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Archives of Dermatological Research Jun 2024Cutaneous malignancies affecting the ear, exacerbated by extensive ultraviolet (UV) exposure, pose intricate challenges owing to the organ's complex anatomy. This... (Review)
Review
Cutaneous malignancies affecting the ear, exacerbated by extensive ultraviolet (UV) exposure, pose intricate challenges owing to the organ's complex anatomy. This article investigates how the anatomy contributes to late-stage diagnoses and ensuing complexities in surgical interventions. Mohs Micrographic Surgery (MMS), acknowledged as the gold standard for treating most cutaneous malignancies of the ear, ensures superior margin control and cure rates. However, the ear's intricacy necessitates careful consideration of tissue availability and aesthetic outcomes. The manuscript explores new technologies like Reflectance Confocal Microscopy (RCM), Optical Coherence Tomography (OCT), High-Frequency, High-Resolution Ultrasound (HFHRUS), and Raman spectroscopy (RS). These technologies hold the promise of enhancing diagnostic accuracy and providing real-time visualization of excised tissue, thereby improving tumor margin assessments. Dermoscopy continues to be a valuable non-invasive tool for identifying malignant lesions. Staining methods in Mohs surgery are discussed, emphasizing hematoxylin and eosin (H&E) as the gold standard for evaluating tumor margins. Toluidine blue is explored for potential applications in assessing basal cell carcinomas (BCC), and immunohistochemical staining is considered for detecting proteins associated with specific malignancies. As MMS and imaging technologies advance, a thorough evaluation of their practicality, cost-effectiveness, and benefits becomes essential for enhancing surgical outcomes and patient care. The potential synergy of artificial intelligence with these innovations holds promise in revolutionizing tumor detection and improving the efficacy of cutaneous malignancy treatments.
Topics: Humans; Mohs Surgery; Skin Neoplasms; Ear Neoplasms; Carcinoma, Basal Cell; Tomography, Optical Coherence; Microscopy, Confocal; Spectrum Analysis, Raman; Dermoscopy; Margins of Excision
PubMed: 38822894
DOI: 10.1007/s00403-024-03127-5 -
Ophthalmic Plastic and Reconstructive... May 2024To describe the outcomes of acellular fish skin grafts for repair of periocular anterior lamella skin defects after Mohs surgery for skin cancers.
PURPOSE
To describe the outcomes of acellular fish skin grafts for repair of periocular anterior lamella skin defects after Mohs surgery for skin cancers.
METHODS
Following the institutional review board approval, we conducted a retrospective chart review of patients treated with acellular fish skin grafts between January 2022 and December 2023. Indication was to repair defects after Mohs excision of basal cell carcinoma and squamous cell carcinoma. Demographics, smoking and diabetes status, diagnosis, defect location, graft size, and complications were evaluated. Outcomes were analyzed using the scar cosmesis assessment and rating scale.
RESULTS
Six patients (3 females and 3 males) with a mean age of 60.8 (range 44-80) had Mohs surgery for basal cell carcinoma (4) and squamous cell carcinoma (2). Location of defects included eyebrow (3 cases), lateral nasal wall (1 case), lower eyelid (1 case), and medial lower eyelid/nasal wall (1 case). Defect size ranged from 8 × 10 mm to 30 × 40 mm. Two patients had more than 1 application of xenograft. One patient developed a mild cicatricial ectropion. No other postoperative complications were seen, and all had good wound healing and cosmetically acceptable results.
CONCLUSIONS
In this pilot study, acellular fish skin xenografts are shown to be promising skin graft substitutes in patients with Mohs defects and decrease the need for autologous skin harvesting or allogenic skin donation.
PubMed: 38819161
DOI: 10.1097/IOP.0000000000002699 -
Journal of the European Academy of... May 2024
PubMed: 38818858
DOI: 10.1111/jdv.20167 -
SAGE Open Medical Case Reports 2024Ecrrine porocarcinoma, a rare aggressive skin tumor, develops from sweat glands located in lower limbs, followed by the head and neck, trunk, and upper limbs. The...
Ecrrine porocarcinoma, a rare aggressive skin tumor, develops from sweat glands located in lower limbs, followed by the head and neck, trunk, and upper limbs. The incidence represents only about 0.005% of all cutaneous malignant tumors. The most common site is the lower extremities in elderly patients. As it has a high chance of metastases and recurrence after surgery, mainstay of treatment modality is wide local excision or Mohs (micrographically oriented histographic surgery) micrographic surgery. Mohs micrographic surgery (MMS) is a more effective treatment modality for tumors located in cosmetically and functionally important areas of the head and neck. We present a 56-years-old male patient with a large fungating eccrine tumor on the left axilla with ipsilateral nodal involvement on histomorphological grounds supported with immunohistochemical studies.
PubMed: 38812832
DOI: 10.1177/2050313X241256868 -
Dermatologic Surgery : Official... May 2024
PubMed: 38810278
DOI: 10.1097/DSS.0000000000004246 -
Journal of Cutaneous and Aesthetic... 2024Squamous eccrine ductal carcinoma is a rare cutaneous malignancy. It has the potential to locally recur and may occasionally metastasize. It presents a diagnostic...
Squamous eccrine ductal carcinoma is a rare cutaneous malignancy. It has the potential to locally recur and may occasionally metastasize. It presents a diagnostic challenge given its rare nature and overlapping histopathological features with other cutaneous carcinomas.
PubMed: 38800818
DOI: 10.4103/JCAS.JCAS_60_22 -
Cureus Apr 2024Mohs micrographic surgery (MMS) utilizing melanoma antigen recognized by T-cells (MART-1) immunostaining is an increasingly common method of treatment for minimally...
Mohs micrographic surgery (MMS) utilizing melanoma antigen recognized by T-cells (MART-1) immunostaining is an increasingly common method of treatment for minimally invasive melanoma in anatomically constrained areas such as the face, ears, or acral sites. Neurotropic melanoma, also known as neurotrophism in melanoma, refers to the invasion of melanoma cells into the nerves. As such, these tumors can extend well beyond anticipated clinical tumor margins which can increase the risk of local recurrence. Here, we present a case of neurotropic melanoma successfully identified during MMS using MART-1 immunostaining, which was then confirmed with permanent sectioning.
PubMed: 38800274
DOI: 10.7759/cureus.58920 -
Cureus Apr 2024Extramammary Paget's disease is a rare skin cancer that usually arises from the secretory cells of the apocrine glands. In most cases, an extramammary Paget's tumor...
Extramammary Paget's disease is a rare skin cancer that usually arises from the secretory cells of the apocrine glands. In most cases, an extramammary Paget's tumor occurs as a single intraepithelial form not associated with another cancer, although rarely, it may be associated with other loco-regional or distant cancer. It is generally slow-growing and diagnosed in situ. Most often, surgical excision with wide margins is curative, with the local recurrence rate being lower after the Mohs micrographic surgery technique. Nonetheless, relapses are frequent. In the metastatic setting, there are no treatment guidelines or standard therapies; additionally, the experience is limited to a few individual cases, and the efficacy of conventional chemotherapies is not well-defined. Moreover, chemotherapy can also have serious side effects; therefore, there is a need to identify more effective and less toxic therapies. In this case report, we have observed a long-lasting complete response with anti-HER2 plus paclitaxel.
PubMed: 38800219
DOI: 10.7759/cureus.58924 -
Archives of Dermatological Research May 2024Since the scrotum is rarely exposed to sunlight, basal cell carcinoma (BCC) development in this area is an uncommon occurrence. As result, there is a scarcity of... (Review)
Review
Since the scrotum is rarely exposed to sunlight, basal cell carcinoma (BCC) development in this area is an uncommon occurrence. As result, there is a scarcity of research covering this particular presentation, which poses a diagnostic and therapeutic challenge for clinicians. The objective of this systematic review is to provide a thorough overview of scrotal BCC, including a summary of its clinical characteristics, and microscopic subtypes. It also seeks to discuss the many techniques used in the management of this uncommon clinical presentation. Utilizing data from 1957 to October 2023, a systematic review of PubMed and Wiley Online Library was conducted to identify all cases of scrotal BCC with various presentations and managements. A total of 73 patients were included. The median patient age was 65.9 years (range 42 to 87). All studies were either case reports or case series. Our review shows that treatment with Mohs micrographic surgery (MMS), leads to a superior patient outcome based on anecdotal evidence in select cases. To deepen our understanding of Mohs surgery's efficacy in treating scrotal BCC, it is imperative to conduct more robust research in the form of randomized clinical trials.
Topics: Humans; Scrotum; Male; Carcinoma, Basal Cell; Skin Neoplasms; Aged; Mohs Surgery; Middle Aged; Aged, 80 and over; Adult; Treatment Outcome
PubMed: 38795216
DOI: 10.1007/s00403-024-03058-1 -
Archives of Dermatological Research May 2024
Topics: Humans; Fellowships and Scholarships; San Francisco; Dermatology; Internship and Residency
PubMed: 38787440
DOI: 10.1007/s00403-024-02910-8