Clown nose: a case of disfiguring nodular squamous cell carcinoma of the face

Colletti, Giacomo; Allevi, Fabiana; Moneghini, Laura; Palvarini, M.

doi:10.1136/bcr-2013-200471

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…Após remoção de 235 títulos por duplicidade, a amostra ficou reduzida a 718. Na filtragem manual pelo título foram removidas 533 publicações que não tinham relação com o tema de estudo, principalmente pela existência de um tipo de tumor nasal chamado clown nose 10 . Posteriormente, com o Quadro 1.…”

Section: Resultsunclassified

“…Preferimos adotar esse último termo neste estudo. Diversas nomenclaturas foram encontradas para as terapias que utilizam palhaços treinados especificamente para atuar em hospitais, tais como therapeutic clown 12 , clown therapy 13 , clown care 3 ou uma mistura de idiomas como clownterapia 14 e arte clow 10 . Para este trabalho, adotamos o termo palhaçoterapia, ressaltando o potencial terapêutico da interação entre palhaço e paciente, no idioma de publicação deste trabalho.…”

Section: Bases De Dadosunclassified

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Palhaçoterapia em ambiente hospitalar: uma revisão de literatura

Catapan

Oliveira

Rotta

2019

Ciênc. saúde coletiva

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Resumo A inserção do palhaço no hospital é relativamente recente e mais de 700 organizações realizam a palhaçoterapia nessas instituições no Brasil e em outras ao redor do mundo. Dada a ênfase na integralidade do cuidado e humanização da assistência à saúde, torna-se oportuno compreender e analisar a produção nacional e internacional do conhecimento científico sobre esta prática que desafia o modelo hegemônico de cuidado e potencialmente contribui na recuperação da saúde. Foi realizada uma revisão de literatura utilizando análise de conteúdo temática que analisou 18 publicações. As categorias que emergiram foram: respostas fisiológicas, comportamentais e emocionais; ansiedade pré-operatória; e ressignificação das práticas e do ambiente hospitalar. A literatura analisada aponta que a palhaçoterapia provoca diminuição significativa da ansiedade pré-operatória em crianças, comparativamente maior do que a obtida com o uso de um fármaco indutor de anestesia. A maior parte dos estudos investigou o uso da palhaçoterapia na adaptação à hospitalização, auxiliando na atribuição de novos significados. Apesar da baixa representatividade do tema no campo científico e mesmo não sendo amplamente aceita como prática de saúde, os resultados encontrados sugerem benefícios na utilização da palhaçoterapia em ambiente hospitalar.

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Section: Resultsunclassified

Section: Bases De Dadosunclassified

Palhaçoterapia em ambiente hospitalar: uma revisão de literatura

Catapan

Oliveira

Rotta

2019

Ciênc. saúde coletiva

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“…The clown nose-like lesion is a term that refers to the manifestation of a reddish or skin-colored bulge on the tip of the nose or the manifestation of bulbous tip of the nose ( 1 ). Although clown nose-like lesion had been classically considered an indicator of cutaneous metastatic malignancies (e.g., lung cancer), there can be various other causes.…”

Section: Discussionmentioning

confidence: 99%

“…Clown nose-like lesion refers to the manifestation of a reddish or skin-colored bulge on the tip of the nose or the manifestation of bulbous tip of the nose, resembling the fake nose of a clown ( 1 ). Initially, clown nose-like lesion was considered as a indicator of cutaneous metastatic malignancies, including lung cancer ( 2 ), renal clear cell carcinoma ( 3 ), rhabdomyosarcoma ( 4 ), cervical cancer ( 5 ), and liver cancer ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Update of Clown Nose-Like Lesion, a Underrecognized Manifestation of Metastatic Malignancies and Genetic Cancer Predisposition Syndromes

et al. 2021

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Clown nose-like lesion refers to the manifestation of a reddish or skin-colored bulge on the tip of the nose or the manifestation of bulbous tip of the nose. More and more clinical cases show that clown nose-like lesion can also be the indication of some genetic syndromes, not just the manifestation of metastatic visceral tumor as it initially proposed. However, the clinical features of clown nose-like lesion indicated by metastatic malignancies, genetic cancer predisposition syndromes or primary diseases involving the nasal tip are lacking. In this study, patients with clown nose-like lesion in our clinical practices and from published literatures were collected and reviewed. We found that clown nose-like lesions caused by metastatic malignancies including lung cancer are often solitary and more common in male (24/31) older individuals (average age 62.3, ranging 40–78 years old). In addition, they usually appear for a short time, and are prone to be misdiagnosed as primary nasal diseases, leading to a poor prognosis (all patients with data available died within 4 months). Clown nose-like lesions associated with genetic cancer predisposition syndromes usually develop at a young age (mean age 15.3) with female preference (9/10). They are accompanied by multiple-systemic involvements, including low hair volume, developmental delay, cancer predisposition or neurological diseases. They show slow development and often positive family history (6/10). These two kinds of clown nose-like lesions are often asymptomatic, which delays the diagnosis and treatment of underlying malignancies or syndromes. In brief, the term of clown nose-like lesion is underrecognized, and should be updated. Clown nose-like lesions can serve as indicators to at least three categories of clinical issues: metastatic visceral tumors, genetic syndromes, and primary diseases involving the nasal tip. Increased awareness of clinical features of updated clown nose-like lesions can alert physicians to these underlying malignancies or syndromes, render earlier detection of associated medical issues, and allow for genetic counseling of family members.

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“…Cutaneous metastasis on the nasal tip is known as “clown nose”. 12 , 13 It is important to distinguish suspected lesions from common non-melanoma skin cancers and less frequent tumors such as amelanotic melanoma, primary cutaneous lymphomas, and inflammatory lesions. 1 We report two patients with a tumor on the nose, which proved to be the first sign of the metastatic lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Tumor of the Nose – A Rare Manifestation of a Metastatic Lung Cancer

Bolewska¹,

Słowińska²,

Błońska³

et al. 2021

CCID

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Lung cancer most often metastasizes to the central nervous system, bone and liver. Although metastases to the skin are quite rare, it is estimated that they may be the first clinical manifestation of this disease in 0.7%–12% of cases. Metastases to the skin are caused by adenocarcinoma (about 30%), squamous cell carcinoma (30%) and undifferentiated carcinoma (40%). Nasal tip metastases are extremely rare. They can be confused with more common skin problems, including non-melanoma skin cancers, rhinophyma, inflammatory tumors or infectious diseases. We report two patients with a tumor on the nose, which proved to be the first sign of the metastatic lung cancer.

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Clown nose: a case of disfiguring nodular squamous cell carcinoma of the face

Cited by 8 publications

References 12 publications

Palhaçoterapia em ambiente hospitalar: uma revisão de literatura

Palhaçoterapia em ambiente hospitalar: uma revisão de literatura

Update of Clown Nose-Like Lesion, a Underrecognized Manifestation of Metastatic Malignancies and Genetic Cancer Predisposition Syndromes

Tumor of the Nose – A Rare Manifestation of a Metastatic Lung Cancer

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