ABSTRACT
Apocrine hidrocystomas are benign, cystic tumours arising from the apocrine sweat gland. They usually present as a solitary papule or nodule in the periorbital area and it is uncommon for multiple lesions to appear. We present a case of multiple apocrine hidrocystomas on the nasal dorsum which became apparent after ablative laser treatment. We also review the literature for apocrine hidrocystoma, including their clinical presentation, histopathological findings and treatment options.
ABSTRACT
Australian general practitioners (GPs) commonly manage dermatological conditions requiring procedures. GP registrars have limited pre-vocational training exposure to dermatology and find skin problems challenging. We aimed to establish the prevalence, nature and associations of GP registrars' performance of skin procedures. We conducted a cross-sectional analysis from the Registrar Clinical Encounters in Training cohort study. Multivariable logistic regression was used to establish associations of our outcome (skin procedures, both including and excluding cryotherapy). Independent variables included patient and doctor demographics, diagnoses/problems managed and registrars' recourse to in-consultation assistance/information. A total of 1161 registrars provided data on 166,988 consultations, recording 2927 skin procedures (16.7% of all procedures; performed in 1.7% of consultations). Cryotherapy, excision, punch biopsy and shave biopsy were most common. More complex procedures were performed infrequently. Significant associations of performing procedures included rural/remote location (compared to major city), male patients, patient age 65+ (compared to age 15-34) and registrars seeking in-consultation information/assistance. Skin procedures were less likely for Aboriginal patients or those from non-English-speaking backgrounds. For non-cryotherapy procedures, rurality was not significantly associated, but significant differences were found between training regions. In summary, GP registrars perform fewer dermatological procedures compared to established GPs. Findings will inform GP vocational training in skin procedures.
Subject(s)
General Practice/education , Skin Diseases/therapy , Adolescent , Adult , Age Factors , Aged , Australia , Clinical Competence , Cross-Sectional Studies , Cryotherapy/methods , Cryotherapy/standards , Female , Humans , Logistic Models , Male , Middle Aged , Residence Characteristics , Self Concept , Sex Factors , Skin Diseases/diagnosis , Young AdultABSTRACT
BACKGROUND: Minocycline is a commonly prescribed tetracycline antibiotic used for the treatment of a number of dermatological conditions including acne and rosacea. Long-term adverse effects of minocycline include cutaneous hyperpigmentation. Various treatment options have been suggested for the treatment of minocycline pigmentation. We report a case of a patient on long-term low-dose minocycline for the treatment of rosacea with type III minocycline hyperpigmentation. A comparison was made between Q-Switch Nd:YAG and picosecond laser over a nine 9-period with treatments spaced 1 month apart, with a clearance in the patient pigmentation after four treatments with picosecond laser.
Subject(s)
Anti-Bacterial Agents/adverse effects , Hyperpigmentation/chemically induced , Hyperpigmentation/radiotherapy , Low-Level Light Therapy/instrumentation , Minocycline/adverse effects , Aged, 80 and over , Female , Humans , Lasers, Solid-State/adverse effects , Low-Level Light Therapy/adverse effectsABSTRACT
We describe three cases of hair loss in a female pattern hair loss (FPHL) distribution with histologic features of lichen planopilaris (LPP). All patients had a history of diffuse, gradual hair loss in a Christmas tree pattern that clinically presented as FPHL on gross and dermoscopic examination. Notably, there were no characteristic clinical signs of LPP and no histologic features of FPHL. These cases are most consistent with cicatricial pattern hair loss (CPHL). This relatively new entity is similar to fibrosing alopecia in a pattern distribution (FAPD) in that they are both scarring alopecias confined to a FPHL distribution, but CPHL lacks the clinical signs of perifollicular erythema and perifollicular keratosis seen in FAPD. These three cases may present an early, subtle form of CPHL and will be of interest to clinicians and histopathologists alike.
Subject(s)
Alopecia/pathology , Cicatrix/pathology , Lichen Planus/pathology , Adult , Aged , Alopecia/complications , Alopecia/diagnostic imaging , Cicatrix/complications , Cicatrix/diagnostic imaging , Dermoscopy , Female , Humans , Lichen Planus/complications , Lichen Planus/diagnostic imagingABSTRACT
Hypertrichosis cubiti is an uncommon congenital hypertrichosis with links to genetic syndromes, both autosomal dominant and recessive, with variable penetrance and expressivity. It may also present in sporadic cases with no phenotypic abnormalities or family history.
ABSTRACT
Basal cell carcinoma is the most common human malignancy in populations of European origin, and Australia has the highest incidence of basal cell carcinoma in the world. Great advances in the understanding of the genetics of this cancer have occurred in recent years. Mutations of the patched 1 gene (PTCH1) lead to basal cell carcinoma predisposition in Gorlin syndrome. PTCH1 is part of the hedgehog signalling pathway, and derangements within this pathway are now known to be important in the carcinogenesis of many different cancers including sporadic basal cell carcinoma. The molecular biology of the hedgehog pathway is discussed, and mouse models of basal cell carcinoma based on this pathway are explored. New developments in non-surgical treatment of basal cell carcinoma are based on this knowledge. Other genes of importance to basal cell carcinoma development include the tumour suppressor gene P53 and the melanocortin-1 receptor gene. In addition, we discuss molecules of possible importance such as the glutathione-S-transferases, DNA repair genes, cyclin-dependent kinase inhibitor 2A, Brahma and connexins. Evidence of familial aggregation of this cancer is explored and supports the possibility of genetic predisposition to this common malignancy.
Subject(s)
Carcinoma, Basal Cell/genetics , Receptors, Cell Surface/genetics , Skin Neoplasms/genetics , Animals , Basal Cell Nevus Syndrome/genetics , Basal Cell Nevus Syndrome/therapy , Carcinoma, Basal Cell/therapy , Disease Models, Animal , Genetic Predisposition to Disease , Hedgehog Proteins/genetics , Humans , Mice , Mutation , Patched Receptors , Patched-1 Receptor , Receptor, Melanocortin, Type 1/genetics , Skin Neoplasms/therapy , Tumor Suppressor Protein p53/geneticsABSTRACT
We report a patient with pyoderma gangrenosum successfully treated with intravenous immunoglobulin. He had previously been treated for 4 years with high-dose corticosteroids and had developed insulin-dependent diabetes mellitus. Multiple corticosteroid-sparing agents had failed or were contraindicated. He developed no adverse effects from intravenous immunoglobulin, which allowed reduction of his prednisone to 3 mg/day, and his ulcer has completely healed.
