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At least 55 records · Page 3Linked to original sources

Temperature monitoring during photodynamic therapy of skin tumors with topical 5-aminolevulinic acid application.

Temperature monitoring during photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) cream application was performed on 22 patients with solar keratoses (SK) and basal cell carcinoma (BCC). The lesions were located on the forehead, nose, ear and cheek. Temperature measurements during photoirradiation, with a power density of 100 mW/cm2 from an incoherent light source (light delivery system for PDT), were carried out by noncontact (infrared thermal imaging radiometer) and contact (thermocouple) methods. Thermal imaging analysis revealed nonuniform temperature distribution in the irradiated areas. The temperature gradually increased from the peripheral to the central zone of the area. The results showed that photoirradiation induced heating of the skin tumors to 39.5-42.5 degrees C during the PDT procedure. The temperature of normal skin areas disposed symmetrically to the lesions on the contralateral side at the same conditions of irradiation (without prior ALA application) was about 42-43.5 degrees C. The surface temperature differences (delta T) between the normal and tumor tissues after 10 min of irradiation were 3.3 +/- 0.5 degrees C in the forehead areas, 2.5 +/- 0.4 degrees C in the nose areas and 0.8 +/- 0.3 degrees C in the ear areas.

Aminolevulinic Acid↗

Prolonged evolution of a lentigo maligna.

Lentigo maligna (LM) is a melanocytic lesion which is a potential precursor to melanoma and often has a prolonged intraepidermal growth phase before evolving into lentigo maligna melanoma (LMM). LM is also noted for its tendency to locally recur after treatment. We present a patient who had a persistent LM on her left cheek which, despite multiple excisions, persisted and transformed into a partially amelanotic LMM roughly three decades later. Our patient's course was also notable for this melanoma recurring at the edge of, and subsequently migrating into, a previously placed skin graft.

Aged↗

The use of botulinum A toxin to ameliorate facial kinetic frown lines.

PURPOSE: External photography and subjective response were used to evaluate the use of botulinum A toxin to diminish glabellar kinetic folds. METHODS: Eleven patients with glabellar folds and midline forehead wrinkling received one to four injections of 0.1 ml of 100 U/1 ml botulinum A toxin. The injections were given into the procerus or corrugator muscles or both. The number of injections corresponded to the wrinkle lines in each patient. The patients were examined and photographed just before the injections and at 7 to 10 days after the injections. Treatment efficacy was judged by photographic evaluation and by the patient's subjective evaluation of the effect of the treatment. RESULTS: Photographic evaluation showed objective improvement in the glabellar wrinkling in 6 of 11 patients in relaxed facial position and in all 11 patients during contraction of the periocular mulscles. Ten of the 11 patients reported satisfaction with their cosmetic results and indicated that they would choose to have the procedure done again. CONCLUSIONS: The results of this study suggest that botulinum A toxin is a safe and effective treatment for glabellar folds.

Adult↗

Syringoma presenting as milia.

We present two unrelated patients with numerous infraocular milium-like lesions that histologically revealed syringoma with many overlying keratin cysts in the papillary dermis. A Fontana-Masson stain revealed no melanin-containing cells in the keratin cyst walls, suggesting that they originated from eccrine ductal structures. A classification of the clinical variants of syringoma is presented.

Adenoma↗

Inverted follicular keratosis.

Inverted follicular keratosis, a benign tumor of the skin believed to arise from the infundibular portion of the hair follicle that can involve perioral skin, has a unique histologic picture. It can be confused with forms of skin cancer; with knowledge of this entity, oral and maxillofacial surgeons may be able to avoid unnecessary surgery. The clinical and microscopic findings of 12 cases of inverted follicular keratosis are reported.

Adult↗

Treatment of skin carcinomas of the face by high-dose-rate brachytherapy and custom-made surface molds.

PURPOSE: To analyze the results obtained in a prospective group of patients with basal or squamous cell skin carcinomas of the face treated by high-dose-rate (HDR) brachytherapy via custom-made surface molds. METHODS AND MATERIALS: A total of 136 patients with basal or squamous cell carcinomas of the face were treated between March 1992 and March 1997 by surface molds and HDR brachytherapy with iridium-192. Nineteen patients were treated with standard Brock applicators and 117 patients with custom-made polymethyl methacrylate applicators, built over a plaster mold obtained of the patient's face. Minimum dose administered to the tumor was 6000 to 6500 cGy in 33 to 36 fractions at 180 cGy/fraction in lesions of up to 4 cm. Lesions greater than 4 cm were boosted up to 7500-8000 cGy after a 3-week pause. RESULTS: With the custom-made surface molds, the dose distribution was uniform in the surface of the skin and at 5 mm depth in the whole area of the applicator. Differences between the areas of maximum and minimum dose at this depth never reached values higher than 5% of the prescribed dose. At the edges of the custom-made molds dose gradient was sharp, with the detected dose at 5 mm from the applicator being negligible. All the patients were complete responders. There were 3 local recurrences, 1/73 patients treated for primary tumor and 2/63 patients treated for recurrent tumor. Actuarial local control at 5 years for all patients was 98%, for those patients with primary tumors 99%, and for recurrent patients 87%. The treatment tolerance was excellent in all cases. No severe, early, or late, complications were detected. CONCLUSIONS: Radiotherapy is a highly effective treatment of skin carcinomas of the face. Custom-made molds, to be used in conjunction with HDR brachytherapy equipment, make possible a uniform dose distribution, with a sharp dose gradient in the limits of applicators. Custom-made surface molds are easy and safe to use, and they fit very accurately for daily treatment. Local control is excellent with minimal sequelae or complications. Probably they will become the standard way of treatment of face skin carcinomas in the near future.

Adult↗

Ear, nose and throat manifestations of Lyme disease.

The manifestations of Lyme disease as they may present to the ENT surgeon are discussed. The most important ENT symptom is facial palsy. Particularly when combined with other cranial palsies, systemic illness or signs of meningeal irritation, the diagnosis must be considered. Three case reports are used to illustrate the presentation and diagnosis and treatment of Lyme disease. The characteristics of the disease are reviewed and the limitations of serological testing outlined. The literature has concentrated on bilateral or relapsing facial palsy. A review of palsies in Zurich that presented to the ENT clinic found only unilateral and partial palsies. The diagnosis should be considered in every case of facial palsy of unknown aetiology especially in children.

Adult↗

Fatal bacteria granuloma after trauma: a new entity.

In the past 20 years, more than 20 cases of a type of granulomatous disease have been noticed by dermatologists in different areas of China. The patients had these features in common: (i) the lesions followed a slight trauma to the face; (ii) they were spreading dark-red plaques without pus or ulceration; (iii) new lesions appeared near to or far from the original lesion; (iv) histopathology showed histiocytic granuloma; (v) the patients had severe headache and clouding of consciousness during the later stages of the disease; (vi) all patients died within 1.5-4 years; (vii) treatment with prednisone led to some healing of the lesions but accelerated death; and (viii) all patients were from rural areas. We examined the tissues from two similar patients by electron microscopy and identified two kinds of bacteria as a possible cause of the disease. One was an anaerobic actinomycete, the other was Staphylococcus capitis. The anaerobic actinomycete was sensitive to lincomycin (a forerunner of clindamycin). After a 5-month therapy with lincomycin, one patient survived. We infer that the cause of death is the unknown anaerobic actinomycete. Because the disease is very severe, we suggest the name 'fatal bacteria granuloma after trauma' to draw attention.

Actinomycetales Infections↗

Tuberous sclerosis: clinicopathologic features and review of the literature.

INTRODUCTION: Tuberous sclerosis is a hamartoneoplastic syndrome, which may involve multiple organ systems. Oral hard tissue manifestations of the syndrome have been described in the literature only as recently as 1955. Patients who presented with clinical manifestations of tuberous sclerosis did not routinely undergo oral surveys to rule out 'lesions', and consequently data on 'lesions' in the maxillofacial complex is scant. Ten cases have been found in the English language literature, which describe maxillofacial 'lesions', which may be tumours, new growths, neoplasms or overgrowths occurring in patients diagnosed with tuberous sclerosis. PURPOSE: To review the literature for all maxillofacial lesions associated with tuberous sclerosis and to present an eleventh case of a patient with a maxillofacial lesion diagnosed as having tuberous sclerosis. RESULTS: Eleven cases were found with maxillofacial fibroblastic lesions associated with tuberous sclerosis. These lesions were all fibrous benign neoplasms found in the maxillofacial bony complex. CONCLUSIONS: Maxillofacial fibroblastic lesions in tuberous sclerosis have various histopathological presentations, some of which may be difficult to differentiate. Consequently, close microscopic examination of these lesions is necessary so that adequate surgical treatment is provided.

Child, Preschool↗