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Surrounding Skin (surrounding + skin)
Selected AbstractsLaser-Doppler Examination Shows High Flow in Some Common Telangiectasias of the Lower LimbDERMATOLOGIC SURGERY, Issue 4 2005Imre Bihari MD Background. The accepted pathophysiology of telangiectasias is reflux from superficial or deep veins. There are physical signs and scientific findings that do not fit this theory but support the possibility of arteriovenous (AV) shunt origin. Objective. If there is a higher flow in spider veins than in the surrounding skin, it means that AV shunts participate in the circulation of the telangiectasia. On the other hand, slow flow indicates reflux as the etiologic factor. Method. Telangiectasias and the surrounding skin of 22 legs of 19 patients were examined with laser-Doppler equipment. Results. The probe over the spider vein found a higher flow value (average 28.2 perfusion units [PU]) than in the surrounding skin (15.6 PU) in 13 limbs, but it was significantly higher only in 5 cases. In 9 limbs, the flow was slower. Conclusion. We interpret the higher flow values as a consequence of open AV shunts. This means that AV shunt pathophysiology was present in some of our cases. IMRE BIHARI, MD, PHD, ANIKÓ MURÁNYI, MD, AND PéTER BIHARI, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Why do melanomas get so dark?EXPERIMENTAL DERMATOLOGY, Issue 11 2009Rossitza Lazova Abstract:, Cutaneous malignant melanomas often exhibit pigmented regions that are darker than the surrounding skin. While melanoma cells are the original source of the melanin, keratinocytes and melanophages also contribute to the tumor colour because they contain melanin obtained from melanoma cells. However, little is known of the origin of darkly pigmented melanoma cells or of the molecular pathways regulating their melanin production. Here we discuss observations that dark melanoma cells emerge from within populations of melanoma in situ and that, in addition to producing abundant dark pigment, they appear to be undergoing autophagy. Moreover, autophagy appears to be a common trait of invasive melanoma cells in the dermis. The underlying cause of this phenomenon may stem from aberrant production of glycosylation structures known as ,1,6-branched oligosaccharides. Our studies of dark cutaneous melanomas were prompted by analyses of experimental mouse macrophage-melanoma hybrids fused in the laboratory. Like melanoma cells in cutaneous malignant melanoma, experimental hybrids also displayed abundant dark pigment and autophagy, and had high levels of ,1,6-branched oligosaccharides. Whether or not darkly pigmented malignant melanoma cells originate from fusion with macrophages in vivo remains to be determined. In any event, pigmentation in melanoma, long considered as a secondary aspect of the malignancy, may be a visible warning that the cells have gained competence for invasion and metastasis. [source] Pseudoepitheliomatous hyperplasia , an unusual reaction following tattoo: report of a case and review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2007Wei Cui MD A 59-year-old woman presented with an itchy and uncomfortable raised lesion at a tattoo site (Fig. 1) on the lateral aspect of the left leg, just above the ankle. The tattoo had been placed 2 years before her presentation and the tattoo site was sun exposed. Immediately after she had the tattoo, she noticed redness of the skin. After a week, a pruritic and red scaly nodule developed that continued to gradually enlarge until her presentation. The patient had tried topical vitamin A and D ointment with no relief. The patient also had tattoos on the arms without any noticeable skin changes. The patient reported that the tattoo procedure on her leg was more painful than that on her arms, and was performed by a different (and perhaps inexperienced) tattoo artist. The original tattoo contained red, green, and yellow pigments. Figure 1. Raised nodular lesion with irregular margins A diagnosis of tattoo granuloma was considered; squamous cell carcinoma and fungal infection were included in the differential diagnosis. A punch biopsy was performed, followed by complete surgical excision of the lesion with a split-thickness skin graft from the right thigh. The skin excision specimen showed a 3 × 2.5-cm granular and pitted pink lesion with well-demarcated, somewhat irregular borders. The lesion was raised 0.5 cm above the skin surface. The lesion was present in the center of the original tattoo. Portions of the original tattoo with green and blue,green pigmentation were visible on either side of the lesion. No satellite lesions were identified. Microscopically, the raised lesion demonstrated striking pseudoepitheliomatous hyperplasia, with irregular acanthosis of the epidermis and follicular infundibula, hyperkeratosis, and parakeratosis (Fig. 2). Follicular plugging was present with keratin-filled cystic spaces. There was a brisk mononuclear inflammatory infiltrate in the dermis, composed primarily of lymphocytes, with admixed plasma cells and histiocytes. Giant cells were occasionally identified. Dermal pigment deposition was noted both within the lesion and in the surrounding skin, corresponding to the original tattoo. Variable dermal fibrosis was noted, with thick collagen bundles in some areas. There was no evidence of epidermal keratinocytic atypia, dyskeratosis, or increased suprabasal mitotic activity. Special stains (periodic acid,Schiff and acid-fast) for microorganisms were negative. Figure 2. (a) Raised lesion with marked pseudoepitheliomatous hyperplasia and follicular plugging (hematoxylin and eosin; magnification, ×2.5). (b) Irregularly elongated and thickened rete pegs with blunt ends associated with dermal chronic inflammation (hematoxylin and eosin; magnification, ×5). (c) Follicular dilation and plugging with keratin-filled cystic spaces (hematoxylin and eosin; magnification, ×5). (d) Dermal pigment and fibrosis (hematoxylin and eosin; magnification, ×10) [source] Pulsed erbium:YAG laser-assisted autologous epidermal punch grafting in vitiligoINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2000Mukta Sachdev MD Background A pilot study was conducted to evaluate the efficacy and safety of pulsed erbium:YAG laser ablation of autologous minipunch grafted sites for the treatment of refractory or stable vitiligo. Methods Thirteen patients, seven men and six women, aged between 19 and 58 years, with Fitzpatrick skin types ranging from type IV to VI, were grafted. The pulsed erbium: YAG laser was used to create recipient graft sites. Results Repigmentation was observed in 12 out of 13 patients. Failure of grafts to repigment ranged from 3% to 100%. No untoward side-effects of surgery were noted. Conclusions Using an erbium:YAG laser to create graft recipient sites permits the survival of punch harvested grafts and the spread of pigmentation to the surrounding skin. [source] Long-term results after reconstruction of full thickness scalp defects with a dermal regeneration templateJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2010J Faulhaber Abstract Objective, Large scalp defects in which the pericranium has to be resected can be reliably reconstructed using Integra®. In the present study, we retrospectively analysed the long-term outcome of our patients. Methods, Nineteen patients were included who had received Integra® dermal regeneration template for treatment of full thickness scalp defects after resection of various malignant tumours. All patients were followed up with a mean follow-up time of 31 months (14,72). Results, All transplants were on almost equal levels with the surrounding skin. Cosmetic results were acceptable and scars were stable. Nodal ultrasound status was negative in all patients. During the follow-up period of up to 72 months, no local recurrences were observed. One patient with a leiomyosarcoma received radiotherapy after transplantation. In the irradiated area, multiple small regular-shaped round ulcerations and later on partial necrosis of the transplant occurred when the patient developed renal failure 29 months after the initial operation. Five patients died of disease not related to the primary skin tumour. All other patients are alive and free of disease without any complications. Conclusion, After reconstruction of full thickness scalp defects with Integra®, the cosmetic results are appealing and we observed no local recurrences during the follow-up period. [source] Nuclear ,-catenin in basal cell carcinoma correlates with increased proliferationBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2004G. Saldanha Summary Background Virtually all BCCs have deregulation of the Hedgehog (Hh) signalling pathway and a proportion show nuclear ,-catenin accumulation. The latter is thought to be due to Hh pathway-directed Wnt expression but this has not been tested. An alternative cause of nuclear ,-catenin accumulation is gene mutation, which stabilizes the protein. Theoretically, reduced E-cadherin expression could also be important because it can sequester ,-catenin at the cell membrane. In turn, nuclear ,-catenin can increase expression of MYC and cyclin D1, thus potentially altering proliferation. Objectives To assess whether nuclear ,-catenin occurs in BCC, and to look at potential causes and consequences. Methods Nuclear ,-catenin was assessed by immunohistochemistry, and its causes by analysis of E-cadherin expression, ,-catenin exon 3 mutation and WNT5A expression. Its consequences were assessed by analysing proliferation. Results We found nuclear ,-catenin in 20 of 86 paraffin-embedded sections of BCCs using immunohistochemistry. BCCs showed increased WNT5A relative to the surrounding skin. No mutations in exon 3 of the ,-catenin gene were found in 10 cases. There was no association between ,-catenin localization and E-cadherin expression. Tumours with nuclear ,-catenin had significantly higher proliferation (P < 0·01). Conclusions The absence of ,-catenin gene mutations indicate that the Hh pathway-directed Wnt signalling remains the most likely cause of nuclear ,-catenin accumulation in BCC. Additionally, the correlation with increased proliferation is the first evidence that nuclear ,-catenin may have a biological effect. However, a causal link between Hh pathway deregulation, Wnt ligand overexpression, nuclear ,-catenin accumulation and increased proliferation remains to be confirmed. [source] | ||||||||||