Posted by James
Nasal continuous positive airway pressure (CPAP) has been demonstrated to be highly effective in the elimination of nocturnal upper airway occlusion in the obstructive sleep apnea (OSA) syndrome. Daytime hypersomnolence can be reversed and the long-term cardiopulmonary sequelae of sleep apnea can often be eliminated with nasal CPAP. Long-term patient compliance with this modality has been reported to be excellent in several reports. Sanders et al analyzed long-term home nasal CPAP therapy in somewhat greater detail. They analyzed the number of nights per week and the fraction of nightly sleep time during which the device was used in a group of 24 patients and found an excellent long-term compliance rate of 75 percent. No differences were detected between compliant and noncompliant patients in reported daytime sleepiness, sleep apnea index, or degree of improvement while receiving nasal CPAP Krieger and Kurtz attempted to objectively measure long-term compliance by using a built-in time counter on the nasal CPAP device. They reported an acceptance rate of greater than 90 percent in 46 patients with OSA over a mean follow-up period of approximately eight months.
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Posted by James
The histopathologic differential diagnosis includes adenoid basal cell carcinoma (BCC), eccrine adeno- carcinomas, metastatic adenocarcinomas, and epi- thelioid angiosarcomas. BCC must show, at least in part, the typical peripheral palisading, peritu- moral lacunae, and stromal mucin. Most eccrine neoplasms are positive for S-100, EMA, CEA, and CKs, while A-SCC stains positive for only EMA and CKs. Epithelioid angiosarcoma shows positivity for endothelial markers. Metastatic adenocarcinoma shows multiplicity, acantholytic dyskeratosis and the absence of clear epidermal attachments.
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Posted by James
SCC is an uncommon variant of SCC that was first described by Lever in 1947 as adenoacanthoma of the sweat glands. It was also known as adenoid , lobular SCC, or pseudoglandular SCC. As can be guessed by the name, it was previously thought to be a tumor of a sweat gland origin because of gland-like and solid epithelial prolifera¬tions extending into the dermis. However, A-SCC is now accepted as a distinct variant of SCC rather than a sweat gland tumor.
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Posted by James
An 82-year-old woman presented with an ery- thematous nodule on the left eyebrow with a 4-months-history. The patient was on medication for hypertension, but otherwise healthy without any other systemic diseases. She had a history of Mohs micrographic surgery for SCC on the right cheek 2 months previously. On examination, a non-inflamed slightly pruritic hyperkeratotic papule with tenderness was located on the left eyebrow (Fig. 1). Clinically prurigo nodularis, seborrheic keratosis, and SCC were suspected and then a shaving biopsy was performed for making the diagnosis.
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Posted by James
INTRODUCTION
Squamous cell carcinoma (SCC) is the second most common type of skin cancer and it has several subtypes that have varying clinical behavior and malignant potential. Acantholytic SCC (A-SCC) is the uncommon variant of SCC in which significant portions of the neoplastic proliferation show a pseudoglandular or tubular pattern. It resembles the structures of eccrine neoplasms, but it is negative for dPAS, CEA, and mucicarmine and it is only positive for EMA and cytokeratins (CKs). Read the rest of this entry »
Posted by James
Steatocystoma simplex is thought to originate from a nevoid malformation of the pilosebaceous duct junction and a non-heritable benign adnexal tumor. Brownstein first reported 30 cases of stea- tocystoma simplex as distinct clinical entity compared with steatocystoma multiplex as a counterpart disease in 1982.
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Posted by James
A 49-year-old man presented to our outpatient clinic with an asymptomatic papule on the right parietal scalp which had been present for about 1 year. The lesion had slowly enlarged a few months ago. The physical examination revealed a skin- colored, deep-seated, soft cystic mass on his right parietal scalp, 0.9 cm in diameter (Fig. 1). There was no remarkable family history of similar lesions. Clinically, the lesion appeared to be a trichilemmal cyst, and was completely excised. The histological examination revealed an undulating, configured cystic mass that was empty. The cyst was located in the dermis and the cystic walls were thin and lined by stratified squamous epithelium that lacked a stratum granulosum (Fig. 2A). The cyst contained eosinophilic hyalinized cuticle in the lumen and flattened sebaceous gland lobules close to the cystic wall (Fig. 2B). There have been no signs of recurrence or development of other cysts during the 4 month follow-up. Read the rest of this entry »