The clinical and pathological features and treatment of two patients with multiple eccrine hidrocystomas are presented. The first case is characterized by multiple pearly papules with a bluish hue located in the periorbital region and the bridge of the nose. The second case is characterized by multiple, skin-coloured papules located in the periorbital area, forehead, chin and nose. Both were exacerbated by a hot and humid environment. Histopathologically, both demonstrated a unilocular cyst located in the dermis, with a 2-3-layer wall composed of cuboidal epithelium that was non-keratinizing. Treatment with topical atropine sulphate 1% in aqueous solution three times a day was instituted in the first case; however, this was poorly tolerated because of blurred vision and nausea. The lesions were subsequently hyfrecated with a good response. The second case was treated with topical atropine sulphate 1% in aqueous solution three times a day with a good response.
Excessive axillary sweating is a common problem for which many patients frequently seek dermatological advice. The removal of axillary sweat glands using liposuction with tumescent anaesthesia in an outpatient setting is a relatively short and simple procedure with few complications, as seen in this case series. We present 10 patients treated with axillary liposuction under tumescent anaesthesia. Of the 10 patients treated, four relapsed with axillary hyperhidrosis and required additional liposuction to the same area. The longest time to relapse was 15 months, with 4 months being the shortest time. Six patients have not required additional liposuction, with 7 years being the longest time of remission. The complications reported were bruising in the axillae of two patients and relapse of hyperhidrosis in four patients.
An 82-year-old man presented with invasive squamous cell carcinoma of the glans penis arising in erythroplasia of Queyrat. He underwent Mohs' micrographic surgery for the invasive carcinoma. Seven weeks later, the residual erythroplasia of Queyrat was treated using photodynamic therapy. Methyl aminolevulinate cream was applied to the glans of the penis under occlusion for 3 hours and then, after local anaesthesia, irradiated with a 630-nm red-light-emitting diode lamp at a dose of 37 J/cm(2) for 8 min. The patient experienced some mild swelling, redness and pain, which subsided over the following 5 days. Eighteen weeks after photodynamic therapy, there had been no recurrence of the lesion, when the patient died from an unrelated cause.
This retrospective study assesses the long-term cure rate for the treatment of lentigo maligna using total circumferential margin control with vertical and horizontal permanent sections using life-table analysis. A cohort of 31 patients in Sydney with lentigo maligna treated with total circumferential margin control with vertical and horizontal permanent sections over a 6-year period were followed up. Follow up to determine recurrence was obtained by direct examination, by contact with the referring dermatologist, general practitioner, or by telephone interview with the patient's relative if the patient was deceased. Following our total circumferential margin control technique, of the 16 primary tumours, only one recurred (a cure rate of 94%). Of the 15 recurrent tumours, two had recurred. The mean follow-up time in this study was 42 months (range 12-89 months). Kaplan-Meier analysis estimated that at 5 years, 87% of patients would be free from disease (95% confidence interval 70-100%). Seventy-five per cent of the population can be expected to be disease-free for 6 years (lower 95% confidence limit 4 years). We describe the use of total circumferential margin control with vertical and horizontal permanent sections for the treatment of lentigo maligna that we believe is simple, effective and reproducible.
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