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Biomedical subjects

S J Hodge

Publications and source records attributed to S J Hodge.

18 recordsLinked to original sources
PubMed1992

Atypical melanocytic nevi. Clinical and histopathologic predictors of residual tumor at reexcision.

BACKGROUND: The appropriate method for surgical management of melanocytic lesions with disordered architecture and melanocytic atypia (formerly dysplastic nevi) has been controversial. Physicians often reexcise these lesions after primary removal because of their potential relation to malignant melanoma. The outcomes of these reexcisions and the original biopsy specimens have not been previously examined. OBJECTIVE: The purpose of this study was to examine reexcision specimens and their respective original specimens to determine whether there were any characteristics predictive of the presence of residual nevus cells (RNCs) on reexcision. METHODS: One hundred eighty-nine reexcision specimens of atypical melanocytic lesions were evaluated for this study. The original specimens were examined for specific histopathologic features without knowledge of the findings on reexcision. Clinical characteristics were also examined. RESULTS: Of the 189 reexcision specimens, 47 (24.9%) contained RNCs. The proportion of specimens with RNC on reexcision was significantly greater if the original lesion was removed by punch biopsy rather than by shave or elliptical excision (38.3% vs 22.0% vs 10.5%, respectively; p < 0.03). Lesions located on the chest had a higher likelihood of RNCs than those on the back or leg (52.2% vs 21.7%; p = 0.009; 52.2% vs 9.7%, p < 0.002, respectively). Mean age was greater in those with RNCs at reexcision than those without (43.6 vs 37.9 years, respectively; p < 0.0001). The proportion of specimens with RNCs at reexcision was greater in those that had both lateral margins involved than in those that had nevus cells in either one or neither of the lateral margins in the original biopsy specimens (39.7% vs 24.0% vs 7.8%, respectively; p = 0.0005). One of the 189 reexcision specimens (0.5%) contained melanoma, although the original histopathologic diagnosis was an atypical melanocytic nevus. CONCLUSION: We identified several clinical and histopathologic factors that are strongly associated with the presence of RNCs on reexcision.

Adolescent↗
PubMed1991

Twenty percent of biopsy specimens from sun-exposed skin of normal young adults demonstrate positive immunofluorescence.

Fifty normal healthy adults, aged 18 to 41 years, without a history of systemic diseases, dermatoses, or photosensitivity and who were not receiving medication were studied. Paired 3-mm punch biopsy specimens were obtained from the sun-exposed and the non-sun-exposed skin. The data from the study revealed a bright continuous band of immunofluorescence (IF) along the dermoepidermal junction in 10 (20%) of 50 sun-exposed skin biopsy specimens, as compared with none from non-sun-exposed skin biopsy specimens with the use of polyvalent antisera. Fractionated monospecific immunoglobulin demonstrated a bright continuous band of IF composed of IgG alone in one patient, IgA alone in two patients, IgG and IgA in combination in two patients, and the combination of IgG, IgM, and IgA in five patients. There was a statistically significant increase in positive IF in men (seven of 15) vs women (three of 35). This information suggests that in the examination of a patient suspected of having lesions of cutaneous lupus erythematosus, positive IF from sun-exposed skin is nonspecific and adds little information to the clinical and histopathologic findings.

Adolescent↗
PubMed1990

Cutaneous leukocytoclastic vasculitis. Serial histopathologic evaluation demonstrates the dynamic nature of the infiltrate.

Data from experimentally induced cutaneous vasculitis have suggested that the inflammatory infiltrate is dynamic. In contrast, data from humans with cutaneous vasculitis have suggested that two distinct patterns of cellular infiltrate exist, a mononuclear-predominant and a neutrophilic-predominant type. There are little data regarding the temporal evolution of spontaneously occurring cutaneous vasculitis in humans. A patient with a cutaneous leukocytoclastic vasculitis manifest as palpable purpura had four lesions encircled on the day of presentation. Biopsies of these lesions were obtained sequentially at 0, 24, 48, and 120 hours. The histopathologic specimens were graded without knowledge of the timing of the biopsy. The character of the infiltrate progressively changed from a neutrophilic-predominant to a mononuclear-predominant infiltrate supporting the theory of a dynamic process in cutaneous vasculitis. The previous reports that suggest that there are two distinct inflammatory cell types may be the result of performing the biopsy at one point in time during this transitory process.

Aged↗
PubMed1988

Immunoperoxidase technique on paraffin sections fails to demonstrate immunoglobulin deposition in cutaneous lesions from patients with dermatomyositis.

Nine formalin-fixed paraffin sections of skin biopsy specimens of patients with clinically and histologically proven dermatomyositis were studied using the avidin-biotin immunoperoxidase technique. No evidence of dermoepidermal junction or perivascular IgG, IgA, or IgM deposits were noted. These findings may be related to loss of antigenicity during the fixation process or to the small amount of immunoglobulin deposit previously reported in dermatomyositis. The negative findings demonstrate an inability to use this technique to find immunoglobulin deposition retrospectively in dermatomyositis.

Adolescent↗
PubMed1979

Cutaneous horns: a histopathologic study.

We report a series of 230 cutaneous horns, of which fewer than one fourth were frankly malignant. Actinic keratoses were the lesions most commonly found underlying cutaneous horns (37.39%). Cutaneous horns overlying a benign lichenoid keratosis, epidermolytic hyperkeratosis, trichilemmoma, an epidermal inclusion cyst, and a benign fibroma are reported. Three cases were nondiagnosable because of inadequate biopsies that were too superficial to show the base of the lesion.

Carcinoma, Squamous Cell↗
PubMed1979

Zosteriform inflammatory metastatic carcinoma.

A 57-year-old man presented with chest wall lesions and swelling of his left arm. The rapid onset of vesicular lesions in a dermatomal distribution resulted in an initial diagnosis of herpes zoster. Cutaneous biopsy revealed adenocarcinoma and further evaluation revealed a primary source of pulmonary adenocarcinoma. Lymphatic spread of tumor cells is the most likely source of the zosteriform skin lesions, but other possibilities are discussed.

Adenocarcinoma↗
PubMed1978

Cutaneous angiosarcoma of the hip.

An elderly patient is presented who developed a fatal angiosarcoma of the hip about ten years after surgery and radiation for a uterine malignancy. She developed a metastasis of the uterine tumor, requiring additional radiation, which led to aseptic necrosis of the hip and chronic joint and soft tissue infection of the hip from a joint prosthesis. Subsequently she developed chronic lymphedema of the hip and finally the cutaneous angiosarcoma in this area. Any or all of these factors might bear a causative relationship to the angiosarcoma, but none can be proved.

Female↗
PubMed1978

Inflammatory linear verrucose epidermal nevus.

We treated three patients with inflammatory linear verrucose epidermal nevus. The lesions were either verrucose or psoriasiform and all had an inflammatory component. Histologic features included psoriasiform acanthosis with spongiosis and parakeratosis. Features that distinguish this entity and the differential diagnoses are discussed.

Adult↗
PubMed1978

Purpura fulminans.

Purpura fulminans is the cutaneous manifestation of acute activation of the clotting mechanism resulting in massive hemorrhage due to an intravascular consumption coagulopathy. Peripheral necrotizing purpura is a warning signal, and early recognition of the clinical situation and heparin therapy may be lifesaving. Clinical manifestations and histologic features of this condition, along with its pathogenesis, treatment, and differential diagnosis are discussed.

Diagnosis, Differential↗
PubMed1976

Induction of labor with prostaglandin E2 administered orally.

The effectiveness of orally administered prostaglandin E2 in inducing labor was studied in 60 patients with uncomplicated, full-term pregnancies, using three dosage schedules. Although 40 patients did deliver, 11 patients' amniotic membranes ruptured at a time considered by the investigators to introduce an undesired variable in attempting to evaluate the drug. Twenty (33%) failed to deliver despite adequate Bishop scores. Side effects were noted in 45% of patients. No significant advantage for induction of labor occurred with the three dosage schedules used.

Adult↗
PubMed1975

Topical 5-fluorouracil treatment of superficial basal cell epithelioma. A light and electron microscopic study.

A 27-year-old patient developed superficial basal cell epitheliomas approximately 20 years after taking Fowler's solution. One of the lesions was successfully treated with topical 2% 5-fluorouracil soultion under occlusion. Sequential biopsies of the lesion before, during and after therapy were examined by light and electron microscopy, and the changes at various stages are described. Changes occurred only in tumor cells and adjacent epidermis, and only after occlusion of 5-FU. After one week of occlusive therapy, focal discontinuities in the basal lamina and intercellular spaces were wider with reduction and condensation of tonofilaments. Mitochondrial degeneration was seen along with irregularities in nucleoli. These changes were most prominent after two weeks of occlusive therapy, and many degenerating keratinocytes were seen detached from other cells. One month after cessation of therapy, the entire area was excised, and no evidence of tumor was seen.

Administration, Topical↗