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Journal articles on the topic 'Skin recurrences'
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Gage, I., S. J. Schnitt, A. Recht, A. Abner, S. Come, L. N. Shulman, J. M. Monson, B. Silver, J. R. Harris, and J. L. Connolly. "Skin recurrences after breast-conserving therapy for early-stage breast cancer." Journal of Clinical Oncology 16, no. 2 (February 1998): 480–86. http://dx.doi.org/10.1200/jco.1998.16.2.480.
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PURPOSE To assess the frequency and prognosis of skin recurrences after breast-conserving therapy (BCT) compared with other breast recurrences. MATERIALS AND METHODS From 1968 to 1986, 1,624 patients with unilateral stage I or II breast cancer treated with BCT at the Joint Center for Radiation Therapy (Boston, MA) underwent gross tumor excision and received a dose of > or = 60 Gy to the tumor bed. Skin recurrences (SR) were defined as breast recurrences without associated parenchymal disease. An invasive breast recurrence with any parenchymal disease noted clinically or radiographically was scored as an other breast recurrence (OBR). Median follow-up for survivors was 137 months. RESULTS SR represented 8% (18 of 229) of all breast recurrences and occurred in 1.1% of all patients. The outcome after local recurrence was different for patients with SR and invasive OBR. Patients with SR more frequently had uncontrolled local failure (50%; 9 of 18) than did patients with OBR (14%; 26 of 188) (P = .0007). Forty-four percent (8 of 18) of patients with SR had distant metastasis simultaneously or within 2 months of the recurrence compared with 5% (9 of 188) of invasive OBR patients (P < .0001). For patients without distant metastasis at the time of recurrence, the 5-year actuarial rate of development of distant metastasis was 60% for SR patients compared with 39% for invasive OBR patients (P = .07), and the corresponding 5-year actuarial survival rates beyond the time of local failure were 51% and 79%, respectively (P = .06). CONCLUSION In contrast to other types of invasive breast recurrence after breast-conserving therapy, skin recurrences are rare and are associated with a significantly higher rate of distant metastasis and uncontrolled local disease as well as a lower rate of survival.
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Rahimian, Joseph, Raymond Khan, and Keith A. LaScalea. "Does Nasal Colonization or Mupirocin Treatment Affect Recurrence of Methicillin-Resistant Staphylococcus aureus Skin and Skin Structure Infections?" Infection Control & Hospital Epidemiology 28, no. 12 (November 2007): 1415–16. http://dx.doi.org/10.1086/523273.
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Some patients with community-associated methicillin-resistant Staphylococcus aureus skin and skin structure infections have experienced frequent recurrences. We performed a retrospective study and determined that the presence of nasal colonization did not affect recurrence and nasal mupirocin treatment marginally decreased recurrence
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Long, Tyler, Austin Dunn, Mary Arndt, and Eric Parlette. "Melanoma Recurrence after Mohs Micrographic Surgery with MART-1: A Systematic Review and Meta-analysis." SKIN The Journal of Cutaneous Medicine 5, no. 6 (November 5, 2021): 579–89. http://dx.doi.org/10.25251/skin.5.6.2.
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Background: Surveys suggest wide-spread use of MART-1 in MMS for CM among Mohs surgeons, but no previous systematic review has investigated the efficacy of this specific procedure. Methods: A systematic search and meta-analysis of retrospective studies on MMS with MART-1 was performed from Pubmed, Medline, and Cochrane databases for articles published from their inception to October 30, 2020. We performed a chi-squared analysis of homogenized data to examine the relationship between recurrence location and rate of recurrence. A risk of bias was obtained with the ROBINS-I tool. [PROSPERO ID: CRD42020221826] Results: Among the included studies, there were a total of 15 (0.52%) local recurrences of melanoma in-situ and invasive melanoma after MMS with MART-1. Conclusions: This review has served to demonstrate that MMS with MART-1 immunostaining in frozen sections is a technique that produces satisfactory recurrence rates for melanoma in-situ and invasive melanoma.
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Tonev, Ivan Dimitrov, Yana Stoeva Pirgova, and Nikolay Vladimirov Conev. "Primary Adenoid Cystic Carcinoma of the Skin with Multiple Local Recurrences." Case Reports in Oncology 8, no. 2 (June 3, 2015): 251–55. http://dx.doi.org/10.1159/000431082.
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Primary adenoid cystic carcinoma (PACC) of the skin is a rare tumor with fewer than 70 cases studied in detail in the English literature. This type of tumor shows a prolonged course and a growth pattern usually manifested by multiple local recurrences and has a low potential for distant metastases. The most important modality for primary treatment is surgical resection followed by radiotherapy. We report a woman aged 43 years at the time of diagnosis, who presented with a slow-growing nodule in the right axilla without lymph node enlargement. A wide local excision was performed, and the histology revealed an adenoid cystic carcinoma. During the next 24 years, another four local recurrences were excised (the last one in 2015) and confirmed histologically to be adenoid cystic carcinoma. The patient was given 44 Gy of radiotherapy after the second surgery in 1996. PACC of the skin is a rare tumor with insufficient data concerning the efficacy of the surgical technique and chemotherapy and radiotherapy treatment, even more so in the case of multiple recurrences. After the last recurrence, the patient was offered an active follow-up based on the long tumor-free intervals in the past and because the site of the primary tumor allowed further surgical excisions in future recurrences.
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Berlière, M., F. P. Duhoux, L. Taburiaux, V. Lacroix, C. Galant, I. Leconte, L. Fellah, et al. "The Place of Extensive Surgery in Locoregional Recurrence and Limited Metastatic Disease of Breast Cancer: Preliminary Results." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/782654.
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The aims of this study were first to clearly define two different entities: locoregional recurrences and limited metastatic disease and secondly to evaluate the place of extensive surgery in these two types of recurrence.Material and Methods. Twenty-four patients were followed from June 2004 until May 2014. All patients underwent surgery but for 1 patient this surgery was stopped because the tumour was unresectable.Results. The median interval between surgery for the primary tumour and the locoregional recurrence or metastatic evolution was 129 months. Eight patients had pure nodal recurrences, 4 had nodal and muscular recurrences, 5 had muscular + skin recurrences, and 8 had metastatic evolution. Currently, all patients are still alive but 2 have liver metastases. Disease free survival was measured at 2 years and extrapolated at 5 years and was 92% at these two time points. No difference was observed for young or older women; limited metastatic evolution and locoregional recurrence exhibited the same disease free survival.Conclusion. Extensive surgery has a place in locoregional and limited metastatic breast cancer recurrences but this option must absolutely be integrated in the multidisciplinary strategy of therapeutic options and needs to be planned with a curative intent.
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Yevcheva, A. F., and S. M. Pukhlik. "CLINICAL SIGNS AND TREATMENT MANAGEMENT IN MALIGNANT PROCESSES OF THE SKIN OF THE EXTERNAL NOSE." Odes’kij medičnij žurnal (The Odessa Medical Journal), no. 6 (2022): 43–48. http://dx.doi.org/10.54229/2226-2008-2021-6-8.
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Diagnosis and treatment of malignant neoplasms of the head and neck is an urgent modern problem of oncology, as there is a steady increasing of this pathology. At the same time are untimely diagnosis and frequent recurrences take place. The purpose is to test the method of excision of the tumor of the skin of the external nose and assess its feasibility in radical surgical removal by using anemic Klein solution. Material and methods of research: 64 patients were examined with skin neoplasms that received surgical treatment options using Klein’s anematize solution at the ENT department from 2015 to 2020 years. Patients ranged in age from 28 to 65 years, 15 women and 49 men. Patients are divided into two groups depending on the morphology of the tumor. The first group — 50 (78.2%) patients with malignant skin lesions. From this sample, 17 (34%) with basal cell carcinoma of the nasal skin and 33 (66%) with squamous cell carcinoma (G1) of the nasal skin. The second group consists of 14 (21.8%) patients with melanoma of the skin of the nose and torso. Metastasis in the deep jugular chain were diagnosed in 6 (16.7%) patients from the group of patients with melanoma. Results of the study and discussion: observations of patients for 5 years showed a satisfactory quality of life of all patients with malignant skin tumors. No recurrence of nasal cancer in the first group was registered during the follow-up of patients. Among a group of patients with melanoma, 1 (7.1%) patient was diagnosed with recurrence in the visual organ and brain. Conclusions: 1. Clinically, skin cancer was non-aggressive, had a relatively slow growth and 100% of patients had no recurrence of cancer after surgery for 5 years (p<0.05). 2. Melanoma of the skin was aggressive in a year — 1 (7.1%) patient was diagnosed recurrence in the visual organ and brain. 3. The use of Klein’s solution 5 minutes before the surgery under the base of the tumor provided a pronounced hemostasis due to vasospasm and contributed to the prevention of intraoperative recurrence in 63 (98.4%) patients (p<0.05). Key words: malignant tumors, skin of the external nose, surgical treatment, recurrences.
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Ganusevich, O. N., T. N. Nesterovich, I. V. Fedorkevich, and A. S. Yakovenko. "Treatment of Locoregional Recurrences of Skin Melanoma (a Clinical Case)." Kuban Scientific Medical Bulletin 27, no. 3 (June 18, 2020): 105–12. http://dx.doi.org/10.25207/1608-6228-2020-27-3-105-112.
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Aim. To demonstrate an interesting clinical case of treating a patient with intradermal melanoma metastases.Materials and methods. A patient with intradermal melanoma metastases was given a combined treatment including photodynamic therapy (PDT) and immunotherapy (intradermal administration of an immunological preparation into metastatic foci).Results. A clinical case of a patient with a locoregional recurrence of skin melanoma (SM) of the left lower leg was described. Given the prevalence of the pathological substrate and the presence of concomitant pathologies, two treatment methods were selected – PDT and intradermal administration of interferon into metastatic foci. These methods provided both the local and systemic effect. As a result, the stabilisation of the tumour process was achieved.Conclusion. Combined treatment of locoregional recurrences of skin melanoma using PDT and intrametastatic injections of immunopreparations can be used as an alternative to surgical intervention in somatically weakened patients with a large area of intradermal metastases, which will allow the tumour process to be stabilised. In cases where the area of locoregional intradermal recurrences in somatically compensated patients does not permit surgical treatment, the proposed technique may be the only possible treatment method.
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Sequeira, Andrew Jose, and MARIO Jose SEQUEIRA. "Long Term Follow Up of Cutaneous Sinus Histiocytosis (Rosai-Dorfman Disease)." SKIN The Journal of Cutaneous Medicine 3, no. 5 (September 13, 2019): 350–52. http://dx.doi.org/10.25251/skin.3.5.11.
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Rosai-Dorfman disease is a benign histiocytic proliferative disorder of unknown etiology with cutaneous variants clinically presenting with painless cervical lympadenopathy, fever, leukocytosis and other systemic findings.1 Although the skin is the most common extranodal site, rare purely cutaneous forms of the disease exist and diagnosing such case rests solely on histopathologic findings.2 We report a case with a fifteen year follow up period of this uncommon disorder and describe itsclinical course marked by multiple episodic recurrences.
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Chung, Sun M., Sandra J. Shin, Xia Chen, and Paul Peter Rosen. "Recurrent Breast Carcinoma Arising in a Transverse Rectus Abdominis Myocutaneous Flap." Archives of Pathology & Laboratory Medicine 128, no. 10 (October 1, 2004): 1157–60. http://dx.doi.org/10.5858/2004-128-1157-rbcaia.
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Abstract Reconstruction after mastectomy for breast carcinoma with implants or myocutaneous flaps is a widely used surgical technique. Recurrence of breast carcinoma after these procedures is uncommon. Most recurrences occur in the skin or scar site of the mastectomy and are readily detectable by physical examination. There are rare reported cases of recurrent carcinoma occurring within the flaps that are usually diagnosed with the aid of imaging and subsequent pathologic examination. In most cases, these recurrences represent invasive or in situ ductal carcinoma. We report an additional 2 cases of breast carcinoma recurring within the myocutaneous flap, both of which exhibited uncommon histologic features not previously reported.
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Alarcon-Rozas, A. E., M. R. Cueva, J. Galarreta, J. Torres, E. Gonzales, and J. Ramirez. "Features of recurrence of triple-negative (TN), non-metastatic breast cancer (NMBC) patients: A single institution study." Journal of Clinical Oncology 29, no. 27_suppl (September 20, 2011): 180. http://dx.doi.org/10.1200/jco.2011.29.27_suppl.180.
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180 Background: The TN BC is the most agressive subtype. Previous studies suggested that DFS of women with TN-BC is shorter than any other subtype and they demonstrated racial differences. The behaviour of these tumours are characterised by poor prognosis affecting mostly African American young obese women. Our goal is to determine the incidence of TN in non metastatic (NM) BC, the recurrence rate (RR), the patterns of recurrence by anatomic region and the DFS. Methods: We reviewed the medical records of patients with BC diagnosed between Jan/2000 to Dec/2005 at Almenara Hospital in Lima, Peru. There were a total of 1042 patients with BC; of them 215 were identified as TN NM BC according to IHC ER, PR, and Her2/neu negatives. We collected the clinical data including age, menopausal status, staging, hormone receptor status as well as Her2/neu status. The data were analized by statistic software SPSS v. 17.0. Results: The incidence of TN NM BC were 20.6% (215); of them 18.6% (40) patients had recurrences. The median age of recurrence were 52.5 years (31-93); the median DFS were 27 months, with a median follow-up of 64 months. According to inicial staging the recurrences were 7.5% (3); 32.5% (13); and 60% (24) respectively for patients with stages I, II and III. Almost one third (35%) of patients with recurrences were lymphatic node negative at diagnosis after mastectomy. The most frequent involved organs were visceral (lung=12, liver=3) 37.5% (15); bone 25% (10); skin 20% (8); CNS 12.5% (5) and contralateral breast 5% (2). There were four nuliparus women two of them had skin recurrence and the others two had bone metastasis. Conclusions: TN NM BC constitutes 20.6% of all BC in our institution; the majority of relapses were stage III (60%). The median DFS for recurrence were 27 months and the most frequent sites involved were visceral (37%) and bone (25%). 12.5% of recurrences were to CNS and one third of the patients were lymph node negatives. This is to our knowledge the first study of patterns of recurrence in TN nonmetastatic BC in a Latino population. The incidence of TN-BC which is close to African-American population (25%).
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WITTHAUT, J., K. STEFFENS, and E. KOOB. "Reliable Treatment of Pyogenic Granuloma of the Hand." Journal of Hand Surgery 19, no. 6 (December 1994): 791–93. http://dx.doi.org/10.1016/0266-7681(94)90260-7.
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Pyogenic granuloma (PG) is a common skin tumour whose aetiology is unknown. There is a significant recurrence rate whatever method of treatment is used, and there are many studies in the literature on the treatment of recurrence. In our experience, the most effective way of preventing recurrence is the complete removal of the tumour using the microscope, operating in a bloodless field. Only then can the whole tumour with its supply vessels be reliably removed. 20 cases of PG on the hand, three cases in the shoulder-neck area and one case on the foot have been treated in our department over a period of 4 years. Five of these were recurrences and all involved the hand. Three of these were infected. 17 patients were followed for 3 months to 3.5 years. There were no recurrences in these patients, all of whom were operated on using the method described above.
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Rose, P. G. "Skin bridge recurrences in vulvar cancer: frequency and management." International Journal of Gynecological Cancer 9, no. 6 (November 1999): 508–11. http://dx.doi.org/10.1046/j.1525-1438.1999.99069.x.
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Kozak, O., I. V. Gorot, and N. M. Tkachenko. "EP-1913: Brachytherapy in non-melanoma skin cancer recurrences." Radiotherapy and Oncology 111 (2014): S327. http://dx.doi.org/10.1016/s0167-8140(15)32031-4.
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Toffoli, Ludovica, Giulia Bazzacco, Claudio Conforti, Claudio Guarneri, Roberta Giuffrida, Enrico Zelin, Nicola di di Meo, and Iris Zalaudek. "Pilomatrix Carcinoma: Report of Two Cases of the Head and Review of the Literature." Current Oncology 30, no. 2 (January 19, 2023): 1426–38. http://dx.doi.org/10.3390/curroncol30020109.
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Background: Pilomatrix carcinoma (PC) is a rare skin tumor arising from hair follicle matrix cells. It is locally aggressive with a high rate of local recurrence after surgical excision. Few cases in the literature have been described and the management is not well defined. Objectives: The aim of this study was to present two cases of PC located on the head and review the relevant literature about epidemiology, clinical and dermoscopic evaluation, characteristics of local and distant metastases, local recurrence rate and management of this rare skin tumor. Methods: We consulted databases from PubMed, Research Gate and Google Scholar, from January 2012 to November 2022. We reviewed the literature and reported two additional cases. Results: We selected 52 tumors in middle-aged to older patients located mostly on the head. Dermoscopy evaluation was rarely performed in the pre-operative diagnostic setting. The most definitive treatment was wide local excision, but local recurrences were common. In total, we observed 11 cases of recurrences and 9 patients with locoregional or distant metastases. Four patients received adjuvant radiotherapy, two patients needed chemotherapy and local cancer therapy and one patient received radiochemotherapy. Conclusions: Our reports and the review of the literature can provide a better awareness and management of this rare tumor.
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Pratita, Raras, and Lita Setyowatie. "Case Report: Combination of Electrocautery and Echinacea Therapy in Condylomata Acuminata." Asian Journal of Health Research 1, no. 3 (November 29, 2022): 59–64. http://dx.doi.org/10.55561/ajhr.v1i3.48.
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Introduction: Condylomata acuminata or genital warts are classified as sexually transmitted infections caused by the Human Papilloma Virus. The main purpose of Condylomata acuminata treatment is to remove warts and prevent recurrence. Monotherapy is often unsatisfactory. Combination therapy can be done for a better response and minimizing recurrences, one of which is by using an immunomodulator, namely Echinacea. Case Presentation: A 47-years-old woman, widowed, heterosexual, with complaints of genital warts since 2 months ago. Dermatovenerological examination on the major and minor labia showed papules with skin and mucosa color, verucose, multiple, no tenderness and no bleeding. Inspeculo examination found no lesions on the vaginal wall. The acetowhite test showed a positive white color. Patient was diagnosed with condylomata acuminata. The patient received electrocauter therapy once and Echinacea 500 mg for 3 months. Follow-up for 6 months did not reveal any new or recurrent lesions. Conclusion: Therapy for condylomata acuminata is still challenging. Monotherapy is often unsatisfactory due to high degree of recurrence. The use of combination therapy is aimed at minimizing recurrences, one of which is the use of imunomudulator. In this case report, there were no relapses in the 6th month of follow up with combination treatment. These case report can increase knowledge about therapeutic options for CA to avoid recurrences.
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K C, Hari Bahadur, Jayan Man Shrestha, and Ishwar Lohani. "Recurrent dermatofibrosarcoma protuberans: A Case report and literature review." Journal of Society of Surgeons of Nepal 23, no. 2 (December 31, 2020): 67–69. http://dx.doi.org/10.3126/jssn.v23i2.35844.
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Introduction: Dermatofibrosarcoma protuberans is a rare soft tissue tumor which is known for its high recurrence behavior. Adequate excision and regular follow up is the current treatment modality.
Case report: 42 years male developed multiple nodular lesions on anterior chest wall for which he underwent surgical therapy for five times, but tumor recurred on every occasion. Wide local excision and split skin grafting was performed with negative margin on histopathology.
Conclusion: Dermatofibrosarcoma protuberans has high recurrence rate due to its infiltrative growth pattern. Regular follow up is required after surgery during early post-operative period to detect any recurrences.
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Lazarevic, Diana, Egle Ramelyte, Reinhard Dummer, and Laurence Imhof. "Radiotherapy in Periocular Cutaneous Malignancies: A Retrospective Study." Dermatology 235, no. 3 (2019): 234–39. http://dx.doi.org/10.1159/000496539.
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Background: Due to the importance of function and cosmetics, periocular skin malignancies represent a therapeutic challenge. Objective: To evaluate the safety and efficacy of radiotherapy (RT) treating periocular skin tumors. Methods: Data of patients with periocular tumors treated with grenz or soft X-rays at the University Hospital Zurich, Switzerland, between 2009 and 2014 were reviewed. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) with associated in situ lesions, cutaneous melanoma, lentigo maligna (LM), cutaneous lymphoma and Kaposi’s sarcoma were included in the analysis. Results: We found 159 periocular lesions in 145 patients. Overall recurrence was highest for actinic keratosis and Bowen’s disease (27%), melanoma (17%) and LM (15%), whereas SCC and BCC showed recurrence in 11 and 10%, respectively. 45% of all recurrences occurred within 12 months after treatment, with a median time to recurrence of 13 months (range 3–73). Conclusion: RT, which provides a good therapeutic response with minimal adverse events, is a therapy option for periocular cutaneous malignancies.
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Otsuka. "Cutaneous Metastases in Ovarian Cancer." Cancers 11, no. 9 (September 2, 2019): 1292. http://dx.doi.org/10.3390/cancers11091292.
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Skin metastases in ovarian cancer are uncommon, but their incidence may be increasing due to improved survival rates. Skin metastases can be divided into umbilical metastases, which are known as Sister Joseph nodules (SJNs) and are associated with peritoneal metastasis, and non-SJN skin metastases, which usually develop within surgical scars and in the vicinity of superficial lymphadenopathy. As most skin metastases develop after specific conditions, recognition of preceding metastatic diseases and prior treatments is necessary for early diagnosis of skin lesions. The prognosis of skin metastases in ovarian cancer varies widely since they are heterogeneous in the site of lesion and the time of appearance. Patients with SJNs at initial diagnosis and patients with surgical scar recurrences without concomitant metastases may have prolonged survival with a combination of surgery and chemotherapy. In patients who developed skin recurrences as a late manifestation, symptoms should be treated with external beam radiotherapy and immune response modifiers. Immune checkpoint blockade can enhance anti-tumor immunity and induce durable clinical responses in multiple tumor types, including advanced chemoresistant ovarian cancer. With the use of radiation therapy, which enhances the systemic anti-tumor immune response, immune checkpoint blockade may be a promising therapeutic strategy for distant metastasis, including skin metastasis.
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Kunos, Charles, Vivian von Gruenigen, Steven Waggoner, James Brindle, Yuxia Zhang, Brenda Myers, Gary Funkhouser, Barry Wessels, and Douglas Einstein. "Cyberknife Radiosurgery for Squamous Cell Carcinoma of Vulva after Prior Pelvic Radiation Therapy." Technology in Cancer Research & Treatment 7, no. 5 (October 2008): 375–80. http://dx.doi.org/10.1177/153303460800700504.
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Limited options exist for patients experiencing a local recurrence of vulvar malignancies after surgery and pelvic radiation. These recurrences often are associated with cancer-related skin desquamation and poor clinical outcomes. A new radiotherapeutic treatment modality for the previously irradiated patient is cyberknife radiosurgery, which uses a linear accelerator mounted on an industrial robotic arm to allow non-coplanar radiation therapy delivery with sub-millimeter precision. This study describes the first reported use of cyberknife radiosurgery for the treatment of recurrent vulvar cancer in three women.
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Volpi, Annalisa, Saverio Savini, Wainer Zoli, Mara Vasinl, Silvia Morgagni, Andrea Amadori, Roberta Volpi, and Dino Amadori. "An Efficient Method for Culturing Human Breast Epithelium: Analysis of Results." Tumori Journal 77, no. 6 (December 1991): 460–64. http://dx.doi.org/10.1177/030089169107700602.
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We have examined the possibility of obtaining primary cultures from breast tissue utilizing a method especially developed for breast epithelium. The number of specimens able to grow in culture was very high: 82.8%, 64.3 %, 75.0 % and 77.8 %, respectively, for primary breast cancer, skin recurrences, inflammatory breast cancer and normal breast tissue. In our experience, growth was not related to menopausal status or histopathologic type, whereas for skin recurrences, a prior pharmacologic treatment (chemotherapy) of the patient enhanced the growth capacity of the tissue. This culture method could help to study the basic biology of breast epithelia and to improve the chemotherapy approach of breast cancer patients.
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Sims, Matthew. "1332. Identification of Genetic Markers Linked to Recurrent Methicillin-Resistant Staphylococcus aureus Skin and Soft-Tissue Infections." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S481—S482. http://dx.doi.org/10.1093/ofid/ofz360.1196.
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Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common and problematic causes of bacterial skin and soft-tissue infections (SSTI). MRSA tends to form complex skin infections, furuncles, boils and abscesses. Many patients go on to have recurrent infections, requiring significant additional therapy to treat each infection as well as needing to undergo decolonization of the skin in order to remove the bacteria and try to prevent future infections. A test to distinguish patients at risk for recurrence can allow earlier more aggressive treatment for those at risk for recurrent infection. This can potentially reduce healthcare costs, prevent future hospital admissions and surgical procedures, and reduce loss of productivity experienced by patients suffering from multiple recurrences. Methods A genome-wide association study using the Affymetrix gene array was performed on 11 patients with confirmed recurrent MRSA SSTIs and 3 controls who never developed an SSTI despite confirmed heavy exposure to MRSA in order to identify single nucleotide polymorphisms (SNP) associated with recurrent MRSA. The 10 genes identified were then fully sequenced using an Illumina NextSeq 500 to identify additional SNPs. Results A total of 22 SNPs were found in 10 separate genes which distinguished patients with recurrent MRSA from patients without recurrent MRSA despite heavy exposure. The 10 genes are shown in Table 1 along with a representative SNP. The P-values for each individual SNP were between 3.5 × 10−5 and 1.2 × 10−7. Conclusion This study provides the first evidence of a genetic risk for those patients who develop recurrent MRSA SSTIs. The majority of the genes involved are related directly to the skin, not to immune functions thus it appears the major risk factor for development of recurrent MRSA SSTI is related to the barrier function of the skin and not to an immune defect. Being able to determine which patients are at risk for recurrence at the time they first present with an MRSA SSTI would be of great help in preventing future recurrences, reducing morbidity and reducing healthcare costs. Disclosures All authors: No reported disclosures.
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Shope, Chelsea, Laura Andrews, Courtney Linkous, Pelin Sagut, and Lara Wine Lee. "Predicting Skin Cancer Development after Liver Transplant." SKIN The Journal of Cutaneous Medicine 7, no. 1 (January 10, 2023): 602–7. http://dx.doi.org/10.25251/skin.7.1.8.
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Introduction: As the number of solid organ transplants (SOTs) continues to increase and post-transplant therapies improve, SOT recipients (SOTRs) live longer and thus, are increasingly affected by post-transplant sequala such as skin cancer. Research investigating risk factors associated with skin cancer development in SOTRs has largely been conducted in kidney recipients. Methods: We performed a retrospective chart review of SOTRs seen by dermatology from January 1, 2012 – June 1, 2022. Data was analyzed using Pearson chi-square testing and Classification and Regression Tree (CART) modeling. Results: Of 530 patients meeting inclusion criteria, 80 received liver transplants. Among liver recipients, a total of 155 skin cancers and five recurrences developed following transplant among 37 patients (46.25%). Patients who developed skin cancer were Caucasian (94.6%, p-value=0.186) and were significantly more likely to be male (78.4%, p-value=0.045) and former smokers (59.5%, p-value=0.038). CART showed age greater than 43 years was the biggest predictor for later skin cancer development. Patients most frequently developed squamous cell carcinoma (60.87%) of the head and neck (51.35%) or upper extremities (29.73%). Conclusion: Risk factors associated with skin cancer development in liver transplant recipients include increased age at transplant, white race, male sex, and smoking status. Stratification of referrals to dermatology based on these factors should be considered.
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Wapner, Keith L., Prodromos A. Ververeli, John H. Moore, Paul J. Hecht, Carl E. Becker, and Richard D. Lackman. "Plantar Fibromatosis: A Review of Primary and Recurrent Surgical Treatment." Foot & Ankle International 16, no. 9 (September 1995): 548–51. http://dx.doi.org/10.1177/107110079501600906.
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Plantar fibromatosis can be quite disabling to the patient, as well as a technical challenge to the surgeon. Patients who undergo previous local excisions and in whom aggressive recurrences develop are difficult to manage successfully. We present a consecutive series of five primary procedures on patients with painful plantar fibroma and seven revision operations on patients with recurrent plantar fibroma. The average follow-up was 47 months (range, 22–66 months) in the primary group and 40 months (range, 21–78 months) in the revision group. The overall results were satisfactory in four of the five primary operations, with only one recurrence. In the revision group, five of seven results were satisfactory with no recurrences. The major complication that led to unsatisfactory results was the development of a postoperative neuroma. In this article, we outline our present surgical techniques of wide primary excision and a staged revision procedure with delayed split-thickness skin graft closure. These techniques can be used successfully to manage this disabling, progressive disease.
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Patel, Mitulkumar, Samantha Smalley, Yanina Dubrovskaya, Justin Siegfried, Christopher Caspers, Vinh Pham, Robert A. Press, and John Papadopoulos. "Dalbavancin Use in the Emergency Department Setting." Annals of Pharmacotherapy 53, no. 11 (June 3, 2019): 1093–101. http://dx.doi.org/10.1177/1060028019855159.
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Background: Although dalbavancin’s (DBV’s) long half-life and one-time dosing strategy confer ideal administration in the ambulatory setting, the optimal role of DBV in the management of acute bacterial skin and skin structure infections (ABSSSIs) remains to be elucidated. Objectives: The primary objective of this study was to compare treatment outcomes of ABSSSI between patients who received DBV in the emergency department (ED) as part of standard care versus patients who received DBV as part of a telehealth program. Methods: This was a retrospective cohort study evaluating patients who received DBV at 3 urban EDs. The primary end point was the incidence of ABSSSI recurrence. Secondary outcomes included need for hospital admission and ED length of stay (LOS; in hours). Results: A total of 65 ABSSSI treatment courses were included; 42 were included in the telehealth criteria (TC) cohort and 23 in the initial criteria (IC) cohort. There were 14% (6/42) infection recurrences in the TC cohort and 22% (5/23) in the IC cohort, with median time to recurrence being 4 and 14 days, respectively. Median ED LOS was significantly shorter in the TC (5 vs 25 hours, P < 0.05). Numerically fewer individuals in the TC cohort required inpatient admission (0 vs n = 2, 9%). Conclusion and Relevance: Our results suggest that patients may be safely administered DBV in an ED setting, with telehealth follow-up. Providing structured patient selection criteria is an effective method of assisting ED providers in selecting appropriate DBV candidates to limit potential recurrences and readmissions.
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Zikiryakhodzhaev, Aziz, Yelena Rasskazova, and Shakhnoz Khakimova. "ONCOLOGICAL SAFETY OF RADICAL SUBCUTANEOUS/ SKIN-SPARING MASTECTOMIES WITH SIMULTANEOUS RECONSTRUCTION IN CANCER." Problems in oncology 65, no. 6 (June 1, 2019): 832–37. http://dx.doi.org/10.37469/0507-3758-2019-65-6-832-837.
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The article analyzes 472 patients diagnosed with breast cancer (breast cancer) who underwent radical subcutaneous/ skin-sparing mastectomy in combined or complex treatment. In the Department of Oncology and reconstructive plastic surgery of breast and skin mnioi them.P. A. Herzen radical skin-sparing mastectomy was performed in 255 (54.1 %) and radical subcutaneous mastectomy in 217 (45.9 %) patients. Reconstruction was carried out by autotissues, expander, followed by replacement with an endoprosthesis, as well as a combination of patches and endoprostheses. The mean age of patients was 43.8±2.2 (18-73) years. 11 (2,3±0,7 %) patients were diagnosed with relapse of breast cancer, while in 6 cases local and in 5 cases regional relapse (metastases in subclavian lymph nodes). Treatment of recurrences of breast cancer was as follows: in two cases, polychemotherapy courses were conducted, in 8 operations were performed - excision of relapse in the breast (3) and subclavian lymphadenectomy (2), removal of the reconstructed gland (3), in 1 case - radiation therapy. In 13 % recurrences of breast cancer were diagnosed at stage III OF breast cancer, the lowest percentage of relapse was 1.4 % at stage I. In luminal type A, recurrence of breast cancer was diagnosed in 1.8 %, in luminal B in 3.6 %, in triple negative type - 2.5 %, in luminal In Neg2 positive - 4.1 %. Metastases of breast cancer in our group of patients were diagnosed in 26 (5.5±1 %) patients. The highest percentage of long-term metastasis in our study revealed - 12.5 % at stage III, the lowest percentage of 3.4 at stage I breast cancer. 3-year overall survival of breast cancer patients in our group was 97.4 % (n=269).
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Ribag, Yassamina, Lahcen Khalfi, Jalal Hamama, and Karim El Khatib. "SOLITARY FIBROUS TUMOR OF THE SKIN: AN UNUSUAL LOCATION." International Journal of Advanced Research 10, no. 09 (September 30, 2022): 959–64. http://dx.doi.org/10.21474/ijar01/15442.
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Background : Solitary fibrous tumours rare spindle cell neoplasms, initially regarded as occurring exclusively within the thoracic cavity with a pleural origin. We report an unusual and rare case, of solitary fibrous tumor of the skin. Whose evolution has been marked by several recurrences after surgical excision Case Report: 49 year old man, with a dorsolumbar cutaneous tumor.
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Batsakis, John G., Adel K. El-Naggar, and Randal S. Weber. "Two Perplexing Skin Tumors: Microcystic Adnexal Carcinoma and Keratoacanthoma." Annals of Otology, Rhinology & Laryngology 103, no. 10 (October 1994): 829–32. http://dx.doi.org/10.1177/000348949410301016.
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Microcystic adnexal carcinoma and keratoacanthoma have a marked predilection for the skin of the head and neck. The adnexal carcinoma continues to be underrecognized, and the consequences for the patient are locally aggressive recurrences. The keratoacanthoma, on the other hand, may be inappropriately overdiagnosed, causing squamous cell carcinoma of the skin to be missed. In the instance of the solitary keratoacanthoma a conservative complete excision is recommended.
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Zanger, Philipp, Johannes Holzer, Regina Schleucher, Helmut Scherbaum, Birgit Schittek, and Sabine Gabrysch. "Severity of Staphylococcus aureus Infection of the Skin Is Associated with Inducibility of Human β-Defensin 3 but Not Human β-Defensin 2." Infection and Immunity 78, no. 7 (April 19, 2010): 3112–17. http://dx.doi.org/10.1128/iai.00078-10.
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ABSTRACT Gram-positive bacteria are the predominant cause of skin infections. Antimicrobial peptides (AMPs) are believed to be of major importance in skin's innate defense against these pathogens. This study aimed at providing clinical evidence for the contribution of AMP inducibility to determining the severity of Gram-positive skin infection. Using real-time PCR, we determined the induction of human β-defensin 2 (HBD-2), HBD-3, and RNase 7 by comparing healthy and lesional mRNA levels in 32 patients with Gram-positive skin infection. We then examined whether AMP induction differed by disease severity, as measured by number of recurrences and need for surgical drainage in patients with Staphylococcus aureus-positive lesions. We found that HBD-2 and -3, but not RNase 7, mRNA expression was highly induced by Gram-positive bacterial infection in otherwise healthy skin. Less induction of HBD-3, but not HBD-2, was associated with more-severe S. aureus skin infection: HBD-3 mRNA levels were 11.4 times lower in patients with more than 6 recurrences (P = 0.01) and 8.8 times lower in patients reporting surgical drainage (P = 0.01) than in the respective baseline groups. This suggests that inducibility of HBD-3 influences the severity of Gram-positive skin infection in vivo. The physiological function of HBD-2 induction in this context remains unclear.
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Rahestyningtyas, Eccita, Pungky Mulawardhana, and Tomy Lesmana. "Abdominal skin metastasis in endometrial cancer." Majalah Obstetri & Ginekologi 27, no. 2 (September 19, 2019): 84. http://dx.doi.org/10.20473/mog.v27i22019.84-89.
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Objectives: Surgical wound metastases in stage 1 endometrial cancer are possible, with a variety of different pathophysiological possibilities. Comprehensive management is needed to keep the patient on the possibility of a good prognosis.Cases Report: During January 2015 – January 2018 at dr. Soetomo Hospital, there were 2 cases of metastatic endometrial cancer in the laparotomy wounds by which the condition is very rare. Case 1, The patient was diagnosed with endometrial carcinoma following the results of curettage. Anatomical pathology examination was done and obtained grade 2 endometrioid adenocarcinoma. In Case 2, the patient underwent Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy in 2013 at Mojokerto General Hospital, indicating Uterine Fibroids and Ovarian Cysts. The results of anatomical pathology examination were unknown. On April 2017, the patient complained abdominal swelling since 3 months ago.Conclusion: In January 2015 - January 2018, 2 cases of metastatic endometrial cancer was found in a former laparotomy operation where this condition is very rare in endometrial cancer cases with low grade ,so that follow-up, monitoring and more vigilance are required in patients with low-grade endometrial Ca who have finished undergoing a surgery and chemotherapy. Rapture or mass resection, followed by external radiation, may be performed in patients with recurrence in the laparotomy wound area or in patients with high risk factors for endometrial cancer such as a history of estrogen use, tamoxifen, nullipara, obesity, diabetes mellitus, and family history of endometrial cancer. Currently, there is no fixed procedure (guideline) in RS. Dr. Soetomo to overcome recurrences especially in the scars of cancer surgery.
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Zelenkov, N. P., R. N. Voloshin, A. P. Svetitsky, and A. V. Snitko. "Cryodestruction of recurrent malignant skin tumors of different localizations in polyclinics." Ural Medical Journal 20, no. 3 (November 11, 2021): 49–53. http://dx.doi.org/10.52420/2071-5943-2021-20-3-49-53.
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Introduction. Skin cancer is one of the most common types of malignant neoplasms in Russia. Radiation therapy, surgical intervention, and combined treatment are usually used for skin cancer. Unfortunately, the above methods are not always successful. The reason for the incomplete effect of surgical treatment may be insufficient radicalism of the intervention due to the doctor's desire to cause the least trauma to the surrounding healthy tissues in order to obtain a good cosmetic result. Selective destruction of tumor tissue in cryogenic exposure with minimal damage to surrounding healthy tissues is accompanied by a hemostatic effect, which is especially important in the treatment of both primary and recurrent decaying tumor ulcers. Aim — to evaluate the effectiveness of cryodestruction as the method of choice in the outpatient treatment of recurrent skin cancer. Materials and methods. The study was controlled, non-randomized. The criterion for inclusion in the study was the establishment of the diagnosis of recurrent skin cancer at the application and subsequent treatment in the outpatient clinic of the State Budgetary Institution "Oncologic Dispensary" in Novocherkassk from 2016 to 2020. A total of 532 patients were studied. Patients were planned to undergo tumor cryodestruction with several freeze-thaw cycles, lasting 2-5 minutes. Results. The results of the study indicate high efficiency of cryodestruction. Complete recovery in the treatment of recurrent skin cancer was observed in 446 (83.4%) patients. Repeated cryodestruction was performed in 86 (16.6%) patients, who experienced continued growth and recurrence after cryodestruction within 1 to 18 months. Subsequently, 38 of 86 patients (7.2%) did not experience continuation of growth and new recurrences. Discussion. Based on the literature data and our treatment results it was determined that cryodestruction is the most acceptable and simple method of treatment for this category of patients. Conclusion. In the presence of limited recurrences of skin cancer of various localizations, cryogenic exposure is effective (in 90.6% of the outcome — recovery) in patients of different sex and age, regardless of the location and prevalence of the tumor process and is the method of choice of treatment in an outpatient setting.
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Katiyar, Vatsala, Tiago Araujo, Nasma Majeed, Nicholas Ree, and Shweta Gupta. "Multiple recurrences from cervical cancer presenting as skin metastasis of different morphologies." Gynecologic Oncology Reports 28 (May 2019): 61–64. http://dx.doi.org/10.1016/j.gore.2019.02.008.
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Vinícius Jardini Barbosa, Marcus, Anna Rita de Cascia Carvalho Barbosa, and Frederico Alonso Sabino de Freitas. "Analysis of the Histopathological Profile and Surgical Margins Resulting from Resection of Nonmelanoma Skin Cancers." Journal of Advanced Plastic Surgery Research 5, no. 1 (December 30, 2021): 22–26. http://dx.doi.org/10.31907/2414-2093.2020.06.05.
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: Introduction: Non-melanoma skin cancer is a group of malignant neoplasms composed basically by sarcomas, basal cell carcinoma and squamous cell carcinoma. Its etiology is multifactorial with specificity for each of the two types, except for exposure to ultraviolet radiation, which is a common factor between both. When detected early, it has a high cure rate, and surgical excision with safety margins being the treatment of choice in most cases. Thus, it is important to recognize the profile of the patients, as well as the histopathological characteristics of the lesions and the medical approach used to avoid recurrences. Purpose: This study aimed to analyze the histopathological profile and surgical margins resulting from the resection of non-melanoma skin cancers in patients treated at a plastic surgery facility in Brazil. Methods: The cases of squamous cell carcinoma and the histopathological types of the basal cell carcinoma were individually analyzed for compromised margins, and later divided into a low-risk group and a high-risk group. Results: 228 lesions were resected from 141 patients. Gender distribution was 55.3% female and 44.6% male. The most affected age group was over 70 years old. The predominant histological type was basal cell carcinoma (74.6%) followed by squamous cell carcinoma (25.4%); the most affected site was the cephalic-cervical segment (71.92%). Surgical margins were compromised in 12.3% with no significant difference between the two types of carcinoma. Conclusion: There was a predominance of basal cell carcinoma (nodular type) in women over 40 years old, predominantly in the cephalic-cervical region. The number of recurrences was proportionally higher in the BCC, unrelated to the presence of positive margins. Keywords: Skin Neoplasms, Basal Cell Carcinoma, Squamous Cell Carcinoma, Recurrence, Margins of Excision.
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Mucha-Małecka, A., K. Urbanek, A. Ambicka, P. Majchrzak, and K. Małecki. "Radiotherapy in lymphoepithelioma-like carcinoma of the skin: review of the literature and report of a recurrent and metastatic case." Strahlentherapie und Onkologie 195, no. 11 (September 9, 2019): 1028–32. http://dx.doi.org/10.1007/s00066-019-01516-8.
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Abstract Primary lymphoepithelioma-like carcinoma of the skin (LELCS) is a very rare cutaneous neoplasm. Only about 70 cases have been documented in the literature. There are no prospective data regarding treatment methods. Surgical excision is sufficient therapy in the majority of cases. Radiation therapy is sometimes used in case of recurrence or positive margins after surgery. The metastatic potential of LELCS is extremely low and only five previously documented cases of lymph node spread have been reported. We present the case of an 80-year-old male with a tumor primarily located on the lower eyelid, with two regional recurrences and cervical lymph node spread after surgery, treated with concurrent chemoradiation. According to the available data, this is the first case of lymph node spread from an eyelid location and the first nodal recurrence after surgery.
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Peralta, Diego P., Aymara Y. Chang, and Enrique Soto-Ruiz. "A Case of Recurrent Skin Abscesses: A Conundrum Solved after Obtaining a Thorough Sexual History." Case Reports in Infectious Diseases 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/4765697.
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Background. Despite the improvement in patient-physician communication techniques, sexuality and sexual health continue to be challenging areas for discussion during a clinical encounter. Most people are not prepared to discuss sexual matters openly as it can be perceived as negative or inappropriate. Consequently, an incomplete health assessment can result in delayed diagnosis or misdiagnosis.Case Report. We present a 33-year-old woman who developed recurrent left breast abscesses. She required multiple incision and drainage procedures in the operating room followed by antimicrobial therapy. Although she always had an initial improvement with this approach, she continued to have recurrences and development of new abscesses in other body areas. The polymicrobial nature of her recurrences prompted an extensive and costly workup to determine the nature of her condition. The cause was finally elucidated when a thorough sexual history was obtained. Poor hygiene practices during her sexual encounters were considered the cause of her recurrent abscesses. After medical therapy and modification of her sexual practices, she has not developed new recurrences for more than two years.Conclusion. Discussions on sexuality and sexual health are important parts of any clinical encounter, yet frequently forgotten or avoided. Becoming aware of their importance would avoid delayed diagnosis or misdiagnosis.
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Naik, Sudhir, BL Yatish Kumar, S. Ravishankara, T. Shashikumar, and RM Deekshith. "Modified Sistrunk Procedure: A Novel Method of Hyoid Resection using Skin Punches in Subhyoid Thyroglossal Cysts." An International Journal of Otorhinolaryngology Clinics 8, no. 3 (2016): 97–100. http://dx.doi.org/10.5005/jp-journals-10003-1240.
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ABSTRACT Background/objectives Managing thyroglossal duct cyst requires surgical excision of the cyst with its tract through the tongue base. Incomplete removal results in cyst recurrence, the common complications of incompletely performed Sistrunk procedure. The Modified Sistrunk procedure using skin punches increases the easiness of surgery and chances of complete removal of the tract. Materials and methods Resection of the middle body of the hyoid was done by coring out the nonossified bone with 4.5 mm skin punches under 3.5× loupes and the tract above till the base. Results A total of 14 primary cases were operated by this slight modification, and no recurrences were seen on 1 year of follow-up. Conclusion Sistrunk operation is the treatment of choice for primary thyroglossal cysts. Modified Sistrunk operation using skin punches results in easy and precise coring of the hyoid bone with the tract attached to it. Secondary cysts should be treated with removal of core of tongue base muscle and foramen cecum mucosa along with hyoid and scarred cyst excision. How to cite this article Naik SM, Kumar BLY, Ravishankara S, Shashikumar T, Deekshith RM. Modified Sistrunk Procedure: A Novel Method of Hyoid Resection using Skin Punches in Subhyoid Thyroglossal Cysts. Int J Otorhinolaryngol Clin 2016;8(3):97-100.
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Bernkopf, Edoardo, Andrea Lovato, Giulia Bernkopf, Luciano Giacomelli, Giovanni Carlo De Vincentis, Francesco Macrì, and Cosimo de Filippis. "Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report." BioMed Research International 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/2473059.
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Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods. The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p<0.0001) and multivariate analysis (p=0.001). Conclusions. RAOM showed better outcomes in children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction.
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Adrada, Beatriz Elena, Niloofar Karbasian, Monica Huang, Gaiane Maia Rauch, Piyanoot Woodtichartpreecha, and Gary Whitman. "Imaging Surveillance of the Reconstructed Breast in a Subset of Patients May Aid in Early Detection of Breast Cancer Recurrence." Journal of Clinical Imaging Science 11 (November 9, 2021): 58. http://dx.doi.org/10.25259/jcis_113_2021.
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Objectives: The purpose of this study is to determine the biological markers more frequently associated with recurrence in the reconstructed breast, to evaluate the detection method, and to correlate recurrent breast cancers with the detection method. Material and Methods: An institutional review board-approved retrospective study was conducted at a single institution on 131 patients treated with mastectomy for primary breast cancer followed by breast reconstruction between 2005 and 2012. Imaging features were correlated with clinical and pathologic findings. Results: Of the 131 patients who met our inclusion criteria, 40 patients presented with breast cancer recurrence. The most common histopathologic type of primary breast cancer was invasive ductal carcinoma in 82.5% (33/40) of patients. Triple-negative breast cancer was the most common biological marker with 42.1% (16/38) of cases. Clinically, 70% (28/40) of the recurrences presented as palpable abnormalities. Of nine patients who underwent mammography, a mass was seen in eight patients. Of the 35 patients who underwent ultrasound evaluation, an irregular mass was found in 48.6% (17/35) of patients. Nine patients with recurrent breast cancer underwent breast MRI, and MRI showed an irregular enhancing mass in four patients, an oval mass in four patients, and skin and trabecular thickening in one patient. About 55% of patients with recurrent breast cancer were found to have distant metastases. Conclusion: Patients at higher risk for locoregional recurrence may benefit from imaging surveillance in order to detect early local recurrences.
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Caldas, Regina, Filipa T. Almeida, Teresa Pereira, Inês Carvalho, Sofia D. Carvalho, and Celeste Brito. "Late Metastases from a Thin Primary Cutaneous Malignant Melanoma." Journal of the Portuguese Society of Dermatology and Venereology 78, no. 1 (May 6, 2020): 71–74. http://dx.doi.org/10.29021/spdv.78.1.1157.
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Cutaneous malignant melanoma is the third most common type of skin cancer, and its incidence has been rising. Its mortality rate is considerable, due to an aggressive phenotype and great ability of dissemination, mainly in the first years of follow- -up. Late recurrences, those presenting more than 10 years after diagnosis, are rare. The main prognostic factor of cutaneous malignant melanoma is tumor thickness, which also guides management. Thin tumors often have a good prognosis. We report a case of a 66-year-old woman with a history of excision of a thin primary cutaneous malignant melanoma of the dorsum, presenting 16 years later with an unexpected, rapidly progressing and lethal recurrence.
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LOOI, K. P., M. TEH, and R. W. H. PHO. "An Unusual Case of Multiple Recurrence of a Glomangioma." Journal of Hand Surgery 24, no. 3 (June 1999): 387–89. http://dx.doi.org/10.1054/jhsb.1998.0013.
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Glomus tumour is a benign lesion arising from the glomus apparatus of the skin and subcutaneous tissue. Glomangioma is the angiomatous variant, which is uncommon. We report a very rare presentation of a glomangioma with multiple recurrences. We advocate preoperative angiography to delineate the extent of the lesion to facilitate complete excision.
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Qi, Weijie. "Analysis of the Application Effect of Health Education in Skin Care." Journal of Nursing 9, no. 4 (February 20, 2021): 75. http://dx.doi.org/10.18686/jn.v9i4.187.
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<p>Objective: to analyze the effect of health education intervention in clinical nursing of patients with skin diseases. Methods: from January 2018 to March 2019, 122 patients with skin diseases were admitted to our hospital and randomly divided into two groups, with 61 cases in each group. The selected patients gave informed consent to this study. The control group was given routine dermatological care, and the observation group was given systematic health education. The treatment effect, mood score and quality of life score of the two groups were compared. Results: the treatment time, recurrence times and outpatient treatment times of the observation group were lower than those of the control group, the difference was statistically significant (P < 0.05); the HAMA score and HAMD score of the observation group after intervention were lower than the control group, the difference was statistically significant (P < 0.05). Conclusion: the implementation of health education for patients with skin diseases during the nursing process can effectively promote the recovery of the condition and reduce the number of treatments and recurrences. At the same time, it can improve the patients’ bad mental mood and improve the quality of life of the patients.</p>
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Maradesha, P. S., Divya H. R., and Veenapani M. K. "Clinical study of preauricular sinus and its management." International Journal of Otorhinolaryngology and Head and Neck Surgery 5, no. 5 (August 27, 2019): 1204. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20193605.
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<p class="abstract"><strong>Background:</strong> Preauricular sinus is the common congenital disease with tendency for repeated infections. It can present as a pit or depression at the anterior margin of ascending limb of helix. It is due to defect in auricular embryogenesis, which results in preauricular sinus.</p><p class="abstract"><strong>Methods:</strong> This is the prospective study conducted in Mysore Medical College. All preauricular sinus patients were included for this study. 20 patients of all gender underwent surgery by supra-auricular dissection. </p><p class="abstract"><strong>Results:</strong> In all the cases plane of temporalis fascia identified, skin anterior to the sinus is excised along with a piece of adjoining helical cartilage. With this method no recurrences were encountered.</p><p class="abstract"><strong>Conclusions:</strong> Standard surgical technique i.e. sinusectomy has more recurrence rate. In our study we observed that surgical outcome after supra–auricular dissection method had no recurrences.</p>
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Berman, Brian, Mark S. Nestor, Joshua Fox, Michael Jones, George Schmieder, and Eduardo T. Weiss. "Low Rate of Keloid Recurrences Following Treatment of Keloidectomy Sites with a Biological Effective Dose 30 of Superficial Radiation." SKIN The Journal of Cutaneous Medicine 1 (October 27, 2017): s122. http://dx.doi.org/10.25251/skin.1.supp.121.
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Badalament, R. A., H. W. Herr, G. Y. Wong, C. Gnecco, C. M. Pinsky, W. F. Whitmore, W. R. Fair, and H. F. Oettgen. "A prospective randomized trial of maintenance versus nonmaintenance intravesical bacillus Calmette-Guérin therapy of superficial bladder cancer." Journal of Clinical Oncology 5, no. 3 (March 1987): 441–49. http://dx.doi.org/10.1200/jco.1987.5.3.441.
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Between August 1981 and July 1984, 93 patients with polychronotopic superficial papillary carcinoma (Ta and/or T1), flat carcinoma in situ (Tis), or concomitant superficial papillary and in situ bladder carcinoma were entered into a prospective randomized trial of maintenance v nonmaintenance intravesical bacillus Calmette-Guérin (BCG) therapy. Forty-six patients who received BCG weekly for 6 weeks were compared with 47 patients receiving the six-weekly doses of BCG plus monthly BCG for 2 years. Both groups were evaluated every 3 months by cytology, cystoscopy, and biopsy. A significant reduction in the number of recurrent tumors per patient-month was demonstrated for both groups (P less than .0001); however, the difference in reduction of tumors between the two groups was not significant. Additionally, patients receiving maintenance and nonmaintenance therapy had similar tumor recurrence and progression rates. These results indicate that monthly maintenance BCG does not prevent, delay, or reduce tumor recurrence or progression observed with the 6-week regimen. Maintenance BCG was associated with increased local toxicity, primarily dysuria, frequency, and urgency. Dosage reduction was required in 22 of 47 patients (46.8%). When the data were subjected to multivariate analysis, the presence or absence of tumor following induction BCG and PPD skin test results were found to be significant variables. Controlling for either the presence or absence of tumor following induction BCG, tumor recurrence and progression rates were not significantly different for the two treatment groups. However, the absence of tumor after induction BCG was associated with a longer disease-free duration (P = .00001) and time to progression (P = .095). Patients with a reactive tuberculin skin test before and after induction BCG had significantly less tumor recurrences than patients with different PPD skin tests results (P = .02). Tumor progression was not related to tuberculin skin testing.
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Jhunjhunwala, Adarsh Kumar, Dilasma Gharti Magar, Dipesh Upreti, Niku Thapa, Arnab Ghosh, Sushma Thapa, Sudeep Regmi, and Bishowdeep Timilsina. "Mucinous Carcinoma of the Skin: A Case Report." Journal of Nepal Medical Association 60, no. 248 (April 15, 2022): 402–5. http://dx.doi.org/10.31729/jnma.7415.
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Primary mucinous carcinoma of the skin is a rare malignant neoplasm showing predilection to the periorbital region. These tumours are indolent and low-grade, with a tendency for local, sometimes multiple, recurrences. Distinguishing between these primary neoplasms and the more frequent metastatic mucinous deposits on the skin from primaries in the breast and gastrointestinal tract constitutes a diagnostic dilemma. In this case report, we have put forth the findings of a 70-year-old male who presented with a slow-growing periorbital swelling and was subsequently diagnosed with mucinous adenocarcinoma. An extensive workup in search of another primary tumour failed to show a primary malignancy elsewhere and the diagnosis of primary mucinous adenocarcinoma of the skin was rendered.
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Aluisio, Frank V., Scott D. Mair, and Reginald L. Hall. "Plantar Fibromatosis: Treatment of Primary and Recurrent Lesions and Factors Associated with Recurrence." Foot & Ankle International 17, no. 11 (November 1996): 672–78. http://dx.doi.org/10.1177/107110079601701105.
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Plantar fibromatosis is a benign but often problematic foot disorder which, when surgically treated, is difficult to eradicate. The purpose of this investigation was to identify epidemiologic factors associated with disease recurrence and to determine which method of treatment most successfully eliminated recurrence. A retrospective review of surgical pathology reports and clinical histories from 1979 to 1993 was performed to identify all patients who underwent surgery for plantar fibromatosis at our institution during that time. Thirty-three feet of 30 patients were identified with a minimum 2-year follow-up. Seventeen feet underwent surgery for primary lesions, and 4 of 10 that had local excision, 1 of 3 that had wide excision, and 2 of 4 that had subtotal fasciectomy (with or without skin grafting) had recurrence. All 16 feet in patients presenting with recurrent lesions had undergone prior local excision at other institutions. When combined with patients from our institution who underwent a second procedure, 21 feet had surgery for recurrent plantar fibromatosis. Of these, three of four had further recurrence when treated with local or wide excision. In feet with recurrences treated with subtotal fasciectomy, only 4 of 17 had recurrence after the first attempt at such treatment. Average follow-up for all patients was 7.7 years, and all patients with postoperative recurrences showed evidence of disease within 14 months after surgery (mean, 6.9 months). Factors identified with an increased risk for recurrence were multiple nodules, bilateral lesions, and positive family history. In treating recurrent disease, subtotal fasciectomy was more effective than local or wide excision. This study identified factors associated with a significant likelihood of postoperative recurrence in treating plantar fibromatosis and found subtotal fasciectomy to provide the most successful treatment in eradicating disease in recurrent cases.
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Chaft, Jamie E., Daniel Botelho Costa, Alona Muzikansky, Joseph B. Shrager, Michael Lanuti, James Huang, Kavitha Ramchandran, et al. "Randomized phase II study of adjuvant afatinib for three months versus two years in patients with resected stage I-III EGFR mutant NSCLC." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): 8507. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.8507.
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8507 Background: EGFR tyrosine kinase inhibitors are superior to chemotherapy in patients with advanced EGFR+ lung cancers. In the adjuvant setting, erlotinib for two years improves recurrence free survival (RFS) compared to historical controls. The optimal duration of adjuvant TKI is unknown. Methods: Patients with completely resected Stage I-III NSCLC with a sensitizing EGFR mutation were enrolled after standard adjuvant therapy. Pts were randomly assigned to 3 months (3m) or 2 years (2y) of adjuvant afatinib. Afatinib was started at 30 mg by mouth daily. Patients without toxicity after 28 days were allowed to escalate to 40 mg daily. Patients were imaged with CT every 6 months for 3 years and then annually or as clinically indicated. RFS was measured from the date of randomization. The primary study endpoint was recurrence rate at 2 years. 60 randomized patients would provide 82.5% power to detect a 26% difference in 2y-recurrence rate. Results: Patient characteristics are in the Table. The study was terminated for slow accrual after 46 of the planned 60 patients. Planned treatment was completed by 92% (22/24) pts in the 3m arm and 41% (9/22) of pt in the 2y arm. 22 patients required ≥1 dose modification due to toxicity including expected GI, mucosal, and skin AEs. With a median follow-up of ≥38 months there were 10 recurrences and 3 deaths in the 3m arm and there were 5 recurrences (2 on treatment) and 2 deaths in the 2y arm. Median RFS has not been reached in either arm, but recurrence was more common in the 3m arm at every landmark. 2y-recurrence rates were 29% for 3m and 15% for 2y. Conclusions: Recurrences at 2 years were 14% less common with 2y versus 3m of adjuvant afatinib. This difference did not meet the primary study endpoint. The RFS curves show a durable and clinically meaningful separation with substantial follow-up. Failure to meet significance was likely influenced by under-accrual and early drug discontinuation on the 2y arm. In the era of TKIs with improved tolerance, duration of adjuvant therapy remains an important question. Clinical trial information: NCT01746251. [Table: see text]
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Sharma, Jyoti, and Lalit Chandrakant. "Oligometastatic recurrence in radically treated stage II lower thoracic ca oesophagus at two drain sites: a treatment challenge?" International Surgery Journal 8, no. 3 (February 25, 2021): 1060. http://dx.doi.org/10.18203/2349-2902.isj20210952.
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Ca oesophagus is a dreaded malignancy with less than 15 % cure rate and majority of the patients presenting with advanced unresectable disease. Prognosis remains poor despite advances in combined modality treatments. Most common sites of loco-regional recurrence after surgery remains the mediastinal lymph node clearance area while other common sites are lung liver and bone. Unexpected sites of metastasis have been reported like skin, muscle, eyes etc. We report a case of 66-year-old male patient diagnosed with stage II poorly differentiated squamous cell carcinoma lower oesophagus radically treated with neoadjuvant chemotherapy, trans hiatal esophagectomy followed by adjuvant chemotherapy, who subsequently developed oligometastatic recurrences at two drain sites. Patient was treated with surgical excision followed by radiotherapy and chemotherapy.
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Eftimie, Lucian G., Daniel O. Costache, Constantin D. Uscatu, Remus R. Glogojeanu, and Raluca S. Costache. "Non‑melanoma skin cancer (NMSC): Extramammary Paget ’s disease." Romanian Journal of Military Medicine 123, no. 3 (August 1, 2020): 184–89. http://dx.doi.org/10.55453/rjmm.2020.123.3.6.
Full textAbstract:
Non ‑melanoma skin cancer (NMSC) comprises squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and severalrare skin tumors (i.e., Extramammary Paget’s disease), being the most common malignancy-affecting people worldwide. Itrepresents the majority of skin cancers and a significant percentage of all malignancies. Despite increasing public awarenessand scientific interest, the incidence of NMSC is constantly increasing. Even though most NMSC`s are associated with lessaggressive behavior, they can still be invasive locally and cause extensive damage to neighboring structures, inducingsignificant morbidity. In addition, different types and subtypes of NMSC tend to have frequent recurrences and may have significantmetastatic potential. As a direct consequence, NMSC has become an important issue for healthcare systems with a significantsocio ‑economic impact.
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Ramzan, Muhammad, Muhammad Khalid Mirza, and Muhammad Arif Ali. "PILONIDAL SINUS." Professional Medical Journal 23, no. 12 (December 10, 2016): 1499–504. http://dx.doi.org/10.29309/tpmj/2016.23.12.1805.
Full textAbstract:
Objectives: To prospectively evaluate the results of modified Karydakisprocedure with subcuticular skin closure in presacral pilonidal sinus disease patients. Design:Prospective cohort study. Setting: Armed Forces Hospital Dhahran. Period: Jan.2007 and Jan2013 were prospectively followed for 2 & ½ yrs. Methodology: 243 patients having pilonidalsinus disease who underwent surgery by modified Karydakis technique with subcuticular skinclosure. They were evaluated for age, sex, BMI, duration of symptoms, hospital stay, morbidity,recurrence and cosmetic satisfaction. The patients having acute pilonidal sinus abscess wereexcluded from the study. Results: Out of 243 patients, 230 were males and 13 females with amean age and BMI of 24.7, 26.3, 29.4 and 30.8 respectively. The most common symptom wasseropurulent discharge from the sacrococcygeal area. 232 (95.5%) patients completed theirfollow up whereas 11 (4.53%) patients (5 females and 6 males) could not be traced in follow upcalls after 3 months. 22/243 patients (9%) had minor wound related complications like minorwound infection, partial wound or skin disruption and seroma formation. There were only 3(1.23%) recurrences (2 males and 1 female). All patients were fully satisfied with the cosmeticresult. Conclusion: Karydakis asymmetrical flap closure using subcuticular skin closure is asimple technique which gives best outcome in terms of morbidity and Cosmesis.
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Hamid, Raashid, Aadil Hafeez, Ashraf M. Darzi, Inam Zaroo, Habib Owais, and Afrozah Akhter. "Dermatofibrosarcoma protuberans: Role of wide local excision." South Asian Journal of Cancer 02, no. 04 (October 2013): 232–38. http://dx.doi.org/10.4103/2278-330x.119926.
Full textAbstract:
Abstract Objectives: The main objective of the present study was to study the outcome of surgical treatment of dermatofibrosarcoma protuberans. Materials and Methods: This study included 45 patients both retrospective and prospective from December 1995 to December 2010. Results: Out of 45 patients, 30 were males and 15 females with the male to female ratio of 2:1. Mean age of presentation was 38.4 + 13.2 years. Commonest mode of presentation was raised firm multinodular lesion with fixity to overlying skin. Site distribution was 42.22% trunk, 57.88% extremities and head and neck. None of the patients had lymph node involvement All patients underwent wide local excision. On histological examination, 8 patients had positive margins. Overall recurrence rate was 22.22%. (please clarify what is the difference between the rate of recurrence following surgery and the overall recurrence rate) Only 2 patients developed metastasis to lungs in the course of their follow‑up. Out of 45 patients, 35 remained recurrence free over a varying period of 5 months to 13 years (mean 68 months). Ten patients developed one or more local recurrences. Average time from initial treatment to recurrence was 32 months. All patients with recurrent tumors were subjected to salvage treatment, i.e., re‑excision. Average recurrence‑free period was 36 + 44 months within a mean follow‑up of 68 months. Conclusion: Because of the potential of local recurrence, therapy for DFSP should be directed toward adequate local excision of the primary lesion. Minimal resection should include a surrounding margin, comprising 3-cm margin of normal skin and removal of underlying deep fascia. Compromising on margins invites higher chances of local recurrence.