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PubMed2004

Plasma cell cheilitis.

Plasma cell cheilitis is a rare inflammatory disorder of the lip with a characteristic band-like infiltrate of plasma cells in the upper dermis. Differential diagnosis should consider allergic/irritant contact cheilitis, candidiasis, syphilis, Queyrat's erythroplasia, granulomatous cheilitis, plasmoacanthoma, plasmacytoma, squamous cell carcinoma and exfoliative or factitious cheilitis. We observed plasma cell cheilitis in a 60-year-old Caucasian female who had a partial response to topical steroids and oral griseofulvin.

Antifungal Agents↗
PubMed1986

Carcinoma in situ of the glans penis and distal urethra.

A case is presented of erythroplasia of Queyrat involving the distal glans penis surrounding the urethral meatus. Therapy with topical 5-fluorouracil was followed by recurrence within 14 months. Treatment by excision utilizing the Mohs technique demonstrated carcinoma in situ of over 5 cm of the distal urethra. Plastic surgical reconstruction produced a cosmetically and functionally normal penis.

Adult↗
PubMed1979

Topical fluorouracil therapy for precancers and cancers of the skin.

Topical fluorouracil (FU) is an extremely effective agent for treating multiple actinic keratoses. It is also of value in the treatment of Bowen's disease, actinic cheilitis, arsenical keratoses, radiodermatitis, X-ray-induced keratoses, leukoplakia, and the erythroplasia of Queyrat. Topical FU may be successful in the treatment of superficial basal-cell carcinomas, but should not be used for nodular carcinomas of the face or neck except under unusual circumstances and with mandatory histologic follow-up evaluation. The usual method of treatment is twice daily application of a 1 percent FU solution in propylene glycol. Several modifications of various types of commonly employed preparations and the manner in which each is used are described, along with the respective indications. The considerable discomfort associated with the use of topical FU can be lessened by the stepwise approach outlined--a method extraordinarily valuable for older patients. Occasional complications are primary irritant dermatitis and allergic contact dermatitis; these must be recognized promptly and treated, as must other less frequent side effects. Topical FU appears to be of great value in the destruction of existing precancerous skin lesions. When used repeatedly, it may postpone indefinitely the development of significant precancerous and cancerous skin lesions.

Administration, Topical↗
PubMedDate not supplied

Early detection, diagnosis, and management of oral and oropharyngeal cancer.

1. Drinkers and cigarette smokers are at very high risk for the development of upper aerodigestive tract and lung squamous carcinomas. 2. The floor of the mouth, the ventrolateral tongue, and the soft palate are high-risk sites within the oral cavity and oropharynx. 3. Mucosal erythroplasia rather than leukoplakia is the earliest visual sign of oral and pharyngeal carcinomas. 4. Areas of mucosal abnormality, especially redness or inflammation in high-risk sites, that persist for more than 14 days without obvious etiology or resolution should be biopsied. 5. Asymptomatic, erythroplastic lesions should not be regarded merely as precancerous changes. The evidence indicates that these lesions in high-risk sites should be considered to be invasive carcinoma or at the very least carcinoma in situ, unless proven otherwise by biopsy. 6. Toluidine blue staining is a useful diagnostic adjunct, particularly as a method of ruling out false-negative clinical impressions. It may also be used as a screening rinse in high-risk patients to encompass the entire oral mucosa after a negative clinical examination and as a guide to improve biopsy yields. 7. If oral or pharyngeal cancer is identified, evaluations of the larynx, hypopharynx, esophagus, and lungs should be performed to rule out second primary cancers. Yearly aerodigestive surveillance should be continued after satisfactory treatment of the index cancer.

Aged↗
PubMedDate not supplied

Early diagnosis of asymptomatic oral and oropharyngeal squamous cancers.

An examination of the oral cavity and oropharynx in asymptomatic patients at high risk requires an orderly visual inspection of the entire oral and oropharyngeal mucosa with particular attention to the tongue, floor of mouth, soft palate, uvula, tonsillar pillars, and the lingual aspects of the retromolar trigones. Completion and clear documentation of the entire examination should be recorded. Detected lesions that do not resolve in a reasonable length of time--two to three weeks--require intense and assiduous investigation. The following specifics should be considered. 1. Alcohol drinkers and cigarette smokers, especially those 40 years of age and older, are at very high risk for the development of upper aerodigestive tract and lung squamous carcinomas. 2. The floor of the mouth, the ventrolateral tongue, and the soft palate complex are the high-risk sites within the oral cavity and oropharynx. 3. Persistent mucosal erythroplasia rather than leukoplakia is the earliest visual sign of oral and oropharyngeal carcinoma. These lesions should not be regarded merely as precancerous changes. The evidence indicates that these lesions in high-risk sites should be considered to be invasive carcinoma or carcinoma in situ unless proven otherwise by biopsy. 4. Toluidine blue staining is a useful diagnostic adjunct, particularly as a method of ruling out false-negative clinical impressions. It may also be used as a rinse in high-risk patients to encompass the entire oral mucosa after a negative clinical examination and as a guide to improve biopsy yields. 5. If oral or oropharyngeal cancer is identified, evaluations of the larynx, hypopharynx, esophagus, and lungs should be performed to rule out multiple primary cancers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Course and morphology studies in penile cancer].

A 75-year-old male patient showed an extensive erosion mainly restricted to the penile site, which was found when he received appendectomy. The penile lesion had persisted for about ten years, during which period the erosion extended gradually while he missed to consult a physician. The lesion was a florid and wetting erosion, with a definite boundary, which covered the entire circumference of the penile foreskin and also extended to the suprapubic area, scrotum and external urethral orifice. Although the diagnosis could not be made by biopsy, extra mammary Paget's disease was strongly suspected. Bilateral modified inguinal lymphadenectomy and systemic evaluation were first performed to confirm that there was no metastasis or complexed disease in other organs. Then extensive wide resection of the skin lesion and reconstruction using a split-thickness skin graft were performed. Histopathological examination of the surgical specimen revealed poorly differentiated squamous cell carcinoma, although most part showed only inflammatory erosion. Clinical course and the histopathological findings including specific staining patterns led to the diagnosis of poorly differentiated squamous cell carcinoma originated from erythroplasia. During post-operative 18 months until now, no local recurrence or distant metastasis has been observed.

Aged↗
PubMed1992

[Cancer of the penis and its treatment].

It had been believed that carcinoma of the penis was rather rare in the developed countries comparing with that in the under-developing countries, however, the recent epidemiological studies failed to reveal any clear difference of the incidence of carcinoma of the penis all over the world. In these days so called successful treatment is coming to be evaluated by the quality of life (QOL) after surgical or nonsurgical treatment (especially sexual function tended to be considered very important factors altering QOL). I want to emphasize the following issues in this report. 1. Erythroplasia of Queyrat and Bowen's disease are carcinoma in situ and should be dealt as carcinoma of the penis. 2. relation of human papilloma virus and carcinoma of penis. 3. usefulness of TNM classification over Jackson's classification. 4. SCC antigen is a reliable tumor marker of carcinoma of the penis? 5. effectiveness of chemotherapy based on BLM combined with radiation therapy for carcinoma of the penis. 6. usefulness of Mohs microscopically controlled surgery and modified groin dissection. It is generally accepted that since carcinoma of the penis is a rare disease and for one institution up to 50 cases can be experienced during 20 years in Japan, there exist no integrated study involving a large number of institutions. I really wish a certain form of group study to be completed and the results from this study utilized to overcome the present problems for the treatment of carcinoma of the penis.

Antibiotics, Antineoplastic↗
PubMed1992

Premalignant and early carcinomas of the penis and scrotum.

Premalignant penile lesions are a spectrum of diseases ranging from those that are almost always benign to neoplasms that are carcinoma in situ. Balanitis xerotica obliterans is a localized variant of lichen sclerosus et atrophicus. The Buschke-Löwenstein tumor is a low-grade malignancy, whereas erythroplasia of Queyrat is a carcinoma in situ. Obtaining the correct diagnosis may challenge even the skilled clinician. It is increasingly likely that papillomaviruses play a role in the development of some cases of penile carcinoma. Scrotal cancer has both historical and current significance as an indicator of occupational health. Occasionally, extramammary Paget's disease presents as a primary scrotal neoplasm.

Carcinoma↗
PubMed2004

Photodynamic therapy--mechanism and employment.

Photodynamic terapy (PDT) is a new treatment for a wide variety of malignancies and premalignant dysplasias, as well as some non-cancer indications. Therapeutic response to PTD is achieved through the activation of non-toxic photosensitiser located within neoplastic tissue, using visible light tuned to the appropriate absorption band of the photosensitiser molecule. This produces cytotoxic free radical such as singlet oxigen, which result in local photo-oxidation, cell damage and destruction of the tumour cells. Systemic administration of photosensitisers has been used with endoscopic light exposure to treat a variety of internal malignances. A topical drug delivery is used in the skin deseases treatment. The selective distribution of photosensitiser in the target tissue is the fundamental to the process of PDT. This tissue specific photosensitation and normal tissue sparing results in good healing and often very good cosmetic results. Peterson PTD can be used for the treatment of cutaneous lesions (e.g., SCC, BCC, Bowen's disease, mycosis fungoides, erythroplasia of Queyrat, Gorlin's Syndrome, actinic keratoses), lower genital tract neoplasia (VIN and CIN), gastrointestinal tumours, etc., as well as nononcological indications (e.g., acne, condyloma acuminatum, lichen planus, psoriasis, vitiligo, vulval lichen sclerosus, warts and verrucae).

Humans↗
PubMed1990

[Chlamydia trachomatis infection in women].

A random specimen of 288 women was examined by the use of the indirect immunofluorescent test (IIF) for the proof of the Chlamydia trachomatis antigen in endocervical swabs (by the help of monoclonal antibodies), and with the ELISA test for the proof of IgG antibodies against Chlamydia trachomatis in serums, and the complement--fixation reaction for the proof of antibodies against the Chlamydia-group antigen. These women were previously examined anamnestically and clinically in detail. The Chlamydia trachomatis infection was determined in 29.51% of cases, with a high percentage of positive results in all age groups. These infections were more frequently proved, to a considerable extent, in women with the diagnosis of sterility than in all other examined women, and in relation to all other inflammatory processes it was most frequently diagnosed in women with uterine cervix changes (endocervicitis and erythroplasia). A high percentage of Chlamydia positive subjects (40.91%) was established in those examined women which had pathological pregnancies and births in their past medical histories. The humoral immune response to the presence of Chlamydia trachomatis infections was proven in 70.59% of cases. Presented and analyzed are the diagnostic possibilities of the used diagnostic tests, where the combination of the IIF and ELISA test has shown to be the best.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

[The intraepithelial carcinoma of the mouth mucosa and its anatomo-clinical variants].

Contrary to common opinion the intraepithelial cancer of the buccal mucosa presents clinical symptoms, but they are discreet and different from those observed in an invasive carcinoma. Usually, there is leucoplakia with an erythema and an irregular keratosis or a punctuated one. There is an erythematous variation (Queyrat's erythroplasia) which is without keratinasation. Only histological evidence can confirm the diagnosis cancer. It should be differentiated against Bowen's disease and the light, intermediated and severe dysplasias.

Bowen's Disease↗
PubMed1989

[Precancerous oral lesions. Diagnostic and therapeutic protocol].

The NRC (National Research Council) task force on head and neck cancer issued this document to help clinicians involved in diagnosing and treating precancerous oral diseases. Chapter 1 includes definition, epidemiology, risk factors (alcohol, smoking, poor oral hygiene), WHO classification, clinical picture of leukoplakias, erythroplasia, lichen planus, as well as their natural history. Chapter 2 points out the clinical signs to be looked for in order to make a proper diagnosis and discusses biopsy techniques. Chapter 3 deals with therapeutic procedures (surgical technique and medical treatment), while Chapter 4 concerns follow-up according to the clinical and histological diagnosis. Finally, some statistical forms are enclosed: Form 1 consists of information regarding educational qualifications, occupation, alcohol consumption, smoking and dietary habits; Form 2 consists of information about previous diseases and the history of the present disease; Form 3 records the signs and symptoms observed for the precancerous lesion; Form 4 records treatment modalities; Form 5 records patient follow-up.

Humans↗
PubMed1987

[Bowen's disease of the anus].

Bowen's disease of the anus and the perineum is undoubtedly a rare pathology. This is demonstrated by the fact that, while described by M. Bowen in 1912, only 112 cases have been reported in 1979. The differential diagnosis is more difficult than that of Bowen-like papulosis and Queyrat's erythroplasia. Ano-perineal Bowen's disease is, or may be, in a large number of cases, seen concomitantly with a primary ano-rectal or vaginal carcinoma, even if they were diagnosed after Bowen's disease.

Anus Neoplasms↗
PubMed1994

[Groups at high risk for skin cancer].

A special program aimed at detecting skin cancer at early stages was worked out and launched into use in 1989. It provides for a series of measures for primary examination and subsequent follow-up of population. Dermatologists conducted examinations of persons at high risk 2-4 times a year depending on the disease. They were joined by oncologists, whenever required, and morphological examinations were sometimes carried out. The group at high risk for skin cancer included patients older than 50, with the following pathologies: (I) Obligate precancerous dermatites: Bowen's syndrome, erythroplasia of Queyrat, Paget's disease (extramammary localization), intraepidermal epithelioma of Jadassohn, late-onset radiation dermatitis, early childhood-Kaposi's disease, Manganotti's chilitis and verrucous precancer of the lip; Optional precancerous dermatosis: childhood-onset epidermodysplasia veruciformis, actinic keratosis, cutaneous horn, keratoacanthoma, carcinoid papillomatosis of Gottron, giant condyloma of Buschke-Lowenstein, leukoplakia and limited precancerous hyperkeratosis of the lip's red edge; (2) Dermatoses involving pathological regeneration: eruthematosis, lupus tuberculosis, psoriasis (more than 15 years old), trophic ulcers, extensive scars (particularly, those caused by burns), chronic ulcerative pyoderma and pyoderma vegetans; (3) Hemorrhagic diathesis on the surface or fundus of neoplasm; (4) Consolidation at neoplasm base; (5) Absence of complaints; (6) Resistance to therapy.

Aged↗
PubMed1993

[Roentgen therapy of malignant skin tumors].

In dermatologic oncology several good indications for radiotherapy are known. Precancerous lesions can be treated by grenz rays, as e.g. large senile (actinic) keratoses, lentigo maligna or large lesions of Bowen's disease or Queyrat's erythroplasia. Well-known indications are also mid-sized basal cell and squamous cell carcinomas, especially in the face of elderly patients. The lentigo-maligna melanoma should no longer be considered a radioresistant tumor, and it must be stressed that larger lesions can be successfully treated by radiotherapy. Dermato-radiotherapy shows also excellent palliative results, e.g. in cutaneous T-cell lymphomas such as mycosis fungoides, but also in Kaposi's sarcoma either of the classical type or AIDS-associated. In conclusion, radiotherapy is a good alternative treatment modality, especially in elderly patients, since it is painless and is possible on an outpatient basis with excellent functional results.

Follow-Up Studies↗
PubMed1993

A long-term evaluation of the CIN-lesions. A clinicopathological study.

Among patients treated over a 20-year period cytological screening demonstrated a high-grade cervical dyscariosis (III-V Papanicolaou group) in 565 (2.3%) cases. In a group of 159 of these patients, all with cervical erythroplasia, a detailed study was possible and punch-biopsy (without colposcopy) was performed. Comparative analysis of cytology and pre-operative histology revealed good correlation. The patients in whom punch-biopsy demonstrated high-grade CIN and also those with negative histology, but with dyscariosis permanently occurring in cervicovaginal smears, underwent surgical treatment (conization). The results of histology in the punch-biopsies and in the surgical specimens of the cervix were discordant, mostly in low-grade CIN. Most patients are alive and well and remain in permanent clinical control. Conclusion--Cytology is a useful method of selecting the high-risk patients, who should subsequently be followed clinically, by cytology and histology. Surgical treatment seems to prevent invasive cancer: however these patients should remain under permanent control.

Adult↗
PubMed1993

[Oral lichen planus and cancer. Apropos of 2 cases].

Malignant changes in oral lichen planus lesions are still the subject of controversy. Two new cases provide supportive data for this thesis. Case 1: A 64 year old non smoking diabetic woman presented with combined atrophic lichen planus and erythroplasia lesions of the right buccal mucosa and a unique reticular lichen planus lesion of the left buccal mucosa. Both lesions were histologically confirmed. Despite treatment, degeneration of the Bowen's type lesion into an epidermoid carcinoma was noted within 11 months. Case 2: A 47 year old non smoking woman consulted for combined cutaneous and oral lichen planus lesions. Clinical examination showed an "acute" oral lichen planus associated with extensive ulcerative, atrophic and reticular lesions involving almost the total oral mucosa. Histology of a left buccal biopsy confirmed the diagnosis. Systemic and local corticotherapy produced marked improvement in her condition and she was not seen for five years. Follow up examination then detected a proliferative ulcerative type of epidermoid carcinoma on the left buccal mucosa. These findings appear to fulfil the clinical and histologic criteria suggestive of development of epidermoid carcinoma on a lichen planus lesion.

Atrophy↗
PubMedDate not supplied

[Chemoprevention in cancer of the head and neck].

The world-wide incidence of cancer of the head and neck of 500,000 cases/year has remained unchanged in recent years in spite of anti-smoking campaigns. Moreover, long-term survivors of cancer of the head and neck or of other respiratory and digestive tumors have a constant annual 5-7% risk of developing a second primary tumor in the same area. Lately, prevention programs have added synthetic and natural products to prevention programs for the purpose of reversing the progression of premalignant lesions to invasive cancer or reducing the probability of developing cancer in high-risk individuals. These products are known as chemoprevention agents. In the case of tumors of the head and neck, it is known that leukoplasia and erythroplasia are epithelial lesions on which invasive tumors may develop. Recent studies have demonstrated that the use of retinoids can produce regression rates over 60%, thus reducing the risk of secondary neoplasms of the respiratory and digestive tract by 35-55%. The current status of chemoprevention in head and neck cancer and the use of retinoids as chemoprevention agents in this type of neoplasm are reviewed.

Head and Neck Neoplasms↗