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1.
Int J Dermatol ; 47(1): 59-60, 2008 Jan.
Article in English | MEDLINE | ID: mdl-18173605

ABSTRACT

A 27-year-old woman presented with linear, flesh-colored papules along her vermillion borders, 4 years after a cosmetic lip tattoo was applied. A biopsy of the lesion was performed and histology showed it to be a granulomatous reaction surrounding the tattoo pigment. Following the biopsy, the lesions began to resolve spontaneously within 4 weeks and were not noticeable at a follow-up review. Granulomatous reactions are rare after cosmetic facial tattoos and may respond to topical corticosteroids or laser ablation. We present a unique report of a delayed granulomatous reaction to a cosmetic tattoo completely resolving without any specific treatment.


Subject(s)
Coloring Agents/adverse effects , Cosmetic Techniques/adverse effects , Granuloma, Foreign-Body/etiology , Lip Diseases/pathology , Tattooing/adverse effects , Adult , Biopsy , Female , Granuloma, Foreign-Body/pathology , Humans , Mucous Membrane/pathology , Remission, Spontaneous
2.
Australas J Dermatol ; 47(4): 266-9, 2006 Nov.
Article in English | MEDLINE | ID: mdl-17034469

ABSTRACT

A 65-year-old man presented with a history of multiple skin coloured papules on his face that were asymptomatic. He had an adenocarcinoma resected from his proximal colon 12 years prior to presentation as well as a family history of colon cancer on the maternal side. Diagnostic biopsies showed the lesions to be sebaceous adenomas and epitheliomas and the diagnosis of Muir-Torre syndrome was made. The sebaceous tumour tissue showed microsatellite instability and immunohistochemical staining indicated diminished expression in the DNA mismatch-repair protein complex MSH2/MSH6. Genetic analysis showed a germline mutation in the MSH2 gene confirming the diagnosis of Muir-Torre syndrome. The patient and his first-degree relatives have been referred for genetic counselling and screening. We review the diagnostic criteria in this syndrome and review the recommended screening guidelines.


Subject(s)
Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis , Colorectal Neoplasms, Hereditary Nonpolyposis/genetics , Genetic Predisposition to Disease , Sebaceous Gland Neoplasms/diagnosis , Sebaceous Gland Neoplasms/genetics , Aged , Colorectal Neoplasms, Hereditary Nonpolyposis/pathology , DNA Mismatch Repair , Diagnosis, Differential , Face/pathology , Genetic Testing/standards , Humans , Male , Practice Guidelines as Topic , Sebaceous Gland Neoplasms/pathology
4.
Australas J Dermatol ; 47(2): 134-6, 2006 May.
Article in English | MEDLINE | ID: mdl-16637812

ABSTRACT

A 59-year-old woman undergoing narrowband UVB phototherapy for treatment of psoriasis presented suddenly with tense blisters on both hips. The blisters were asymptomatic and disappeared within 24 hours. Histopathology together with a negative porphyrin screen made the diagnosis of pseudoporphyria. Blood tests including a full blood count, urea and electrolytes, liver function tests and antinuclear autoantibodies were normal. The patient was otherwise healthy; there was no history of extensive sun exposure, sunbeds or medication with non-steroidal anti-inflammatory drugs. This presentation of pseudoporphyria secondary to narrowband UVB radiation is unusual, as UVB radiation is not known to be associated with pseudoporphyria.


Subject(s)
Porphyrias/diagnosis , Psoriasis/radiotherapy , Ultraviolet Rays/adverse effects , Ultraviolet Therapy/adverse effects , Diagnosis, Differential , Female , Humans , Middle Aged , Porphyrias/etiology , Porphyrias/pathology , Psoriasis/pathology
5.
Australas J Dermatol ; 47(1): 46-8, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16405483

ABSTRACT

SUMMARY The short-term efficacy of imiquimod 5% cream for the treatment of primary superficial basal cell carcinoma has been established. This study investigated its efficacy following curettage (without electrodesiccation) for the treatment of primary nodular basal cell carcinoma on the trunk and limbs. Seventeen patients with a total of 34 lesions were enrolled. Curettage was used to de-bulk the lesion and confirm suitable histology. Lesions displaying more aggressive subtypes (such as micronodular or morpheoic components) were excluded. Lesions were treated daily for 6 to 10 weeks with imiquimod 5% cream. Three months post treatment all lesions were excised, and 32 of 34 treated lesions (94%) were histologically clear of basal cell carcinoma. Fourteen of 17 patients rated the cosmetic outcome of treatment as excellent or good. Curettage followed by imiquimod 5% cream is effective for the treatment of primary nodular basal cell carcinoma on the trunk and limbs, and most patients are pleased with the cosmetic outcome.


Subject(s)
Aminoquinolines/therapeutic use , Antineoplastic Agents/therapeutic use , Carcinoma, Basal Cell/therapy , Skin Neoplasms/therapy , Administration, Topical , Adult , Aged , Biopsy, Needle , Carcinoma, Basal Cell/pathology , Combined Modality Therapy , Curettage/methods , Emollients/therapeutic use , Female , Follow-Up Studies , Humans , Imiquimod , Immunohistochemistry , Male , Middle Aged , Neoplasm Staging , Pilot Projects , Risk Assessment , Single-Blind Method , Skin Neoplasms/pathology , Treatment Outcome
6.
Photodermatol Photoimmunol Photomed ; 21(5): 229-33, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16149934

ABSTRACT

BACKGROUND: Both pigmentation and non-pigmentary processes contribute to the development of photoadaptation yet the exact contribution of either in the resting state and in response to ultraviolet (UV) radiation is unclear. The purpose of this study was to estimate independently these changes occurring in the epidermis following repeated exposure to UV in two groups with differing degrees of constitutive pigmentation. METHODS: We describe a mathematical model for explaining the spectral absorbance of excised human epidermis based on the absorbance of constituent chromophores. The model was applied to spectral absorbance data measured on samples of epidermis excised from pre-irradiated skin and from skin obtained following UV irradiation on 3 successive days. RESULTS: We found that in Asian skin there was only a mild photoadaptive response, principally by a small increase in pigmentation. On the other hand, the significant adaptive response in Caucasian skin was through hyperplasia of the epidermis, with tanning contributing only to a much smaller degree. CONCLUSION: This study has enabled us to study independently the pigmentary and non-pigmentary pathways and has shown that in those people with a lower degree of constitutive pigment, the primary mechanism of photoadaptation is via the non-pigmentary route.


Subject(s)
Adaptation, Physiological , Epidermis/metabolism , Models, Biological , Skin Pigmentation/radiation effects , Ultraviolet Rays , Asian People , Epidermis/pathology , Female , Humans , Hyperplasia , Male , Spectrophotometry, Ultraviolet , White People
7.
Pigment Cell Res ; 18(3): 220-3, 2005 Jun.
Article in English | MEDLINE | ID: mdl-15892719

ABSTRACT

Pheomelanin is widely thought to be causally related to susceptibility to the harmful effects of ultraviolet radiation: epidemiological studies show that those with a higher ratio of pheomelanin to eumelanin in hair have higher rates of melanoma, and work in mouse and cell culture shows that pheomelanin generates excess free radicals after UVR exposure. By contrast, based on measurements of eumelanin and pheomelanin in human skin, before and following irradiation, we now report that both pheomelanin and eumelanin are positively related to skin colour, and by inference, inversely with cancer susceptibility. The ratio of melanin classes is similar in people with widely different cancer rates and UVR sensitivity. Although our numbers are small, our results extend previous work in man, and lead us to speculate that factors other than the amount of pheomelanin may be important in determining UVR susceptibility in persons with red hair.


Subject(s)
Epidermis/chemistry , Epidermis/radiation effects , Melanins/radiation effects , Ultraviolet Rays , Epidermis/metabolism , Humans , Melanins/analysis , Melanins/metabolism
8.
J Invest Dermatol ; 123(5): 965-72, 2004 Nov.
Article in English | MEDLINE | ID: mdl-15482486

ABSTRACT

The dynamics of human pigmentation in response to ultraviolet radiation (UVR) remain poorly characterized. In part, this is attributable to methodological issues relating to the overlap in spectra of hemoglobin and melanin. We describe a new method, based on the recording of reflectance properties following iontophoresis of a potent vasoconstrictor, noradrenaline. This removes the influence of blood, allowing measurement of pigmentation, represented as L* on the L*a*b* scale. Blood flow was separately assessed using laser Doppler flowmetry. We show that there is a clear dose response with the dose of UVR administered, that pigmentation peaks at 1 wk and declines over the following 10 wk, but does not return to baseline within this period. We show clear differences in the degree, but not the temporal pattern of pigmentation between different pigmentary groups. We also report that the relation between facultative pigment and constitutive pigment is incomplete, with a wide scatter of responses for the development of pigmentation irrespective of constitutive levels. For comparison we also document overall photoadaptation and relate changes in pigmentation to the overall changes in photoadaptation.


Subject(s)
Adaptation, Physiological/radiation effects , Erythema/diagnosis , Erythema/physiopathology , Skin Pigmentation/radiation effects , Skin/radiation effects , Adaptation, Physiological/physiology , Female , Hair Color , Humans , Iontophoresis , Male , Norepinephrine , Regional Blood Flow/drug effects , Regional Blood Flow/radiation effects , Skin/blood supply , Skin Pigmentation/physiology , Sympathomimetics , Ultraviolet Rays/adverse effects
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