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M L McCollough

Publications and source records attributed to M L McCollough.

35 records · Page 2Linked to original sources
PubMed1996

Tattoo pigment mimicking metastatic malignant melanoma.

BACKGROUND: The benefits of elective lymph node dissection (ELND) in the treatment of melanoma remain controversial, however, it may be beneficial in some patients. Tattoo pigment from decorative tattoos may migrate to the regional lymph nodes. In patients who develop malignant melanoma and who have been tattooed, this pigment may clinically mimic metastatic disease. OBJECTIVE: We wish to alert clinicians that pigment from tattoos may migrate to the regional lymph nodes. In the unusual instance of a tattooed patient who develops malignant melanoma, when undergoing ELND, surgeons should rely on histologic confirmation of metastatic disease before altering operative plans. METHODS: ELND for malignant melanoma, in a patient with a history of decorative tattoos that had been removed by dermabrasion, was performed. Black lymph nodes that clinically resembled metastatic disease were identified. Subsequent histologic examination revealed normal lymph node architecture with a heavy collection of black pigment. Mass spectrophotometry showed this pigment to be consistent with tattoo dye. RESULTS: A patient who had undergone dermabrasion for removal of decorative tattoos developed malignant melanoma in the same extremity. Clinically suspicious black lymph nodes were identified during ELND. Histologic examination did not reveal metastatic disease. Additional therapy was not considered intra- or postoperatively even though the clinical suspicion of metastatic disease was high. The patient was not subjected to any unnecessary emotional or physical distress pending histologic confirmation. CONCLUSIONS: Tattoo pigment in the lymph nodes may clinically mimic metastatic melanoma. Histologic confirmation of metastatic disease should always be obtained before additional therapy is considered.

Adult↗
PubMed1996

A pigmented scalp nodule: malignant blue nevus.

The malignant blue nevus is an aggressive dermal melanocytic neoplasm. The lesion occurs most frequently on the scalp of men in their fifth decade of life, often metastasizes to the regional lymph nodes, and commonly results in fatality. Controversy exists as to whether this lesion is a malignant melanoma in the dermis or a separate neoplasm arising in the architecture of a cellular blue nevus. The lesion is treated with wide local excision and close monitoring for the occurrence of metastatic disease.

Diagnosis, Differential↗
PubMed1995

Vertical and transverse sections of alopecia biopsy specimens: combining the two to maximize diagnostic yield.

BACKGROUND: Traditional vertical sections of scalp biopsy specimens contain few hair follicles. For this reason transverse sections of scalp biopsy specimens have been advocated. Both methods have advantages and disadvantages. We have developed a simple method that we believe offers the best of both methods. OBJECTIVE: Our purpose was to assess the impact of combining vertical and transverse sections of scalp biopsy specimens. METHODS: Two 4 mm punch biopsies are performed. One specimen is bisected vertically: half for hematoxylin-eosin (H-E) staining, half for direct immunofluorescence. The second specimen is bisected transversely and submitted for H-E. The three pieces of tissue for H-E staining are embedded in a single cassette. RESULTS: Because a biopsy specimen for direct immunofluorescence is commonly obtained in cases of alopecia, our method does not add a surgical procedure. All three pieces of tissue for H-E staining are embedded in a single paraffin block. Therefore the cost of histologic interpretation is not increased. Our diagnostic yield improved. Transverse sections were superior in cases of lupus erythematosus and lichen planopilaris with focal follicular involvement. Features of the follicular degeneration syndrome were also best demonstrated in transverse sections. Interface changes, lupus panniculitis, miniaturized hairs, and trichomalacia were better demonstrated in vertical sections. CONCLUSION: Our method exploits the advantages of both vertical and transverse sections and improves diagnostic yield without increasing cost.

Alopecia↗
PubMed1995

Acute cutaneous reactions to docetaxel, a new chemotherapeutic agent.

BACKGROUND: Docetaxel (RP 56976) is a new chemotherapeutic agent that has shown promise in a number of animal studies and is currently undergoing phase I and phase II trials. Early in the phase I trials, it was noted that a significant number of patients were experiencing a variety of cutaneous complaints, so we elected to prospectively evaluate the cutaneous reactions occurring during the first three courses of therapy in the first 12 patients enrolled for phase I chemotherapy at our institutions. OBSERVATIONS: All but one patient had some type of cutaneous eruption over the three courses of therapy. Of the 27 evaluable courses of docetaxel given, 19 (70%) resulted in a cutaneous eruption with four (21%) being asymptomatic and 15 (79%) being at least mildly symptomatic. The most common reaction seen was characterized by discrete erythematous to violaceous patches or edematous plaques similar to acral erythema. CONCLUSION: Although a majority of patients receiving docetaxel experience some degree of cutaneous reaction, the eruptions are usually mildly symptomatic and almost always self-limiting.

Acute Disease↗
PubMed1992

Neuroendocrine carcinoma of the skin (Merkel cell carcinoma) in a black.

Neuroendocrine carcinoma of the skin is an uncommon, small-cell neoplasm most commonly found on white, sun-exposed skin. Diagnosis by clinical and histologic means may be difficult. Immunohistochemical and ultrastructural analysis are often required. Because of the aggressive nature of neuroendocrine carcinoma of the skin, prompt diagnosis and treatment are essential. We present the rare occurrence of a neuroendocrine carcinoma of the skin on sun protected skin in a black. Clinical, histologic, immunohistochemical, and ultrastructural features are reviewed, and therapeutic options are discussed.

Black People↗
PubMed1991

Orbital dermoid cysts showing conjunctival epithelium.

The orbital area is one of the most common sites for dermoid cysts. Most often these cysts are lined by keratinizing squamous epithelium; however, dermoid cysts may rarely be lined with conjunctival epithelium. We describe such a cyst and the features that distinguish it from other dermoid cysts.

Adult↗
PubMed1990

Hypergammaglobulinemic purpura of Waldenström.

Hypergammaglobulinemic purpura of Waldenström is characterized by hypergammaglobulinemia, recurring purpura, an elevated erythrocyte sedimentation rate, and the presence of rheumatoid factor indicative of circulating immune complexes. There is a significant association with autoimmune diseases, especially Sjögren's syndrome and lupus erythematosus. Hypergammaglobulinemic purpura is considered primary when there is no other associated disease or secondary when associated with other diseases, usually autoimmune. Immune derangements are fundamental in its pathogenesis, although its cause is still unknown. Therapy is unrewarding and is probably unnecessary for this usually benign condition. Three cases are presented that are representative of patients with hypergammaglobulinemic purpura.

Adult↗
PubMed1989

Frontalis-associated lipoma of the forehead.

We describe a deeply placed lipoma of the forehead. This fatty tumor is usually misdiagnosed initially as an epidermal inclusion cyst. Preoperative recognition allows its proper depth within the tissue, that is, within or just below the frontalis muscle, to be anticipated.

Diagnosis, Differential↗
PubMed1989

Interpretation of Mohs micrographic frozen sections: a peer review comparison study.

The ability of the Mohs surgeon to interpret frozen sections generated during Mohs surgery has been questioned recently. In this study 1000 Mohs micrographic slides were interpreted by a Mohs surgeon and subsequently by a general pathologist. The disputed slides were then reviewed independently by two Mohs surgeons, two pathologists, and a dermatopathologist. Overall, there was a 98.9% agreement in interpretation among the Mohs surgeons, the pathologists, and the dermatopathologist. Results would indicate that a well-trained and experienced Mohs surgeon is competent to interpret slides prepared under his or her supervision during Mohs surgery.

Basal Cell Carcinoma↗
PubMed1989

Pseudocyst of the auricle associated with trauma.

A pseudocyst of the auricle (benign idiopathic cystic chondromalacia) is an intracartilaginous cystic swelling of the anterior auricle. The cause is uncertain, and most patients deny any history of inflammation or trauma. A patient had antecedent trauma and a fracture in the conchal cartilage; a simple surgical procedure was used to treat this patient.

Adult↗
PubMed1969

Comparison of the fatty acids of proteolytic type B and nonproteolytic types E and F of Clostridium botulinum.

Lipids were extracted from vegetative cells and spores of Clostridium botulinum. The total lipids extracted averaged approximately 3.8% of the dry weight of vegetative cells and 2.5% of the dry weight of spores of types 61E, "F," and 115B. The fatty acids were analyzed in the form of their methyl esters by gas-liquid chromatography. Infrared spectroscopy, mercuric acetate fractionation, and silver nitratethin layer chromatography served as complementary means of analysis. The total fatty acids included straight chain, saturated, unsaturated, and cyclopropane acids. Hexadecanoic and tetradecanoic acids were the predominant acids in both the spores and vegetative cells. Together, they comprised over 50% of the total fatty acids. Unsaturated acids were the second major group. These were primarily 7,8-tetradecenoic, 9,10-hexadecenoic, 7,8-hexadecenoic, 11,12-octadecenoic, and 9,10-octadecenoic acids. Nonproteolytic types 61E and "F" possessed an 18-carbon diunsaturate, which was not found in the vegetative cells or spores of proteolytic type 115B. A mechanism for the synthesis of unsaturated and cyclopropane acids was proposed.

Chromatography, Gas↗