Postirradiation primary Kaposi's sarcoma of the head and neck.
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Biomedical subjects
Publications and source records attributed to M R Nasca.
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BACKGROUND: The purpose of this study was to examine the clinical and epidemiologic features of pemphigus in eastern Sicily. METHODS: All new cases of pemphigus seen in the Dermatology Clinic at the University of Catania during the period January 1982 to June 1996 were studied retrospectively. RESULTS: Eighty-four patients with pemphigus represented 1.3% of 6653 patients admitted to our clinic in a 13.5-year period, with an average annual incidence of six cases per year. The most common form of presentation was pemphigus vulgaris (PV) (75%), followed by pemphigus erythematosus (17%), pemphigus herpetiformis (6%), and pemphigus vegetans (2%). In 6% of PV patients, the oral lesions were not followed by skin involvement, and the lag time between the onset of illness and the final diagnosis in five PV cases was prolonged, ranging from 4 to 7 years, probably due to the mild clinical presentation of the disease. Two trauma-related PV cases were documented; in one case, the blisters were located in a surgical scar and in the other in a burn scar. CONCLUSIONS: Our findings showed that pemphigus has a relatively high prevalence in eastern Sicily compared with other Italian regions; PV is the most common variant, and may have a mild course not always requiring aggressive therapy.
One of the possible unwanted side effects following contact immunotherapy of alopecia areata is skin hypopigmentation, either in the form of a transient, post-inflammatory hypopigmentation or as the development of a persistent, depigmented patch. A case of leucoderma occurring on the forehead of a 16-year-old girl following application of squaric acid dibutylester to the scalp for the treatment of alopecia areata is described. Past medical and family history were negative for vitiligo and autoimmune disorders. The hypopigmented patch was distant from the scalp area where squaric acid dibutylester had been applied, and it was not preceded by any sign of eczema, erythema or itch in the same area. Moreover, it faded as soon as treatment was discontinued. A 4-year follow-up revealed no evidence of vitiligo. In conclusion, the possible occurrence of a transient leucoderma in untreated areas should be included among the side effects of contact immunotherapy of alopecia areata with squaric acid dibutylester.
Penile tumors, although not frequent, represent a difficult diagnostic and therapeutic challenge. Of the malignant penile neoplasms, the most frequent is penile carcinoma, which includes squamous cell carcinoma and its well-differentiated variant, verrucous carcinoma. Current concepts about classification, epidemiology, pathogenesis, histopathology, diagnosis, staging, prognosis, and treatment are presented.
BACKGROUND: Among contact allergens that are frequently used in the treatment of alopecia areata (AA), squaric acid dibutylester (SADBE) stands out for its good tolerability and its mild side effects. METHODS: One hundred and forty-four patients with AA of varying degrees were treated with SADBE. Of these, 71 had AA affecting less than 50% of the scalp, and 73 had a severe form, including 13 patients with alopecia totalis (AT) and two with alopecia universalis (AU). The patients were treated using both traditional and nontraditional methods. RESULTS: In the less severe form, we obtained a 80% rate of regrowth, compared to the 49% of the more severe form including 13 cases of AT and the two of AU. The failure rate was higher for patients with the more severe form (29%) compared to a 7% rate only for patients with mild AA. We also observed four cases of initial regrowth on the side of the scalp opposite to the site of application ('castling phenomenon'). Among those patients who were treated with application of SADBE on the right side of the back, three displayed regrowth on the left side of the scalp, (i.e., on the opposite side) and in an area distant from the site of application; for two patients the regrowth began on the right side of the scalp and one of them also displayed growth of fine hairs in the right dorsal region, the site of application of the compound. CONCLUSIONS: Our data further support the hypothesis of a systemic action of SADBE; however, further confirmation on a larger sample of cases is needed.
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Agminated lentiginosis (AL) is characterized by numerous lentigines confined to a body segment, with a sharp demarcation at the midline. So far, only 13 cases have been reported in the literature. We report a 30-year-old woman with a multifocal AL. The cutaneous lesions first appeared at 5 years of age and gradually increased in number with time. Clinically, they appeared as numerous brown macules, ranging in size from 1 to 5 mm in diameter, in a peppered distribution over an area extending bilaterally on the neck, chin, and cheeks. On the trunk the lesions were localized to the left shoulder and breast, involving the axilla and upper part of the abdomen down to the umbilicus. Four café au lait macules ranging in diameter from 10 to 15 mm were present, with no evidence of neurofibromas. Histopathology of a macule showed the features of lentigo; in addition, groupings of melanocytes were observed at the dermoepidermal junction. The differential diagnosis of AL includes speckled lentiginous nevus and segmental neurofibromatosis.
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Cellular blue nevi (CBN) are benign tumors of the skin derived from dermal melanocytes histologically characterized by increased cellularity and often by a dual cell population of nevoid cells. CBN rarely tend to invade the underlying tissues. Only six cases of CBN of the scalp invading the skull have been reported. A new case of a CBN infiltrating the underlying bone is presented. The patient, a 23-year-old woman, had a large hairless area on her right parietal scalp, present since the early months of life. Her past medical history included, on the same site, the presence, at birth, of a raised, dark, soft and hairless mass that was subsequently electrodesiccated. Radiographs of the skull showed an area of osteolysis underlying the cutaneous lesion. Histologic examination of a biopsy specimen revealed a CBN of the scalp infiltrating the underlying bone. Surgical resection of the entire lesion was planned. There were no other anomalies or malignancies. The patient is currently being followed in our clinic.
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