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Keratosis lichenoides chronica: report of a new case with partial response to PUVA therapy.

Keratosis lichenoides chronica is a rare disorder characterized by a distinctive seborrheic dermatitis-like facial eruption together with development of asymptomatic verrucosities on the limbs and the trunk, with a partially linear distribution. We report a case of a 35-year-old Syrian woman who presented with keratotic plaques and papules of the limbs for several years, and a seborrheic dermatitis-like facial eruption. A diagnosis of keratosis lichenoides chronica was clinically and histologically. Treatment with isotretinoin was without benefit. She had partial response to PUVA.

Adult↗

Actinic keratosis: preventable and treatable like other precancerous and cancerous skin lesions.

Actinic keratosis, like many other precancerous and cancerous skin lesions are preventable and treatable. Nurses, physicians, other health care providers, school teachers, daycare workers, grandparents, parents, and children must assume the role of educating others regarding attitudes and knowledge about sun damage to the skin. Protecting one's skin should be a lifelong process from the newborn period onward. However, if sun damage does occur, the next important step is early detection of skin cancer. Individuals with associated risk factors should be screened routinely by health care personnel with expertise in the area of skin cancer. The best treatment of actinic keratosis, as with most diseases, is prevention.

Education, Nursing, Continuing↗

[Chronic lichenoid keratosis: disease variant or disease entity?].

The presentation of a new case of keratosis lichenoides chronica (KLC) in a 61-year-old woman lead us to this comprehensive study of the cases already published in the literature. The clinical and histological substrate of KLC and its differential diagnosis and treatment are discussed in detail. The clinical appearance is mainly characterized by an eruption of (1) lichenoid, keratotic papules, (2) linear or plaque-like keratosis, and (3) psoriasis-like scaling lesions on the trunk and extremities. The course of the disease is chronic and progressive. Histopathological study shows variable features, which are similar to those of lichen planus only on rare occasions. This dermatosis does not show any pathological relationship with other dermatological conditions; we therefore suggest that KLC is a distinct entity.

Diagnosis, Differential↗

[Spreading pigmented actinic keratosis--diagnosis and therapy].

Spreading pigmented actinic kereatosis is a rarely described premalignant epidermal lesion occurring on the skin following exposure to the sun. On clinical examination it may be difficult to distinguish it from pigmented seborrheic keratosis or lentigo maligna. Spreading growth and a diameter greater than 1.5 cm are characteristic features. We report a case of spreading pigmented actinic keratosis in a 61-year-old patient.

Facial Neoplasms↗

[Cutaneous signs of Noonan's syndrome. Apropos of a case with ulerythema ophyogenes, disseminated pilar and sudoral keratosis and progressive alopecia].

A case of typical Noonan syndrome (NS) with eye abnormalities, pterygium colli, cryptorchid testes, lymphoedema and asymmetrical cardiac septal hypertrophy is reported in a 8-month old infant. This case was particularly interesting since it included skin manifestations which enabled an early diagnosis to be made. Ulerythema ophryogenes has already been proposed as a cutaneous marker of NS, but the keratinization disorders in our patient also included disseminated keratosis of both hair follicles and sweat glands orifices. Abnormally brittle short curly hair has already been reported, but our patient exhibited progressive alopecia which is very rare in NS. Biochemical hair analysis did not show any abnormalities of aminoacids. All these features were suggestive of keratosis follicularis spinulosa decalvans. It therefore seems very likely that NS is associated with keratinization disorders but ulerythema ophryogenes might only be the limited form of these disorders. The other skin manifestations of NS are reviewed. Since the patient had 4 "café au lait" spots, the relation of NS with Von Recklinghausen syndrome, and neurofibromatosis-Noonan syndrome is discussed. Watson's Leopard and cardio-facial syndromes overlap with, and may represent subsets of NS.

Abnormalities, Multiple↗

Cholesteatoma of the external auditory canal and keratosis obturans.

Keratosis obturans and external auditory canal cholesteatoma have often been regarded as a single entity. However, these are two distinct disorders with their own clinical presentations, physical and pathologic findings, and treatment. Keratosis obturans is an accumulation of obstructive desquamated keratin in the external auditory meatus. External auditory canal cholesteatoma is an invasion and erosion of squamous epithelium into a localized area of the bony ear canal. The origin of both entities remains obscure. The clinical symptoms, pathologic processes, and treatment are outlined and compared. Case reports are presented to illustrate the features of these two diseases.

Adult↗

[Tricholemmal keratosis and tricholemmal cancer].

Three cases of tricholemmal keratosis and two of tricholemmal carcinoma are reported. All patients were female and the age range was from 71 to 83 years. These rare tumors occur on the face and are obviously the result of long-standing actinic skin damage. Clinically, verrucous hyperkeratosis or cornu cutaneum (keratosis) are observed and in the case of tricholemmal carcinomas, ulcerated tumor nodules. Histologically pale, glycogen-rich polygonal cells with signs of tricholemmal keratinization without the presence of a granular cell layer are characteristic features. Tricholemmal keratoses exhibit no atypia or only a mild form; however, carcinoma in situ may occasionally develop. In contrast, tricholemmal carcinomas are characterized by increased pleomorphia, an increase in the rate of mitosis, and an invasive growth pattern. The prognosis is favourable.

Aged↗

Automastoidectomy caused by keratosis obturans: a case report.

This is a case report of a 25-year-old Oriental woman with persistent and neglected keratosis obturans. The enlarging plug of keratin in the deep meatus produced an "automastoidectomy" in the left ear. The clinical findings are supplemented with a preoperative CT scan, and by pre- and postoperative Hopkins rod photographs of the ear. This case demonstrates dramatically the extensive erosion of bone that can occur in a patient with neglected keratosis obturans.

Adult↗

[Spreading pigmented actinic keratosis].

Two cases of spreading pigmented actinic keratosis are reported. In case number one, an invasive, pigmented squamous cell carcinoma developed in the lesion. Clinicopathologic features include size greater than normal, lateral spread of the lesion, and presence of melanin in dysplastic epidermal cells, dendritic melanocytes and dermal melanophages. Differential diagnosis to be considered includes lentigo maligna, lentigo maligna melanoma and seborrheic keratosis.

Aged↗

Keratosis circumscripta. A distinct dermatological entity or a variant of psoriasis?

45 cases of a dermatosis believed to be the same as those originally described by Schrank in 1963 among Nigerian children of Yoruba ethnic origin and named keratosis circumscripta by him are reviewed. All evidences point towards the fact that the dermatosis observed by us as well as those originally described by Schrank are a variant of psoriasis possibly modified by environmental factors. It has therefore been suggested that this dermatosis should not be regarded as a new dermatological entity, and that the original names should be modified. To reflect the original work done by Schrank as as well as the true clinical picture of this dermatosis, the nomenclature psoriasis circumscripta with palmo plantar keratosis is suggested.

Adolescent↗

Keratosis punctata of the palmar creases.

Nineteen cases of keratosis punctata of the palmar creases are presented. This entity, currently regarded as a variant of keratosis punctata of the palms and soles, is seen almost exclusively in blacks. It is benign, mostly asymptomatic, and sometimes familial without any sex predilection. The clinical lesions are pits and keratotic papules confined to the creases of the palms and volar surfaces of the fingers. The soles are rarely affected but a new finding reported here is the involvement of the side of feet in eight of the nineteen cases.

Adolescent↗

DNA repair deficiency in lymphocytes from patients with actinic keratosis.

DNA repair activity was measured in peripheral blood lymphocytes from 18 patients with Actinic Keratosis and 18 age-matched control subjects, by comparing the incorporation of 3H-thymidine into cells after irradiation with ultraviolet light with that into unirradiated cells. The incorporation was followed autoradiographically or by measuring acid insoluble radioactivity in cells labelled in the presence of hydroxyurea. The repair activity in lymphocytes from Actinic keratosis patients was only 47.1 percent (+/- 6.5%) of that in cells from the control subjects.

Aged↗

Actinic keratosis and squamous cell carcinoma.

Actinic keratosis is a common skin disorder in elderly patients with fair complexions. It is caused by exposure to ultraviolet light. If left untreated, actinic keratosis may progress to squamous cell carcinoma. The metastatic potential and prognosis vary with the type and location of the lesion. Several approaches to treatment are available, including local destruction, excisional surgery, Mohs surgery, cryosurgery and radiotherapy.

Carcinoma, Squamous Cell↗

[Keratosis lichenoides striata associated with a pseudo-sinhum and a neurological picture (author's transl)].

The authors reported a case which does not seem to be possibly related to any known clinical entity; an aspect of keratosis lichenoides striata is associated with an ichthyosiform condition of the trunk and a pseudo-ainhum; there is also a neurological syndrome similar to a multilocular sclerosis. This patient resembles the previous cases of the literature; however there is neither erythema nor any striation at the back of the knees. There is also a pseudo-ainhumm. Concerning this observation, a review of the literature on keratosis lichenoides striata is presented.

Adult↗

[Glycohistochemical analysis of seborrheic keratosis in eyelids].

The glycoconjugates of seborrheic keratosis in the eyelids were examined by in situ hybridization histochemistry using cRNA probes for sialyltransferase (ST) and lectin histochemistry. We considered that the cells, which expressed both cytoplasmic distribution of ST-mRNA and binding of lectins specific for sialic acids to the cell surfaces, were actively producing sialoglycans. We also considered that the cells whose surfaces were stained with the lectins without cytoplasmic distribution of ST-mRNA have completed the synthesis of sialoglycans. These viewpoints suggest that the O-linked sialoglycan, whose turnover-rate is slow, may be distributed over the cells of the thickened spinocellular layer in the tumor of seborrheic keratosis and involved in its pathomechanism. It also appears that the turnover rate of the terminal sialic acids in the N-linked glycan in the spinocellular layer may be fast.

Aged↗

[Keratosis palmoplantaris varians et punctata. Clinical variability of an single genetic defect?].

Palmoplantar keratodermia (PPK) varians and PPK punctata are considered different entities within the group of hereditary palmoplantar keratodermas. Keratosis punctata of the palmar creases constitutes a localized form of keratodermia palmoplantaris punctata. We describe a 31-year-old man exhibiting both nummular and papular keratoses on the soles, as well as small punctate keratoses confined to the palmar creases. In view of the co-occurrence of these two types of PPK, the question arises whether keratosis palmoplantaris of the varians and the punctate type represent distinct entities or represent variable manifestations of the same gene defect.

Adult↗

Natural history and management of keratosis, atypia, carcinoma-in situ, and microinvasive cancer of the larynx.

Keratosis, atypia, carcinoma in situ, and microinvasive cancer occurring as white or red patches on the vocal cords are part of the diathesis of cancer of the aerodigestive tract and represented a sequential continuum. Excisional biopsy is the preferred treatment for identification and potential cure of the lesion. If the margins of excision are inadequate, further treatment options are either reexcision or radiotherapy. Radiotherapy should be used only when the need for voice conservation prevails. Cessation of smoking does not remove the potential for progression of the disease, therefore, all patients must be followed indefinitely. Excisional biopsy of keratosis, carcinoma in situ, and microinvasive cancer of the larynx offers an excellent prognosis for voice preservation and survival.

Adult↗

Keratosis follicularis of the oral mucosa with oral squamous cell carcinoma.

Darier's disease or keratosis follicularis is a genodermatosis which may involve the oral mucosa. Malignant degeneration is rare. We report the first case of the combined manifestation of oral keratosis follicularis and oral squamous cell carcinoma and discuss the possible involvement of ATP2A2 (located in 12q23-24.1) which encodes the sarco/endoplasmic reticulum Ca(2+)-ATP isoform 2 (SERCA2), in the pathogenesis.

Calcium-Transporting ATPases↗