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Biomedical subjects

S Kossard

Publications and source records attributed to S Kossard.

At least 19 recordsLinked to original sources
PubMed1992

Cutaneous Bowen's disease. An analysis of 1001 cases according to age, sex, and site.

BACKGROUND: There are no large studies of Bowen's disease that have analyzed its distribution according to age, sex, and site. OBJECTIVE: This study was performed primarily to determine whether there were significant sex and site differences in the distribution of Bowen's disease. METHODS: One thousand one skin biopsy specimens of Bowen's disease were analyzed according to age, sex, and site of origin. RESULTS: This study revealed that the most common site of Bowen's disease was the head and neck (440 lesions), whereas specimens from the lower limbs (298 lesions) and upper limbs (198 lesions) outnumbered specimens from the torso (65 lesions). Of 298 specimens from the lower limbs, 72.1% were from women; 79.3% of the 87 specimens from the scalp and ears were from men. Eighty percent of the 85 specimens of Bowen's disease from the cheeks were from women. CONCLUSION: These results indicate that cutaneous Bowen's disease occurs mainly on sun-exposed sites. This is also supported by the predominance of Bowen's disease on the lower limbs in women and on the scalp and ears in men. The basis for the female predominance on the cheeks is unknown, but may reflect the increased vulnerability to sun damage of superficial vellus hair follicles that predominate on the cheeks in women. This finding may provide indirect support for the hypothesis that some forms of Bowen's disease have a follicular histogenesis.

Adult↗
PubMed1992

Mast cell quantitation by image analysis in adult mastocytosis and inflammatory skin disorders.

Mast cell numbers were quantitated in adult cases of mastocytosis demonstrating non-diffuse perivascular and upper dermal concentrations of mast cells. Using the Leder stain and computerised video image analysis, a mean of 382 (+/- 28 SE) mast cell per mm2 were counted in the superficial dermis in skin biopsies from 30 adult cases of mastocytosis, in contrast to a mean of 43 (+/- 5 SE) mast cells per mm2 in skin biopsies from 50 inflammatory dermatoses represented by subacute dermatitis, pigmented purpuric dermatosis, erythema multiforme, lichen planus and granuloma annulare. Ten skin biopsies showing no significant inflammation had a mean of 54 (+/- 7 SE) mast cells per mm2 in the upper dermis. The mean area of individual mast cells as assessed by image analysis in the mastocytosis group was 47.40 microns 2 (+/- 2.26 microns 2, SE) which was significantly different (P < 0.01) than the mast cell area (32.34 microns 2 +/- 2.22 microns 2, SE) in all other groups combined. Computerised video image analysis represents an alternative technique which is useful in assessing mast cell numbers and particularly mast cell size in adult cases of macular mastocytosis and in other dermatoses.

Adult↗
PubMed1991

Lentinginous dysplastic naevi in the elderly: a potential precursor for malignant melanoma.

Seventy-seven skin biopsies diagnosed histologically as lentiginous junctional naevi from individuals aged over 60 years were reviewed. Seventy-three specimens showed a primarily nested pattern with disordered arthitecture concentrated within the rete ridges conforming to the pathology of a lentiginous dysplastic naevus. In 28 biopsies this was combined with a melanoma in situ. The latter was reflected by a focal loss of the rete ridge system, confluent melanocytic hyperplasia and single cell invasion of the epidermis by atypical malanocytes. Four biopsies showed lentiginous junctional naevi with only isolated naevus cell nests without a disordered architecture or cellular atypia. Thirty-seven of the 57 naevi in men were located on the back in contrast to 5 of the 20 women. In women the lower limb was the most frequent site with 8 of the 20 lesions originating at this site in contrast to 1 of the 57 men. The pathological diagnosis of dysplastic lentiginous naevi in the elderly needs to be recognised as having a high association of melanoma-in-situ changes.

Aged↗
PubMed1991

Disseminated superficial actinic porokeratosis. A histological review of 61 cases with particular reference to lymphocytic inflammation.

The pathology of 61 cases of disseminated superficial actinic porokeratosis was reviewed and the relative frequency of the histological features associated with the cornoid lamella and the pathology within and outside the porokeratotic rim were assessed. Papillary dermal lymphocytic infiltrate (97%), spinous layer vacuolar changes (90%), dyskeratotic cells in the epidermis (77%), and liquefaction degeneration of the basal layer (67%) were frequently seen under the cornoid lamella. Papillary lymphocytic infiltration was seen more frequently inside the porokeratotic ring in comparison to the outer skin. Lymphocyte marker studies in nine cases showed a predominance of activated T lymphocytes with positive LN3 and UCHL-1 staining. Together with the finding of a lichenoid reaction pattern, these results lend support to the hypothesis that actinic porokeratosis represents a migrating clone of abnormal keratinocytes with an associated immunological host response.

Atrophy↗
PubMed1990

Reticular erythema with ostial porokeratosis.

An asymptomatic reticular erythema associated with myriads of monomorphous micropapules developed in a symmetric distribution concentrated on the inner aspects of both arms and both legs of a 15-year-old girl. Skin biopsy specimens revealed cornoid lamellae within multiple appendageal ostia and focal lymphocytic inflammation in the papillary dermis. Reticular erythema with ostial porokeratosis is one of an increasing number of clinical presentations of punctate porokeratosis that lack a classic marginated rim.

Adolescent↗
PubMed1990

Halo eczema surrounding seborrhoeic keratoses: an example of perilesional nummular dermatitis.

Two patients developed halo eczema around isolated seborrhoeic keratoses and in one individual similar halo eczema developed around the nipples. This phenomenon which was previously described with melanocytic naevi has been associated with a number of different central lesions and can be readily recognised. Both the clinical pattern and histopathology suggest that this phenomenon may represent a localised form of nummular dermatitis with a predilection for elevated lesions.

Adult↗
PubMed1990

Necrobiotic granulomas localised to the penis: a possible variant of subcutaneous granuloma annulare.

Three young men developed multiple firm asymptomatic nodules confined to the shaft of the penis. Skin biopsies from all 3 cases showed prominent necrobiotic granulomas indistinguishable from granuloma annulare. One of the patients had repeated recurrent nodules confined to the penis which were removed surgically over a period of 20 months. This unusual, but benign, presentation of granuloma annulare has to be distinguished from other granulomatous and malignant processes which may present as penile nodules.

Adult↗
PubMed1989

Squamous cell carcinoma in porokeratosis in two patients.

Malignancy arising in porokeratoses is a well recognised but infrequently reported complication. Histological studies suggest that malignancy arises from the abnormal clone of keratinocytes which produce the cornoid lamella. We report two cases of squamous cell carcinoma arising in porokeratoses and postulate genetic, environmental and host factors as important in the evolution of their malignancy.

Aged↗
PubMed1989

Eruptive infundibulomas. A distinctive presentation of the tumor of follicular infundibulum.

Hundreds of asymptomatic pale erythematous lesions, 2 to 15 mm in diameter, with complex angulated shapes in a mantle distribution over the upper portion of the chest and back and the shoulders, developed in two unrelated young men. Actinic porokeratosis, discoid lupus erythematosus, pityriasis versicolor, and acne scars were considered as possible diagnoses, but none of these appeared appropriate. Multiple skin biopsy specimens from both patients showed tumors of follicular infundibulum (infundibulomas), benign platelike proliferations of the external root sheath that were outlined by a prominent brushlike elastic network. This presentation of the tumor of follicular infundibulum can be recognized by its unusual clinical pattern and histopathology.

Adult↗
PubMed1989

The scleroderma neck sign.

The scleroderma neck sign, as described by Barnett, is a visible and palpable tight band over platysma in the hyperextended neck. A recent survey of 76 patients with scleroderma revealed that more than 90% had the scleroderma neck sign. Our study was performed using 15 patients with scleroderma and 30 controls including 3 with primary Raynaud's disease to examine the specificity of the scleroderma neck sign, and to look for a correlation between the presence of the scleroderma neck sign and histological changes of scleroderma in the skin overlying platysma. The scleroderma neck sign was present in 12 of the 15 patients with scleroderma but in none of the 30 controls. It was found both in patients with diffuse (5 out of 5) and limited (7 out of 10) scleroderma. In 10 of the 12 cases where the scleroderma neck sign was positive, there were characteristic histological changes of scleroderma on biopsy of the skin overlying platysma, in 1 there were nondiagnostic abnormalities, and in 1 the biopsy was unsatisfactory. The 3 patients with scleroderma in whom the scleroderma neck sign was absent had either nondiagnostic changes (1) or normal biopsies (2). The 3 patients with Raynaud's disease had normal skin biopsies. The scleroderma neck sign appears to be produced by scleroderma changes in the skin of the neck. In limited or early scleroderma where these changes are otherwise clinically inapparent, the scleroderma neck sign may be diagnostically useful.

Adult↗
PubMed1988

[Symmetrical lividity of the fingers].

Symmetric lividity of the soles of the feet was first reported in two children in 1925 by Pernet. The characteristic manifestation of this dermatosis consisted in hyperkeratosis and hyperhidrosis with livid discoloration of the pressure areas of the soles. Later the same name was applied to a similar dermatosis in which the hyperkeratotic and hyperhidrotic patches of skin on the soles had a whitish grey discoloration and the livid color, if present at all, was seen only over the marginal areas not affected by the keratosis. Similar livid keratoses affecting the palmar sides of the fingers have been seen only occasionally. The 17-year-old girl presented in this paper had a 11-year history of emotional hyperhidrosis and is a rare illustration of symmetrical lividity in its original form, localized to the fingers only.

Adolescent↗
PubMed1987

Necrotizing lymphocytic folliculitis: the early lesion of acne necrotica (varioliformis).

Skin biopsy specimens from four patients who had recurrent bouts of lesions conforming to the clinical description of acne necrotica were studied. The pathologic findings were dominated by lymphocytic inflammation around centrally placed follicles evolving to follicular necrosis that extended to the perifollicular epidermis and dermis. Early lesions showed the development of multiple individual necrotic keratinocytes within the follicular sheath and adjacent epidermis with lymphocytic exocytosis. Later lesions showed more intense necrosis and scale crust obscuring the central target but were still dominated by a peripheral lymphocytic infiltrate. The early pathologic findings of acne necrotica (varioliformis) are represented by a necrotizing lymphocytic folliculitis and differ from the pattern seen in association with nonspecific excoriations, acute bacterial folliculitis, classic comedogenic acne, or acnitis.

Acne Vulgaris↗