Subject(s)
Skin Neoplasms , Female , Humans , Incidence , Male , Melanoma/epidemiology , Melanoma/prevention & control , Melanoma/surgery , Mohs Surgery , Skin Neoplasms/epidemiology , Skin Neoplasms/prevention & control , Skin Neoplasms/surgery , Sunburn , Sunscreening Agents , United States/epidemiologyABSTRACT
Most skin cancers can be managed effectively using standard therapeutic methods. However, specific subsets of skin cancers--including tumors that are recurrent, large, or aggressive, along with tumors located at sites of functional and cosmetic concern--provide a significant therapeutic challenge. Mohs micrographic surgery offers the greatest potential cor cure of difficult tumors, while providing for maximal preservation of healthy tissue. This paper describes the history of Mohs surgery, the technique, and the indications for its use.
Subject(s)
Carcinoma, Basal Cell/surgery , Carcinoma, Squamous Cell/surgery , Mohs Surgery/methods , Skin Neoplasms/surgery , Ambulatory Surgical Procedures , Humans , Mohs Surgery/statistics & numerical data , Treatment OutcomeSubject(s)
PUVA Therapy , Skin Transplantation , Vitiligo/therapy , Adult , Combined Modality Therapy , Female , HumansSubject(s)
Anesthesia, Conduction , Anesthesia, Local , Dermatologic Surgical Procedures , Adult , Anesthetics/administration & dosage , Anesthetics/adverse effects , Anesthetics/pharmacology , Anesthetics, Local/administration & dosage , Anesthetics, Local/adverse effects , Anesthetics, Local/pharmacology , Child , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/etiology , Drug Interactions , Epinephrine/adverse effects , HumansABSTRACT
Retinoids profoundly affect the normal growth and differentiation of epithelial tissues. Retinoic acid receptor-gamma (RAR-gamma) is a member of a family of retinoid receptors, and has been shown to be expressed almost exclusively in skin. However, little is known about the cellular localization of this receptor in human skin. The authors studied the expression of RAR-gamma in normal skin and human skin tumors by Northern blot analysis and in situ hybridization. RAR-gamma mRNA was detected in normal skin as well as in cultures of neonatal keratinocytes. Using an oligonucleotide specific for the RAR-gamma cDNA isoform 1 (RAR-gamma 1), RAR-gamma 1 mRNA was localized to all layers of the epidermis, the outer root sheath of hair follicles, follicular hair bulbs, eccrine and sebaceous glands. Basal cell carcinoma constitutively expressed gamma-1 mRNA and one of seven squamous cell carcinomas showed loss of gamma-1 mRNA expression, relative to adjacent epithelium. By contrast, normal melanocytic nevi and tumor-associated lymphocytes expressed little or no RAR-gamma mRNA. These results suggest that RAR-gamma 1 may play an important role in the maintenance and differentiation of normal epidermis and skin appendages.
Subject(s)
Carrier Proteins/metabolism , Skin Neoplasms/metabolism , Skin/metabolism , Blotting, Northern , Cells, Cultured , Humans , Nucleic Acid Hybridization , Receptors, Retinoic Acid , Reference Values , Skin/pathology , Skin Neoplasms/pathologyABSTRACT
A novel approach to the management of vitiligo is described using a combination of epidermal autografts transplanted into the depigmented areas and psoralen-ultraviolet-A (PUVA) therapy. Epidermal autografts can be obtained rapidly and in large numbers using a device that combines the synergistic effects of suction and heat on the skin. Subsequent exposure to PUVA therapy promotes spread of pigmentation out of the grafts resulting in even and complete pigmentation. In certain situations, the combination therapy appears to offer the potential for avoiding the disadvantages of both of the two treatments when they are used alone. This article presents our preliminary work in the development of the methodology for this combined approach.
Subject(s)
Epidermis/transplantation , PUVA Therapy , Vitiligo/drug therapy , Vitiligo/surgery , Combined Modality Therapy , Humans , Skin Pigmentation , Suction , Transplantation, Autologous/instrumentation , Transplantation, Autologous/methods , Vitiligo/pathologyABSTRACT
It is clear that central obesity is a strong predictor of multiple health risks. It appears likely that much of the influence for the preferential deposition of fat in these various stores is related to sex hormones, although other factors clearly play a role, including genetic, environmental, nutritional, and other factors. Whereas a great deal has been discovered about these relationships in the past 10 years, further study is necessary to clarify them and determine what role dietary and surgical interventions may play in the prevention and reversal of those risk factors.
