Biomedical subjects
Publications and source records attributed to R S Padilla.
A 34-year-old white female with a 5-cm malignant schwannoma of the upper thigh underwent complete removal of the tumor by fresh-tissue Mohs surgical excision. The patient refused postoperative radiotherapy, and is without signs of recurrence 5 years after surgery. Mohs surgical excision in the treatment of malignant schwannoma has not to our knowledge been reported previously.
Three patients are described who had a distinctive clinical and histologic presentation of dermal elastosis. Sunlight apparently played little role in the development of this elastotic change. To the best of our knowledge, this is the first report of this form of elastosis.
A direct relationship exists between the power density of a carbon dioxide laser and the thickness of scars it produces in rat skin. Statistically significant positive relationships were noted between laser power and scar thickness at days 14, 21, and 32. The slope of the curve increased as the number of days elapsed. At day 32, the ratio of scar thickness to CO2 laser power density delivered was 0.3 microns/W-cm2. Scar formation took longer for completion at higher wattages of irradiation.
Several lines of evidence support the hypothesis that ultraviolet radiation (UVR) is involved in the etiology of cutaneous melanoma in humans. However, progress in understanding the mechanisms involved in induction of melanotic tumors by UVR has been hindered by lack of a suitable animal model. During the course of multiple exposures (3 times/wk for 70 wk) of the South American opossum, Monodelphis domestica, to UVR, we first observed the appearance of areas of dermal melanocytic hyperplasia (MH) on the exposed skin. Post-UVR exposure to photoreactivating light (320-500 nm) suppressed the occurrence of MH. We also observed at 100 weeks from first exposure that 10 of 46 surviving animals had developed melanotic tumors which arose, presumably, from areas of MH. Tumors on three of the 10 animals have been classified as malignant melanomas based on metastasis to lymph nodes. We conclude from these results that UVR can act as a complete carcinogen for melanoma induction and, based on the photoreactivation of MH induction, that DNA damage is involved in melanoma formation.
A malignant melanoma developed in a 2-year-old Hispanic girl with a giant congenital melanocytic nevus (bathing-trunk type). Histopathologic evaluation showed a deep-seated tumor arising from a nonepidermal origin. Cytogenetic analysis demonstrated multiple chromosomal abnormalities in hyperdiploid cells (chromosome range, 56 to 61). No two karyotypes were identical, but many abnormalities were common to all analyzed cells, suggesting both karyotypic instability and evolution. The metaphases were monosomic for 3, 12, and 16, trisomic for 1, 2, 8, 19, 20, and 21, and included structural aberrations deletion 1 and derivatives 3 and 16. Eight markers were identified, including one ring. The extra 19 was possibly an isochromosome. No abnormalities of 6 or 10 were identified.
Three young patients affected by intradermal and subcutaneous vascular proliferations are presented. The lesions were acquired and developed as solitary or multiple erythematous patches and plaques in the upper thorax, neck, and scalp. Light-microscopic examination revealed a deep-seated vascular growth with a distinctly lobular pattern. Ultrastructural and immunocytochemical studies demonstrated the cellular proliferation to be composed of endothelial and perithelial cells, the latter predominating. These cases are interpreted as examples of the vascular disorder described as progressive capillary hemangioma and acquired "tufted" angioma. We believe that it represents a distinctive clinicopathologic entity that is closely related histogenetically and perhaps pathogenetically to the entity recently renamed lobular capillary hemangioma.
A 76-year-old woman with ovarian adenocarcinoma and sudden onset of many seborrheic keratoses is reported. This cutaneous sign, a marker of an internal malignancy, is known as the sign of Leser-Trélat. Its association with gynecologic neoplasms is reviewed.
Lymphoscintigraphy with Technetium antimony sulfur colloid (TASC) was used in four patients with malignant melanoma to identify the pattern of lymphatic drainage, allowing selective lymph node dissection. TASC is safe and predictive of lymph node drainage patterns. Using this technique allows visualization of multiple tiers of lymph nodes in 2 to 6 hours.
A 63-year-old man had epithelioid sarcoma. Light microscopy showed the tumor to resemble granuloma annulare. Enzymatic histocytochemical and ultrastructural studies demonstrated the tumor's histiocytic features. Literature review of epithelioid sarcoma and granuloma annulare showed them to have a similar anatomic distribution.
Serum lysozyme (Muramidase) levels in patients with localized and generalized granuloma annulare were measured by a turbidometric method. More lysozyme is present in the serum samples of patients with generalized granuloma annulare than patients with the localized form or normal controls. The mean level of patients with generalized disease was 9.27 mg/L compared with 5.96 mg/L for patients with localized disease and 6.8 mg/L for controls.
Darier's disease, often complicated by skin infections, has been linked with a depressed cell-mediated immunity. Four moderate to severely affected patients with a negative history of skin infections were studied. T cell function was evaluated by standard delayed hypersensitivity skin tests, enumeration of peripheral T cell-mediated immunity was found. The significance of the results when compared with prior studies is discussed.
Fifty men and women, aged twenty to sixty-one, with dry skin of the legs, were treated over a four week period, comparing the effects of "hard-milled" versus "dry-skin" (triethanolamine) soaps on the condition of the stratum corneum commonly known as dry skin. Subjective preferences of the subjects heavily favored the dry skin soap. Objective grading of skin changes showed a trend in favor of the dry skin soap.
A 55-year-old man with a two-year history of intramuscular pentazocine abuse had classical cutaneous findings as well as secondary venous thrombosis, which, to our knowledge, is previously undescribed. Histologic evaluation, including direct immunofluorescent microscopy, did not establish the mechanism of tissue destruction.
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