RESUMO
BACKGROUND: The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. OBJECTIVE: To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. METHODS: Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. RESULTS: Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p-values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. CONCLUSION: In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion.
Assuntos
Humanos , Queimaduras , Cicatriz , Métodos , Cirurgia de Mohs , Autoavaliação (Psicologia) , Neoplasias Cutâneas , Pele , Transplantes , UltrassonografiaRESUMO
BACKGROUND: The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. OBJECTIVE: To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. METHODS: Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. RESULTS: Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p-values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. CONCLUSION: In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion.
Assuntos
Humanos , Queimaduras , Cicatriz , Métodos , Cirurgia de Mohs , Autoavaliação (Psicologia) , Neoplasias Cutâneas , Pele , Transplantes , UltrassonografiaRESUMO
Cutaneous carcinosarcoma is a biphasic, rare tumor composed of malignant epithelial and mesenchymal components. The most common carcinoma component is a squamous cell carcinoma and the most common sarcoma component is an osteosarcoma. A 74-year-old female patient presented to our hospital with a 3.5x3.5 cm-sized exophytic, eroded tumor surrounded by an erythematous plaque on her right flank that had been present for 10 years. On the incisional biopsy specimen, the tumor was composed of atypical malignant squamous cells and epithelioid cells. Furthermore, immunohistochemistry revealed that the tumor cells were positive to cytokeratin AE1/AE3, cytokeratin 5/6, epithelial membrane antigen, p63, and vimentin but were negative to HMB45, S-100, CD31, CD34, factor VIII, smooth muscle actin, and desmin. Finally, based on these histopathological and immunohistochemical findings, we diagnosed this tumor as cutaneous carcinosarcoma consisting of squamous cell carcinoma and epithelioid sarcoma.
Assuntos
Idoso , Feminino , Humanos , Actinas , Biópsia , Carcinoma de Células Escamosas , Carcinossarcoma , Citocromo P-450 CYP1A1 , Desmina , Células Epitelioides , Fator VIII , Imuno-Histoquímica , Queratinas , Mucina-1 , Músculo Liso , Osteossarcoma , Sarcoma , VimentinaRESUMO
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.
Assuntos
Feminino , Humanos , Actinas , Doença de Bowen , Carcinoma Basocelular , Carcinoma de Células Escamosas , Queilite , Estudo Clínico , Dermatologia , Orelha , Cisto Epidérmico , Cabeça , Incidência , Ceratose Actínica , Ceratose Seborreica , Coreia (Geográfico) , Melanoma , Pescoço , Nevo Intradérmico , Patologia , Estudos Prospectivos , Estudos RetrospectivosRESUMO
A 12-year-old girl visited our clinic with pruritic non-follicular pustules on reddish bases and scales on her face, trunk, and proximal extremities. She complained of fever and chills. Before she was admitted to our clinic, she had been treated with terbinafine (125 mg/day) for tinea corporis. Three days after beginning the terbinafine treatment, whitish pustules on erythematous bases occurred abruptly in the intertriginous areas. A physical examination showed that the girl's body temperature was 38degrees C. Laboratory investigations revealed neutrophil-dominant leukocytosis. A skin biopsy specimen taken from a pustular lesion on the trunk revealed subcorneal pustules. The papillary dermis was edematous, and a superficial perivascular lymphocytic infiltrate with scattered interstitial neutrophils was noted. She was diagnosed as having acute generalized exanthematous pustulosis because of terbinafine use on the basis of her history, and clinical and histopathological findings. Her terbinafine treatment was discontinued promptly, and systemic corticosteroids and antihistamines were administered and topical corticosteroids were applied. Three days later, the skin lesions and constitutional symptoms had improved and there has been no recurrence to date.
Assuntos
Criança , Feminino , Humanos , Pustulose Exantematosa Aguda Generalizada , Corticosteroides , Biópsia , Temperatura Corporal , Calafrios , Derme , Extremidades , Febre , Antagonistas dos Receptores Histamínicos , Leucocitose , Neutrófilos , Exame Físico , Recidiva , Pele , Tinha , Pesos e MedidasRESUMO
Cutaneous mucormycosis is a rare disease caused by zygomycetes such as Rhizomucor, Mucor, Absidia, and Rhizopus. The disease usually occurs in immunocompromised individuals, and the organism is rarely pathogenic in an immunocompetent host. Herein, we report a 77-year-old female patient who had multiple erythematous papules and pustules on the left 3rd finger. She had received systemic steroid therapy prior to the occurrence of the skin lesions. The histopathological examination of Periodic Acid Schiff stained section showed chronic granulomatous inflammation and fungal hyphae. Rhizopus species was isolated on the fungal culture of the tissue specimen. The patient was finally diagnosed with cutaneous mucormycosis and was treated with itraconazole.
Assuntos
Idoso , Feminino , Humanos , Absidia , Dedos , Hifas , Inflamação , Itraconazol , Mucor , Mucormicose , Ácido Periódico , Doenças Raras , Rhizomucor , Rhizopus , PeleRESUMO
Juvenile dermatomyositis is a common idiopathic inflammatory myopathy in childhood and is characterized by symmetric proximal muscle weakness and specific cutaneous manifestations. We here report on a 12-year-old boy who presented with violaceous maculopatches with multiple deep skin ulcerations on the right arm and lower back 4 months ago. One month after the initial visit, he had difficulty climbing stairs and elevating his arms above the head. Laboratory tests showed elevation of the serum levels of skeletal muscle enzymes, and electromyogram and muscle biopsy indicated myopathy. Histopathological analysis of the ulceration indicated necrotizing vasculitis and calcification. Based on these findings, his condition was diagnosed as juvenile dermatomyositis. We believe that this case is unique because of the difficulty in diagnosing the condition, as skin ulceration is a rare cutaneous manifestation of dermatomyositis.
Assuntos
Criança , Humanos , Masculino , Braço , Biópsia , Dermatomiosite , Cabeça , Debilidade Muscular , Músculo Esquelético , Doenças Musculares , Miosite , Úlcera Cutânea , Úlcera , VasculiteRESUMO
Nevus sebaceus is frequently complicated by development of a variety of other benign skin tumors. On the other hand, malignant skin tumors are rarely observed in associated with nevus sebaceous. The most common benign skin tumor developing in nevus sebaceus is trichoblastoma, while the most common malignant skin tumor is basal cell carcinoma. However, cases of squamous cell carcinoma developing within nevus sebaceous are rare. A 42-year-old man presented a solitary 3x3-cm sized hemorrhagic, crusted, verrucous mass on the left occipital scalp, which was congenital. He visited our clinic due to the mass rapidly enlarging over the past 3 years and due to bleeding of the mass in the past 3 months. Histopathologically, the tumor showed typical findings of well-differentiated nevus sebaceus and squamous cell carcinoma. We herein report a case of squamous cell carcinoma developing in nevus sebaceous.