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L F Glass

Publications and source records attributed to L F Glass.

44 records · Page 3Linked to original sources
PubMed1992

Alkaptonuria and ochronosis: case report and review.

Alkaptonuria is a rare genetic disorder in which the enzyme homogentisic acid oxidase is deficient, resulting in the accumulation of homogentisic acid in various bodily tissues. This is a multisystem disorder with a characteristic blue-black discoloration of the skin and cartilage, which is termed ochronosis. Herein we report a profound case of ochronosis secondary to alkaptonuria. Furthermore, we review the clinical manifestations of alkaptonuria and discuss the spectrum of ochronosis, both endogenous and exogenous.

Aged↗
PubMed1991

Morsicatio buccarum et labiorum (excessive cheek and lip biting).

In some individuals habitual cheek and lip biting becomes a fixed neurosis. Pieces of oral mucosa are actually torn free from the surface, producing a distinctive clinical appearance termed morsicatio buccarum et labiorum. Sometimes it may be confused with other dermatological disorders involving the oral mucosa, and can lead to misdiagnosis. Most patients with this condition are unaware of their habit and will not aid in the diagnosis. We suggest that the histopathological features of this condition are distinctive, if not pathognomonic, and that an accurate diagnosis should be rendered if a biopsy sample is taken. Two cases are reported herein that were originally misdiagnosed as pemphigus, one of which resulted in complications of improper oral corticosteroid use.

Adult↗
PubMedDate not supplied

Selective lymphadenectomy in patients with Merkel cell (cutaneous neuroendocrine) carcinoma.

BACKGROUND: Merkel cell carcinoma (MCC) is an aggressive cutaneous tumor with a propensity for local recurrence, regional and distant metastases. There are no well-defined prognostic factors that predict behavior of this tumor, nor are treatment guidelines well established. METHODS: Staging of patients with a new diagnosis of MCC was attempted using selective lymphadenectomy concurrent with primary excision. Preoperative and intraoperative mapping, excision, and thorough histologic evaluation of the first lymph node draining the tumor primary site [sentinel node] was performed. Patients with tumor metastasis in the sentinel node underwent complete resection of the remainder of the lymph node basin. RESULTS: Twelve patients underwent removal of 22 sentinel nodes. Two patients demonstrated metastatic disease in their sentinel lymph nodes, and complete dissection of the involved nodal basin revealed additional positive nodes. The node-negative patients received no further surgical therapy, with no evidence of recurrent local or regional disease at a maximum of 26 months follow-up (median 10.5 months). CONCLUSIONS: While the data are preliminary and initial follow-up is limited, early results suggest that sentinel lymph node mapping and excision may be a useful adjunct in the treatment of MCC. This technique may identify a population of patients who would benefit from further surgical lymph node excision.

Biopsy↗
PubMedDate not supplied

Histopathologic study of recurrent Clark level II melanomas.

Overall, the prognosis for thin lesions of melanoma (less than 0.76 mm) is excellent. However, a number of melanoma patients with seemingly innocuous lesions have been reported to develop recurrences. For this reason, we examined histologic sections taken from eight cases of Clark level II melanoma that unexpectedly recurred, and compared their histopathologic features with an equal number of nonrecurrent lesions in whom reliable clinical follow-up data were available. Prognostic variables including Breslow thickness, mitotic rate, ulceration, the presence or absence of regression, a vertical growth phase component, and an associated banal nevus were evaluated in a double blind manner. When attempts were made to predict outcome based on one or more prognostic variables, the only correlation of statistical significance was the Breslow thickness (P = 0.04). A Breslow thickness greater than 0.4 mm was associated with a significantly shorter disease free interval than a thickness below 0.4 mm. There was no significant correlation between predicted outcome based on the histologic features examined and the eventual outcome based on history of recurrence (P = 0.36). These data indicate that although prognostic models that predict outcome in melanoma are generally reliable, there is a sizable population of patients with thin melanomas that do worse than would be expected.

Adult↗