PubMed Health⌕ Search

Biomedical subjects

K F Helm

Publications and source records attributed to K F Helm.

At least 19 recordsLinked to original sources
PubMed2001

Poromas of the head and neck.

BACKGROUND: The "eccrine" poroma is a benign neoplasm previously thought to originate from the eccrine sweat gland. Early studies suggested that these were primarily lesions of the hairless acral surfaces. OBJECTIVE: This article reports the clinical and histologic findings of 10 cases of poroma of the head and neck area. METHODS: The clinical and histologic findings of 10 cases of poroma of the head and neck area are compared with 10 poromas occurring on the extremities. RESULTS: Some poromas demonstrated evidence for apocrine origin. Unlike poromas found on the extremities, head and neck poromas were usually asymptomatic and were never correctly diagnosed clinically. Although 9 of 10 poromas on the extremities occurred in male patients, the head and neck poromas showed no gender predilection. CONCLUSION: Clinicians should be aware that poromas can occur in the head and neck area and may be of apocrine origin.

Acrospiroma↗
PubMed2000

An unusually aggressive trichoblastoma.

Trichogenic tumors are neoplasms of the hair germ cell that usually exhibit benign behavior. We describe a case of a large invasive trichoblastoma requiring Mohs micrographic surgery for its removal. Immunohistochemical studies performed demonstrate overlapping features of this trichogenic tumor with basal cell carcinoma.

Dermatologic Surgical Procedures↗
PubMed2000

Pemphigus foliaceus successfully treated with mycophenolate mofetil as a steroid-sparing agent.

Pemphigus foliaceus is an autoimmune blistering disease of unknown origin with antibodies produced against desmoglein 1, an adhesive protein found in the desmosomal cell junction in the suprabasal layers of the epidermis. The disease is primarily treated with corticosteroids and corticosteroid-sparing immunosuppressive agents. We report a case of pemphigus foliaceus successfully treated with mycophenolate mofetil. It remains to be seen whether this agent has a significant effect on the course of the disease and remission induction.

Adult↗
PubMed2000

Inexpensive digital photography in clinical dermatology and dermatologic surgery.

Digital photography can be used to follow clinical improvement in a variety of dermatoses, document pre and postoperative results, and document histologic findings from skin biopsies. Images may be printed as part of text documents and can be filed in conventional medical charts. Images can be transmitted via electronic mail rapidly and to any location. We have found digital photography to be relatively inexpensive and a powerful tool to enhance dermatologic practice.

Dermatologic Surgical Procedures↗
PubMed2000

Spiny keratoderma.

Spiny keratoderma is a descriptive term used to encompass a variety of unusual, disparate keratodermas. Spiny keratoderma has been associated with lipid abnormalities and has been limited to the palms and soles in some individuals. We describe an acquired case of spiny keratoderma in which an adult woman developed filiform lesions predominating on the trunk and proximal extremities. Treatment with topical emollients and keratolytic agents was unsuccessful, but topical tazarotene led to long periods of resolution. She has had no other associated abnormalities. The clinical features and differential diagnosis of spiny keratoderma are reviewed.

Administration, Topical↗
PubMed1999

Cytokeratin 20: a marker for diagnosing Merkel cell carcinoma.

Merkel cell carcinoma is an aggressive cutaneous neoplasm that is often difficult to diagnose because of its histologic and immunohistochemical similarity to metastatic oat cell carcinomas and other cutaneous neoplasms. Our purpose was to determine the utility of immunoperoxidase staining of cytokeratin 20 (CK 20), a newly discovered intermediate filament protein, in Merkel cell carcinomas and other cutaneous tumors. Sixty-one tumors were sectioned and stained with antibodies directed at CK 20. The staining of Merkel cell carcinomas was compared with metastatic oat cell carcinomas, lymphomas, squamous cell carcinomas, basal cell carcinomas, melanomas, metastatic carcinoids, spiradenomas, eccrine carcinomas, adenoidcystic carcinoma, sebaceous carcinomas, hidradenomas, sebaceous epitheliomas, trichoblastomas, mixed tumors, and metastatic adenocarcinomas. Nine of 10 Merkel cell carcinomas stained with antibody to CK 20. Two metastatic carcinomas to the skin were also positive. One hidradenoma and one squamous carcinoma exhibited focal staining, but were otherwise negative. All other tumors were nonstaining. Cytokeratin 20 is a sensitive and specific marker for Merkel cell carcinoma and is helpful in distinguishing between Merkel cell carcinoma and other malignant and benign neoplasms.

Biomarkers, Tumor↗
PubMed1999

Rapidly growing squamous cell carcinoma.

BACKGROUND: Squamous cell carcinoma (SCC) may present with a history of rapid growth. Although multiple subtypes have been described regarding histologic characteristics and etiology, the subset of rapidly growing squamous cell carcinomas (RGSCC) has not been described. OBJECTIVE: To evaluate and describe the clinical and histologic characteristics of squamous cell carcinomas that grow rapidly. METHODS: Recorded clinical data and biopsies of 26 lesions with a history of rapid growth and histologically diagnosed as SCC were reviewed. RESULTS: Rapidly growing SCC occurred most commonly on the head and neck, followed by hands and extremities, and had an average duration of 7 weeks before diagnosis. The average size of the lesions was 1.29 cm and nearly 20% occurred in immunosuppressed patients. CONCLUSIONS: Some SCCs may grow rapidly. The reason for the rapid growth is not clear and several hypotheses are discussed including immunosuppression and viral etiology. These lesions should be treated aggressively as their behaviour and prognosis are not yet well described.

Aged↗
PubMed1998

Localized limb cutaneous metastases.

Cutaneous metastatic disease may be evident in a variety of forms and locations. Anatomically, it may on occasion be confined as localized limb metastases. We report on two patients with localized limb metastases, one from melanoma and the other from Merkel cell carcinoma. Patients with localized limb metastasis have a poor prognosis; however, treatment options not available for generalized cutaneous metastatic disease, such as amputation or isolated limb perfusion with chemotherapeutic agents, can be at times be beneficially employed.

Aged↗
PubMed1998

Sweet's syndrome without granulocytosis.

BACKGROUND: Sweet's syndrome (SS), acute febrile neutrophilic dermatosis, has been linked to hematologic malignancies and presents with characteristic edematous dermal plaques. Peripheral blood neutrophilia is frequently seen in association with SS and is one of the diagnostic criteria. OBJECTIVE: To report the clinical, laboratory, and hematologic data of four patients with myeloid leukemia who developed SS after chemotherapy. Three of these patients were neutropenic. METHODS: A retrospective study of four patients with SS and hematologic malignancies was undertaken. Three patients had de novo acute myelogenous leukemia and one was in the acute blast crisis of chronic myelogenous leukemia. RESULTS: Sweet's syndrome was not originally suspected in these patients because of the low peripheral white blood cell counts caused by chemotherapy. All of the patients presented with fevers, arthralgias, and an eruption. They had been treated with antibiotics because of a presumed infection. Once the correct diagnosis was made and oral prednisolone was started, a rapid response followed. CONCLUSIONS: Sweet's syndrome should be considered in the differential diagnosis when acute myeloid leukemic patients develop skin lesions and unexplained fevers regardless of the peripheral blood counts.

Acute Disease↗
PubMed1998

Utility of deeper sections and special stains for dermatopathology specimens.

Special (non-hematoxylin and eosin) stains and deeper sections are routinely used in dermathopathology, although their utility has not been well established. All cases requiring special stains or deeper sections over a three-month period were reviewed to see how often these additional studies contributed to accurate diagnosis. In our series, deeper sections provided diagnostic information to the pathologist in 37.3% [95% confidence interval (CI) 28-46%] of the cases in which they were performed. Deeper sections are more likely to provide a more accurate diagnosis (23.6%, 95% CI 16-32%) rather than establish a new diagnosis not seen on the original sections (13.6%, 95% CI 7-20%). Their use is especially helpful in assessing the presence or absence of cutaneous malignancy rather than in diagnosing inflammatory skin processes. Special stains contributed to the diagnosis in 21.1% (95% CI 11-32%) of cases. When special stains were performed to diagnose an infection they were effective in 14.7% (95% CI 6-24%) of the cases. When special stains were performed to diagnose any other pathologic processes (neoplasm, inflammation, collagen vascular disease, and amyloid) they were effective in 31.8% (95% CI 24-44%) of the cases.

Coloring Agents↗
PubMed1998

Diagnosing basal cell carcinoma by dermatoscopy.

BACKGROUND: Dermatoscopy (DS) has been used primarily to evaluate pigmented skin lesions. Little information is available on DS findings of basal cell carcinoma (BCC). Dermatoscopy is a noninvasive technique that allows visualization of cutaneous features from the skin surface to the papillary dermis. Basal cell carcinoma, the most common cutaneous malignancy, is traditionally diagnosed clinically and confirmed with biopsy. OBJECTIVE: To determine the dermatoscopic features of nonpigmented basal cell carcinomas. METHODS: The dermatoscopic findings of 27 lesions that clinically were suspicious for BCC were analyzed. RESULTS: Of these 27 clinically suspect lesions, the biopsies revealed BCC in 20 specimens and squamous cell carcinoma (SCC) in two specimens. Twenty of these 22 specimens had dermatoscopic findings of BCC: diffusely distributed, branching blood vessels, asymmetric, and narrow blood vessels distributed deeper in the dermis, or a milky-red corona with superficial wide blood vessels. One nodular BCC in our study showed no distinct findings. CONCLUSIONS: Many BCCs have characteristic DS findings; however, dermatoscopic examination of some tumours will not demonstrate any known characteristic findings. As such, the DS criteria we propose for BCC are best utilized as an adjunctive study of clinical impressions. Biopsy remains the definitive diagnostic tool.

Aged↗
PubMed1998

Acute hemorrhagic edema of infancy: Finkelstein's disease.

Acute hemorrhagic edema of infancy (AHEI) is a benign form of leukocytoclastic vasculitis limited to the skin, which occurs in children younger than 2 years of age. The abrupt onset of fever, peripheral edema, and purpuric targetoid plaques in an infant may be confused with other dermatoses such as Henoch-Schönlein purpura, Sweet's syndrome, erythema multiforme, or septic vasculitis. Laboratory studies of patients with AHEI typically show normal results and the disorder follows a benign course with spontaneous resolution occurring in 1 to 3 weeks. We present a case of AHEI occurring in a 7-month-old boy and review the characteristic features of this acute dermatosis.

Acute Disease↗
PubMed1997

The immunohistochemical characteristics of the basosquamous cell carcinoma.

BACKGROUND: The basosquamous cell carcinoma (BSCC) is a poorly defined and often misunderstood cutaneous malignancy. OBJECTIVE: The purpose of this study was to compare, using immunohistochemical techniques, the BSCC, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). METHODS: BSCC occurring at Pennsylvania State University over the past 10 years were identified. Choosing seven BCC, and nine SCC as controls, all specimens were stained for keratin, lack of apoptosis, glycoproteins, and altered gene products using the avidin/biotin and strep-avidin immunoperoxidase techniques. Each malignancy was then graded for the percentage of cells stained with each marker. RESULTS: Of the markers studied, all stained to varying degrees the malignant aspects of the specimens. There were similar patterns between tumors, with the BSCC showing a transition zone between typical BCC and SCC. This was most striking for Ber-EP4, where over two-thirds of the BCC stained, none of the SCC, and half of the BSCC showed reactivity. CONCLUSION: BSCC has staining patterns similar to both the BCC and SCC. The presence of a transition zone does not support the concept that all BSCC are collision tumors, but rather a differentiation of one tumor into another. We confirm earlier reports that Ber-EP4 could be used to distinguish between classic BCC and SCC. AE1/AE3, bcl-2, TGF-alpha, and p53 were not helpful in separating the tumors.

Basal Cell Carcinoma↗