Biomedical subjects

Olympia Kovich

Publications and source records attributed to Olympia Kovich.

6 recordsLinked to original sources

PubMed2005

Nevus sebaceus.

A 35-year-old woman presented with cosmetically disturbing facial plaques, which had been present since birth and were consistent with nevus sebaceus on histopathologic examination. Nevus sebaceus is a congenital, hairless plaque, which is found most commonly on the scalp and face and typically becomes thicker and more verrucous in appearance as the patient enters adulthood. There is an association with benign and malignant neoplasms. Typically, these lesions are either removed surgically or the patients are followed clinically. Other therapeutic modalities utilized for cosmesis include carbon dioxide laser and photodynamic therapy.

Adult↗

PubMed2005

Generalized granuloma annulare.

A 94-year-old man presented with a relatively asymptomatic eruption of his forearms, abdomen, and back comprising symmetric erythematous papules and plaques. Generalized granuloma annulare is an idiopathic disorder that occurs more commonly in older patients and is characterized by numerous flesh-colored-to-erythematous papules. It is distinguished histologically by palisading granulomas with central connective tissue degeneration and with central mucin. Therapy has been attempted with various modalities with moderate efficacy.

Aged, 80 and over↗

PubMed2004

Cowden's syndrome.

A 59-year-old woman initially presented with facial papules, which were consistent with trichilemmomas on histopathologic examination. Her course was complicated by breast, endometrial, and renal-cell carcinomas, as well as a multinodular goiter that necessitated a thyroidectomy. Cowden's syndrome is a rare autosomal dominant syndrome that is characterized by hamartomas of ectodermal, mesodermal, and endodermal origin as well as an increased risk of breast, thyroid, and endometrial neoplasias. Medical management includes screening for breast cancer and thyroid abnormalities, and performing other age-specific examinations. Treatment of facial papules includes topical 5-fluorouracil, isotretinoin, curettage, laser ablation, or surgical excision.

Female↗

PubMed2004

Acquired perforating disorder.

A 53-year-old man presented with asymptomatic, hyperkeratotic papules and hyperpigmented macules of the face and upper extremities. Treatment was initiated with topical tretinoin and intralesional glucocorticoids. Acquired perforating disorder is a disorder of keratinization that is associated with diabetes mellitus and uremia. Classic presentation involves hyperkeratotic papules with a central core, which occur most frequently on the lower extremities. Treatment includes topical tretinoin, glucocorticoids, keratolytics, systemic retinoids and glucocorticoids, and ultraviolet B phototherapy.

Diabetes Complications↗

PubMed2003

Thrombotic complications related to discontinuation of warfarin and aspirin therapy perioperatively for cutaneous operation.

BACKGROUND: Aside from anecdotal reports, there are few data on the risk of thrombotic complications in patients in whom use of warfarin and aspirin is discontinued perioperatively for cutaneous operation. OBJECTIVE: Our aim was to present a large case series of thrombotic complications resulting from this practice and to estimate the incidence of these events. METHODS: A total of 504 members of the American College of Mohs Micrographic Surgery and Cutaneous Oncology were surveyed regarding thrombotic complications when blood thinners were withheld perioperatively to ascertain the frequency of these complications and to describe associated morbidity and mortality. RESULTS: A total of 168 responding physicians reported 46 patients who experienced thrombotic events. Of these patients, 54% (25 of 46) experienced the event when warfarin was withheld and 39% (18 of 46) when aspirin use was discontinued. Thrombotic events included 24 strokes, 3 cerebral emboli, 5 myocardial infarctions, 8 transient ischemic attacks, 3 deep venous thromboses, 2 pulmonary emboli, and 1 retinal artery occlusion leading to blindness. Three deaths were reported. Calculation of incidence yielded an estimated thrombotic risk of 1 event per 12,816 operations, 1 in 6219 operations when use of warfarin was discontinued and 1 in 21,448 when aspirin was withheld. CONCLUSIONS: With no documented increase in severe hemorrhagic complications during continued use perioperatively of blood thinners, these data provide a compelling argument to maintain patients on medically necessary blood thinners during cutaneous operation. All relevant clinical facts must be weighed when making this decision.

Aged↗

PubMed2002

Perioperative management of anticoagulants and platelet inhibitors for cutaneous surgery: a survey of current practice.

BACKGROUND: Perioperative management of therapy with anticoagulants or platelet inhibitors for patients having cutaneous surgery presents dilemmas for dermatologic surgeons. OBJECTIVE: To outline the current spectrum of practice for perioperative management. METHODS: Questionnaires were mailed to 504 dermatologic surgeons. Data included use of warfarin, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) perioperatively and involvement of other physicians in making management decisions. RESULTS: Of the responding physicians, 83% routinely ask primary physicians or cardiologists for recommendations about perioperative management, 80% discontinue warfarin therapy perioperatively at least some of the time, 26% always discontinue aspirin therapy, 38% manage aspirin and NSAIDs in the same manner, and 53% withhold therapy with NSAIDs for less time than with aspirin. CONCLUSION: Dermatologic surgeons use various perioperative management strategies. Despite no published evidence of increased hemorrhagic risk with anticoagulant or platelet inhibitor therapy during cutaneous surgery, many physicians discontinue therapy perioperatively.

Anti-Inflammatory Agents, Non-Steroidal↗