Skin biopsy techniques: Part 1.
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Biomedical subjects
Publications and source records attributed to C W Hanke.
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Basal-cell carcinoma with perineural invasion is a rare occurrence. Ten patients with this phenomenon are described. Review of our cases and cases in the literature indicates that perineural spread of basal-cell carcinoma is most common in men with recurrent tumors. The horizontally cut frozen sections that are utilized in Mohs surgery maximize the chances of discovering basal-cell carcinoma with undiagnosed involvement.
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Four men who underwent hair implantation for pattern baldness were treated for complications such as infection, foreign-body reaction, pruritus, and scarring. The complications were similar to those reported with synthetic modacrylic fiber implants that have been used for the same purpose. Although we believe this is the first article to report complications from hair implants, the illogical basis of the procedure suggests that complications will occur in many unsuspecting patients who undergo hair implantation.
Forty-one patients who underwent one technic of fiber implantation for pattern baldness were studied. Complications were frequent and included rejection of fibers, infection, facial swelling, pain, pruritus, and scarring. In addition, patients incurred risks of carcinogenesis from deeply embedded bits of fiber and also loss of their own natural hair. Fiber implantation is an unsuccessful method of hair restoration, and its use has been discouraged by state and federal agencies.
Several methods of fiber implantation have been used to reduce pattern baldness, and similar results have been reported: fiber breakage, foreign-body reaction, infection and scarring. Since one method or another tends to predominate in different geographic areas, the physician often is unable to compare the results of the various methods. The two patients described in this article underwent different methods of fiber implantation; serious complications occurred in both. Fiber implantation is an unsafe technique and must be discouraged.
Leiomyomas of the skin are classified as pilar, genital, or angioleiomyoma depending on the site of origin. Pilar leiomyomas are the most common form, and usually multiple tumors are found in a single patient. An unusual variant of multiple pilar leiomyoma is nevus leiomyomatosus systematicus, a descriptive term used when tumors are wide-spread and patterned, suggesting a nevoid condition. Many of the large pilar tumors are painful and require surgical excision for relief of symptoms.