Subject(s)
Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Precancerous Conditions/pathology , Tumor Virus Infections/diagnosis , Condylomata Acuminata/diagnosis , Condylomata Acuminata/epidemiology , Condylomata Acuminata/therapy , Female , Humans , Incidence , Male , Papillomavirus Infections/epidemiology , Papillomavirus Infections/therapy , Precancerous Conditions/epidemiology , Primary Prevention/methods , Prognosis , Risk Assessment , Tumor Virus Infections/epidemiology , Tumor Virus Infections/therapySubject(s)
Central Nervous System Diseases/etiology , Neurofibromatosis 1/complications , Central Nervous System Diseases/diagnostic imaging , Central Nervous System Diseases/pathology , Humans , Magnetic Resonance Imaging , Neurofibromatosis 1/diagnostic imaging , Neurofibromatosis 1/pathology , Skin Diseases/diagnostic imaging , Skin Diseases/etiology , Skin Diseases/pathology , Tomography, X-Ray ComputedSubject(s)
Histiocytosis, Langerhans-Cell/diagnostic imaging , Skull/pathology , Adolescent , Adult , Age of Onset , Alveolar Bone Loss/diagnostic imaging , Alveolar Bone Loss/etiology , Child , Child, Preschool , Diagnosis, Differential , Histiocytosis, Langerhans-Cell/diagnosis , Humans , Infant , Infant, Newborn , Jaw/diagnostic imaging , Jaw/pathology , Magnetic Resonance Imaging , Mandibular Diseases/diagnostic imaging , Mandibular Diseases/etiology , Radiography , Skull/diagnostic imaging , Tooth Loss/etiologyABSTRACT
BACKGROUND: Lobular capillary hemangiomas (pyogenic granulomas) occur on both mucosal and cutaneous surfaces. There are conflicting data regarding the increased prevalence of lobular capillary hemangiomas in female versus male subjects. Some studies have noted a female predominance of lobular capillary hemangiomas, but other studies do not reveal such a disparity. Because of an increased prevalence during pregnancy, oral tumors are also known as "granuloma gravidarum" or "pregnancy tumors." A hormonal influence for these mucosal lesions has been postulated. There are, however, no studies that address a possible relationship between hormones and cutaneous lesions. OBJECTIVE: This study presents the epidemiology of lobular capillary hemangiomas, with an emphasis on cutaneous lesions. METHODS: We reviewed 63,759 dermatopathology reports from a regional, private dermatopathology laboratory and found 325 cases of lobular capillary hemangiomas over a 1-year period. RESULTS: In our study of lobular capillary hemangiomas, cutaneous lesions accounted for 86%, with mucosal lesions representing only 12% of cases. Seven cases were excluded (one was intravascular, two were subcutaneous, and in 4 the location was not specified). Overall, male patients outnumbered female patients. The peak incidence for cutaneous lobular capillary hemangiomas was found in the second decade of life. The most common cutaneous sites were the trunk, upper extremities, and head. Mucosal lesions were primarily seen on the lips, gingiva, and tongue, and these affected females more than males by a ratio of 2:1, most commonly in the fourth decade of life. CONCLUSION: Cutaneous lobular capillary hemangiomas were equally prevalent in male and female patients. This would refute a female hormonal influence in the induction of cutaneous lobular capillary hemangiomas. Our data may suggest a hormonal influence on mucosal lesions because mucosal lobular capillary hemangiomas were twice as common in female patients. However, the small number of lesions in our study precludes us from making such a conclusion.
Subject(s)
Granuloma, Pyogenic/epidemiology , Pregnancy Complications/epidemiology , Skin Diseases/epidemiology , Skin/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Epidemiologic Studies , Female , Granuloma, Pyogenic/pathology , Humans , Incidence , Infant , Male , Middle Aged , Mucous Membrane/pathology , Pregnancy , Pregnancy Complications/pathology , Sex Factors , Skin Diseases/pathologySubject(s)
Facial Dermatoses/pathology , Gingival Hyperplasia/pathology , Granulomatosis with Polyangiitis/diagnosis , Adult , Diagnosis, Differential , Facial Dermatoses/etiology , Gingival Hyperplasia/etiology , Granulomatosis with Polyangiitis/complications , Granulomatosis with Polyangiitis/pathology , Humans , MaleABSTRACT
Proliferative verrucous leukoplakia (PVL) is a distinct variant of oral leukoplakia characterized by a high rate of malignant transformation. Histologic features are variable and range from epithelial dysplasia to verrucous squamous cell carcinoma. To our knowledge, there have been no previous reports of cutaneous PVL. We present an interesting case of PVL involving the skin.
Subject(s)
Leukoplakia, Oral/complications , Skin Diseases/etiology , Aged , Biopsy , Chronic Disease , Diagnosis, Differential , Female , Humans , Leukoplakia, Oral/pathology , Oropharynx/pathology , Skin/pathology , Skin Diseases/pathologyABSTRACT
Benign tumors of the vulva, although relatively uncommon, are often referred to dermatologists for evaluation and treatment. The clinical features of benign tumors may overlap with malignant neoplasms, and therefore, a biopsy is often necessary to make a definitive diagnosis. This article discusses benign tumors of the vulva that are not associated with infectious agents and presents their classification according to cell of origin.
Subject(s)
Vulvar Neoplasms/diagnosis , Adenoma, Sweat Gland/diagnosis , Biopsy , Dermatitis, Seborrheic/diagnosis , Diagnosis, Differential , Endometriosis/diagnosis , Female , Granular Cell Tumor/diagnosis , Hemangioma/diagnosis , Histiocytoma, Benign Fibrous/diagnosis , Humans , Leiomyoma/diagnosis , Lipoma/diagnosis , Lymphangioma/diagnosis , Neurofibroma/diagnosis , Nevus/diagnosis , Polyps/diagnosis , Vulvar Neoplasms/classification , Vulvar Neoplasms/pathology , Vulvar Neoplasms/surgeryABSTRACT
OBJECTIVES: Mucocutaneous diseases are common in patients infected with human immunodeficiency virus (HIV). To identify cutaneous diseases for which HIV-infected people are at high risk, we sought those that are strongly associated with specific HIV-related oral lesions and with progression of HIV disease. DESIGN: A cross-sectional study of HIV-positive outpatients referred to a university stomatology clinic for diagnosis and treatment of oral diseases. Each subject underwent both complete oral and cutaneous examinations. RESULTS: Among 55 men, with a median age of 41 years and a median CD4 cell count of 125/microliter (range 0-950/microliter), 93% had active oral diseases or conditions, including candidiasis, hairy leukoplakia, ulcers, Kaposi's sarcoma (KS), and xerostomia, and 95% had skin conditions, including onychomycosis, dermatophytosis, seborrheic dermatitis, KS, folliculitis, xerosis, and molluscum contagiosum. Seborrheic dermatitis, xerosis, skin KS, and molluscum contagiosum were associated with oral HIV-sentinel lesions (oral candidiasis, hairy leukoplakia, and KS), with low CD4 cell counts, and with AIDS. CONCLUSION: Our results suggest that xerosis and seborrheic dermatitis may be early harbingers of HIV disease progression. Their roles as predictors warrant further study, based on their associations with low CD4 cell counts and AIDS and strong co-prevalence with one of the most common HIV-related oral lesions, oral candidiasis.
Subject(s)
AIDS-Related Opportunistic Infections , HIV Infections/complications , Mouth Diseases/etiology , Skin Diseases/etiology , Acquired Immunodeficiency Syndrome/complications , Adult , Aged , CD4 Lymphocyte Count , Candidiasis, Oral/etiology , Cross-Sectional Studies , Dermatitis, Seborrheic/etiology , Dermatomycoses/etiology , Disease Progression , Folliculitis/etiology , Humans , Ichthyosis/etiology , Immunocompromised Host , Leukoplakia, Hairy/etiology , Male , Middle Aged , Molluscum Contagiosum/etiology , Odds Ratio , Sarcoma, Kaposi/etiology , Statistics, NonparametricABSTRACT
Many diseases present with both neurologic and dermatologic manifestations. Eight such clinical cases are presented, along with clinical photographs of the skin lesions, in the format of a self-evaluation. Each case is followed by a discussion and a brief review of the characteristic cutaneous and neurologic findings. The intent is to demonstrate classic dermatologic manifestations of diseases seen by neurologists.
Subject(s)
Nervous System Diseases/complications , Nervous System Diseases/diagnosis , Skin Diseases/diagnosis , Skin Diseases/etiology , Adult , Anticonvulsants/immunology , Child , Drug Hypersensitivity/diagnosis , Female , Humans , Lyme Disease/diagnosis , Male , Meningitis, Meningococcal/diagnosis , Middle Aged , Multiple Myeloma/diagnosis , POEMS Syndrome/diagnosis , Rocky Mountain Spotted Fever/diagnosis , Syphilis/diagnosis , Tuberous Sclerosis/diagnosisABSTRACT
EPIDEMIOLOGY: Is the study of disease occurrence in human populations. As a science, epidemiology emphasizes descriptive and analytic observation, clinical trial, behavioral intervention, and the practical utility of diagnostic tests. "Epidemiology" is derived from the Greek epi (among), demos (people), and logos (doctrine). CLINICAL EPIDEMIOLOGY: Is the application of epidemiologic principles and methods to problems arising in clinical medicine, dermatology included. For dermatologists, understanding this discipline is as important as mastering other basic sciences, such as immunology, microbiology, and dermatopathology. The recognization of Lyme disease is a classic work of "infectious" disease epidemiology. In 1972, a disease characterized by erythema chronicum migrans and "endemic arthritis" clustered in Lyme, Connecticut. By 1975, an infectious agent was suspected to be the cause of the disease. In 1977, the tick was thought to be the vector; in 1980, the spirochete became the prime suspect and, in 1982, Borrelia burgdorferi was identified as the etiologic agent. The study of hexachlorobenzene exposure, resulting in porphyria turcica, is an example of classic "chronic" disease epidemiology. The illness began in 1955 when sporadic cases of porphyria occurred in eastern Turkey. In 1957, the first case with illness resembling congenital erythropoietic porphyria was described. In subsequent years, over 3000 patients developed "epidemic" porphyria. The cause was due to the ingestion of seed wheat which had been treated with fungicides containing 20% hexachlorobenzene. EPIDEMIOLOGIC METHODS: For research, published elsewhere as Dermatoepidemiology. I., include descriptive observational study, analytic observational study, epidemiologic experimental study and tests for sensitivity, specificity, and positive/negative predictive value. Epidemiologic principles, instead, stress the correct interpretation of data, minimization of bias, and the appreciation of natural variations in collected data.
Subject(s)
Skin Diseases/epidemiology , Bias , Epidemiologic Methods , Humans , Incidence , Skin Neoplasms/epidemiologyABSTRACT
During the past few years there has been significant interest in studying methods that document outcomes of medical care. Outcomes management should result in higher quality health care at lower cost. However, what does outcomes research mean and how does it apply to dermatology and specifically to the individual dermatologist? This article reviews the evolution of medical outcomes research and presents the status of the current instruments, indices, and methods.
Subject(s)
Outcome Assessment, Health Care , Dermatology , Humans , Outcome Assessment, Health Care/trends , Quality Assurance, Health Care , Quality of Life , Skin Diseases/classification , Skin Diseases/therapyABSTRACT
The prevalence of infections in the immunocompromised host is increasing. The oral cavity is a primary or sole site in many cases. It is important for the practicing clinician to recognize the more common infections in this growing patient population. Oral examinations are an essential component of all physical examinations, especially when immunosuppression is known or suspected. We recommend that all patients starting immunosuppressive therapy receive a comprehensive oral examination before the institution of such therapy to eliminate potential sources of oral and odontogenic infections. The examination should include full mouth dental radiographs and a complete soft-tissue examination. Timely, accurate diagnoses may have important implications with regard to management, prognosis, cost, morbidity, and mortality.
