Nonpigmented Premalignant Lesions of the Skin

Gard, Don A.

doi:10.1016/s0094-1298(20)30611-8

Cited by 5 publications

(1 citation statement)

References 46 publications

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“…Solar sen-sitivity (sunburns with severe bullous lesions, facial freckles), ocular involvement (photophobia, keratitis, atrophy of the eyelid skin), and increased tendency to cutaneous malignancies (squamous cell carcinoma [SCC], basal cell carcinoma [BCC], melanoma) are the three main clinical features of the disease. It was first described by Moriz Kaposi in 1870, and the etiology and pathogenesis were elucidated by James Cleaver in 1968 [1][2][3][4]. Solar injury and aging is evident in the regions exposed to the sun, with sharp boundaries between exposed and non-exposed regions.…”

Section: Introductionmentioning

confidence: 99%

Technical Aspects and Difficulties in the Management of Head and Neck Cutaneous Malignancies in Xeroderma Pigmentosum

et al. 2016

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BackgroundXeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment.MethodsBetween 2005 and 2015, 11 XP patients with head and neck cutaneous malignancies were included in this study. Demographic data and treatment options of the patients were evaluated.ResultsThe mean age of the patients was 32 years (range, 10–43) (4 males, 7 females). The most common tumor type and location were squamous cell carcinoma (6 patients) and the orbital region (4 patients), respectively. Free tissue transfer was the most commonly performed surgical intervention (4 patients). The average number of surgical procedures was 5.5 (range, 1–25). Six patients were siblings with each other, 5 patients had local recurrences, and one patient was lost to follow-up.ConclusionsAlthough genetic components of the disease have been elucidated, there is no definitive treatment algorithm. Early surgical intervention and close follow-up are the gold standard modalities due to the tendency toward rapid tumor growth and possible recurrence. Treatment must be individualized for each patient. In addition, the psychological aspect of the disease is an important issue for both patients and families.

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Section: Introductionmentioning

confidence: 99%

Technical Aspects and Difficulties in the Management of Head and Neck Cutaneous Malignancies in Xeroderma Pigmentosum

et al. 2016

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Digital syndactylization for the treatment of interdigital squamous cell carcinoma in situ (Bowen disease)

Liu

Lovell

Steinberg

2004

The Journal of Foot and Ankle Surgery

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Prospective Study of the Accuracy of the Surgeon's Diagnosis in 2000 Excised Skin Tumors

Hallock¹,

Lutz²

1998

Plastic & Reconstructive Surgery

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Expeditious yet efficacious removal of skin tumors is a common responsibility for the plastic surgeon. The need to minimize potential risks for mortality or morbidity from undue or excessive surgical resections and to control costs by avoiding unnecessary procedures behooves us to make a precise clinical diagnosis preceding any decision even for such "minor" surgery. Just how accurate these decisions can be expected to be for a typical surgical practice was scrutinized by means of this prospective 4-year study involving the resection of 2058 skin lesions. Each lesion was initially assigned a clinical diagnosis after a brief gross examination and then compared with the pathology report, which was always considered to be the correct answer. Within these parameters, only 65 percent of all tumors were identified correctly preoperatively. Two-thirds of all lesions were benign. Three-quarters of benign lesions were as assumed, and 92 percent of all presumed benign lesions were benign even if incorrectly identified initially, whereas fortunately only 3 percent proved to be malignant. On the other hand, only three-fifths of malignant lesions were identified correctly clinically, yet only 11 percent were benign, implying that most such lesions properly deserved excision anyway. Therefore, approximately 90 percent of all lesions whether benign or malignant were removed appropriately without compromising the patient, but to expect a clinical acumen of 100 percent in this setting may not be realistic. The accuracy of the surgeon in identifying lesions as probably benign was certainly high enough that cost-containment mechanisms designed to deny authorization for their removal probably would be justifiable and difficult to appeal. Any suspicious or equivocal lesions still will require mandatory intervention despite such constraints, because often only histologic examination will allow a definitive diagnosis.

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Nonpigmented Premalignant Lesions of the Skin

Cited by 5 publications

References 46 publications

Technical Aspects and Difficulties in the Management of Head and Neck Cutaneous Malignancies in Xeroderma Pigmentosum

Technical Aspects and Difficulties in the Management of Head and Neck Cutaneous Malignancies in Xeroderma Pigmentosum

Digital syndactylization for the treatment of interdigital squamous cell carcinoma in situ (Bowen disease)

Prospective Study of the Accuracy of the Surgeon's Diagnosis in 2000 Excised Skin Tumors

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