, with acne vulgaris (duration > three months) were included in the study. In group A, 32 patients were administered topical 0.1% adapalene whereas, in group B, 32 patients were given topical 4% benzoyl peroxide. Both medicines were applied at night daily. Patients were called for follow-up after 12 weeks. In both groups, the final efficacy evaluation was done using the Global Acne Grading System (GAGS) score after 12 weeks of treatment period. Results In group A, the age ranged from 15 to 40 years with a mean age of 25.781±3.93 years while the duration of complaint was 5.843±1.27 months. GAGS score was 25.281±2.65 and mean BMI was 23.092±3.51 kg/m2. In group B, the mean age was 25.187± 4.06 years, the duration of complaint was 7.375±2.25 months, the GAGS score was 23.906± 2.60 while the mean BMI was 21.485±3.88 kg/m2. Efficacy in group A was noted in 25 (78.1%) patients as compared to 24 (75%) patients in group B (p =0.768). Conclusion The present study showed that the safety and efficacy of 0.1% adapalene the traditional drug 4% benzoyl peroxide in the SOC population was comparable.
PubMed: 38576696
DOI: 10.7759/cureus.55555 -
Skin Therapy Letter Mar 2024Hidradenitis suppurativa (HS) is a severe, debilitating, chronic inflammatory skin disease characterized by recurrent painful nodules, abscesses and draining sinus... (Review)
Review
Hidradenitis suppurativa (HS) is a severe, debilitating, chronic inflammatory skin disease characterized by recurrent painful nodules, abscesses and draining sinus tracts in intertriginous areas. While this condition appears to stem from follicular unit dysfunction, its cause is multifactorial and the exact pathogenesis has yet to be fully elucidated. These factors make treatment selection challenging and contribute to variable therapeutic response among affected patients. Typical regimens consist of a combination of medical and surgical modalities, tailored to individual responses. However, HS is often refractory to traditional treatments, prompting the need for newer and more effective therapies. Herein, we review current and emerging HS therapies.
Topics: Humans; Hidradenitis Suppurativa; Dermatitis
PubMed: 38574201
DOI: No ID Found -
Indian Journal of Dermatology 2024
PubMed: 38572047
DOI: 10.4103/ijd.ijd_520_23 -
The Canadian Veterinary Journal = La... Apr 2024An 8-year-old neutered male shih tzu dog underwent laparotomy for cystolithectomy. Ten days later, multiple various-sized cystic nodules were observed on the suture line...
An 8-year-old neutered male shih tzu dog underwent laparotomy for cystolithectomy. Ten days later, multiple various-sized cystic nodules were observed on the suture line and surrounding abdominal skin, although the surgical incision had healed well. Microscopically, various-sized cysts lined with thin walls of stratified squamous epithelium in the dermis were dilated and filled with keratin. Adnexal differentiation from the wall was not seen. Thus, the abdominal lesions were diagnosed as comedones and epidermal cysts. Herein, we describe the case of a dog with comedones and epidermal cysts on the abdominal skin after a laparotomy. Key clinical message: Multiple various-sized cystic lesions of the follicles are described. The implantation of epidermal fragments into the dermis by surgery may induce epidermal cysts and comedones in the skin of hyperadrenocorticism-affected dogs.
Topics: Dogs; Male; Animals; Epidermal Cyst; Laparotomy; Dog Diseases
PubMed: 38562972
DOI: No ID Found -
Clinical, Cosmetic and Investigational... 2024Fordyce angiokeratoma, a benign tiny lesion usually on the scrotum, increases with age and may cause symptoms like itching and bleeding in nearly half of the cases....
BACKGROUND
Fordyce angiokeratoma, a benign tiny lesion usually on the scrotum, increases with age and may cause symptoms like itching and bleeding in nearly half of the cases. Although treatment is not always necessary, it is primarily considered for cosmetic reasons in the case of larger or atypical lesions.
CASE REPORT
We present the case of a healthy adult male with multiple large red-blue hyperkeratotic nodules and papules on his scrotal skin, causing bleeding upon minor trauma and personal embarrassment. After confirming the diagnosis of angiokeratomas of the scrotum through histopathology, the patient underwent two sessions of Long-Pulse Alexandrite Laser treatment, resulting in a 90% reduction in lesions, no scrotal bleeding, and a satisfactory cosmetic outcome.
CONCLUSION
The Long-Pulse Alexandrite Laser is a precise and effective treatment for vascular lesions, like angiokeratomas, offering customizable parameters. However, patient-specific factors and careful evaluation are essential, recognizing the laser's limitations for optimal results.
PubMed: 38562554
DOI: 10.2147/CCID.S458914 -
Cureus Mar 2024Primary cutaneous diffuse large B-cell lymphomas (PCDLBCLs) represent approximately 10%-20% of primary cutaneous B-cell lymphomas. They present as nodules in the skin or...
Primary cutaneous diffuse large B-cell lymphomas (PCDLBCLs) represent approximately 10%-20% of primary cutaneous B-cell lymphomas. They present as nodules in the skin or as rapidly growing aggressive behavior tumors with a poor prognosis. In this article, we report a case of PCDLBCL presented with an aggressively enlarging skin lesion on the right cheek. This case was diagnosed based on clinicopathological features and characteristic immunohistochemical expression. During the 11-month follow-up period, the patient showed significant clinical improvement after undergoing rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone, abbreviated as R-CHOP chemotherapy, without evidence of extracutaneous dissemination or disease relapse.
PubMed: 38559516
DOI: 10.7759/cureus.55300 -
Clinics in Shoulder and Elbow Jun 2024Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative...
BACKGROUND
Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients.
METHODS
A retrospective review was performed to identify patients with available preoperative shoulder CT who subsequently underwent shoulder arthroplasty procedures at a single institution between 2015 and 2021. Data including age, sex, and smoking status were obtained. Radiology reports for CTs were reviewed for incidental findings and categorized based on location, tissue type, and/or body system. The rate of incidental findings and the rate at which further follow-up was recommended by the radiologist were determined.
RESULTS
A total of 617 patients was identified. There were 173 incidental findings noted in 146 of these patients (23.7%). Findings ranged from pulmonary (59%), skin/soft tissue (16%), thyroid (13%), vascular (9%), spinal (2%), and abdominal (1%) areas. Of the pulmonary findings, 50% were pulmonary nodules and 47% were granulomatous disease. Overall, the final radiology report recommended further follow-up for 50% of the patients with incidental findings.
CONCLUSIONS
Incidental findings are relatively common in preoperative CTs obtained for shoulder arthroplasty, occurring in nearly one-quarter of patients. Most of these findings are pulmonary in nature. Overall, half of the patients with incidental findings were recommended for further follow-up. These results establish population data to guide orthopedic surgeons in patient counseling. Level of evidence: III.
PubMed: 38556913
DOI: 10.5397/cise.2023.00836 -
International Journal of Surgery Case... May 2024Pilomatrix carcinoma (PC) is a rare skin malignancy of the hair follicles matrix that tends to be locally aggressive with 10-16 % risk of metastasis mostly to the...
INTRODUCTION
Pilomatrix carcinoma (PC) is a rare skin malignancy of the hair follicles matrix that tends to be locally aggressive with 10-16 % risk of metastasis mostly to the pulmonary and lymphatic system. There are no clear protocols for the management of PCs, however surgical intervention with clear margins has been highly considered in PC management to decrease risk of recurrence.
CASE PRESENTATION
A 40 year-old male patient presented to our clinic to evaluate an asymptomatic, slow-growing nodule localized on his left thigh. A CT scan revealed a well-defined, enhanced lesion with microcalcification. "En bloc" surgical resection of the lesion was performed and histopathology confirmed the diagnosis of pilomatrix carcinoma.
CLINICAL DISCUSSION
Given its rarity, there are no definitive guidelines regarding PC treatment. However, surgical intervention with clear margins including wide local excision or Mohs micrographic surgery has been highly considered. In our case, wide excision of the lesion with clear margins was performed with no evidence of recurrence one year later.
CONCLUSION
Given the local aggressive nature of PC, appropriate surgical intervention is essential in decreasing the risk of recurrence. Wide excision with clear margins has been proposed to decrease the risk of recurrence. Additionally, total-body skin examination should be done 2-3 times annually to evaluate for recurrence or metastasis.
PubMed: 38552375
DOI: 10.1016/j.ijscr.2024.109528 -
Indian Dermatology Online Journal 2024Adult orbital xanthogranulomatous diseases (AOXGD) present clinically with symmetrical swellings around the eyes and are collectively considered within the broader group...
Adult orbital xanthogranulomatous diseases (AOXGD) present clinically with symmetrical swellings around the eyes and are collectively considered within the broader group of non-Langerhans cell histiocytosis. A 45-year-old female presented with asymptomatic progressive, skin-colored, thick raised lesions around the eyes of 1 year duration. On dermatological examination, large indurated, lobulated, skin-colored thick plaques were seen bilaterally over infraorbital areas, along with a few hard, discrete nodules over the left infraorbital area. Histopathology showed pan-dermal infiltration with foamy histiocytes, non-lipidized histiocytes, a few multinucleate giant cells, lymphocytes, and a few plasma cells, with immunohistochemistry showing CD68 and S100 positivity. Laboratory and imaging studies did not show any abnormality. Based on the above findings and the absence of internal organ involvement, the patient was diagnosed with adult-onset orbital xanthogranuloma (AOX). The patient was treated with three monthly sessions of intralesional corticosteroid injections, along with methotrexate 12.5 mg per week for 8 weeks, resulting in a moderate reduction in the size of the plaques. The patient is under regular follow-up. The present case highlights the rare case of AOX and the importance of prompt recognition and evaluation in view of its potential hematological and systemic associations.
PubMed: 38550817
DOI: 10.4103/idoj.idoj_117_23