Guidelines of care for office surgical facilities. Part II. Self-assessment checklist. American Academy of Dermatology.
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Biomedical subjects
Publications and source records attributed to G F Graham.
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Many advances have been made in cryosurgery during the past decade. Important considerations are the high cure rate, good cosmetic result, convenience, and cost effectiveness. In an era of budget restraints with regard to medical care and in a time of concern with exposure to bloodborne pathogens, cryosurgery offers unique solutions. Cure rates for skin cancer in the area of 97 to 98 percent, for actinic keratosis, 98 percent, and for lentigo maligna, 96 percent, should encourage its use in more patients. The effectiveness in freezing lesions of leukoplakia, dermatofibroma, hemangioma, keloid, and lentigo adds to the versatility of the method. With the further development of ultrasound in measuring the depth of tumors prior to freezing and the availability of superior monitoring systems and perhaps helium cryosurgical units, cryosurgery could become the most widely used technique in dermatology. The development of a cryopeel for sundamaged skin provides an alternative treatment to the chemical peels in use today.
This article has discussed the use of cryosurgery as a method for treating benign, premalignant, and malignant skin lesions. Treatment of acne has also been discussed. Correct freeze times for obtaining good cosmetic results and a high cure rate have been stressed. Methods for obtaining high cure rates in treating skin cancer have been given. Modern day cryosurgery is an efficient, effective modality yielding good cosmetic results and high cure rates.
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A 70-year-old woman with the multiple hamartoma syndrome is described. Diagnosis was based on the clinical presentation and histopathologic examination of cutaneous trichilemmomas. The case is reported to document the association of Cowden's disease with non-Hodgkin's lymphoma. This is the first known report of the occurrence of trichilemmomas in the sacral area. The literature concerning the association of the multiple hamartoma syndrome with malignancy is reviewed.
Although experimental studies in animals show that selenium may prevent cancer, case-control studies of internal human cancers have been difficult to interpret because neoplastic tissue sequesters selenium. We therefore conducted a case-control study to examine the association between plasma selenium level and skin cancer, a neoplasm with minimal tumor mass at the time of diagnosis. The mean selenium level among patients with either basal cell epithelioma (N = 142), squamous cell carcinoma (N = 48), or both (N = 50), was 0.141 micrograms/g. This was significantly lower than the mean plasma selenium level of the 103 control subjects, which was 0.155 micrograms/g. The noncancer control groups were drawn from current clinic patients and past clinic patients. The logistic estimate of the odds ratio for the lowest versus the highest decile of selenium for all cases combined versus the group of current patient controls was 4.39; for all cases combined versus the past patient controls, the logistic estimate of the odds ratio was 5.81.
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