Surgical management of Hailey-Hailey disease.
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Electrosurgery↗
Biomedical subjects
S K Spencer
Publications and source records attributed to S K Spencer.
A clinical trial of beta carotene to prevent basal-cell and squamous-cell cancers of the skin. The Skin Cancer Prevention Study Group.
BACKGROUND: Beta carotene has been associated with a decreased risk of human cancer in many studies employing dietary questionnaires or blood measurements, and it has had protective effects in some animal models of carcinogenesis. METHODS: We tested the possible cancer-preventing effects of beta carotene by randomly assigning 1805 patients who had had a recent nonmelanoma skin cancer to receive either 50 mg of beta carotene or placebo per day and by conducting annual skin examinations to determine the occurrence of new nonmelanoma skin cancer. RESULTS: Adherence to the prescribed treatment was good, and after one year the actively treated group's median plasma beta carotene level (3021 nmol per liter) was much higher than that of the control group (354 nmol per liter). After five years of follow-up, however, there was no difference between the groups in the rate of occurrence of the first new nonmelanoma skin cancer (relative rate, 1.05; 95 percent confidence interval, 0.91 to 1.22). In subgroup analyses, active treatment showed no efficacy either in the patients whose initial plasma beta carotene level was in the lowest quartile or in those who currently smoked. There was also no significant difference between treated and control groups in the mean number of new nonmelanoma skin cancers per patient-year. CONCLUSIONS: In persons with a previous nonmelanoma skin cancer, treatment with beta carotene does not reduce the occurrence of new skin cancers over a five-year period of treatment and observation.
Aged↗
The Skin Cancer Prevention Study: design of a clinical trial of beta-carotene among persons at high risk for nonmelanoma skin cancer.
We describe a randomized clinical trial of oral beta-carotene (50 mg/day) for preventing nonmelanoma skin cancer. It is a multicenter study conducted at sites in California, Minnesota, and New Hampshire. This report describes the design of the study, baseline characteristics of the 1805 randomized patients, changes in their plasma beta-carotene and retinol levels after 1 year of treatment, and plans for statistical analyses. Important features of this study are (1) a high proportion of potential subjects were found to be ineligible or chose not to enter the study, (2) the study agent is readily available over the counter and in common foods, and (3) nonmelanoma skin cancer is a relatively minor health concern for most patients. These considerations necessitated intensive efforts to encourage compliance with the study regimen. There are also some unusual statistical features of the study. One is that the study outcome is routinely assessed only at annual examinations, so the precise time of failure cannot be identified. Also, a secondary goal of the study is to determine whether beta-carotene decreases the average number of new skin cancers per patient per year, and there are no established statistical methods for analysis of data in this situation. Alternative approaches to the analysis are discussed.
Adult↗
Metastatic islet cell amphicrine carcinoma of the pancreas. Association with an eosinophilic infiltration of the skin.
Nodular skin lesions consisting of eosinophilic cell infiltrates developed in a 45-year-old man with metastatic islet cell amphicrine carcinoma of the pancreas. These infiltrates did not fit previously described eosinophilic skin conditions. Although the tumor responded to conventional chemotherapy, the skin lesions did not. They did, however, respond completely to radiation therapy. This clinical constellation has not been reported previously and may represent a new paraneoplastic syndrome.
Adenoma, Islet Cell↗
Electrosurgical fundamentals.
Electrosurgery is used regularly by physicians in the performance of minor outpatient surgery. Most dermatologists are familiar with the electrosurgical methods used to treat many common skin lesions. Many practitioners, however, are unfamiliar with the electrophysical fundamentals underlying these modalities. The basic principles necessary for the safe and optimal use of these methods are presented herein.
Electrocoagulation↗
Fluoroderma.
Papulonodular eruptions from certain bromide and iodide preparations are widely recognized entities, but skin lesions following fluoride ingestion are rare. Modern prophylaxis for postirradiation dental caries includes the use of fluoride gel preparations applied to the teeth. In two patients receiving such therapy a papulonodular eruption developed, similar to the recognized halogenodermas. These cases may help to increase awareness of this entity.
Cariostatic Agents↗
Treatment of recurrent herpes simplex.
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Administration, Topical↗
Glucagonoma syndrome. Report of two cases and literature review.
The glucagonoma syndrome is characterized by dermatitis, stomatitis, elevated serum glucagon levels, abnormal glucose tolerance, weight loss, and anemia--all in association with a glucagon-secreting alpha-cell tumor of the pancreas. A review of 21 cases showed strikingly similar features. A generalized, symmetrical dermatitis initially appeared to be asteatotic or eczematous over the perineum, buttocks, and lower extremities. Gradually, a more characteristic migratory necrolytic erythema with transient bulla formation and erosions developed in intertriginous and dependent areas. Histologically, the most specific features included necrolysis of the upper epidermis, with liquefaction necrosis of the granular cell layer and subcorneal clefting or blister formation. The dermatologist is often first to examine such patients; early recognition of this syndrome with prompt surgical removal of the primary pancreatic lesion may afford cure of the neoplasm.
Adenoma, Islet Cell↗