No abstract

Basal cell carcinoma (BCC) and squamous cell carcinoma are the most common type of nonmelanoma skin cancers (NMSCs). Bowen's disease (BD), a premalignant condition, has a marginal potential (3-5%) to progress to invasive carcinoma. We report here a rarest of a rare case of multiple pigmented BD with overlying squamous cell cancer along with a giant neglected BCC on the scalp of a 76-year-old man. The occurrence of multiple BD and NMSC in a single patient compelled us to explore the following hypothesis: (1) The multiple precancerous and cancerous lesions can be due to common etiopathogenesis. Chronic ultraviolet exposure, immunosupresssion, human papillomavirus infection, dietary factors, and environmental factors including arsenic exposure were probed in to. (2) There is evolution of precancerous lesions into a different type of cancers in different time frame. (3) The new cancerous lesions are subsequent cancers that developed after neglected untreated primary cancer.

Background: Patellofemoral pain syndrome (PFPS) is a commonly seen condition in athletes. Several potential contributing factors have been postulated. Although hip muscle strength has been suggested to play a major role, concentrichipmusclefunctioninathleteswithPFPShas not been formally investigated. Objectives:We aimed to compare the concentric hip muscle strength in athletes withPFPSwiththatofcontrols,andtoderiveaconcentric knee extension-to-flexion (quadriceps: hamstring) ratio Subjects and Methods: University athletes with PFPS (n=25)andasymptomaticcontrols(n=25)werestudied. Concentrictorqueofthehipabductors,adductors,flexors and extensors along with concentric knee extensors and flexors torque were assessed. Participants rated their kneepainintheweekbeforethestudyonavisualanalog scale and a self-administered anterior knee pain scale (AKPS).Strengthtestingwasperformedat60º/s.Results: Participants with PFPS exhibited much lower concentric hip abduction, adduction, flexion and extension peak torquecomparedtocontrols.Theconcentrichipabduction to adduction and extension to flexion ratios showed no difference.Quadriceps:hamstringratiowashigherforPFPS participants. Conclusion:We propose that concentric hip musclestrengthissignificantlyaffectedinPFPS.Clinicians are urged to include concentric strengthening exercises for the hip along with quadriceps and hamstring muscles duringtherehabilitationofathleteswithPFPS.