ABSTRACT
Objective To investigate early diagnosis and treatment of Paget disease of breast. Methods The clinicopathological data of 26 cases of breast Paget disease in the First Affiliated Hospital of Wenzhou Medical University from January 1995 to June 2018 was analyzed. Results The main clinical manifestation of 26 patients was eczema like papillae in 19 cases (73.1%), and associated with nipple discharge in 9 cases (34.6% ) and breast mass in 6 cases (23.1% ). The diagnosis of this disease was based on curettage cytology in 4 cases (15.4% ), biopsy in 8 cases (30.8% ), and needle aspiration cytology or post resection pathological examination in 14 cases (53.8% ). Paget disease consisted of simple papillary Paget disease in 3 cases (11.5%), ductal carcinoma in 18 cases (69.2%) and invasive ductal carcinoma in 5 cases (19.2%). Pathological TNM staging was 0 stage in 19 cases (73.1%), stageⅠin 3 cases (11.5%), stageⅡin 2 cases (7.7%), stageⅢin 2 cases (7.7%) and no stage inⅣcase. In this group, 2 cases underwent radical mastectomy, 18 cases underwent modified radical mastectomy, 4 cases underwent simple mastectomy, and 2 cases underwent mastectomy combined with low axillary lymph node dissection and intraoperative rapid frozen examination. Fourteen patients received adjuvant chemotherapy with CEF(cyclophosphamide + pharmorubicin + tegafur)/EC (pharmorubicin + cyclophosphamide) + T(docetaxel) or TP(docetaxel + cis- platinum)regiment after operation, 2 cases were treated with trastuzumab targeted therapy and 5 cases with adjuvant radiotherapy. Twenty-five of 26 patients were followed up for 8-108 months except one patient lost in follow-up. The 5-year survival rate was 96.0% (24/25), and the 10-year survival rate was 52.0% (13/25). Conclusions The diagnosis of Paget disease of the breast depends on cytology or pathology, and multidisciplinary treatment based on surgery is judged of by tumor stage and coincident other types of breast cancer and axillary lymph node involvement.
ABSTRACT
Tinea incognito is the dermatophytosis of atypical clinical presentation that induced by topical and systemic corticosteroid treatment or new class of topical non-steroidal agent such as tacrolimus or pimecrolimus. We report a case of eczema-like tinea incognito in a 15-year-old girl. The lesions were manifested by pruritic to tender, scaly well-demarcated erythematous macules and patches with pustules on the lateral side of right shin. She had been treated with topical corticosteroid and pimecrolimus for 6 months. Direct microscopic examination of the lesion was positive for hyphae and fungal culture revealed colonies of Trichophyton(T.) rubrum. Histopathologic examination of the skin lesion showed mild perivascular inflammation with presence of fungal hyphae in the horney layer of the epidermis. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Skin lesions improved one month after the treatment, and no recurrence was observed.
Subject(s)
Adolescent , Humans , Epidermis , Hyphae , Imidazoles , Inflammation , Leg , Naphthalenes , Recurrence , Skin , Tacrolimus , TineaABSTRACT
The combination of interferon alpha with ribavirin is currently recommended in the treatment of hepatitis C virus (HCV) infection. Commonly reported cutaneous reactions include localized reactions such as injection site inflammation and necrosis and worsening of other skin disorders, including psoriasis, lichen planus, vitiligo, or systemic lupus erythematosus. However, generalized eczematous reactions have been reported to occur uncommonly in patients treated with interferon and ribavirin, however such a case has not been described in the Korean literature. Herein, we describe a 49-year old female showing generalized eczema-like eruption after treatment of interferon alpha-2b and ribavirin for chronic HCV infection.