PubMed Health⌕ Search

Biomedical subjects

J A Tschen

Publications and source records attributed to J A Tschen.

At least 19 recordsLinked to original sources
PubMed2001

Perineural invasion of cutaneous malignancies.

BACKGROUND: Perineural invasion is an important mode of tumor spread and is associated with increased aggressiveness and a propensity for recurrence among cutaneous malignancies. OBJECTIVE: To review the pathogenesis, diagnosis, and treatment of cutaneous tumors exhibiting perineural invasion. METHODS: This article is based on a review of the medical literature concerning tumors with perineural involvement. RESULTS: This article describes the clinical signs and histologic features of cutaneous malignancies exhibiting perineural involvement. CONCLUSION: Appropriate patient care mandates consideration of perineural invasion in the evaluation of cutaneous tumors. As the majority of patients present without symptoms of neural involvement, physicians must be vigilant in the search for this type of tumor spread.

Humans↗
PubMed2001

Verrucous carcinoma of the foot associated with human papillomavirus type 16.

BACKGROUND: We present 2 patients with verrucous carcinoma (VC) of the foot, a malignancy of unknown origin. OBJECTIVE: Molecular studies from the VCs were undertaken to determine the presence, type, and physical state of human papillomavirus (HPV) as well as the expression levels of certain oncogenes and antioncogenes. METHODS: Synthetic consensus and type-specific primers were used to determine the HPV type from both VCs via polymerase chain reaction (PCR). Verification of fragments was accomplished by means of specific isotope-labeled oligonucleotide probes. The physical state of HPV DNA was determined by two-dimensional gel electrophoresis. Quantitative oncogene and antioncogene expression studies were performed with the use of reverse transcriptase PCR. RESULTS: HPV type 16 was identified in episomal and integrated forms in both tumors. Expression studies revealed increased messenger RNA levels of c-Ki-ras oncogene and the p53 antioncogene and decreased messenger RNA levels of the Rb antioncogene in both VCs. CONCLUSION: Episomal and integrated forms of HPV-16 DNA were found in VCs of the foot, along with alterations of c-Ki-ras, p53, and Rb genes.

Carcinoma, Verrucous↗
PubMed2001

Erythema elevatum diutinum mimicking extensive keloids; quiz 386.

GOAL: To describe a case of erythema elevatum diutinum (EED) that clinically mimicked extensive keloids. OBJECTIVES: Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Describe the clinical presentation and lesion appearance in EED. 2. Discuss the electron microscopic and laboratory findings of EED. 3. Outline treatment options for EED. CME: This article has been peer reviewed and approved by Michael Fisher, MD, Professor of Medicine, Albert Einstein College of Medicine. REVIEW DATE: April 2001. This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Albert Einstein College of Medicine and Quadrant HealthCom, Inc. The Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians. Albert Einstein College of Medicine designates this educational activity for a maximum of 1.0 hour in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. This activity has been planned and produced in accordance with ACCME Essentials.

Dapsone↗
PubMed2000

Comparison of S-100 versus hematoxylin and eosin staining for evaluating dermal invasion and peripheral margins by desmoplastic malignant melanoma.

Desmoplastic malignant melanoma (DMM) is a rare and locally aggressive variant of malignant melanoma, which is difficult to diagnose clinically and microscopically. A retrospective study of 21 DMM were collected during 7 years, representing 1.7% of melanomas. By comparing S-100 and hematoxylin and eosin (H & E) staining in DMM, we sought to determine whether S-100 staining offered a more accurate means of assessing dermal and neural invasion, tumor thickness, and peripheral margins. Eleven cases were excluded because the tumor extended past the deep margin. Six cases that were stained with S-100 showed a greater tumor thickness than by H & E (difference of 0. 13 to 2.79 mm). In two cases, the tumor thickness was greater by using H & E than S-100, and there was no difference in the remaining two cases. Of the eight cases in which the peripheral margins were positive by S-100, neoplastic cells were only apparent at those margins in four cases when examined with H & E. The remaining two cases showed negative margins by both stains. Clinical follow-up was obtained from nine cases, and none had recurrence of melanoma. Particularly for hypocellular and amelanotic tumors, S-100 staining proved to be a valuable adjunct in determining the extent of the tumor at the peripheral margins.

Adult↗
PubMed1999

Scleromyxedema: treatment with interferon alfa.

Scleromyxedema is a variant of papular mucinosis characterized by fibroblast proliferation and mucin deposition in the dermis. Historically, it has been very difficult to treat and can cause significant morbidity and mortality with systemic involvement. We describe a case of a woman with scleromyxedema and systemic manifestations treated with interferon alfa. Her skin responded very well to therapy within 3 months; however, her systemic manifestations showed little change. We conclude that interferon alfa may be a useful therapy for patients with scleromyxedema, particularly if the disease process is limited to the skin.

Biopsy↗
PubMed1999

Primary carcinosarcoma of the skin: report of a case and review of the literature.

BACKGROUND: Carcinosarcoma is a biphasic tumor composed of intimately admixed epithelial and mesenchymal elements, both of which are malignant. Primary cutaneous involvement is extremely rare. Therefore it has been difficult to characterize the clinical course of carcinosarcoma of the skin. OBJECTIVE: To describe a further case of carcinosarcoma of the skin and to provide a review of the literature. METHODS: The clinical records of the patient and histopathology of the neoplasm are reviewed. In addition, the results of all previously reported cases of carcinosarcoma of the skin are compiled for reexamination. RESULTS: After complete excision of the carcinosarcoma, the patient shows no evidence of disease for 9 months. Long-term follow-up is needed because of the risk of recurrence or metastasis that may occur with this neoplasm. CONCLUSION: Carcinosarcoma of the skin appears to be associated with a good prognosis when compared with similar tumors located elsewhere. Metastasis (with or without documented mortality) has been reported in 3 of 16 patients (16.7%). Death from local disease has been reported in one additional patient (6.3%). However, further cases with long-term follow-up are needed in order to better understand the nature of this cutaneous neoplasm.

Aged↗
PubMed1999

Recurrent sclerotic fibroma of the skin.

The pathologic findings of a sclerotic fibroma of the skin may resemble those of other benign cutaneous lesions. In this report, the sequential pathologic changes of a recurrent sclerotic fibroma of the skin during a period of 7 years are documented. As the lesion became older, there was not only a decrease in cellularity, but also a progressive organization of the collagen bundles toward a "plywood-like" appearance.

Adult↗
PubMed1998

Syringomatous changes of eccrine sweat ducts associated with prurigo nodularis.

Alteration of the eccrine sweat ducts has been observed in association with an expanding list of conditions. To our knowledge, this phenomenon has not been described in association with prurigo nodularis. We report on a 68-year-old man with a fibrotic nodule on his chin that had been present for 8 months. Microscopic examination showed marked hyperkeratosis overlying the epithelium. There was also hypergranulosis, marked acanthosis, and irregular elongation of the rete ridges. These findings were consistent with prurigo nodularis. In addition, within the reticular dermis, there was marked fibrosis and a proliferation of eccrine sweat ducts. The ducts were enlarged and varied from cystic to rarely solid structures. Rare ducts formed a tadpole-shaped tail, reminiscent of syringoma. The duct lining demonstrated a multilayered epithelium that was three to eight cells thick, yielding a solid component to some of the cysts. Although some of these features were similar to those of a syringoma, the typical small gland proliferation and bilayered lining was not evident. This case (a) demonstrates the association of syringomatous changes of eccrine sweat ducts with yet another condition, prurigo nodularis, and (b) emphasizes the importance of differentiating this benign reactive process from the malignant neoplasms microcystic adnexal carcinoma and squamous cell carcinoma.

Aged↗
PubMed1997

Follicular mucinosis associated with scarring alopecia, oligoclonal T-cell receptor V beta expansion, and Staphylococcus aureus: when does follicular mucinosis become mycosis fungoides?

A diagnosis of alopecia mucinosa, occurring as a single scalp lesion, was made in a 40-year-old white woman who had a history of trauma. Follicular mucinosis, Staphylococcus aureus, and oligoclonal expansion of the T-cell receptor V beta chain genes 6 and 7 were present in the skin. Epidermotropic T-cell skin diseases with oligoclonal T-cell proliferations may be the result of HLA- and cytokine-determined reaction patterns to persistent antigens.

Adult↗
PubMed1997

Segmental neurofibromatosis: case reports and review.

Segmental neurofibromatosis (neurofibromatosis type V) is a rare disorder characterized by café-lu-lait macules and neurofibromas, or only neurofibromas, limited to one region of the body. Three patients with segmental neurofibromatosis are described, and cases of this condition in the world literature are reviewed. Segmental neurofibromatosis has only been described in 82 patients, including our three. The median age at onset was 28 years and the incidence was higher in women (58%). The neurofibromas most commonly occupied either a cervical or thoracic dermatome and were unilateral, occurring more often on the right side (43 patients) than the left (34 patients). Café-au-lait macules were present in 26% of patients. Axillary freckling was described in only nine patients. Disease-associated systemic involvement was uncommon. Most patients with segmental neurofibromatosis (93%) do not have a family history of neurofibromatosis.

Adult↗
PubMed1996

Cutaneous lesions due to Pleurophoma (Phoma) complex.

We report a case of striking and disfiguring facial mycosis due to an organism belonging to the Pleurophoma complex of Coelomycetes. This condition was likely acquired through repeated contact with infected soil and exacerbated by prolonged applications of topical corticosteroid preparations. Antifungal drug susceptibility testing was used to direct a therapeutic choice in this unusual infection.

Adult↗
PubMed1995

Evidence that a low-fat diet reduces the occurrence of non-melanoma skin cancer.

The effect of a low-fat diet on occurrence of non-melanoma skin cancer was examined in a 2-year dietary intervention trial. A total of 101 skin-cancer patients were randomized either to a control group that consumed, on average, 38% of caloric intake as fat, and in which no changes in dietary habits were introduced, or to a low-fat dietary-intervention group, in which patients were instructed to limit their calories from fat to 20% of total caloric intake. Patients were examined at 4-month intervals by dermatologists blinded to their dietary assignments. Nutrient analyses, conducted at each of the 4-month follow-up visits, indicated that the % calories of fat consumed in the intervention group had been reduced to 21% at 4 months and remained below this level throughout the 2-year period. There were no significant differences in total calories consumed, or in mean body weights, between the control and the intervention groups. Nor were there significant group differences in P/S ratios until month 24. Numbers of new skin cancers treated at each examination were analyzed in 8-month periods of the 2-year study. Comparisons of skin-cancer occurrences revealed no significant changes in the control group from baseline values. However, cancer occurrence in the low-fat intervention group declined after the first 8-month period and reached statistical significance by the last 8-month period. Patients in this group had significantly fewer cancers in the last 8-month period than did patients in the control group. In addition, there was a significant reduction in the number of patients developing skin cancer in the last 8-month period, as compared with the first 8-month period, within the low-fat intervention group. There were no significant changes in the control group. These data indicate that a low-fat diet can significantly reduce occurrence of a highly prevalent form of cancer.

Carcinoma↗