ABSTRACT
BACKGROUND: Benign familial pemphigus (BFP) is a chronic blistering disease with significant morbidity. Surgical methods are often needed to control flares in difficult cases. OBJECTIVE: To describe the response of BFP to vaporization with a pulsed carbon dioxide (CO2) laser. METHODS: A 38-year-old woman with chest and axillary involvement unresponsive to conventional therapy was treated with the UltraPulse 5000 Laser (Coherent Medical Group, Palo Alto, CA). After active sites of BFP showed good response to treatment, we treated uninvolved skin of the left axilla to assess the efficacy of prophylactic therapy. RESULTS: Treatment of affected areas, except biopsy sites, resulted in clearing of active lesions after 1-2 weeks. We noted striking sparing of the treated areas from developing subsequent disease. The region that was later treated prophylactically has shown minor, asymptomatic recurrence of BFP in less than 5% of the area treated over an 18-month follow-up period. CONCLUSION: The pulsed carbon dioxide laser is a useful modality in treatment of BFP. In our patient, prophylactic treatment led to near complete eradication of disease in the treated area. A controlled, larger study is needed to confirm our results, and to determine optimal laser parameters. Long-term effects and duration of remission remain to be determined.
Subject(s)
Laser Therapy , Pemphigus, Benign Familial/surgery , Adult , Axilla , Biopsy , Female , Humans , Pemphigus, Benign Familial/diagnosis , Pemphigus, Benign Familial/pathology , Recurrence , Skin/pathology , Thorax , Treatment OutcomeABSTRACT
Tufted angioma is a rare acquired cutaneous angiomatous proliferation characterized by slowly spreading erythematous macules and plaques, sometimes surmounted by nodular formations. Synonyms are progressive capillary hemangioma and Nakagawa's angioblastoma. Tufted angioma appears to be benign since follow-up studies did not report malignant transformation. This lesion must be distinguished from other vascular tumors, especially from Kaposi's sarcoma. If this lesion appears in an older patient, angiosarcoma should be excluded.
Subject(s)
Hemangioma, Capillary/pathology , Skin Neoplasms/pathology , Child, Preschool , Diagnosis, Differential , Female , Hemangioma/diagnosis , Hemangioma/pathology , Hemangioma/surgery , Hemangioma, Capillary/diagnosis , Hemangioma, Capillary/surgery , Humans , Skin Neoplasms/diagnosis , Skin Neoplasms/surgerySubject(s)
Autoimmune Diseases/diagnosis , Crohn Disease/diagnosis , Polychondritis, Relapsing/diagnosis , Autoimmune Diseases/etiology , Autoimmune Diseases/pathology , Biopsy , Crohn Disease/etiology , Crohn Disease/pathology , Diagnosis, Differential , Ear Cartilage/pathology , Humans , Male , Middle Aged , Polychondritis, Relapsing/etiology , Polychondritis, Relapsing/pathologyABSTRACT
We report the case of a 77-year-old man with a recurrent malignant clear cell hidradenoma. Establishing histopathological criteria of malignancy for these tumors can be difficult as nuclear anaplasia may be slight to moderate or even absent; however, in contrast to the benign form, malignant clear cell hidradenoma tends to invade the surrounding tissue. As these tumors can show a high rate of local recurrence (50%) and may even metastasize to lymph nodes, bone or visceral organs, wide surgical excision should be performed after the initial diagnosis.
