Journal of the American Academy of Dermatology
-
J. Am. Acad. Dermatol. · Sep 2003
Review Case ReportsCutaneous angiosarcoma as a delayed complication of radiation therapy for carcinoma of the breast.
Three cases of cutaneous angiosarcoma of the breast that arose in irradiated skin tissue in women who had previously undergone treatment for breast carcinoma are reported. A review of the literature identified 55 cases of cutaneous angiosarcoma following radiation therapy as part of the treatment of carcinoma of the breast. For all 58 assembled cases, the mean age at the time of adjuvant radiation therapy for breast carcinoma was 64 years (range 42-83). ⋯ Postirradiation angiosarcoma of the breast has a variety of presentations; thus diagnosis is often delayed. Early diagnosis relies on a high index of suspicion and appropriate histopathologic studies, as the clinical and histopathologic findings may be confused with other conditions. Treatment should be aggressive and include local surgery with consideration of adjuvant systemic chemotherapy.
-
J. Am. Acad. Dermatol. · Sep 2003
Case ReportsBasaloid carcinoma of the lung presenting concurrently with cutaneous metastasis.
Basaloid carcinoma of the lung is a rarely occurring form of lung cancer morphologically resembling the basal cell carcinoma of the skin. Although various histologic types of lung cancers have metastasized to the skin, basaloid carcinoma of the lung that shows cutaneous metastasis has yet to be reported. ⋯ Chest radiography and computed tomography of the thorax revealed an irregular infiltrative mass confined to the central portion of the left lower lobe bronchus, which is a compatible finding of primary lung cancer. Microscopically, both a cutaneous mass and fine-needle aspirate material in the lung revealed the identical findings of basaloid morphologic patterns.
-
J. Am. Acad. Dermatol. · Aug 2003
Case ReportsCutaneous nodular amyloidosis masquerading as a foot callus.
We report a unique case of a 69-year-old man who presented with a 1-year history of pink nodules and plaques limited to the anterior plantar surface of the right foot and a 30-year history of a callus on the right heel. Histologic examination findings of both areas showed deposits of amorphous, eosinophilic material and an infiltrate of plasma cells in the dermis. Congo red-stained deposits exhibited apple-green birefringence with polarized light. ⋯ The diagnosis of nodular primary localized cutaneous amyloidosis (PLCA) was made. Nodular PLCA isolated to pedal or strictly plantar surfaces is an unusual presentation of PLCA. The origin and the clinical and histopathologic features of nodular PLCA are reviewed.
-
J. Am. Acad. Dermatol. · Aug 2003
The design of clinical trials in psoriasis: lessons for clinical practice.
Understanding the process by which drugs are approved gives clinicians a better understanding of the medications they prescribe and how these medications are best used to care for patients. The development of new drugs in the United States proceeds through a series of studies culminating in well-designed, large-scale human trials. ⋯ They also determine the labeling and marketing of products and guide (but do not fully determine) physicians' use of the drug. This article follows a hypothetical drug for use in psoriasis through the approval process, in order to illustrate the process and its implications for clinical practice.
-
J. Am. Acad. Dermatol. · Aug 2003
Case ReportsCutaneous Strongyloides stercoralis infection: an unusual presentation.
Strongyloides stercoralis is a widespread, soil-transmitted, intestinal nematode common in tropical and subtropical countries. The parasite is unique in its capability to carry out its entire life cycle inside the human body. Human beings contract strongyloidiasis by penetration of filariform larvae into the skin or mucous membrane after contact with contaminated soil. ⋯ Chronic strongyloidiasis acquired in endemic areas may last decades and gives rise to various dermatologic lesions, the most characteristic of which is larva currens, a serpiginous, creeping urticarial eruption. In disseminated strongyloidiasis, the characteristic skin lesions are widespread petechiae and purpura. We present a case of disseminated strongyloidiasis with an unusual manifestation mimicking a drug rash and review the dermatologic manifestations of strongyloidiasis infestation.