Biomedical subjects

S V Pollack

Publications and source records attributed to S V Pollack.

At least 19 recordsLinked to original sources

PubMed1992

Basal cell carcinoma treated with Mohs surgery. A comparison of 54 younger patients with 1050 older patients.

The average age of patients with basal cell carcinoma (BCC) is over 60 years, and fewer than 5% of patients with this tumor are under 30 years of age. A comparison of younger (15 to 30 years) and older (56 to 70 years) patients with BCC was conducted to identify specific tumor or host features associated with BCC occurring early in life. According to data collected over an 11-year period, 54 of 2728 (2%) BCCs occurred "de novo" in younger patients. In contrast to the predominantly male older group, most of the younger patients were female. An increased use of tanning booths and hair-dyes was associated with the younger patients (P less than .001). More overall sunlight exposure and actinic keratoses were associated with the older patients (P less than .01). Defect and lesion sizes were smaller (P less than .01) in the younger group. Location, histology, and clinical morphology did not differ appreciably between the two groups. De novo BCCs in younger and older patients are similar, although some differences do exist.

Adult↗

PubMed1991

Basal cell carcinoma in young patients after irradiation for childhood malignancy.

Three patients underwent cranial irradiation as part of treatment for childhood malignancy. Two of these patients had acute lymphocytic leukemia and one had an astrocytoma. All had longlasting remissions from their childhood malignancy but 8-15 years later developed a basal cell carcinoma of the scalp within previous radiation portals. The basal cell carcinomas were all treated successfully using Mohs micrographic surgery. Follow-up of patients receiving irradiation for childhood malignancy should include periodic cutaneous examinations of previously irradiated sites.

Adolescent↗

PubMed1991

DNA image cytometry of keratoacanthoma and squamous cell carcinoma.

The distinction between the keratoacanthoma (KA) and the squamous cell carcinoma (SCC) can sometimes be difficult on the basis of histologic and clinical criteria. The possible diagnostic significance of DNA ploidy initiated the present study evaluating the DNA ploidy in paraffin-embedded tissue sections of 7 KA and 15 SCC, and fresh frozen tissue touch preparations of 15 of the same cases using the CAS 200 Image Analyzer. In paraffin-embedded tissue sections the main peak DNA index was based on normal epidermis, and ranged from 1.03 to 1.59 in KA and from 1.47-2.71 in SCC. The DNA Index (DI) discriminated KA from SCC in 17 of 22 cases (p less than 0.0007). The highest DNA content of single nuclei ranged from 9.0-18.0 picograms (pg) (DI 2.9-6.03) in KA and 14.8-38.6 pg (DI 4.0-11.03) in SCC. The highest DNA content discriminated KA from SCC in 16 of 22 cases (p less than 0.003). In fresh frozen tissue touch preparations from 15 of the same lesions, there was considerable overlap in DNA indices of KA (0.534-1.39) and SCC (0.464-1.41). Abnormal DNA peaks seen in histograms from three SCC in paraffin-embedded tissue sections were lost in the touch preparation histograms, probably due to inadequate sampling. Therefore, image analysis of paraffin-embedded tissue sections is better able to distinguish KA from SCC than touch preparations.

Carcinoma, Squamous Cell↗

PubMed1990

Acne keloidalis. Transverse microscopy, immunohistochemistry, and electron microscopy.

The earliest stages of acne keloidalis are not well characterized. In the present study, transverse sections of the early lesions revealed follicular units in several stages of inflammation. These follicles surrounded the central follicular units that gave rise to the clinically evident papule. Despite a spectrum of inflammatory changes, the most marked inflammation consistently occurred in the deep infundibular and isthmian levels of the hair follicles. Two follicles, presumably in the earliest stage, exhibited primarily an acute folliculitis and perifolliculitis, with destruction of the follicular wall and the release of hair. Central follicles showed predominantly acute neutrophilic or chronic lymphocytic inflammation at the upper isthmian levels and granulomatous inflammation at the deeper isthmian levels. Other follicles showed scar at the isthmian levels trapping hair fragments in the inferior portion of the follicle, with granulomatous inflammation and scarring. Sebaceous glands were absent in all stages of folliculitis in seven of eight follicular units.

Acne Keloid↗

PubMed1990

Rapid instrument sterilization.

A rapid dry heat sterilization system has been found to be an effective alternative to other popular methods for assuring instrument sterility. Unpackaged instruments can be sterilized in as little as 6 minutes. This system would be of particular value to the dermatologist who performs a minimal amount of surgery or maintains only a small inventory of surgical instruments.

Dermatology↗

PubMed1990

Silicone, fibrel, and collagen implantation for facial lines and wrinkles.

In recent decades, cutaneous surgeons have contributed to the development of a number of implantable materials useful in the management of facial lines and wrinkles. Among these, the most effective are injectable liquid silicone, bovine collagen implant (Zyderm/Zyplast, Collagen Corporation, Palo Alto, CA) and gelatin matrix implant (Fibrel, Mentor Corporation, Goleta, CA). Each of these treatments carries its own balance of efficacy, safety, and ease of use. Clinicians are encouraged to evaluate each of these treatments in order to be able to offer a full range of injectable therapy for the aging face.

Aminocaproates↗

PubMed1990

Immunosuppression in patients with metastatic squamous cell carcinoma from the skin.

Sixteen of 70 patients with metastatic squamous cell carcinoma (SCC) from the skin had evidence of clinical immunosuppression. In addition to patients with lymphoproliferative disorders or renal failure, those with cicatricial pemphigoid and those undergoing chronic oral corticosteroid therapy were identified as being at high risk. Host immune surveillance appears to play a major role in determining the metastatic potential of cutaneous SCC.

Adrenal Cortex Hormones↗

PubMed1990

Special considerations in pediatric dermatologic surgery.

Dermatologic surgical procedures can be performed in the pediatric patient in an outpatient setting. Although the surgical techniques involved are the same as those used in adult medicine, special attention must be given to anesthesia and patients' fears when dealing with pediatric patients. In this communication, some insights relating to pediatric surgical procedures performed at Duke University Medical Center's Dermatologic Surgery Unit are presented.

Anesthesia↗

PubMed1989

Mohs micrographic surgery for skin cancer.

Mohs micrographic surgery is a reliable outpatient surgical method of removing skin cancer. The method includes tissue excision in thin layers, colour-coding of excised specimens, accurate orientation of excised tissue through construction of tissue maps, and microscopic examination of horizontal frozen sections. Selected basal and squamous cell carcinomas are treated most commonly by this method, however, a variety of less common tumors are also amenable to treatment. Mohs micrographic surgery offers the highest cure rates for selected malignancies while maintaining maximal preservation of normal tissue and important anatomic structures.

Humans↗

PubMed1989

Metastases from squamous cell carcinoma of the skin and lip. An analysis of twenty-seven cases.

Of 365 consecutive squamous cell carcinomas treated by Mohs surgery, 27 (7.4%) later metastasized. Tumors of the temple, the dorsa of the hands, and the lips were more likely to metastasize than tumors located elsewhere. None of the metastatic lesions developed in antecedent inflammatory or degenerative conditions. No single factor was useful in predicting metastasis, but metastatic lesions, on average, were significantly larger and deeper than nonmetastatic lesions. It was much more difficult to control the primary lesion of patients with metastases. Five of the 27 patients died of metastatic disease despite aggressive surgery, radiation therapy, or both.

Aged↗

PubMed1989

Acne keloidalis: a review.

Acne keloidalis is a chronic scarring folliculitis located on the posterior neck of young black men. It is manifest clinically by follicular papules that coalesce into firm plaques and nodules. Examination of early lesions shows that inflammation begins at the deep infundibular and isthmic levels of the hair follicle and is accompanied by absence of sebaceous glands. The etiology of acne keloidalis is uncertain, but centers around anatomic, infectious, and autoimmune theories. Successful surgical therapy of advanced cases can be carried out using a number of methods as long as subfollicular destruction of the process is achieved.

Acne Keloid↗

PubMed1988

Determination of sex steroid receptor in human basal cell carcinoma.

The role of estrogens in the development of skin cancer is controversial. Sex steroids have a profound effect on the epidermis and epidermal appendages. Estradiol in pharmacologic doses has been reported to stimulate basal cell carcinoma in an animal model. Sex hormones act by means of a specific protein receptor. In this study we used a specific, highly sensitive monoclonal antibody to evaluate sex steroid receptors in human basal cell carcinoma. No estrogen or progesterone receptor protein was detected in the basal cell tumor, despite clear positive control tissues. We conclude that these sex steroid receptors are not present in significant amounts to mediate a direct effect in basal carcinoma.

Adult↗

PubMed1987

Skin cancer in the elderly.

Skin cancer is a major concern in geriatric populations. Cumulative exposure to carcinogens and age-related factors both contribute to the high prevalence of cutaneous malignancy in the elderly. Although mortality rates from skin cancer are relatively low, morbidity can be significant, particularly if lesions are neglected. Physicians can have a major impact on the course of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma by nurturing a high index of suspicion for malignancy when unexplained cutaneous lesions are encountered.

Aged↗

PubMed1986

Gorlin's basal cell nevus syndrome.

A case report is used to illustrate the characteristics of Gorlin's syndrome and to emphasize the need for early recognition by the physician and for thorough lifetime follow-up by the patient to prevent severe sequelae.

Adult↗

PubMed1986

Degradation of porcine dermal connective tissue by collagenase and hyaluronidase.

Selective destruction of connective tissue may be a useful therapeutic tool in conditions associated with abnormal deposition of scar tissue. We have investigated intradermal injections of clostridial collagenase and bovine testicular hyaluronidase alone and in combination in Yucatan miniature hairless pigs. Collagenase in combination with hyaluronidase was quite efficient at destroying the connective tissue matrix, although elastic tissue appeared to be completely spared. Collagenase alone at higher doses degraded collagen, but hyaluronidase had little effect on connective tissue architecture.

Animals↗

PubMed1986

Infiltrative basal cell carcinoma: a nonsclerosing subtype.

Infiltrative basal cell carcinoma is a distinct histologic subtype of basal cell carcinoma (BCC). Criteria for its diagnosis are presented and its nonsclerotic nature emphasized. Analysis of 174 consecutive BCCs referred for Mohs micrographic surgery showed the infiltrative subtype (29 tumors) to be significantly more destructive and difficult to treat than the more common nodular BCC.

Basal Cell Carcinoma↗

PubMed1986

Trauma as a possible etiologic factor in basal cell carcinoma.

1774 basal cell carcinoma lesions treated by Mohs surgery between 1979 and 1986 were evaluated for previous trauma histories. These traumas include burns, sharp trauma, chicken pox scars, blunt trauma, and vaccinations. 129 (7.3%) had a previous history of trauma. Analysis revealed that patients with trauma-related tumors were slightly younger and more likely to be male. Their lesions were larger pre- and post-op, and more often required five or more Mohs surgery stages, indicating these tumors may be especially deceptive clinically. The tumors were not particularly aggressive judging by histologic type. The literature is reviewed and implications for future work suggested.

Burns↗

PubMed1985

Wound healing 1985: an update.

The past decade has given rise to significant advances in our knowledge of the wound-healing process. Work performed by basic scientific investigators and clinical researchers has resulted in new insights into certain biologic-aspects of wound healing. The thoughtful application of some of these findings has led to the development of modern, physiologically sound wound-healing products and improved patient care.

Cells, Cultured↗