ABSTRACT
RESUMEN: Las lesiones pigmentadas malignas en la mucosa oral son de escasa frecuencia, pero de altas tasas de morbilidad y mortalidad, siendo de mal pronóstico a pesar de agresivos tratamientos que pueden combinar grandes resecciones quirúrgicas con quimioterapia y radioterapia. Dado este escenario, la conducta clínica asociada a la pesquisa de lesiones pigmentadas es la biopsia inmediata para la confirmación o descarte de patología maligna y con ello un inicio temprano de tratamiento. Este artículo trata de una paciente recibida en un hospital público aproximadamente seis meses posteriores a las primeras manifestaciones de una lesión pigmentada en mucosa maxilar, que luego de confirmado el diagnóstico de una lesión maligna fue derivada y manejada por un equipo oncológico del mismo centro.
ABSTRACT: Pigmented malignant oral mucosa lesions are infrequent, but with high rates of morbidity and mortality, and have a poor prognosis despite aggressive treatments that can combine large surgical resection with chemotherapy and radiotherapy. Given this scenario, the clinical conduct associated with pigmented lesions is the immediate biopsy to confirm or rule out the disease and thus the early initiation of treatment. This article is about a patient attended in a public hospital about six months after the first signs of an injury to maxillary mucosa, which then confirmed the diagnosis of a malignant lesion, who was referred and treated by a cancer team of the same center.
Subject(s)
Humans , Female , Middle Aged , Mouth Neoplasms/diagnosis , Melanoma/diagnosis , Mouth Neoplasms/pathology , Early Diagnosis , Melanoma/pathology , Mouth Mucosa/pathologyABSTRACT
Basal cell carcinoma (BCC) which is also known as rodent ulcer is the most common type of skin cancer. Prolonged exposure to high-intensity ultraviolet radiation is regarded as the most common risk factor of BCC. This ionizing radiation can induce DNA damage such as point mutations, and single stranded DNA breaks. Other possible pathogenic mechanism includes the involvement of the tumor suppresser gene, and the members of sonic hedgehog signal transduction pathway. Pigmented BCC (PBCC) is a rare variant of BCC, of which only very few cases have been reported in literature. This is a case report of such a case of PBCC.
ABSTRACT
Background: In a dermoscopic examination, besides structural components, inexperienced clinicians should also be able to recognize the gross features of the images. Aim: The aim of this study is, whether or not an inexperienced clinician has problems in the recognition of gross features of the images on dermoscopic examination. Methods: Two dermatologists, of whom one was experienced in the field of dermoscopy and the other was not, examined 161 dermoscopic images of melanocytic lesions in the gross features of their borders. Inner and outer borders were defined for each lesion. Both dermatologists separately evaluated the borders of the lesions for irregularity, asymmetry, and wideness of fading. For subjective image analysis they scored each lesion by using the four-point ordinal scale. For computerized image analysis they manually marked borders with dots, by using a computer program. We used quadratic-weighted kappa for interobserver reliability assessments for subjective scores and intraclass correlation coefficients (ICC) for automatically calculated scores. Results: In a subjective evaluation the inexperienced observer used a higher score than the experienced observer and the kappa values were between 0.241– 0.286. ICC for the automatically calculated scores were between 0.357 and 0.522. According to both the outer and the inner borders, the concordance between experienced and inexperienced observers was almost perfect in measurements of diameter, perimeter, and area (ICC scores were between 0.948 and 0.990). Conclusions: An inexperienced person, in comparison with an experienced person, sees lesions in the same sizes, but in different shapes on dermoscopy. Therefore, it is advisable that making learners familiar with the borders of lesions should be included in the training on dermoscopy.
ABSTRACT
The argon laser has been used in the treatment of a variety of cutaneous vascular and pigmented lesions. In 1983, authors reported on the therapeutic effect from argon laser treatment of nevus flammeus. This study was undertaken to evaluate the therapeutic effect and complication of the argon laser on many cutaneous lesions except nevus flammeus. The data of the 67 patients who were treated between November, 1984 and March, 1986 and could be followed up over 3 months at the Department of Dermatology, Seoul National University Hospital were analyzed. Patients were treated with Coherent Radiation Model No. 920 Laser with a spot size of 1 mm in diatemer. The pawer ranges were between 1.6 and 2.6 W using pulsed wave or continuous wave according to the size and the shape of the lesions. The argon laser is an effective modality in the treatment of superficial vascular lesions and especially when telangiectasia is prominent. In pigmented lesions, argon laser is effective for pigmented nevi excluding intradermal nevi and has been found effective in small sized nevus spilus and lentigines.