Long-Term Follow-Up Results of Topical Imiquimod Treatment in Basal Cell Carcinoma

BACKGROUND Imiquimod 5% topical cream is approved for treatment of superficial basal cell carcinoma (BCC). Data on the long-term efficacy and usage in other BCC subtypes are scarce. OBJECTIVE Evaluation of long-term safety and efficacy of topical imiquimod treatment in various BCC subtypes and locations, with individualized treatment duration. MATERIALS AND METHODS Histopathologically confirmed BCCs treated solely with topical imiquimod were identified retrospectively and included in this study. Clinical and histopathologic tumor clearances were the primary end point. After treatment was concluded, patients were examined every 3 to 6 months. RESULTS In total, 24 BCC samples from 22 patients (F:M = 9: 13;mean age: 73.5 years, SD: 10.767) were evaluated. The majority of the lesions were located in the head and neck area (83%). Mean treatment duration until complete clearance was 15.7 +/- 6 6.9 weeks (6-28 weeks). Imiquimod was discontinued in 3 lesions, due to either clinically or histopathologically insufficient response. During follow-up, 2 lesions recurred, at 42 and 50 months after treatment. During a mean follow-up time of 72.7 (SD = 9) months, 79.1% of the lesions were cured without local recurrence. CONCLUSION Although imiquimod is only approved for superficial BCC, treatment success was high among the study patients with various histological subtypes, with good long-term cosmetic results

Acceleration of Medpor implant fibrovascularization with local vascular endothelial growth-factor injections: An experimental study

Objective: Medpor is a biocompatible, high-density porous polyethylene implant that is used for multiple indications in plastic surgery. The most frequent complications associated with the Medpor implant are infection and implant exposure. The primary cause of these complications is poor fibrovascularization of the Medpor implant and poor nourishment of the overlying skin. The present experimental study aimed to determine whether vascular endothelial growth factor (VEGF) could accelerate and increase Medpor implant fibrovascularization in vivo, and thereby improve local nourishment and prevent complications. Materials and Methods: The Medpor implant was inserted under the dorsal skin area in 40 Sprague-Dawley rats. 20 rats receiving local VEGF injections comprised the study group. The control group received saline injections. Fibrovascularization of the Medpor implants was compared. Results: In the rats injected with VEGF, the Medpor implant fibrovascularized faster, and there were more newly formed blood vessels, as compared with those in the control group. Conclusion: These findings have led to our use of VEGF-like agents that the accelerate angiogenesis in the Medpor implant as a means to reduce the incidence of such complications as infection and implant exposure. [Arch Clin Exp Surg 2015; 4(4.000): 196-201

Dermatopathological characteristics of dermatofibromas from dermatoscopic clues

Background: Several types of dermatofibroma (DF) have been identified dermatopathologically and with dermatoscopic correlation, the dermatopathology has been predictable in limited studies so far. We identify DFs with specific dermatoscopic structures and determine the respective dermatopathological correlates. Methods: Dermatoscopic and dermatopathologic correlation of 403 DFs were assessed. A pattern analysis algorithm was used for the dermatoscopic evaluation, each lesion being evaluated according to 10 dermatoscopic patterns with further subdivision of the atypical subtype according and their dermatoscopic similarities to other defined skin lesions. Results: Dermatoscopic pattern analysis showed typical patterns in 83.4% of DFs with atypical patterns in 16.6%. We classified the atypical DFs according to their dermatoscopic similarity to certain lesions: Melanoma-like 2.7%, basal cell carcinoma-like 0.7%, keratoacanthoma-like 0.5%, seborrheic keratosis-like 2.7%; nevus-like 1.5%; nevus sebaceous-like 0.9%; xanthogranuloma-like 0.5%; pyogenic granuloma-like 0.5%; and spitzoid 6.5%. Dermatopathologically 12 subtypes of DFs were identified. It was found that the most common pattern found in fibrocollagenous DFs was the typical pattern with peripheral reticular lines and central white structureless area (32.9%) whereas non-fibrocollagenous types were more likely to have atypical patterns (65.1%). Conclusions: Our study resulted in new conclusions while supporting some previous findings. The fact that the pathogenesis of DF involves a reactive inflammatory process with fibrosis is likely to have diverse effects on dermatoscopic morphology. If atypical dermatoscopic patterns are identified in suspected DF, excisional biopsy may be prudent

Recurrent optic disc and retinal vasculitis in a patient with drug-induced urticarial vasculitis

Batioglu, Figen/0000-0002-5834-7512; Heper, Aylin Okcu/0000-0002-7807-0717WOS: 000242997200005PubMed: 17162415The purpose of this study was to report recurrent optic disc and retinal vasculitis in a patient with drug-induced urticarial vasculitis. Complete ophthalmological examination including fluorescein angiography and visual field examination were done. A 53-year-old woman with recurrent painful urticarial skin lesions following trimethoprim sulfamethoxazole usage had the clinical and histopathological diagnosis of urticarial vasculitis. Two years after cutaneous manifestations, she began to notice visual disturbances in both eyes that recurred at 1-year intervals. Her ophthalmological findings were consistent with recurrent vasculitis of the optic nerve and retina. Treatment with high-dose corticosteroids and hydroxychloroquine resulted in the resolution of cutaneous and ocular manifestations. This patient demonstrates that recurrent occlusive vasculitis of the optic nerve and retina can occur in this rare disease. These patients should be examined periodically by ophthalmologists

A Case of Acanthosis Nigricans As A Paraneoplastic Syndrome with Squamous Cell Lung Cancer

A 55-year-old man presented with oral mucosal ulcers, blackening of both hands, and hyperpigmentation on axillary, anal, and inguinal regions for the last 3 months, which were all progressive. The patient was referred to the oncology department with the diagnosis of acanthosis nigricans for investigation of an underlying malignancy. He was a smoker. A computed tomography scan of thorax revealed enlarged mediastinal lymphadenopathies and a lesion on the left upper lobe. Fine-needle aspiration biopsy of the mediastinal lesion was consistent with squamous cell carcinoma, and biopsies of the skin and oral mucosal lesion also further confirmed the diagnosis of acanthosis nigricans. After docetaxel and cisplatin chemotherapy, a significant improvement in his skin and mucosal lesions was observed with almost complete resolution of the pulmonary lesion and the mediastinal lymph nodes.PubMedWoSScopu