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[Effect of thermal mud baths on normal, dry and seborrheic skin].

PURPOSE: To investigate the curative effects of thermal water and thermal muds in various cutaneous pathologies. PATIENTS AND METHODS: Modifications of phmetry and sebometry using sulphur thermal muds in normal, dry and seborrheic skin have been studied. The three groups of patients have been submitted to a 14 day treatment with thermal muds. RESULT: The application of thermal mud normalized the value of cutaneous pH and sebometry. CONCLUSIONS: These beneficial effects are long-lasting in individuals who have a prolonged treatment with thermal muds.

Adolescent↗

Seborrheic skin and acne vulgaris as protective factors against the development of basal cell epithelioma.

This study was conducted in order to evaluate a possible protective role of seborrheic complexion and a history of acne on the development of basal cell epithelioma (BCE). For this purpose, 77 patients with this tumor were examined and asked to fill out a questionnaire. The questionnaire included demographic data and questions about skin type, eye and hair colors, sun exposure habits and a past history of acne. The nature, number and location of tumors, the texture of skin and acne scars were noted by a physician. A group of 93 age-, sex- and skin-color-matched patients served as controls. The results show a clear relationship between seborrheic features and a lower risk of developing BCE, after controlling for solar exposure using the Mantel-Haenszel summary measure. The same trend was found in patients with a history of acne. Whether ultraviolet light absorption by sebum, an anticancer activity of Propionibacterium acnes or other factors play a protective role against the development of BCE is as yet unclear.

Acne Vulgaris↗

Seborrheic keratoses.

Seborrheic keratoses are benign tumors of the epidermis that commonly appear during middle age. They are pigmented verrucous papules with a characteristic "stuck on" appearance. The tumors enlarge and become more deeply pigmented with age. The precise etiology is unknown. Differential diagnosis includes malignant melanoma and pigmented basal cell carcinoma. Biopsy should be performed if the diagnosis is in doubt. Treatment, when indicated, includes curettage, shave excision, freezing with liquid nitrogen or the use of trichloroacetic acid.

Basal Cell Carcinoma↗

The relation between seborrheic keratoses and malignant solid tumours. A case-control study.

In order to establish whether or not here is an association between cancer and intense growth of seborrheic keratosis, the so-called Leser-Trelat sign, we conducted a case control study in which the number and features of seborrheic keratosis in 82 patients with recent solid tumours, were compared with 82 age- and sex-matched controls. Neither numbers nor features of seborrheic keratosis differed significantly in patients and controls. Eruptive seborrheic keratosis was noted in only one patient and one control. This study showed that solid malignancies are not generally associated with an increase in the number or size of seborrheic keratosis lesions, thus suggesting that they are not controlled by a hypothetical secretion of growth factors by tumours. Our results suggest that Leser-Trelat is either a coincidence, or at most a very rare sign of unusual types of cancer. We also showed that multiple cherry angiomas, previously reported to be a paraneoplastic sign, are not regularly associated with solid tumours.

Adult↗

Immunolocalization of low-molecular-weight stress protein HSP 27 in normal skin and common cutaneous lesions.

Stress proteins, which are found ubiquitously in mammalian cells, appear to be implicated in the regulation of cell growth and protection from environmental insult. Although we previously demonstrated the expression of low-molecular-weight stress protein, HSP 27, in cultured keratinocytes, HSP 27 has not yet been identified in human skin. Using standard immunohistochemistry on routinely processed paraffin sections, we examined specimens of common epidermal lesions and normal skin with a monoclonal antibody to HSP 27. Normal skin from the breast, foreskin, and lower extremity demonstrated strong cytoplasmic staining in the suprabasal epidermis. There was no change in the intensity of staining or cellular localization related to age, body location, or gender. Sections of actinic keratosis, superficial basal cell carcinoma, seborrheic keratosis, and psoriasis also exhibited strong cytoplasmic staining in the suprabasal layers of the epidermis. In contrast, cutaneous squamous cell carcinoma demonstrated only weak cytoplasmic staining throughout the infiltrating tumor. This is of particular interest, since other investigators have reported a loss of HSP 27 expression in oncogenically transformed cells that exhibit a tumorigenic phenotype. To our knowledge, this study provides the first demonstration of HSP 27 expression in human skin.

Adult↗

Effects of hormonal therapy on the microbiology of seborrheic dogs.

Quantitative and qualitative bacterial assays were performed on the skin of three dogs with endocrine-related primary metabolic seborrhea. After the dogs were treated (thyroid supplementation or castration, bacterial analyses were again performed on the same sites. Before therapy, the dogs had a cutaneous flora composed mainly of Staphylococcus aureus coagulase-positive organisms. After therapy, there was a significantly lower bacterial count, and two of the dogs had floras consisting mainly of coagulase-negative cocci. During the study, the two dogs that reverted bacteriologically to a normal cutaneous microenvironment became normal dermatologically. The third dog improved, but continued to have minor signs of seborrhea.

Animals↗

Ultrastructural comparison of the interface between epithelium and stroma in basal cell carcinoma and control human skin.

Comparative ultrastructural studies of basal cell carcinomas, seborrheic keratoses, actinic keratoses, and control nontumor skin from human patients demonstrate structural differences between invasive and noninvasive tumor cells. Compared to the other specimen groups, biopsies of basal cell carcinomas reveal a decrease in hemidesmosomes and an increase in actin-like microfilaments in cells at the margins of the tumors. Benign tumors, i.e., seborrheic keratoses and actinic keratoses, have hemidesmosome areas and microfilament contents resembling control nontumor skin. The most striking hemidesmosome areas and microfilament contents resembling control nontumor skin. The most striking increase in microfilaments is in the most infiltrative "morphea" variants of basal cell carcinoma. These findings, in the context of other published reports, suggest that increased microfilaments are related to enhanced motility of invasive carcinoma cells in vivo and that decreased hemidesmosomes may be related to loss of cell to substratum or "anchorage" dependence of growth in malignant cells.

Actins↗

Adenocarcinoma of the stomach with eruptive seborrheic keratoses: the sign of Leserp-Trélat.

The sign of Leser-Trélat, the sudden appearance of multiple seborrheic keratoses in conjunction with an internal malignancy, is very uncommon. A case involving a patient who had undergone resection of an adenocarcinoma of the sigmoid colon followed ten years later by the development of an adenocarcinoma of the stomach with exhibition of the sign of Leser-Trélat is presented. A summary of reported cases, along with a discussion of the sign, is provided. This is the first reported case of a patient presenting with the sign of Leser-Trélat along with a second primary malignancy.

Adenocarcinoma↗

Bile duct adenocarcinoma with Leser-Trelat sign and pure red blood cell aplasia.

A case of adenocarcinoma of the bile duct complicating longstanding ulcerative colitis and associated with the rapid onset and growth of multiple seborrheic keratosis (Leser-Trelat sign) and pure red blood cell aplasia is described. This is the first report of a case of the coexistence of the Leser-Trelat sign and pure red blood cell aplasia in a patient with a malignancy. Both manifestations have been doubted as truly paraneoplastic manifestations because of their rarity in clinical medicine. Their co-existence in the present case would support their associaton with malignancy.

Adenocarcinoma↗

Cutaneous horns of the eyelid: a clinicopathological study of 48 cases.

BACKGROUND: Cutaneous horn (cornu cutaneum) is a morphological designation for a protuberant mass of keratin that resembles the horn of an animal. It results from unusual cohesiveness of keratinized material from the superficial layers of the skin or implanted deeply in the cutis. This lesion may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous conditions. METHODS: A retrospective analysis of 48 cases of cutaneous horns of the eyelid treated between 1992 and 2002 has been performed. RESULTS: Twenty-four men and 19 women, with a mean age of 62 years (range 16-90), were treated by surgery. Histologically, 77.1% were associated with benign specimens at the base pathology, 14.6% were premalignant, and finally, 8.3% were caused by malignant skin tumors. The most common lesion was seborrheic keratosis among the benign lesions, actinic keratosis among the premalignant ones, and basal cell carcinoma and squamous cell carcinoma among the malignant ones. CONCLUSION: Cutaneous horns usually appear on exposed skin areas in elderly men. The important issue in this condition is not the horn itself, which is just dead keratin, but rather the nature of the underlying disease, although the horns are usually benign.

Adolescent↗

Irritated seborrheic keratoses and benign verrucous acanthomas do not contain papillomavirus DNA.

Sections from paraffin-embedded tissues of lesions thought to represent verrucous lesions (benign verrucous acanthomas: BVA) as well as materials from controls including seborrheic keratoses (SK), irritated SK, and verruca vulgaris from areas other than the genitalia were analyzed for the presence of multiple human papillomaviruses (HPV) including types 6, 11, 16, 18, and 33 using DNA amplification methodology. HPV DNA sequences were not found in amplified samples of BVA, SK, and irritated SK samples, but were identified in those obtained from verruca vulgaris. Our results suggest that BVA, SK, and irritated SK are generally not associated with HPV DNA even though certain of these lesions may histologically mimic the architecture of verruca.

Blotting, Southern↗

Acantholytic variant of seborrheic keratosis.

From among 524 histologic specimens of seborrheic keratosis (SK), 29 showed acantholysis, not related to pemphigus, Darier's disease, actinic keratosis or acantholytic squamous cell carcinoma. Acantholysis was found in 24 (23.3%) of the irritated type of SK, almost exclusively in the squamous cell nests showing dyskeratosis and spongiosis between and around squamous eddies or horn cysts. Clinically, 65.5% of the lesions were located on the face and scalp, 20.7% on the trunk and 13.8% on the limbs. It was speculated that dyskeratotic, degenerative changes of the keratinocytes together with spongiosis were responsible for the acantholysis.

Acantholysis↗

Epidermal growth factor receptors in idiopathic and virally induced skin diseases.

The altered distribution of epidermal growth factor receptors (EGF-R) in hyperproliferative skin lesions such as psoriasis vulgaris, seborrheic keratoses, acanthosis nigricans, ichthyosis, and others implies aberrant control of growth/proliferation by epidermal growth factor (EGF), transforming growth factor alpha (TGF alpha), and other growth factors/cytokines. Whether overexpression of EGF-R: 1) correlates with epidermal proliferation, 2) serves as a hallmark of specific dermatoses, or 3) is due to modulation by multiple growth factors remains unclear. To correlate distributions of EGF-R with in vivo proliferative status, two benign diseases of unknown etiology, seborrheic keratoses and acrochordons (skin tags), were examined using EGF-R immunolocalization and 125I-EGF binding techniques. Lesions documented as growing by clinical criteria or 5-bromodeoxyuridine incorporation (a measure of cell proliferation) were compared to nongrowing lesions of the same type. To correlate distributions of EGF-R to specific dermatoses, skin diseases of viral etiology (verruca vulgaris and molluscum contagiosum) were also probed by EGF-R immunolocalization and 125I-EGF binding. Elevated immunostaining for EGF-R and 125I-EGF binding sites were associated with actively growing seborrheic keratoses and skin tags whereas normal patterns of immunostaining and 125I-EGF binding were seen in nongrowing seborrheic keratoses and skin tags. Viral diseases showed unique patterns. No EGF-R were detected in verruca vulgaris. Molluscum contagiosum lesions showed intense EGF-R in basal keratinocytes and no EGF-R in virally infected cells. Thus elevations in EGF-R show a positive in vivo correlation with proliferation in at least two differing benign diseases of the epidermis. The decreased levels of EGF-R in virally infected lesions suggests that EGF-R may show unique patterns for specific dermatoses and are not universally elevated in benign hyperproliferative skin disorders.

Cell Division↗

Linear seborrheic keratoses associated with underlying malignancy.

A clinical syndrome, consisting of eruptive linear seborrheic keratoses associated with adenomatous colonic polyps (malignant but without invasion of the stalk) and/or frankly invasive colonic adenocarcinomas, is described in five patients. Partial to almost complete regression of the cutaneous lesions over the succeeding months to years was noted after removal of the internal malignant tumors in all five patients. Resolving lesions were characterized by an accentuation of chronic inflammatory infiltrate both within the epidermis and dermis, suggesting perhaps that the regression of the skin lesions may be related to enhanced immunologic response concomitant with the removal of the underlying malignancy.

Adenocarcinoma↗

Clinical, biochemical and morphologic features of acne keloidalis in a black population.

BACKGROUND: Acne keloidalis (AK) is an important cause of morbidity in Nigeria and accounts for 1.3% of patients with skin conditions in a Nigerian dermatology clinic. Treatment is usually unsatisfactory because the etiopathogenesis is unclear. METHODS: A prospective clinico-pathological study was carried out to identify predisposing factors, viable treatment modalities, and prognostic indicators. RESULTS: The study suggested that AK is associated with the male gender seborrheic constitution, early reproductive years, and increased fasting blood testosterone concentration. Features that may predispose to the vastly predominant occipital location of the lesions include increased mast cell density and dilatation of dermal capillaries. MANAGEMENT: The main aims are diagnosis of early papules and avoidance of physical and chemical traumatizing agents. Retinoic acid analogs and antiandrogens may be helpful. CONCLUSIONS: The widespread use of irritating physical and chemical traditional treatment remedies and delay in seeking medical attention--AK is typically asymptomatic--contribute to the relatively advanced nature of the disease at the time of presentation to the specialist.

Acne Keloid↗

[Seborrheic keratoses studied using scanning electron microscopy].

Ten seborrheic keratosis of acanthotic type have been observed by S.E.M. The morphological study could confirm the existence of two processes in the origin of the horny cysts which are peculiar to this affection. a) an extrafollicular process causes the involvement of groups of keratinocytes which, by assuming a vortex disposition, produce a concentric keratinization; b) a follicular process which causes an accentuated keratinization of the cells surrounding the epithelial sheath. This process was associated to the presence of multiple hairs a single follicle. Moreover, with higher magnification, it was possible to observe a great number of bacteria, yeasts and of particular alteration of the membrane which could be compared to changes in the tone filaments.

Aged↗

[The Leser-Trélat symptom: report of two cases (author's transl)].

The sudden occurrence and rapid increase in size and number of seborrheic keratoses is considered to be a symptom of internal malignancy. But many authors did not fully agree with this finding. We report two cases respectively associated, the first with a mycosis fongoides, the second with a bronchial squamous cell carcinoma. These observations are compared with thin cases previously published in the dermatological literature (13 patients). According to Dantzig the commonest associated malignancy is an adenocarcinoma, and the most frequent site the stomach. But there are also report of acute leukemia, mycosis fongoides, Sézary and lymphocytic lymphoma. The mechanism of the simultaneous growth of the lesions remains unknown and may be purely coincidental. Other case reports and several criteria still to be defined are needed before we accept this symptom as a malignancy marker.

Adenocarcinoma↗

Skin surface electron microscopy in Pityrosporum folliculitis. The role of follicular occlusion in disease and the response to oral ketoconazole.

The yeast Pityrosporum orbiculare is thought to cause the folliculitis associated with seborrheic eczema. However, a combination of mechanical and microbiological factors may be involved, with follicular occlusion leading to yeast overgrowth and folliculitis. Scanning electron microscopy was used to investigate this hypothesis. Skin biopsy specimens obtained from patients with Pityrosporum folliculitis were examined by scanning electron microscopy before and after oral ketoconazole therapy. Patients with active disease showed occlusion of noninflamed follicles, which resolved after ketoconazole treatment. Follicular occlusion was not present in biopsy specimens obtained from unaffected controls nor was it related to the presence of P orbiculare. These findings suggest that follicular occlusion may be a primary event in the development of this folliculitis, with yeast overgrowth a secondary occurrence. The beneficial effect of ketoconazole in this disease may be due to direct effects on the follicle.

Administration, Oral↗