Dermatosis en pacientes geriátricos / Dermatoses in geriatric patients

Introducción: El envejecimiento cutáneo es parte de un proceso de deterioro endógeno y exógeno en las células. Los cambios degenerativos y metabólicos que ocurren, hacen a esta población vulnerable a afecciones dermatológicas. Objetivo: Definir las enfermedades cutáneas frecuentes en pacientes geriátricos, atendidos en consulta de dermatología. Métodos: Se realizó una investigación observacional descriptiva transversal, en pacientes geriátricos atendidos en la consulta de Dermatología en la Policlínica de Combatientes de Ciego de Ávila, en el periodo comprendido de enero a diciembre del 2019. La serie de estudio se conformó con 144 adultos mayores. Las variables estudiadas fueron: edad, sexo, color de piel, fototipos cutáneos, afecciones dermatológicas, localización y morbilidades asociadas. Resultados: Predominaron los adultos mayores entre 70 y 79 años (53,5 por ciento), del sexo masculino (50,7 por ciento). El 63,9 por ciento de los pacientes tenía fototipo cutáneo III. Las dermatosis más frecuentes fueron la púrpura senil (34 por ciento) y queratosis seborreica (25 por ciento), fueron más afectados los adultos mayores de piel blanca (69,4 por ciento). Las dermatosis en la cara y extremidades fueron las más frecuentes (53,5 por ciento y 17,4 por ciento). El 46,6 por ciento de los pacientes padecían de afecciones del sistema osteomioarticular, seguido por la hipertensión arterial (18,5 por ciento) y diabetes mellitus (12,6 por ciento). Conclusiones: Predominaron los adultos mayores del sexo masculino de 70 a 79 años, con fototipo cutáneo III. La púrpura senil, la queratosis seborreica y la xerosis fueron afecciones frecuentes en ancianos de piel blanca. Se destacaron las lesiones limitadas a la cara(AU)

Introduction: Skin aging is part of an endogenous and exogenous deterioration process in cells. The degenerative and metabolic changes that occur make this population vulnerable to dermatological conditions. Objective: To define frequent skin diseases in geriatric patients, seen in a dermatology office. Methods: A cross-sectional descriptive observational investigation was carried out in geriatric patients treated in the Dermatology consultation at the Policlínica de los Combatientes, Ciego de Ávila, in the period from January to December 2019. The study series consisted of 144 older adults. The variables studied were: age, sex, skin color, skin phototypes, dermatological conditions, location and associated morbidities. Results: Older adults between 70 and 79 years old (53,5 percent), male (50,7 percent) predominated. 63,9 percent of the patients had skin phototype III. The most frequent dermatoses were senile purpura (34 percent) and seborrheic keratosis (25 percent), older adults with white skin were more affected (69,4 percent). Dermatoses on the face and extremities were the most frequent (53,5 percent and 17,4 percent). 46,6 percent of the patients suffered from disorders of the osteomyoarticular system, followed by arterial hypertension (18,5 percent) and diabetes mellitus (12,6 percent). Conclusions: Older male adults from 70 to 79 years old, with skin phototype III predominated. Senile purpura, seborrheic keratosis, and xerosis were common conditions in white-skinned elderly. Lesions limited to the face were highlighted(AU)

Melanoacanthoma: a potential pitfall of reflectance confocal microscopy

Abstract Melanoacanthoma is a rare variant of seborrheic keratosis, which is notable for dark pigmentation and fast radial growth, making it difficult to distinguish from melanoma. Histologically, it is characterized by proliferation of keratinocytes and dendritic melanocytes. The authors report a scalp lesion, fast growing, suspected by dermoscopy and confocal microscopy examination, with dendritic cells distributed throughout the lesion. Based on these findings, it was not possible to classify this lesion as clearly benign, so it was excised. Histopathologic evaluation and immunostain were consistent with melanoacanthoma.

Basal Cell Carcinoma Arising within Seborrheic Keratosis

No abstract available.

Topical treatments for Seborrheic Keratosis: A systematic review

Background@#Seborrheic keratosis is a benign skin tumor removed through electrodessication, cryotherapy, or surgery. Alternative options may be beneficial to patients with contraindications to standard treatment, or those who prefer a non-invasive approach.@*Objectives@#To determine the effectiveness and safety of topical medications on seborrheic keratosis in the clearance of lesions, compared to placebo or standard therapy.@*Methods@#Studies involving seborrheic keratosis treated with any topical medication, compared to cryotherapy, electrodessication or placebo were obtained from MEDLINE, HERDIN, and Cochrane electronic databases from 1990 to June 2018.@*Results@#The search strategy yielded sixty articles. Nine publications (two randomized controlled trials, two non-randomized controlled trials, three cohort studies, two case reports) covering twelve medications (hydrogen peroxide, tacalcitol, calcipotriol, maxacalcitol, ammonium lactate, tazarotene, imiquimod, trichloroacetic acid, urea, nitric-zinc oxide, potassium dobesilate, 5-fluorouracil) were identified. The analysis showed that hydrogen peroxide 40% presented the highest level of evidence and was significantly more effective in the clearance of lesions compared to placebo.@*Conclusion@#Most of the treatments reviewed resulted in good to excellent lesion clearance, with a few well-tolerated minor adverse events. Topical therapy is a viable option; however, the level of evidence is low. Standard invasive therapy remains to be the more acceptable modality.

Signo de leser-trélat, signo paraneoplásico en cáncer de mama metastásico: presentación de caso / Leser-trélat sign: paraneoplastic sign in metastatic breast cancer, case presentation / Sinal de leser-trélat: sinal paraneoplásico em câncer de mama metastático, apresentação de caso

Resumen El signo de Leser-Trélat es una erupción súbita y de veloz crecimiento de cuantiosas queratosis seborreicas secundarias a una neoplasia interna. Estas pueden estar relacionadas con prurito y acantosis nigricans. Las neoplasias asociadas frecuentemente al signo de Leser-Trélat son los adenocarcinomas gástricos, de colon y mama, representado en menor cantidad por linfomas, carcinoma de células escamosas y malignidades hematológicas. Siendo el signo de Leser-Trélat una dermatosis paraneoplásica infrecuente, se presenta un caso de una paciente de 76 años con cáncer de mama avanzado asociado a este signo.

Abstract The Leser-Trelat sign is a sudden and rapid growth eruption of large seborrheic keratoses secondary to an internal neoplasm. These may be related to pruritus and acanthosis nigricans. The neoplasms frequently associated with the Leser-Trélat sign are gastric, colon and breast adenocarcinomas, represented to a lesser extent by lymphomas, squamous cell carcinoma and hematological malignancies. As the Leser-Trélat sign is an uncommon paraneoplastic dermatosis, a case of a 76-year-old patient with advanced breast cancer associated with this sign is presented.

Resumo O sinal de Leser-Trélat é uma erupção súbita e de veloz crescimento de múltiplas ceratoses seborreicas secundárias a uma neoplasia interna. Estas podem estar relacionadas com prurido e acantose nigricans. As neoplasias associadas frequentemente ao sinal de Leser-Trélat são os adenocarcinomas gástricos, de colón e mama, representado em menor quantidade por linfomas, carcinoma de células escamosas e malignidades hematológicas. Sendo o sinal de Leser-Trélat uma dermatose paraneoplásica infrequente, apresenta-se um caso de uma paciente de 76 anos com câncer de mama avançado associado a esse sinal.

Collision tumor: pigmented Bowen's disease and seborrheic keratosis

Abstract: Bowen's disease is a type of squamous cell carcinoma in situ of the skin. The pigmented form is rare and represents less than 2% of cases. We report a case of a 74-year-old black man with a blackened and asymptomatic leg injury for about 6 months. Clinically, and under dermatoscopy, the injury was suggestive of melanoma or melanoacanthoma, and a definitive diagnosis was made by histopathological examination.

Ceratose seborreica em idosos de uma região de savana tropical / Seborrheic keratosis in elderly of a tropical savanna region / Queratosis seborreica em ancianos de una region de savana tropical

Objetivo: verificar a prevalência de ceratose seborreica em idosos residentes em região de savana tropical. Método: estudo descritivo transversal, realizado em Palmas, Tocantins, no primeiro semestre de 2016, com idosos de ambos os sexos. Resultados: participaram do estudo 259 idosos, sendo identificada prevalência de 8,5% de ceratose seborreica, com maior ocorrência no sexo masculino, na faixa etária de 70 a 79 anos, e que se auto declararam negros. Quanto às características da pele dos idosos com ceratose seborreica, a maioria apresentava pele ressecada e com diminuição do turgor cutâneo. Considerações finais: dados relacionados aos fatores ressecamento da pele e diminuição do turgor alertam para a necessidade de maior atenção e cuidados preventivos especificamente voltados a pessoa idosa. Esse estudo, representa o início para compreensão sobre a prevalência de ceratose seborréica em idosos em área de savana tropical, e destaca a importância de realização de outros estudos acerca dos fatores intervenientes, ampliando a compreensão sobre o fenômeno.

Objective: verify the prevalence of seborrheic keratosis in elderly residents of a tropical savanna region. Method: this is a descriptive cross-sectional study, carried out in Palmas, Tocantins, in the first half of 2016, with elderly men and women. Results: a total of 259 elderly people participated in the study, that identified a prevalence of 8.5% of seborrheic keratosis, with the highest occurrence in males, aged 70 to 79 years, and who declared themselves black. As to the skin characteristics of the elderly with seborrheic keratosis, the majority had dry skin and decreased skin turgor. Conclusion: the data related to skin dryness and turgor reduction factors point to the need for greater attention and preventive care specifically to the elderly. This study represents the beginning of an understanding about the prevalence of seborrheic keratosis in the elderly in a tropical savanna area, and highlights the importance of other studies about the intervening factors, increasing the understanding about the phenomena.

Objetivo: verificar la prevalencia de queratosis seborreica en ancianos residentes en la región de savana tropical. Método: estudio descriptivo transversal, realizado en Palmas, Tocantins, en el primer semestre de 2016, con ancianos de ambos sexos. Resultados: participaron del estudio 259 ancianos, fue identificada prevalencia de 8,5% de queratosis seborreica, con mayor ocurrencia en el sexo masculino, en el grupo etario de 70 a 79 años, y que se auto declararon negros. En cuanto a las características de la piel de los ancianos con queratosis seborreica, la mayoría presentaba piel reseca y con diminución do turgencia cutánea. Conclusión: datos relacionados a los factores de resecamiento de la piel y diminución de la turgencia alertan sobre la necesidad de mayor atención y cuidados preventivos específicamente orientados a la persona anciana. Ese estudio representa el inicio para la comprensión sobre la prevalencia de queratosis seborreica en ancianos en área de savana tropical, y destaca la importancia de la realización de otros estudios acerca de los factores intervinientes, ampliando la comprensión del fenómeno.

Pigmented Eccrine Poroma Mimicking Seborrheic Keratosis / 대한피부과학회지

No abstract available.

Queratosis seborreica eruptiva y su asociación con cáncer gastrointestinal. Un estudio de casos y controles / Eruptive seborrheic keratosis and its association with gastrointestinal cancer. A case-control study

Resumen Introducción: se ha propuesto la existencia de asociación entre queratosis seborreica eruptiva y algunas neoplasias malignas. Sin embargo, la evidencia acerca de esto es pobre: tres estudios europeos de casos y controles cuyos resultados no la apoyan. El objetivo del estudio es evaluar en población colombiana la existencia o no de esta asociación. Material y métodos: estudio de 130 casos y 260 controles pareados por edad y sexo en mayores de 18 años entre pacientes con cáncer gastrointestinal o pancreatobiliar (casos) u hospitalizados por otras razones no oncológicas (controles) en el Hospital Universitario de Santander, Bucaramanga (Colombia). A todos los pacientes se les realizó examen cutáneo minucioso, incluyendo dermatoscopia, para identificar la presencia y tiempo de evolución de queratosis seborreica en zonas cubiertas por ropa. Resultados: la prevalencia de queratosis seborreica entre los casos fue 26.9% (IC95% 19.5-35.4) y de 15.4% (IC95% 11.2-20.4) entre los controles (OR 1.94, IC95% 1.17-3.19). Siete pacientes con cáncer presentaban la queratosis seborreica en los seis meses previos al diagnóstico de la neoplasia (5.3%, IC95% 2.2-10.8) frente a ninguno entre los pacientes control (0.0%, IC95% 0.0-1.4; p<0.001); tres de ellos tenían 20 o más lesiones de menos de seis meses de aparición (2.3% de los casos, IC95% 0.5-6.6) frente a ninguno entre los controles (p=0.014). Discusión: este estudio trata de subsanar las debilidades de los únicos tres estudios previos que exploran la asociación entre queratoris seborreica y cáncer mediante la rigurosa selección de pacientes, la inclusión de pacientes con cáncer de un solo sistema corporal y un proceso estricto para evaluar las lesiones cutáneas con dermatoscopia. Esto permite concluir que en pacientes colombianos con cáncer gastrointestinal hay mayor frecuencia de queratosis seborreica y de queratoris seborreica eruptiva que en personas de igual edad y sexo sin cáncer. (Acta Med Colomb 2017; 42: 224-229).

Abstract Introduction: the association between eruptive seborrhoeic keratosis and some malignant neoplasms has been proposed. However, the evidence about this is poor: three European case-control studies whose results do not support it. The objective of the study is to evaluate the existence or not of this association in the Colombian population. Material and methods: study of 130 cases and 260 matched controls for age and sex in patients over 18 years of age among patients with gastrointestinal or pancreatobiliary cancer (cases) or hospitalized for other non-oncological reasons (controls) at the University Hospital of Santander, Bucaramanga (Colombia). All patients underwent meticulous skin examination including dermatoscopy, to identify the presence and time of evolution of seborrheic keratosis in areas covered by clothing. Results: the prevalence of seborrheic keratosis among the cases was 26.9% (95% CI 19.5-35.4) and 15.4% (95% CI 11.2-20.4) among the controls (OR 1.94, 95% CI 1.17-3.19). Seven patients with cancer presented seborrheic keratosis in the six months prior to the diagnosis of neoplasia (5.3%, 95% CI 2.2-10.8) compared to none among control patients (0.0%, 95% CI 0.0-1.4, p <0.001); three of them had 20 or more lesions less than six months of onset (2.3% of cases, 95% CI 0.5-6.6) compared to none among controls (p = 0.014). Discussion: this study tries to correct the weaknesses of the only three previous studies that explore the association between seborrheic keratosis and cancer by rigorous selection of patients, the inclusion of cancer patients from a single body system and a strict process to evaluate the skin lesions with dermatoscopy. This allows concluding that in Colombian patients with gastrointestinal cancer there is a greater frequency of seborrheic keratosis and eruptive seborrheic keratosis than in people of the same age and sex without cancer. (Acta Med Colomb 2017; 42: 224-229).

Irritated Subtype of Seborrheic Keratosis in the External Auditory Canal

No abstract available.

A Case of Pigmented Eccrine Poroma on Scalp Clinically Mimicking Seborrheic Keratosis / 대한피부과학회지

No abstract available.

"String of pearls pattern": report of three cases of non clear-cell acanthoma

Abstract The coiled and dotted vessels in a serpiginous arrangement or "string of pearls" is considered a classical vascular pattern associated with clear cell acanthoma. We present three cases of epidermal tumors different from clear cell acanthoma that have the same "string of pearls" vascular pattern. Even though most authors keep considering the "string of pearls" vascular pattern an almost pathognomonic sign of clear-cell acanthoma, the cases presented here suggest that some other epidermal tumors can also show this pattern.

Various Dermatoses What the Patients with Cutaneous Melanoma Had Anxiety for the Recurrence during Postoperative Surveillance

BACKGROUND: The incidence and mortality rates associated with cutaneous melanoma (CM) have steadily increased over the last 20 years. Even with successful treatment, melanoma patients usually experience substantial anxiety regarding the development of terrible recurrence. To date, few studies have investigated various dermatoses what the patients with CM had anxiety for the recurrence during postoperative surveillance (Dw). OBJECTIVE: To describe various Dw and to evaluate the risk of subsequent malignant skin disease in patients with CM. METHODS: We performed a prospective study between August 2002 and August 2015. RESULTS: Fifty-six patients presented with a total of 68 Dw. Among them, melanocytic nevus was the most common (n=27), followed by seborrheic keratosis (n=9) and CM recurrence (n=7). Approximately 5.6% of the lesions were diagnosed as malignant skin diseases. This was a single-center study, so the prevalence of malignant skin diseases following primary melanoma may not represent that of all patients with CM. CONCLUSION: The results of this study can be referred by dermatologists dealing with melanoma especially when CM patients have too excessive or unrealistic anxiety for melanoma recurrence during postoperative surveillance of CM. However, the importance of postoperative surveillance must still be emphasized because of real risk of melanoma recurrence and other malignant skin.

Eccrine Poroma of the Postauricular Area

Eccrine poroma is a common benign cutaneous tumor that originates in an intraepidermal eccrine duct. This tumor exhibits acral distribution (sole, palm), and is rarely encountered in the head and neck area. In fact eccrine poroma in the postauricular area has only been rarely reported. A 55-year-old female visited our hospital with a main complaint of a mass that first developed in the left postauricular area about a year previously. The mass was painless, soft, protruding, domed, and dark red in color, and had slowly enlarged (at presentation it measured 1×1 cm). Excisional biopsy was performed. Histological examination showed distinct features, and eccrine poroma was diagnosed. Follow-up at 6 months postoperatively showed no recurrence. The frequency of eccrine poroma is dependent on eccrine sweat glands density, and thus, usually occurs on the palms or soles. For eccrine poroma in the head and neck region, the differential diagnosis must rule out other masses, such as nevus, skin tag, pyogenic granuloma, cyst, basal cell carcinoma, and seborrheic keratosis. Importantly, 18% of poromas show malignant transformation, and can develop into porocarcinoma. For these reasons, an eccrine poroma in the facial area requires histological examination, complete excision, and follow-up.

Dermatofibroma simulating seborrheic keratosis dermoscopically

Abstract: Dermatofibroma is a frequent benign tumor of easy clinical diagnosis in most cases, but that can mimic other dermatoses. Dermoscopy may help to define the diagnosis and its classical pattern is a central white area, similar to a scar, surrounded by a discrete pigment network. However, dermoscopic findings are not always typical. We describe here a case of dermatofibroma exhibiting ridges, furrows and pseudocomedos, a pattern which is typical of seborrheic keratosis, in dermoscopy.

Cutaneous paraneoplasia in a woman with occult hepatic carcinoma

Tripe palms, sign of Leser-Trélat, and florid cutaneous papillomatosis are paraneoplastic entities most commonly associated with aggressive tumors. Recognition of cutaneous paraneoplasia in this case led to the detection of an occult liver malignancy in a 54-year-old woman who presented with a six-month history of diffuse thickening of palmar skin and an eruption of intensely pruritic hyperpigmented papules and plaques on her neck, abdomen, and extremities. Biopsy from the palm, thigh, and axillary lesions were consistent with tripe palms, seborrheic keratosis, and florid cutaneous papillomatosis, respectively. This patient was asymptomatic for involvement of the gastrointestinal system but had elevated serum CEA and CA 19-9 and was positive for anti-Hbs and anti-HBc. Triple-contrast triphasic scan of the abdomen revealed multiple hepatic masses and persistent sigmoid wall thickening and narrowing. Liver biopsy was positive for carcinoma cells. Therefore, an exhaustive search for the underlying neoplasia should be undertaken even in asymptomatic cases as paraneoplastic entities can be the initial and only physical clues to an underlying malignancy and early detection can be lifesaving.