Application of combined local flaps in repair of large nasal defects after cutaneous tumor excision / 中华医学美学美容杂志

Objective:To explore the experience to reconstruct large nasal defects with combined local flaps after cutaneous tumor excision based on the aesthetic subunit principle.Methods:From May 2007 to May 2019, based on the nasal aesthetic subunit principle, combined local flaps were used to cover the large nasal defects in 21 cases of nasal tumors that were removed. Among 21 cases, there were 11 cases of basal cell carcinoma, 7 cases of squamous cell carcinoma, and 3 cases of pigmented naevus. The locations were dorsum of nose in 8 cases, nasal side in 7 cases, nasal ala in 5 cases, nasal tip in 1 case, and across two nasal subunits in 17 cases. The area of the defect ranged between 1.3 cm × 0.9 cm and 3.6 cm × 3.1 cm. A local combined skin flap was used to repair the skin defect. The secondary defect of donor site was directly sutured.Results:Among 21 cases, 20 cases acquired complete recovery; 1 case had epiderm necrosis over the far end of the flap achieved healing by the first intention. The nasal defect was successfully repaired in all patients, and the all flaps survived. A total of 21 patients were available for follow-up of 1 to 48 months, no tumor recurrence occurred, and the repaired tissues were well matched to the surrounding tissue, good nasal contour was obtained, and the cosmetic results were satisfactory.Conclusions:Based on the nasal aesthetic subunit principle, the combined local flaps can be used to reconstruct the large nasal defects, and the cosmetic results are satisfactory.

Múltiplos pilomatricomas em membros superiores: relato de exérese cirúrgica / Multiple pilomatricomas in upper limbs: report of surgical exeresis

Pilomatricoma é uma neoplasia folicular benigna relativamente rara. Pode ocorrer em qualquer idade, mas menos de 13% dos casos acontecem em pessoas com mais de 50 anos, sendo mais comum em mulheres (1,5 a 2,5 mulheres:1 homem). A localização mais frequente é a região cervical, seguida das áreas frontais, periorbitárias e pré-auriculares (1). Clinicamente, apresenta-se como um tumor subcutâneo ou intradérmico, endurecido e de crescimento lento. O diagnóstico pré-cirúrgico é quase sempre difícil (3). O tratamento padrão é o cirúrgico, com margens de segurança amplas para minimizar o risco de recorrência nas variantes malignas (2,3). Relatamos um caso atípico e exuberante de múltiplos pilomatricomas em membros superiores em um paciente do sexo masculino de 55 anos (AU)

Pilomatricoma is a relatively rare benign follicular neoplasm. It can occur at any age, but less than 13% of cases occur in people over 50 years old, and it is more common in women (1.5 to 2.5 women: 1 man). The most frequent location is the cervical region, followed by the frontal, periorbital and pre-auricular areas (1). Clinically it presents as a hardened and slowly growing subcutaneous or intradermal tumor. Preoperative diagnosis is almost always difficult (3). The standard treatment is surgical, with wide safety margins to minimize the risk of recurrence in malignant variants (2,3). We report an atypical and exuberant case of multiple pilomatricomas in upper limbs in a 55-year-old male patient (AU)

Cirurgia micrográfica no tratamento do carcinoma microcístico anexial / Micrographic surgery in the treatment of microcystic adnexal carcinoma

Carcinoma microcístico anexial é uma neoplasia de glândulas sudoríparas écrinas incomum, localmente agressivo. Facilmente confundido com tumores anexiais benignos e com alto índice de recidiva após tratamento incorreto. O objetivo é divulgar aos cirurgiões plásticos a importância do conhecimento e manejo correto desta afecção com utilização da cirurgia micrográfica de Mohs. Foi realizada revisão da literatura de 1982 a janeiro de 2014 e análise prospectiva de um caso de carcinoma microcístico anexial conduzido na Clínica de Cirurgia Plástica do Hospital Felício Rocho em março de 2011, utilizando a cirurgia micrográfica de Mohs. Descrito em 1982, menos de 700 casos de carcinoma microcístico anexial relatados na literatura mundial. O caso apresentado foi tratado com o uso da cirurgia micrográfica de Mohs, com seguimento 3 anos sem recidiva. Podemos concluir que a cirurgia micrográfica de Mohs é um excelente arsenal terapêutico, com menor índice de recidiva e preservação de tecidos vitais.

Microcystic adnexal carcinoma is an uncommon, locally aggressive eccrine sweat gland tumor that is easily confused with benign adnexal tumors and has a high rate of recurrence after incorrect treatment. The present study was aimed at increasing awareness on the importance of knowing and properly managing this disease among plastic surgeons by using Mohs micrographic surgery. A literature review from 1982 to January 2014 and a prospective case study of a microcystic adnexal carcinoma treated with Mohs micrographic surgery, at the plastic surgery clinic of Felício Rocho Hospital in March 2011, were performed. First described in 1982, microcystic adnexal carcinoma now has at least 700 cases reported in the international literature. The case reported herein was treated with Mohs micrographic surgery, including a 3-year follow-up without recurrence. In conclusion, Mohs micrographic surgery is an excellent therapeutic tool to preserve vital tissues and ensure a reduced recurrence rate.

Tumor mixto cutáneo apocrino, un desafío diagnóstico a considerar / A mixed cutaneous apocrine tumors, a diagnostic challenge to to consider

El tumor mixto cutáneo es una neoplasia se aparición inusual al que se ha denominado también siringoma condroide. Se reporta un caso de Tumor mixto benigno apocrino en una paciente de 63 años. Paciente mujer de 63 años, con lesión tumoral de un año de evolución en zona frontal, asintomática. La ecografía de partes blandas fue compatible con lesión quística y el estudio histológico mostró la presencia de una neoplasia mixta benigna epitelial estromal, correspondiente a un tumor mixto benigno apocrino. Los tumores mixtos benignos apocrinos son neoplasias poco frecuentes, localizadas en las glándulas sudoríparas. Se caracterizan por presentarse como un nódulo subcutáneo o intradérmico, solitario, que puede alcanzar hasta 3 cm. de diámetro. Son asintomáticos y de crecimiento lento. Su principal ubicación corresponde a la cabeza y cuello y predominan en pacientes de sexo masculino, de edad media. El diagnóstico de certeza es histopatológico, encontrándose a la microscopía un patrón epitelial compuesto por estructuras tubulares, ductales, túbulo-alveolares o áreas sólidas con diferenciación pilo-sebácea focal, en un estroma que puede ser mixoide o condroide Se presenta este caso por ser un tumor de baja frecuencia, cuyo diagnóstico es esencialmente histopatológico y cuya terapia resolutiva es la extirpación quirúrgica completa.

Apocrine mixed tumor of the skin: a diagnosis challenge to consider. Cutaneous mixed tumor is an uncommon, benign adnexal neoplasm arising from apocrine or eccrine glands of the dermis. Apocrine mixed tumors often exhibit decapitation secretion, a feature of apocrine epithelium, but they may exhibit a wide range of metaplastic changes and differentiation in the epithelial, the myoepithelial, and the stromal components. We present two clinical cases of Apocrine mixed tumour of the skin in two different patients who have seen in our Department.

A Clinical Study of Cutaneous Tumors of the Head and Neck / 대한피부과학회지

BACKGROUND: There have been many changes to the social and medical environment in Korea and many studies showed a steady increase of cutaneous tumors. But none of them included a data occurring from head and neck. OBJECTIVE: To investigate the incidence and distribution of the cutaneous tumors of the head and neck. METHODS: A total of 1,415 cases of head and neck cutaneous tumors were obtained from pathology specimen at Department of Dermatology between 2010 and 2014. RESULTS: Among 1,415 cases of head and neck cutaneous tumors, 871 cases (61.5%) were benign tumors, 271 cases (19.2%) were malignant tumors, and 273 cases (19.2%) were premalignant lesions. The most common benign head and neck cutaneous tumors was epidermal cyst with 188 cases (21.6%), followed by 173 cases (19.9%) of seborrheic keratosis, 71 cases (8.2%) of intradermal nevi. Among the 271 cases of malignant head and neck cutaneous tumors, there were 164 cases (60.5%) of basal cell carcinoma, 89 cases (32.8%) of squamous cell carcinoma, 5 cases (1.8%) of malignant melanoma. The predilection sites of malignant head and neck tumors were face (87.5%), ear (4.8%) and neck (4.0%). Of the premalignant lesions, there were 210 cases (76.9%) of actinic keratosis, 36 cases (13.2%) of Bowen's disease and 27 cases (9.9%) of actinic cheilitis. CONCLUSION: In our study, the proportion of malignant tumors and premalignant lesion in head and neck tumors was higher than previous reports. Also, the percentage of woman in malignant tumors and premalignant lesions was higher than man, unlike previous studies. However, these results had limitation associated with retrospective study in a single institution, and further prospective study with multi-center is required for confirmation.

Queratosis seborreica: análisis clínico e histopatológico de 5.093 biopsias / Seborrheic keratosis: clinical and histopathological analysis of 5.093 biopsies

Introducción: La presencia de queratosis seborreica (QS) es un frecuente motivo de consulta dermatológica por parte de los pacientes que la padecen. Objetivos: Describir la clínica y epidemiología de los pacientes con queratosis seborreica. Analizar edad y sexo, localización anatómica, variantes histológicas, lesiones adyacentes. Material y Método: Estudio descriptivo retrospectivo de 5.093 biopsias con diagnóstico clínico o histológico de QS entre enero de 2001 a diciembre de 2005. Se evaluaron sexo, edad apellidos del paciente, localización anatómica variante histológica y lesiones. Resultados: De un total de 54.320 biopsias recibidas, 4,515 corresponden a QS confirmada por histología 53% en mujeres y 47% en varones, siendo más frecuentes en áreas fotoexpuestas. La variable histológica más habitual es la queratosis seborreica común. Conclusión: La distribución por grupos de edad en relación al sexo es similar. En este estudio la QS fue más frecuente en el sexo femenino. La mayoría de las QS se encuentran en zonas 100% fotoexpuestas.

Introduction: The presence of seborrheic keratosis (SK) is a frequent cause of dermatological consultation. Objectives: Describe the clinical epidemiology of patients with seborrheic keratosis. Analyzing age and sex, anatomic location, histological variants and adjacent lesions. Material and Method: A retrospective descriptive study of 5,093 biopsies with clinical or histological diagnosis of SK from January 2010 to December 2005. We assessed gender, age, surname, anatomic location histological variants and injuries. Results: Of 54,320 biopsies received, 4,5 1 5 are SK histologically confirmed, 53% in females and 47% in men, being more common in sun-exposed areas. The mast frequent histological variable is common seborrheic keratosis. Conclusion: Distribution by age groups in relation to gender is similar. In this study, SK was more common in females, Most SK are located in 100% sun-exposed areas.

5% Imiquimod Cream for the Treatment of Cutaneous Tumor / 대한피부과학회지

BACKGROUND: Imiquimod is an immune response modifier that shows antiproliferative and antiviral characteristics through synthesis of multiple cytokines. Although it was originally approved by the FDA for the treatment of genital warts, it has also been successfully used to treat various dermatological conditions. OBJECTIVE: The aim of this study was to report our treatment experience of cutaneous tumors with 5% imiquimod cream, and to contemplate the effectiveness and safety of its use for purpose. METHODS: We reviewed 21 patients with biopsy-proven cutaneous tumors who were treated with 5% imiquimod cream. Data was collected through medical records, clinical photographs, and biopsy specimens. RESULTS: The patients had various cutaneous tumors including actinic keratosis, Bowen's disease, Bowenoid papulosis, keratoacanthoma, superficial basal cell carcinoma and invasive squamous cell carcinoma. Among 17 patients who were initially treated with 5% imiquimod cream, 13 patients (76.5%) achieved clinical complete remission, and histologic cure was also confirmed in four. No recurrence was observed during the follow up period in these 13 patients. While applying 5% imiquimod cream, all the patients experienced local side effects but it was mild and generally well-tolerated. CONCLUSION: Topical immunotherapy of cutaneous tumors with 5% imiquimod cream has potential as a patient- friendly, well-tolerated therapy that can achieve cosmetically and functionally pleasing treatment outcomes.

Effect of the exogenous fragile histidine triad(FHIT)gene on the proliferation and apoptosis of cutaneous carcinoma cell line A431 / 基础医学与临床

Objective To investigate the effect of the exogenous fragile hisdidine triad(FHIT) gene on the proliferation and the apoptosis of cutaneous carcinoma cell line A431,and to explore the mechanism of tumor suppression by the FHIT gene.Methods The plasmids pcDNA3-FHIT and pcDNA3-vector were transfected into the cutaneous carcinoma cell line A431 without FHIT gene expression,and then the transfected cells were screened by G418 and the expression of FHIT was determined by the immunocytochemical staining technique.The effect of FHIT on the growth characteristics of cutaneous carcinoma cell line A431 was observed by MTT,colony forming test and flow cytometry.Results Stable FHIT gene expressing A431 cells were produced,the proliferation activity and colony forming capability of A431FHIT were suppressed,whereas the apoptosis was increased.All these differences between A431-FHIT cells and the two control groups of cutaneous carcinoma cells had statistical significance.Conclusion Transfecting the exogenous FHIT gene into cutaneous carcinoma cells line A431can suppress the proliferation of tumor cells,and can also induce apoptosis and cell cycle arrest.