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Facial Lesions (facial + lesion)
Selected AbstractsEffect of inflammation on positive margins of basal cell carcinomasAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2010Neil Macpherson ABSTRACT Background/Objectives:, The use of preparations such as imiquimod in the treatment of basal cell carcinoma is well accepted. Imiquimod induces interferon-,, other cytokines, antigen-presenting cells and innate immunity, against tumour cells. The current study investigated whether the inflammation induced from a surgical procedure could have a similar effect on removing residual tumour after an excision. Method:, A retrospective audit was carried out on basal cell carcinoma removed in the Dermatology Clinic of the Royal Newcastle Centre in 2007. The end-point focussed on the features of those tumours which initially had a positive margin, but were found to have no remaining tumour on subsequent excision. Result:, A linear regression was carried out, revealing two significant predictors of outcome. These were the location of the basal cell carcinoma excision and the excision type. Punch biopsies and excisional biopsy had a greater number of histopathologically negative wider excisions despite initial positive margins. Facial lesions had a greater number of negative wider excisions. Conclusion:, The study has shown the majority of negative re-excisions were from lesions on the head which had had an initial surgical procedure. However, the evidence is not strong enough to advocate a protocol for dealing with positive margins. A larger sample size that encompassed all three factors that affect outcome, that is, the location of lesion, type of lesion and type of excision carried out, would be required in order to make a more definitive statement on protocol change for treatment of basal cell carcinoma. [source] Human herpes simplex labialisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2007M. Fatahzadeh Summary Humans are the natural host for eight of more than 80 known herpes viruses. Infections with herpes simplex virus type 1 (HSV-1) are ubiquitous worldwide and highly transmissible. Herpes simplex labialis (HSL) is the best-recognized recrudescent infection of the lips and perioral tissues caused by HSV-1. Facial lesions of HSL may be unsightly, frequent outbreaks unpleasant, and the infection itself more severe locally and systemically in immunocompromised people. This article highlights the pathogenesis, clinical presentation, diagnostic features and management issues for HSL. [source] Systemic autoimmune disease induced by dendritic cells that have captured necrotic but not apoptotic cells in susceptible mouse strainsEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 11 2005Liang Ma Abstract Systemic lupus erythematosus (SLE) is an autoimmune disorder of a largely unknown etiology. Anti-double-stranded (ds) DNA antibodies are a classic hallmark of the disease, although the mechanism underlying their induction remains unclear. We demonstrate here that, in both lupus-prone and normal mouse strains, strong anti-dsDNA antibody responses can be induced by dendritic cells (DC) that have ingested syngeneic necrotic (DC/nec), but not apoptotic (DC/apo), cells. Clinical manifestations of lupus were evident, however, only in susceptible mouse strains, which correlate with the ability of DC/nec to release IFN-, and to induce the pathogenic IgG2a anti-dsDNA antibodies. Injection of DC/nec not only accelerated disease progression in the MRL/MpJ- lpr/lpr lupus-prone mice but also induced a lupus-like disease in the MRL/MpJ-+/+ wild-type control strain. Immune complex deposition was readily detectable in the kidneys, and the mice developed proteinuria. Strikingly, female MRL/MpJ-+/+ mice that had received DC/nec, but not DC/apo, developed a ,butterfly' facial lesion resembling a cardinal feature of human SLE. Our study therefore demonstrates that DC/nec inducing a Th1 type of responses, which are otherwise tightly regulated in a normal immune system, may play a pivotal role in SLE pathogenesis. [source] Xeroderma pigmentosum with limited involvement of the UV-exposed areas: a case reportINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2003Mostafa Mirshams-Shahshahani MD A 21-year-old woman with skin type IV, who had developed photophobia and brown, spotty, hyperpigmented lesions on her face from early childhood, presented to our center for treatment of her facial lesions. Examination on admission revealed numerous, freckle-like, hyperpigmented macules and actinic keratoses over the central part of the face, with sparing of the forehead, chin, and peripheral area (Fig. 1). The area involved was approximated to be around 2% of the total body surface. The dorsal parts of the hands showed no lesions (Fig. 2), but guttate hypomelanotic lesions were apparent on both forearms. Figure 1. Limitation of xeroderma pigmentosum lesions to the center of the face Figure 2. Hands are devoid of any lesions Histologic examination of biopsies from four different facial lesions revealed them to be keratoacanthoma (1.5 × 2.5 cm ulcerative nodule on the right cheek), sclerosing basal cell epithelioma (nasal lesion), lentigo simplex, and hypertrophic actinic keratosis. Corneal clouding, conjunctival injection, loss of lashes, and atrophy of the lids were apparent on ophthalmologic examination. Other parts of the physical examination, including examination of the oral cavity, were nonsignificant. In addition, except for the presence of mild eczema in a sibling, the patient's family history regarding the presence of any similar problem and also any other important dermatologic or general disorder was negative. [source] Craniofacial trauma in the Prehispanic Canary IslandsINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2007L. S. Owens Abstract The current project is a study of craniofacial trauma in a large sample (n,=,896) of Prehispanic Canary Islanders (PCIs). The possible causes and social implications of the trauma found are considered, with reference to archaeological and historical data. Variables include the island, period and ecology, the sex and age of the individuals, the distribution of lesions across the skull (by side and by individual bone) and ante-mortem tooth loss. The results show a fairly high trauma rate (16%), a low prevalence of peri-mortem trauma (3.8% of all lesions), higher prevalence of trauma in males than in females (25% vs. 13% of all individuals), more cranial than facial lesions (8.9% vs. 3.5% of all elements) and more lesions on the left side of the skull (6.7% vs. 4.5% of all elements) which suggests that the lesions were sustained through intentional rather than accidental agency. There was no correspondence between trauma prevalence and ecology. The archaeological and historical data support the assertion that the lesions may be the result of skirmishing between groups, using weapons such as slingshots, stones and staves. The presence of edged-weapon lesions on some individuals suggests that these may have been the victims of contact-period European groups. Copyright © 2007 John Wiley & Sons, Ltd. [source] Chloracne: histopathologic findings in one caseJOURNAL OF CUTANEOUS PATHOLOGY, Issue 4 2002Maria Antonia Pastor Background: Chloracne is an acneiform eruption due to poisoning by halogenated aromatic compounds having a specific molecular shape. This condition is always a symptom of systemic poisoning by chemical chloracnegens and not just a cutaneous disorder. Methods: We have studied a patient with severe chloracne who showed cutaneous lesions involving mostly the face and the axillae. Results:, Histopathologic study of the facial lesions demonstrated that almost every vellus hair follicle was involved, showing a dilated infundibulum filled by a keratotic plug. This keratotic material was mostly composed of orthokeratotic basket-weave basophilic corneocytes, namely infundibular keratin, although there were also some dilated infundibula containing eosinophilic laminated or granular sebum at their center. Small infundibular cysts were more numerous than comedones. Mature and well-developed sebaceous glands were seen at the base of many of the dilated infundibula and no squamous metaplasia of the sebaceous glands or ducts could be demonstrated. Hyperpigmentation of the lesions resulted from hyperproduction of melanin by a normal number of melanocytes along the basal layer of the epidermis and infundibular epithelium. Abundant melanin granules also impregnated the corneocytes of the infundibular plugs. Conclusions:, Our findings support the notion that tiny infundibular cysts rather than comedones represent the basic lesions of chloracne. [source] Isolation of Sporothrix schenckii from the environmental sources of cutaneous sporotrichosis patients in Himachal Pradesh, India: results of a pilot studyMYCOSES, Issue 6 2007Karan Inder Singh Mehta Summary Himachal Pradesh, India is a known endemic area for cutaneous sporotrichosis. No attempt has been made to isolate Sporothrix schenckii, the causative fungus, from environmental sources in this region or in India as such. This prospective study was carried out to isolate Sporothrix schenckii from different environmental samples collected from the vicinity of cutaneous sporotrichosis patients. All patients of cutaneous sporotrichosis diagnosed during March 2005,February 2006 were studied. Twenty-one biopsy specimens and 62 environmental samples of soil, various thorns, corn-stalk, grass-blades and sphagnum moss were subjected to mycologic culture on Sabouraud's glucose agar. Sporothrix schenckii was identified by colony characteristics, lacto-phenol cotton blue mounts and demonstration of temperature dimorphism. These patients (F : M 15 : 6) were between 12 and 72 years of age and had cutaneous lesions for 45 days to 4 years. Lymphocutaneous and fixed cutaneous sporotrichosis was seen in 14 (66.6%) and 7 (33.3%) patients respectively. Extremities were involved in 16 (76.2%); and 5 (23.8%) patients had facial lesions. Ten (47.4%) biopsy specimens and six environmental (three soil, three corn-stalk) samples were culture-positive, which showed morphological characteristics suggesting Sporothrix schenckii. No variation in colony characteristics and mycelial morphology was observed in growth isolates from clinical or environmental samples. Temperature dimorphism was observed in all the 10 isolates obtained from the clinical specimens and in two isolates cultured from corn-stalk. Corn-stalks are evidently important sources of Sporothrix schenckii infection although subsequent contamination of wounds appears more important for development of clinical disease. Culture of Sporothrix schenckii from environmental sources may not be always possible to correlate with profile of injuries. [source] Broadband targeted UVB phototherapy for localized vitiligo: a retrospective studyPHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 3 2009Ahmet Akar Phototherapy with ultraviolet B (UVB) or PUVA has been used in the treatment of vitiligo for many years. The aim of this study was to analyze retrospectively the efficacy and safety of targeted broadband UVB phototherapy in patients with localized vitiligo. Thirty-two patients (14 male, 18 female), aged 18,65 years, were treated with Daavlin T500x High Dose Targeted Phototherapy System. Patients were treated twice or thrice weekly, totaling 20 to 60 sessions. Out of 32 total patients, only four patients (12.5%) showed visible repigmentation. In two patients, repigmentation was more than 75%. Other two patients showed mild repigmentation (less than 25%). All the lesions responsive to treatment were facial lesions. Mild adverse events recorded in 3 of 32 patients. Although safety of targeted broadband UVB phototherapy in the treatment of localized vitiligo is good, its therapeutic effectiveness is limited and depends on the locations of vitiligo lesions. [source] Cutaneous metastasis resembling acute dermatitis in patient with advanced gastric cancerCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2007D. H. Koo Summary The most common metastatic sites from gastric cancer are the liver, intra-abdominal lymph nodes, ovary and peritoneal cavity. Cutaneous metastasis of gastric cancer is rare, and most cutaneous metastases are typically solitary, nodular, have a firm consistency, and are red or hyperpigmented. Thus, cutaneous metastasis is easily distinguished from other skin disease. We report a case of a 60-year-old woman with cutaneous metastasis of gastric cancer, whose facial skin showed painless pruritic eczema, resembling acute dermatitis. She had earlier undergone a total gastrectomy for advanced gastric cancer in our hospital. After 14 months, she developed eczematous facial lesions; the presumptive diagnosis was acute dermatitis. However, skin biopsy unexpectedly revealed cutaneous metastasis of gastric cancer. After 6 months of systemic chemotherapy with capecitabine and cisplatin, the cutaneous metastasis was markedly improved and a clinically complete remission was accomplished. [source] Comparison of efficacy of azithromycin vs. doxycycline in the treatment of acne vulgarisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2005S. Kus Summary Acne vulgaris is a common inflammatory disorder of the skin. Oral antibiotics are known to be effective in its treatment. A randomized, investigator-blinded study was performed to compare the efficacy of azithromycin with doxycycline. Fifty-one patients were randomized to receive either azithromycin 500 mg/day on 3 consecutive days per week in the first, on 2 consecutive days per week in the second, and on 1 day per week in the third month. The other group was given doxycycline twice a day for the first month and once a day for the second and third months. Clinical assessment was made at baseline, at the end of first, second, third, and post-treatment first and second months. Side effects were recorded. Statistically significant improvement for the facial lesions were obtained with both drugs. Neither drug was shown to be more effective than the other. The beneficial effect continued until 2 months after treatment. In the azithromycin group three patients had diarrohea, while photosensitivity was seen in two patients using doxycycline. This study indicates that azithromycin is at least as effective as doxycycline in the treatment of acne. [source] | ||||||||||