[THE SPECTRUM OF EFFECTIVENESS OF A NEW TOPICAL CORTICOID IN DERMATOLOGIC PRACTICE].
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A case an eleven year old girl with congenital poikiloderma, generalized xerosis and cutaneous atrophy, recurrent blister in extremities, sclerosis of the fingers and toes diffuse hyperkeratosis of palms and soles and webbing between some toes is reported here. Multiple seborrheic keratosis were also found, an association hitherto not mentioned with congenital poikiloderma.
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The epidermoid cyst with a seborrheic verruca-like cyst wall is a newly described variant of the epidermoid cyst. The cyst wall of this variant shows changes simulating seborrheic keratosis and verruca. Our case of a subcutaneous mass was shown histopathologically to have this variant.
A 45-year-old man presented with a pigmented lesion on his face. A clinical diagnosis of melanocytic nevus was made and the lesion was excised. Histopathologic examination showed a reticular seborrheic keratosis associated with a junctional nevus. We discuss the relation of nevocellular nevi with epidermal and adnexal tumors.
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A clinico-statistical study is reported, basing on a material of 639 excised tumours which were defined histologically as seborrheic keratoses. All statements concerning clinical diagnoses and differential diagnoses, localization, development, age and sex of patients were transferred to punch cards. By means of a suitable EDA program, basic counts and a multidimensional analysis of conditioned frequencies [14] were performed. The results indicate, that the different clinical forms of seborrheic warts, often discriminated in the literature, are variants of the same entity.
The sign of Leser-Trélat refers to a sudden increase in size and number of seborrheic keratoses associated with internal malignancy. The validity of this cutaneous sign continues to be debated, particularly because of the prevalence of both seborrheic keratoses and malignancy in the elderly population. Preceding inflammatory skin conditions are known to precipitate eruptions of seborrheic keratoses in otherwise healthy persons. These cutaneous lesions may also be associated with other markers of underlying malignancy such as acanthosis nigricans. We present a young female patient with osteogenic sarcoma in whom eruptive seborrheic keratoses developed. We believe this case is representative of the sign of Leser-Trélat.
Painful sunburns are implicated in the pathogenesis of squamous cell carcinoma, basal cell carcinoma, and malignant melanoma. Chronic exposure to ultraviolet radiation is known as the most important risk factor for the development of actinic keratoses and squamous cell carcinoma. The purpose of the study was to assess the effect of painful sunburns and lifetime sun exposure on the development of actinic keratoses and seborrheic warts in relation to the development of squamous cell carcinoma and basal cell carcinoma, and on the development of melanocytic nevi and atypical nevi in relation to the development of malignant melanoma. We made use of a cohort of 966 individuals who participated in a case-control study to investigate environmental and genetic risk factors for skin cancer. Exposure measurements for sunlight were collected and actinic keratoses, seborrheic warts, melanocytic nevi, and atypical nevi were counted. Relative risks were estimated using exposure odds ratios from cross-tabulation. Multivariate logistic regression was used to adjust for potential confounders. The recall of painful sunburns before the age of 20 y was associated with an increased risk of squamous cell carcinoma, nodular basal cell carcinoma, and multifocal superficial basal cell carcinoma as well as actinic keratoses. Odds ratios with 95% confidence intervals adjusted for age, sex, and skin type were 1.5 (0.97; 2.3); 1.6 (1.1; 2.2); 2.6 (1.7; 3.8); and 1.9 (1.4; 2.6) for the three types of nonmelanoma skin cancer and actinic keratoses, respectively. Painful sunburns before the age of 20 y were also associated with an increased risk of malignant melanoma and the development of its precursors, melanocytic nevi and atypical nevi. Odds ratios with 95% confidence intervals adjusted for age, sex, and skin type were 1.4 (0.86; 2.1); 1.5 (1.1; 2.0); and 1.4 (0.88; 2.3) for malignant melanoma and the two types of precursors, respectively. Lifetime sun exposure was predominantly associated with an increased risk of squamous cell carcinoma (p-value for trend=0.03) and actinic keratoses (p-value for trend <0.0001) and to a lesser degree with the two types of basal cell carcinoma. By contrast, lifetime sun exposure appeared to be associated with a lower risk of malignant melanoma, despite the fact that lifetime sun exposure did not diminish the number of melanocytic nevi or atypical nevi. Neither painful sunburns nor lifetime sun exposure were associated with an increased risk of seborrheic warts.
On the basis of a study of 54 specimens each of large-cell acanthoma, solar lentigo, reticulated seborrheic keratosis, and lichen planus-like keratosis, it is concluded that clinically, histopathologically, and biologically, large-cell acanthoma is a variant of solar lentigo, and solar lentigo (including the large-cell variant) is a stage in the evolution of reticulated seborrheic keratosis and of lichen planus-like keratosis.
Histologic studies have shown the evolution of lentigo senilis and have established the relationship between lentigo senilis, solitary lichen planus-like keratosis, and the reticulated form of seborrheic verruca. Histologic differentiation can be made between lentigo senilis and the early light-brown stage of lentigo maligna.
In 54 of 325 seborrheic keratoses, trichostasis spinulosa was found within the keratinous cysts and between papillomatous surface keratin, in addition to being present in contiguous hair follicles. Trichostasis in seborrheic keratoses and trichostasis spinulosa are both more frequent in older age groups. Trichostasis spinulosa represents a marker of vellus hair follicles and indicates that some seborrheic keratoses incorporate and may be partially derived from the cells of the infundibular portion of the follicle.
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BACKGROUND: The eruptive appearance of numerous seborrheic keratoses, the sign of Leser-Trélat, has been regarded as a reliable cutaneous marker of internal malignancy. OBJECTIVE: We have evaluated the possible association of malignant disease and the sign in 1752 consecutive cases of seborrheic keratoses. METHODS: First, the Swedish Cancer Registry was searched for records of malignancies in the study population (1958 to 1984), and the expected number of malignancies was calculated. Second, records of persons with malignancy within 1 year before or after the diagnosis of seborrheic keratosis were checked for the sign of Leser-Trélat. Third, a case control study was performed to evaluate the possibility of eruptive seborrheic keratoses among the noncancer patients in the study population. RESULTS: The results showed a slight increased risk of cancer in the study population (relative risk = 1.2; 95% confidence interval = 1.0 to 1.3), mainly because of an increased risk of cutaneous squamous cell carcinoma. In 62 patients with seborrheic keratoses, a malignancy (excluding skin) was diagnosed within 1 year before or after the diagnosis of seborrheic keratosis. Of these 62 patients, 6 were regarded as possibly having presented with the sign of Leser-Trélat. For every one of the 62 cases with seborrheic keratosis and malignancy within one year, an age- and sex-matched control patient without cancer was selected from the study population and the records were checked for sudden and eruptive seborrheic keratoses. Among the control patients, five were regarded as possibly having presented with the sign of Leser-Trélat. CONCLUSION: This study gives no evidence to support the opinion that eruptive seborrheic keratoses are related to internal cancer risk.
Maintenance media incubated with biopsy specimens of human skin tissues contained minute (10-12 nm wide), ring-shaped particles (RSP) similar to those described previously in culture media of mammalian cell lines. In addition to the qualitative demonstration of the particles by electron microscopy, a quantitative method was applied to estimate in media the amount of DNA that could be attributed primarily to RSP content. The amounts of DNA, obtained with 146 test specimens, varied with the pathologic condition of the tissue in the following ascending order: normal skin, verruca vulgaris, seborrheic verruca, actinic keratosis, basal cell carcinoma, and squamous cell carcinoma.