Epidemiology of pemphigus in south-western Iran: a 10-year retrospective study (1991-2000)

BACKGROUND: Pemphigus is a disease demonstrating an uneven geographic distribution. This is the first epidemiologic study of pemphigus in Iran. METHODS: Data were collected from the files of all newly registered patients with pemphigus at the sole dermatologic referral center for south-western Iran located in the city of Shiraz, during the period 1991-2000. The data were analyzed with regard to age, sex, subtypes of pemphigus, clinical presentation, and season of onset. RESULTS :The results showed that the mean incidence of the disease for the overall population in Shiraz was 0.67/10(5)/year. The male to female ratio was 1 : 1.33. The mean age at onset of the disease was 38 years (range, 12-93 years). The disease was most common in the third to fifth decades (62.1% of the overall patients). Pemphigus vulgaris was the most commonly encountered type, followed by pemphigus foliaceus (87.7% and 9%, respectively). The first manifestations of the illness most often occurred during winter (30.8% of the patients). CONCLUSIONS: The results reveal a high incidence of pemphigus vulgaris in south-western Iran compared with that encountered in other countries. Our patients also had a relatively young age at onset and a female predominance.     

Cutaneous invasive squamous cell carcinoma: 10-year experience and recommendations for follow up

Currently, the National Health and Medical Research Council do not have any recommendations about the frequency of follow up after treatment of primary cutaneous invasive squamous cell cancer (SCC), due to a lack of data. The present study aimed to establish appropriate follow-up times and to determine the long-term risk of subsequent non-melanoma skin cancers and melanoma. Patients who had a primary invasive cutaneous SCC excised during 1996 were retrospectively identified from the databases of a dermatologist in private practice in south-east Queensland. Data on size, site, depth, differentiation, perineural involvement, lymphovascular involvement of the index SCC were obtained. The patients were regularly followed up and lymph-node involvement, patient immunocompetence, and the presence of local recurrences and subsequent SCC, basal cell carcinomas and melanoma were recorded. Forty patients were identified, comprising 25 men and 15 women with a mean age of 65 years. The majority (60%) of primary incident SCC were in the low-risk category. The median follow-up time was 7.5 years. One in two developed a second SCC within 5 years, a significant number had a second SCC detected only in 5–10 year follow up, and 72.5% had a BCC within 5 years, and 82.5% at 10 years. One in eight had a subsequent melanoma detected.     

The role of CD10 in distinguishing atypical fibroxanthoma from sarcomatoid (spindle cell) squamous cell carcinoma

Background: The role of CD10 needs clarification in a broader immunohistochemical battery for distinguishing atypical fibroxanthoma (AFX) from spindle cell squamous cell carcinoma (sSCC). Methods: We retrospectively reviewed 23 cutaneous spindle cell tumors previously classified as AFX (n = 11) or as sSCC (n = 12). Each tumor was stained with CD10, S‐100, p63 and two or more cytokeratin stains. Defining AFX as a diagnosis of exclusion based on multiple negative cytokeratin stains and negative p63 staining, we reclassified four squamous cell carcinomas (SCCs) as AFX. CD10 staining was reviewed and graded in all tumors. Results: Fifteen tumors were classified as AFX. Strongly positive CD10 staining was observed in all 15 AFXs, as well as four (50%) of the eight SCCs. Expression of p63 was seen in six sSCCs (75%). Conclusions: CD10 is consistently expressed by AFX. However, CD10 is also often strongly expressed by sSCC. Positive staining with p63 favors a diagnosis of sSCC. An immunohistochemical battery useful for distinguishing AFX from sSCC may include CD10, p63 and two cytokeratin markers. However, CD10 alone should not be relied upon in the distinction of these entities. Wieland CN, Dyck R, Weenig RH, Comfere NI. The role of CD10 in distinguishing atypical fibroxanthoma from sarcomatoid (spindle cell) squamous cell carcinoma.     

Adenoid (acantholytic) squamous cell carcinoma of the skin

Cutaneous adenoid squamous carcinoma (ASCC) is a distinctive neoplasm featuring tumor cell acantholysis. Because this lesion occasionally may prove troublesome diagnostically, we studied the clinical, histologic, and immunohistochemical features of 55 examples in order to further elucidate its characteristics. ASCC most often occurred in the skin of the head and neck in elderly patients. Of 49 patients in this series, 46 were men and 3 were women; their ages at diagnosis ranged from 25 to 90 yr, with a mean of 71. Six individuals had 2 metachronous neoplasms. ASCC generally behaved in an indolent manner, although 19% of cases did metastasize widely and prove fatal. Tumor size of greater than 1.5 cm appeared to correlate with the risk of an adverse clinical outcome. In addition, 10 patients with ASCC of the skin subsequently developed visceral malignancies. The cutaneous neoplasms were typified by invasive, tubular or pseudoglandular profiles of polygonal cells in the dermis, with glassy eosinophilic cytoplasm and focal squamous pearl formation. Connections to the overlying epidermis were commonly apparent. Immunohistochemically, ASCC demonstrated uniform reactivity for cytokeratin, but lacked markers of specialized glandular cells. These findings militate against the interpretation that such tumors demonstrate partial adnexal differentiation, and show that immunohistology may prove helpful in the differential diagnosis between ASCC and primary or metastatic adenocarcinomas of the skin.     

Treatment of basal cell carcinoma of the skin with 5-fluorouracil ointment. A 10-year follow-up study.

During the period 1966-1968, 88 patients with a total of 95 basal cell carcinomas were treated with 5% 5-fluorouracil ointment. A follow-up study carried out from November 1977 to January 1978 revealed a total of 12 recurrences in 56 surviving patients with 56 basal cell carcinomas. The recurrence rate is thus 21.4%. It is concluded that there is hardly any indication for using 5-fluorouracil in local treatment of nodular basal cell carcinoma.     

热休克蛋白10、60在皮肤鳞状细胞癌、基底细胞癌、日光性角化病中的表达

目的 探讨热休克蛋白（HSP）10、60在皮肤鳞状细胞癌（SCC）、基底细胞癌（BCC）和日光性角化病（AK）中的表达水平。方法 采用免疫组化EnVision两步法测定HSP10、60在皮肤SCC、BCC、AK中的阳性表达水平,并与正常组对照。结果 与对照组比较,HSP10组只有BCC组的阳性表达高于正常组（Z = 3.24,P < 0.01）,AK组（Z = 0.74,P > 0.05）和SCC组（Z = 0.52,P > 0.05）与对照组比较差异无统计学意义;HSP10组中AK与BCC,AK与SCC的差异有统计学意义（P < 0.05）,但SCC与BCC组间差异无统计学意义（P > 0.05）。HSP60组三组的阳性表达均高于正常组,其中AK（Z = -2.90,P < 0.01）、BCC（Z = -2.15,P < 0.05）、SCC（Z = -2.78,P < 0.01）;三组间两两比较结果为AK = SCC > BCC（P < 0.05）。结论 HSP60的高表达可能与鳞状细胞癌、日光性角化病的生物行为有关。     

尖锐湿疣鳞状细胞癌变的临床研究

目的探讨尖锐湿疣鳞状细胞癌变的临床特征。方法回顾性分析27例尖锐湿疣鳞癌变的临床特征,病理改变,病毒基因亚型分布,与同期首诊、单纯性尖锐湿疣相比较。结果尖锐湿疣鳞癌变病程长(平均31m),首诊、单纯性尖锐湿疣病程较短(平均3m);病理切片显示前者核硝酸银染色硝酸银颗粒/核面积比显著大于后者;首诊、单纯性尖锐湿疣感染的HPV基因亚型主要为低危型6/11型,尖锐湿疣鳞癌变感染的HPV基因亚型主要为高危型16/18型。结论尖锐湿疣鳞状细胞癌变在病程,病理,病毒基因亚型上显著区别于首诊、单纯性尖锐湿疣。     

Development of neuroendocrine (Merkel cell) carcinoma mixed with squamous cell carcinoma in erythema ab igne

Squamous cell carcinoma and neuroendocrine (Merkel cell) carcinoma are cutaneous neoplasms that have only occasionally been reported to coexist. Squamous cell carcinoma, but not neuroendocrine (Merkel cell) carcinoma, is a rare complication of erythema ab igne. This report describes the development of both neoplasms arising within the same tumor mass in an area of erythema ab igne.     

Infundibular (follicular) and infundibulocystic squamous cell carcinoma: a clinicopathological and immunohistochemical study

Two types of squamous cell carcinoma (SCC), which are considered to show infundibular differentiation, have been described so far; namely, follicular SCC and infundibulocystic SCC. The latter includes (1) a well-differentiated form, (2) a less-differentiated form, and (3) an infiltrative variant. This study examined the clinicopathological features of 8 cases of SCC with infundibular differentiation, which included follicular SCCs and infundibulocystic SCCs (a less-differentiated form and an infiltrative variant). The present study confirmed that these SCCs with follicular differentiation are clinicopathologically distinct from keratoacanthoma. However, one example of infundibulocystic SCC (less-differentiated form) proved to be difficult to distinguish from keratoacanthoma. The relationship between the follicular SCC and the less-differentiated form of infundibulocystic SCC was investigated. At the periphery of the latter lesions, a focus corresponding to the follicular SCC or advanced follicular SCC lesions was seen. Therefore, these 2 types of SCCs are considered to be similar and thus represent the same neoplastic disease. The less-differentiated form of infundibulocystic SCC is considered to be a more aggressive condition. A unified term, infundibular (follicular) SCC, was used to describe these 2 conditions in this study. The clinicopathological features of the infiltrative variant of infundibulocystic SCCs were unique and distinct from the other 2 types of SCCs. This variant of infundibulocystic SCC is therefore considered to be a distinct entity and therefore has been simply called infundibulocystic SCC in this study. Infundibulocystic SCC may therefore be related to either a microcystic adnexal carcinoma or a malignant counterpart of the trichoadenoma of Nikolowski.     

皮肤Merkel细胞癌伴鳞状细胞癌一例

患者男,76岁,因左耳前肿物2个月,破溃1个月就诊.2个月前左耳前面颊部无明显诱因出现一约黄豆大小的丘疹,迅速长大,1个月前表面出现破溃,无自觉症状.2周前左耳后出现一蚕豆大小肿大的淋巴结,有触痛,抗炎治疗后缩小.     

棘层松解性鳞状细胞癌一例

棘层松解性鳞状细胞癌又名假腺样鳞状细胞癌、腺样鳞状细胞癌,它是鳞状细胞癌组织病理学上的一种亚型,多见于老年人的面部、耳部、手背等暴露部位,也可发生于口腔、眼结膜及外阴等部位。本文报道1例成功手术治疗高危老龄患者的棘层松解性鳞状细胞癌。临床资料患者,男,91岁。主因右侧颞部肿物3年,于2014年6月18日就诊。患者3年前无明显诱因于右颞部出现甲盖大小红斑,反复破溃、出血、结痂,常     

梭形细胞鳞状细胞癌一例

患者女,62岁.下唇斑块伴轻度瘙痒2年就诊.2年前无明显诱因下唇中部出现一硬化、增厚的黄豆大小斑疹,轻度瘙痒,少许片状脱屑,无糜烂、渗液及结痂.