Biomedical subjects
Publications and source records attributed to C Oster-Schmidt.
We report the first two cases of squamous cell carcinoma successfully treated with imiquimod 5% cream as a monotherapy. Imiquimod is a new immunomodulating drug that is registered for genital HPV infection but has also shown good efficacy in several cutaneous malignancies.
Basal cell carcinomas of the foot are absolutely rare. We describe the case of a 72-year-old female patient who developed a multicentric superficial BCC present on the lateral edge of the right foot. The patient remembers the regular control of the fit of footwear by an X-ray apparatus, the so-called shoe fluoroscope (=Pedoskop in Germany). Probably this may be a hardly estimated risk factor in the genesis of BCC of the foot.
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Malignant melanomas normally arise at the dermoepidermal junction. Development of these tumours in deeper layers of the dermis without having contact with the junction is rare. A small congenital melanocytic nevus localized in the region of the waist band was excised because of mechanical irritation; it had not shown any changes over years. A thorough examination of the whole body did not give any clue to a malignant melanoma. Histologically a compound nevus with the typical architecture of a congenital melanocytic nevus was found. In the deeper dermis there was an isolated nodule of extremely atypical melanocytes with minimal pigmentation of melanin. S100 antigen could be demonstrated throughout the whole tumour whereas HMB45 was only found at the dermoepidermal junction. There was no marking of the tumour cells with a pancytokeratin antibody. A histological relationship between the new tumour and a mixed tumour of the left testicle, which had been excised 3 years ago, could be excluded. We did not find any metastases neither by image-aided methods nor by sentinel lymph node biopsy.
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Therapy of Darier disease is rarely satisfactory. Oral retinoids can improve the skin lesions. Because of previous positive results with topical retinoids, which were often not practical because of marked skin irritation, two patients were treated with the new, topical acetylene-retinoid tazarotene in a 0.01% gel preparation. In both patients skin cleared within 2 to 4 weeks. After stopping the medication patients did not develop any new skin lesions for 12 months. In a third patient, healing with tazarotene gel 0.025% was faster than with a topical preparation containing 10% urea. Tazarotene is an important addition to the therapeutic possibilities in Darier disease.
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We report the case of a 78-year-old woman with a symmetrical type of cyanosis circumscripta e lipomate above both knees. Clinical symptoms, pathogenesis and possible treatments are presented.
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