Diagnosis of Skin Disease

BSc, Mb N. H. Cox; BSc, Mb I. H. Coulson

doi:10.1002/9781444317633.ch5

Cited by 12 publications

(8 citation statements)

References 116 publications

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“…The diagnosis of KA was based on histopathological architecture and pattern of cell differentiation [19]. All lesions were nodules; defined as firm, elevated, round, palpable tumors with a diameter of 5 mm or more [20]. …”

Section: Methodsmentioning

confidence: 99%

Dermoscopic characteristics of nodular squamous cell carcinoma and keratoacanthoma

Lin

Pan

Jalilian³

et al. 2014

Dermatol Pract Concept

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Background:Nodular squamous cell carcinoma (SCC) and keratoacanthoma (KA) may mimic a variety of other benign and malignant non-pigmented nodules.Objectives:To analyze the dermoscopic characteristics of nodular SCC and KA.Patients/Methods:Retrospective analysis of 50 nodular SCCs and 8 KAs collected from a tertiary dermatology referral center and a private dermatology practice in Melbourne, Australia, between 1 September 2009 and 1 October 2012. All lesions were nodules; defined as firm, elevated, round, palpable tumors with a diameter of 5 mm or more. Clinical and dermoscopic images were evaluated by two examiners in consensus.Results:Signs of keratinization were frequently observed and included keratin crust/scale (90% of SCCs, 100% of KAs), central keratin mass (32% of SCCs, 88% of KAs), white structureless areas (66% of SCCs, 50% of KAs), white circles (32% of SCCs, 38% of KAs) and white keratin pearls (14% of SCCs, 12% of KAs). Hemorrhage was present in 72% of SCCs and 88% of KAs and preferentially occurred centrally and in areas of keratinization. For nodular SCCs and KAs, we observed glomerular vessels (42% and 25% respectively), linear irregular vessels (36% and 25% respectively), atypical vessels (30% and 38% respectively) and hairpin vessels (30% and 25% respectively).Conclusions:Hemorrhage, keratinization and vascular features (glomerular, hairpin and linear irregular morphologies) are useful in diagnosing both nodular SCC and KA. Further research on the comparative dermoscopic characteristics of a range of amelanotic nodules is important in order to improve diagnosis of these clinically challenging tumors.

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Section: Methodsmentioning

confidence: 99%

Dermoscopic characteristics of nodular squamous cell carcinoma and keratoacanthoma

Lin

Pan

Jalilian³

et al. 2014

Dermatol Pract Concept

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“…While SJS is drug-induced, EM usually occurs post-infection and is characterized by typical target lesions, chiefly on the extremities, rather than the widespread macules or blisters associated with SJS [39]. Target lesions are defined as less than 3 cm in diameter, with at least 3 'zones': a central zone of dusky erythema or purpura (sometimes blistering), a middle paler area of oedema, and a well-defined outer ring of erythema [46]. All other target lesions lacking this pattern of three zones should be considered atypical target lesions.…”

Section: Management Of Grades 1-3 Telaprevir-associated Dermatitismentioning

confidence: 99%

Dermatological side effects of hepatitis C and its treatment: Patient management in the era of direct-acting antivirals

Cacoub¹,

Bourlière²,

Lübbe³

et al. 2012

Journal of Hepatology

133

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Dermatological adverse events (AEs) are an existing concern during hepatitis C virus (HCV) infection and peginterferon/ribavirin treatment. HCV infection leads to dermatological and muco-cutaneous manifestations including small-vessel vasculitis as part of the mixed cryoglobulinemic syndrome. Peginterferon/ribavirin treatment is associated with well-characterized dermatological AEs tending towards a uniform entity of dermatitis. New direct-acting antivirals have led to significant improvements in sustained virologic response rates, but several have led to an increase in dermatological AEs versus peginterferon/ribavirin alone. In telaprevir trials, approximately half of treated patients had rash. More than 90% of these events were Grade 1 or 2 (mild/moderate) and in the majority (92%) of cases, progression to a more severe grade did not occur. In a small number of cases (6%), rash led to telaprevir discontinuation, whereupon symptoms commonly resolved. Dermatological AEs with telaprevir-based triple therapy were generally similar to those observed with peginterferon/ribavirin (xerosis, pruritus, and eczema). A few cases were classified as severe cutaneous adverse reaction (SCAR), also referred to as serious skin reactions, a group of rare conditions that are potentially life-threatening. It is therefore important to distinguish between telaprevir-related dermatitis and SCAR. The telaprevir prescribing information does not require telaprevir discontinuation for Grade 1 or 2 (mild/moderate) rash, which can be treated using emollients/moisturizers and topical corticosteroids. For Grade 3 rash, the prescribing information mandates immediate telaprevir discontinuation, with ribavirin interruption (with or without peginterferon) within 7 days of stopping telaprevir if there is no improvement, or sooner if it worsens. In case of suspicion or confirmed diagnosis of SCAR, all study medication must be discontinued.

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“…Recent reports in the literature point to a relation between the disease with the fibroblast growth factor receptor 3 gene ( FGFR3 ) and the phosphatidylinositol 3-kinase catalytic subunit alpha (PIK3CA) oncogene. 1 - 4 The mechanism of action of these variants in the development of the disease and phenotypic level have not yet been elucidated; however, such mutations have been described in almost half of cases and have a strong association with oncogenesis. 5 …”

Section: Introductionmentioning

confidence: 99%

“…They rarely present histological findings characteristic of viral warts, acanthosis nigricans or of the verrucous phase of incontinentia pigmenti. 1 …”

Section: Introductionmentioning

confidence: 99%

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Analysis of mutations in the PIK3CA and FGFR3 genes in verrucous epidermal nevus

Miranda

Fracaroli²,

Fonseca

et al. 2013

An. Bras. Dermatol.

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Verrucous epidermal nevi are congenital hamartomas composed of keratinocytes and may occur alone or in association with developmental abnormalities. A close relationship between variations in the PIK3CA and FGFR3 genes and the appearance of nevi has been recently reported. Based on that, we performed molecular assays for the identification of E542K, E545G/K and H1047R mutations in the PIK3CA gene and of the R248C mutation in the FGFR3 gene. Interestingly, during the amplification process, we did not observe the PCR product of exon 9 of the PIK3CA gene, a region comprising amino acids 542-545. This strongly suggests the occurrence of a microdeletion of that region and indicates a possible allelic variant, which has not yet being described in the literature.

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Diagnosis of Skin Disease

Cited by 12 publications

References 116 publications

Dermoscopic characteristics of nodular squamous cell carcinoma and keratoacanthoma

Dermoscopic characteristics of nodular squamous cell carcinoma and keratoacanthoma

Dermatological side effects of hepatitis C and its treatment: Patient management in the era of direct-acting antivirals

Analysis of mutations in the PIK3CA and FGFR3 genes in verrucous epidermal nevus

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