ABSTRACT
BACKGROUND: There are many techniques used to remove professional tattoos. Each method can be complicated by hypertrophic scarring, pigmentary changes, and/or insufficient pigment removal. OBJECTIVE: To study the results of precise, thin, tangential excisions of professional tattoos. The posttreatment migration of dermal tattoo pigment was also evaluated. METHODS: Five healthy white males had their professionally placed tattoos excised at a depth of 0.008 in (0.2 mm) using a Brown dermatome. Pre- and posttreatment biopsies were used to measure the depth of the tattoo pigment. RESULTS: At 3 months posttreatment, four patients had no significant scarring and three patients retained only scattered flecks of tattoo pigment. Each patients demonstrated migration of the deeper dermal pigment to a more superficial level. CONCLUSION: A superficial, tangential excision of a professional tattoo by a Brown dermatome is a viable, low-risk, inexpensive procedure.
Subject(s)
Dermatologic Surgical Procedures , Tattooing , Adult , Cicatrix/etiology , Dermatology/instrumentation , Electrosurgery/instrumentation , Evaluation Studies as Topic , Follow-Up Studies , Humans , Male , Pigments, Biological , Pilot Projects , Skin/pathology , Wound HealingABSTRACT
BACKGROUND: This article describes the clinical and histologic features of seven cases of Bowen's disease (BD) of the nail bed, evaluates the role of human papillomavirus in the bowenoid change, and discusses optimal therapy. OBSERVATION: The patients presented with the clinical features of verruca vulgaris (n = 3), nail dystrophy and onycholysis (n = 2), paronychia (n = 1), and acral melanoma (n = 1). Histologically, the lesions demonstrated acanthosis, hyperkeratosis, and anaplasia, involving the full thickness of the epithelium. In four cases, human papillomavirus type 16 was demonstrated by in situ hybridization. Six lesions were treated by Mohs micrographic surgery, and one case was treated with topical 5% fluorouracil. In two cases, lesions recurred 1 and 2 years following surgery. In the case treated with topical 5% fluorouracil, residual BD was found 6 weeks after therapy. This case was then treated by Mohs surgery. CONCLUSIONS: Bowen's disease of the nail bed and periungual area may present clinically as various inflammatory and neoplastic conditions. An important clinical finding in differentiating BD of the nail bed from verruca is the presence of scaling and onycholysis that are out of proportion to the verrucous changes. Human papillomavirus type 16 may be etiologically related to BD of the nail bed and periungual area. Mohs micrographic surgery is recommended for adequate excision and maximal preservation of normal tissue and function.
Subject(s)
Bowen's Disease/pathology , Nail Diseases/pathology , Skin Neoplasms/pathology , Adult , Bowen's Disease/microbiology , Bowen's Disease/surgery , Female , Humans , In Situ Hybridization , Male , Microsurgery/methods , Middle Aged , Nail Diseases/surgery , Papillomaviridae/isolation & purification , Skin Neoplasms/microbiology , Skin Neoplasms/surgeryABSTRACT
Microcystic adnexal carcinoma is a recently described neoplasm characterized by a locally aggressive growth pattern. The tumor usually affects the upper lip of middle-aged women, but occurs in other facial areas and in men. Histologically, a distinctive combination of keratin-filled cysts, islands and strands of basaloid and squamous cells, and ducts and glandlike structures is seen. A dense, hyalinized stroma is also a feature as well as frequent perineural invasion by tumor cells. While microcystic adnexal carcinoma is deeply infiltrating in its growth, metastasis has not been reported. However, recurrences with extensive local tumor spread are often observed. We describe a middle-aged man who initially had a lesion of microcystic adnexal carcinoma excised 30 years prior to definitive treatment for a recurrence at the original site. To our knowledge, this is the longest follow-up of a patient with microcystic adnexal carcinoma and confirms its locally infiltrating, indolent biologic behavior.
Subject(s)
Carcinoma/pathology , Facial Neoplasms/pathology , Lip Neoplasms/pathology , Biopsy , Female , Follow-Up Studies , Humans , Lip/pathology , Male , Middle Aged , Neoplasm Recurrence, Local , Skin/pathologySubject(s)
Edema/pathology , Skin/pathology , Adolescent , Atrophy , Elasticity , Exudates and Transudates , Female , Humans , Lupus Erythematosus, Systemic/pathologyABSTRACT
A case of verrucous carcinoma occurred on the face of a patient and prompted a review of the literature on this disorder. It is difficult to make a histopathologic diagnosis in such cases.
Subject(s)
Carcinoma, Papillary/pathology , Facial Neoplasms/pathology , Aged , Cheek , Eyelid Neoplasms/pathology , Humans , MaleABSTRACT
Renal-cell carcinoma develops as an insidious neoplasm, frequently metastasizing to the skin. Cutaneous manifestations vary regarding morphology and sites of predilection. A patient was recently seen demonstrating a metastasis from a renal neoplasm. The lesion was unusual in that it grossly resembled a cutaneous horn. Dermatologists should continue to be alert to the possibility of renal tumor metastasis when evaluating cutaneous tumors.
