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[Malignant skin neoplasms].

Malignant skin neoplasms of the auricle and peri-auricular region constitute only 6% of all skin cancers. However, rates of recurrence and metastasis are higher than for other cutaneous malignancies. Of 81 patients with malignant skin neoplasms of the auricle, 53.1% had basal cell carcinoma, 39.5% squamous cell carcinoma and 7.4% malignant melanoma. The neoplasms were 4 times more common in men (more than in other series), and more common in those of Ashkenazi origin (75% of the patients) and in the elderly (peak incidence in the 7th decade). All patients were treated surgically, and 21 were also irradiated. In 4 with cervical metastases neck dissection was performed. The recurrence rate for all neoplasms was 12.4% and the rate of metastases to regional lymph nodes from squamous cell carcinoma, 12.5%. There was a marked correlation between positive margins after surgical excision and rates of recurrence and regional metastases. Malignant skin neoplasms of the auricle should be regarded as high risk lesions which often recur and/or metastasize. Therefore, it is recommended to excise the tumors adequately so as to get negative margins, and to follow-up with careful, frequent evaluation.

Adolescent

Trends in morbidity on the basis of newly-reported cases of malignant skin melanoma (172 ICD) and other skin neoplasms (173 ICD) in Czechoslovakia during the period 1961--1972.

According to newly-reported cases of all malignant neoplasms of the skin (172 + 173 ICD) morbidity rate for the period 1961--1972 showed a rising trend of statistical significance only in Bohemia; while in Slovakia it persisted at a practically steady level throughout the period followed. Malignant skin melanomas (172 ICD) were on the increase in both regions, the rate being of statistical significance only in men in Bohemia. Morbidity from other malignant skin neoplasms (173 ICD) during the same period showed a stable pattern in Slovakia while it rose steadily in a significant degree in both, males and females in Bohemia. The causes for these varying trends must be further analyzed.

Adolescent

Spontaneous skin neoplasms in aged Sprague-Dawley rats.

A total of 93 tumors of the epidermis, its appendages, and dermis were observed in 1,433 (717 males, 716 females) rats employed in oncogenicity studies over a 2-yr period. Mammary gland neoplasms will be reported separately. Fifty-seven (61.3%) were epithelial with 49 in males and 8 in females. Keratoacanthoma was the most frequent epithelial neoplasm in males (22) followed by squamous cell carcinoma (11) and papilloma (5). Sebaceous gland neoplasms seen in males (5) included both adenomas (3) and carcinomas (2). In males, there were also 3 trichoepitheliomas, 1 pilomatricoma, 1 basal cell tumor, and 1 malignant melanoma. Of the 8 epithelial neoplasms in females, there were 3 squamous cell carcinomas, 2 keratoacanthomas, and 1 each basal cell tumor, malignant melanoma, and trichoepithelioma. There were 21 mesenchymal neoplasms in males and 15 in females. The most frequent neoplasm was fibroma (7 males, 8 females) followed by lipoma (7 males, 4 females) and fibrosarcoma (4 males, 3 females). One male had a liposarcoma and 2 males each had hemangioma. The total neoplasm incidence of 70/717 (9.8%) in males and 23/716 (3.2%) in females showed that skin neoplasms were 3 time more common in males than in females. Epithelial neoplasms of the skin were 6 times more common in males than in females. Males were more than twice as likely to have epithelial rather than mesenchymal skin neoplasms whereas the reverse was seen in females.

Aging

Reduced levels of UV-induced unscheduled DNA synthesis in epidermal keratinocytes of patients with xeroderma pigmentosum and correlation with development of skin neoplasms.

Primary epidermal keratinocytes obtained from 25 patients with xeroderma pigmentosum (XP) (nine with XP-A, one with XP-C, two with XP-D, five with XP-E, and eight with XP-variant) exhibited less UV-induced unscheduled DNA synthesis (UDS) than did those from 34 normal subjects. Levels of UDS depended greatly on the type of XP; i.e., 3-17% of the control in XP-A, 14% in XP-C, 33-53% in XP-D, 38-77% in XP-E and 58-98% in XP-variant. The extent of UDS in epidermal keratinocytes was almost the same as that in dermal fibroblasts in XP-C, D, and E, but in three out of eight of the XP-variant the level of UDS in epidermal keratinocytes was significantly lower than that in normal subjects. Clinically, three out of nine XP-A patients developed skin neoplasms before 20 years of age. Both patients with XP-D developed skin neoplasms around 40 years of age. In the five XP-E patients, two developed multiple basal cell epithelioma on sun-exposed areas during the forth decade, and one of them also developed squamous cell carcinoma at the age of 50. Four out of the eight patients with the XP-variant developed various skin neoplasms during their 20s and 30s. These results suggest that a defect in UV-induced UDS in epidermal keratinocytes of XP patients is responsible for skin carcinogenesis and the extent to which this defect occurs tends to relate to the age of onset of skin neoplasms.

Adult

Clinical pharmacology of systemic chemotherapeutic agents in skin neoplasms.

Considerable progress recently has been made in the systemic chemotherapy of disseminated skin neoplasms. Several agents are particularly useful in this regard: the nitrosoureas, methotrexate, actinomycin D, and dacarbazine. This paper reviews their pharmacologic disposition in man. The nitrosoureas have short plasma half-lives; however, they are extensively degraded to metabolites that persist in the body, and are only slowly excreted. Highly soluble in lipids, the nitrosoureas penetrate significantly into the central nervous system. Actinomycin D is only minimally metabolized in vivo; its elimination from the plasma shows a prolonged slow phase with a half-life of 36 hours; but its excretion is even slower than expected about 30% in a week. A potent inhibitor of dihydrofolate reductase, methotrexate exhibits a multiphasic plasma disappearance, and accumulates in tissues with high dihydrofolate reductase activities. At the normal therapeutic dosages, methotrexate is eliminated by the kidneys as the unchanged drug; appropriate dosage modifications are mandatory if renal function is compromised. Dacarbazine has a relatively short plasma half-life, and is rapidly excreted partly as the unchanged drug; it undergoes extensive biotransformation in the body. Like other antitumor agents, these drugs may cause gastrointestinal toxicities and myelosuppression; in addition each drug can have its own individual organ toxicity.

Antineoplastic Agents

Cytology in veterinary practice. A review of clinical cytology--body fluids, lymph nodes and skin neoplasms.

A review over the most applicable areas of veterinary clinical cytology is given. The areas described are body fluids, lymph nodes and selected skin neoplasms. The review includes tables that survey general and specific cytologic criteria and is supplemented by photomicrographs. A classification of effusions according to cytologic criteria is discussed and there is a short discussion of 62 cases which also included histopathology.

Animals

Trends in mortality rate from malignant skin melanoma and other malignant skin neoplasms in Czechoslovakia during the period 1921--1970.

Mortality from malignant skin melanoma (172 ICD) has an ascending trend in Czechoslovakia (CSSR) the rate being higher after the year 1960 in Bohemia (CSR) than the Slovakia (SSR). Mortality from other malignant neoplasms of the skin (173 ICD) declines; this decline for the whole of Czechoslovakia has been statistically influenced mainly by the lower death rate from this cause in Bohemia, for in Slovakia this mortality rate has risen, although significantly only in women. The proportion of deaths from malignant skin melanoma (172 ICD) out of the total number of deaths from malignant skin neoplasms (172 + + 173 ICD) is relatively low in Czechoslovakia--lower in Slovakia than in Bohemia.

Adolescent

Distribution of complement regulators (CD46, CD55 and CD59) in skin appendages, and in benign and malignant skin neoplasms.

Immunohistochemical studies were performed to establish the distribution of membrane cofactor protein (MCP; CD46), decay-accelerating (DAF; CD55) and homologous restriction factor (HRF20; CD59), in normal skin appendages, and in benign and malignant skin neoplasms. At least two of these regulators were detected on normal eccrine glands, apocrine glands and sebaceous glands. They were also found in cellular naevi (CN), seborrhoeic keratoses (SK), basal cell carcinoma (BCC), Bowen's disease (BD), squamous cell carcinoma (SCC) and Paget's disease (PD). Although there were slight differences in their distribution, these regulators were found in all the cells examined, indicating that they are essential factors in human skin as well as other organs, and in neoplasms, in preventing autologous complement attack.

Antigens, CD

Transplantation studies of preputial gland and epithelial skin neoplasms derived from benzidine-based dye carcinogenicity assays in Fischer 344 male rats.

Neoplasms of preputial gland and skin were obtained from Fischer 344 male rats on lifetime drinking water studies of the benzidine congener 3,3'-dimethoxybenzidine, C.I. Direct Blue 15 or C.I. Acid Red 114, bisazobiphenyl dyes derived from 3,3'-dimethoxybenzidine and 3,3'-dimethylbenzidine. Portions of these well differentiated neoplasms were implanted into the left mammary fat pad of Fischer 344 male recipients. The rate of growth, presence of local invasion and distant metastases, and morphologic features were observed following 4 serial transplantations. All implants appeared early, grew rapidly, and were histomorphologically similar to the original neoplasms. Metastases from transplants were observed with both preputial gland and skin tumor lines in serial passages. The transplantation results confirm the malignant nature of these neoplasms.

Animals

[Epithelial tumor-like changes, precancerous conditions and skin neoplasms (standardization study)].

A retrospective study of bioptic material was used to design the following outline of a histological classification of epithelial skin tumours tentatively compared with handbooks published by the WHO (1) and AFIP (2): I. Tumour-like changes: 1. senile verruca (mixed, acanthotic, melanoacanthotic, hyperkeratonic, reticular, inverted). 2. Virus verrucosities (v. vulgaris, v. plana, c. accuminatum, molluscom contagiosum). 3. Hamartogenic verrucosities (naevus verrucosus, n. comedonicus, fibroepithelial papilloma. 4. Genetically undefined verrucosities (acanthosis nigricans, light cell acanthoma, verrucous dyskeratosis). 5. Cysts (atheroma, epidermoid cyst, dermoid cyst, others). 6. Unclassified. II. Precanceroses: 1. Pseudoepitheliomatous hyperplasis, 2. keratosis senilis, 3. Radiation dermatosis, 4. Unclassified. III. Epithelial tumours A. From surface epithelium 1. Spinocellular carcinoma (basic type, anaplastic, adenoid, sarcomatoid, clear cell carcinoma, intraepidermal). 2. Basocellular carcinoma: a) varieties derived from surface epithelium (intraepithelial, superficial, solid, cystic, invasive), b) varieties with adenoid features (cylindromatous, fibroepithelia), c) varieties with trichoepithelial features (keratinizing, pigment-type, clear cell type), d) naevus varieties (basocellular naevi). 3. Spinobasocellular carcinoma. 4. Unclassifiable. B. Sweat gland tumours: 1. syringocystadenoma papilliferum, 2. hidradenoma papillare, 3. nodular hidradenoma (eccrine spiradenoma, eccrine acrospiroma, myxochondroepithelioma, myoepithelioma, mucinous epithelioma), 4. syringoma, 5. eccrine cylindroma, 6. hidrocystoma, 7. eccrine poroma, 8. carcinomas (so called extramammary Paget carcinoma), 9. unclassifiable. C. Sebaceous gland tumours: 1. adenoma sebaceum, 2. carcinoma sebaceum, 3. quasi tumours (naevus sebaceus, Pringle's hamartoma, steatocystoma multiplex, hyperplasia), 4. unclassifiable. D. Trichoepithelial tumours: 1. trichofolliculoma, 2. follicular poroma, 3. keratoacanthoma, 4. tricholemoma, 5. pilomatrixoma, 6. trichogenic adnexal tumour, 7. trichoepithelioma, 8l unclassifiable.

Aging

[Intra-parotid lymph node metastasis of malignant skin neoplasms of the head].

More than 75% of parotid metastases represent a secondary localization in the parotid region lymph nodes of malignancies arising from the skin of the head. Among 94 parotidectomies performed at the Otolaryngologic Clinic of the University of Brescia in the years 1980-1987, 21 were primary malignant growths and of these 5 (23.8%) proved to be intraparotid lymph node metastases of previously resected cutaneous tumors of the face (1 melanoma and 4 squamous cell carcinomas). Parotid metastases were treated by lateral (3 cases) or total parotidectomy (2 cases) with preservation of the facial nerve; in 4 cases a homolateral neck dissection of the functional type was performed in the same session (N+ in 1 case only). Three out of four patients with squamous cell carcinoma were subsequently submitted to Co60 radiation therapy. Four patients died 1 to 22 months after the treatment: in three, death was due to a local recurrence or a distant metastasis; in 1 case to osteoradionecrosis with no signs of relapse of the tumor. One patient only treated with total parotidectomy, functional neck dissection (N-) and postoperative radiation therapy is still alive and free of disease 18 months after surgery.

Aged