Background:Topical tazarotene has been shown to offer efficacy in amelioratin g multiple effects of photodamage. Objectives To evaluate the histological effec ts of tazarotene cream on photodamaged skin. Methods:In th...Background:Topical tazarotene has been shown to offer efficacy in amelioratin g multiple effects of photodamage. Objectives To evaluate the histological effec ts of tazarotene cream on photodamaged skin. Methods:In this multicentre, doubl e-blind, randomized, vehicle-controlled study, 50 patients with photodamaged f acial skin (at least mild fine wrinkling and mottled hyperpigmentation, with at least one of these being moderate) were randomized to apply tazarotene 0.1%crea m or vehicle cream to their face, once daily for 24 weeks. Results:Blinded asse ssments showed that tazarotene was less likely than vehicle to be associated wit h an increase in keratinocytic and melanocytic atypia, and more likely than vehi cle to be associated with a reduction in atypia. Between-group comparisons in d istribution of change from baseline categories of severity were in favour of taz arotene (P=0.055 for keratinocytic atypia, P= 0.034 for melanocytic atypia, and P < 0.001 for the number of granular cell layers). Compared with vehicle, tazaro tene was associatedwithanincreaseinepidermalpolarity(P=0.008)and epidermalthickn ess(P=0.012),and a tendency for stratum corneum compaction,Tazarotene was also a ssociated with widened intercellular spaces (reported as epidermal oede ma) relative to vehicle (P < 0.001). Conclusions:Treatment of photodamaged sk in with tazarotene is associated with an amelioration of keratinocytic and melan ocytic atypia, an improvement in epidermal polarity, and an increase in epiderma l thickness.展开更多
Myxofibrosarcoma (MFS) is one of the most common sarcomas of adults, and includes lesions ranging from low to high grade based on increasing cellularity, nuclear pleomorphism, and mitotic activity. We present an unusu...Myxofibrosarcoma (MFS) is one of the most common sarcomas of adults, and includes lesions ranging from low to high grade based on increasing cellularity, nuclear pleomorphism, and mitotic activity. We present an unusual case of MFS, which initially showed features of a pleomorphic hyalinizing angiectatic tumor (PHAT), a rare soft- tissue tumor considered benign in the WHO classification. The initial lesion showed a subcutaneous proliferation of spindled to polygonal eosinophilic cells with striking cellular pleomorphism, set in amyxoid to sclerotic stroma with prominent hyalinized and angiectatic vasculature, classic characteristics of PHAT. Rare mitotic figures were identified. The preliminary diagnosis of PHAT was confirmed by a consultant expert soft- tissue pathologist. Four months after the initial surgery, local recurrencewas noted. The recurrent tumor demonstrated findings of a high- grade MFS, with a diffuse and cellular proliferation of atypical spindle cells set in a prominent myxoid stroma. Multiple mitoses, including atypical ones, were present. In light of these findings, the original specimen was reexamined and the initial diagnosis was amended to MFS. MFS may mimic or be confused with several benign soft- tissue lesions. Cases mimicking PHAT have not been previously reported. We describe a unique case of a high- grade MFS that initially showed characteristic features of a PHAT, to illuminate the fact that MFS may rarely arise in, or have areas that masquerade as, PHAT. It is also conceivable, although speculative, that at least some cases of PHAT, currently considered a benign tumor by the WHO, may actually represent or evolve into a unique form of MFS of low malignant potential.展开更多
文摘Background:Topical tazarotene has been shown to offer efficacy in amelioratin g multiple effects of photodamage. Objectives To evaluate the histological effec ts of tazarotene cream on photodamaged skin. Methods:In this multicentre, doubl e-blind, randomized, vehicle-controlled study, 50 patients with photodamaged f acial skin (at least mild fine wrinkling and mottled hyperpigmentation, with at least one of these being moderate) were randomized to apply tazarotene 0.1%crea m or vehicle cream to their face, once daily for 24 weeks. Results:Blinded asse ssments showed that tazarotene was less likely than vehicle to be associated wit h an increase in keratinocytic and melanocytic atypia, and more likely than vehi cle to be associated with a reduction in atypia. Between-group comparisons in d istribution of change from baseline categories of severity were in favour of taz arotene (P=0.055 for keratinocytic atypia, P= 0.034 for melanocytic atypia, and P < 0.001 for the number of granular cell layers). Compared with vehicle, tazaro tene was associatedwithanincreaseinepidermalpolarity(P=0.008)and epidermalthickn ess(P=0.012),and a tendency for stratum corneum compaction,Tazarotene was also a ssociated with widened intercellular spaces (reported as epidermal oede ma) relative to vehicle (P < 0.001). Conclusions:Treatment of photodamaged sk in with tazarotene is associated with an amelioration of keratinocytic and melan ocytic atypia, an improvement in epidermal polarity, and an increase in epiderma l thickness.
文摘Myxofibrosarcoma (MFS) is one of the most common sarcomas of adults, and includes lesions ranging from low to high grade based on increasing cellularity, nuclear pleomorphism, and mitotic activity. We present an unusual case of MFS, which initially showed features of a pleomorphic hyalinizing angiectatic tumor (PHAT), a rare soft- tissue tumor considered benign in the WHO classification. The initial lesion showed a subcutaneous proliferation of spindled to polygonal eosinophilic cells with striking cellular pleomorphism, set in amyxoid to sclerotic stroma with prominent hyalinized and angiectatic vasculature, classic characteristics of PHAT. Rare mitotic figures were identified. The preliminary diagnosis of PHAT was confirmed by a consultant expert soft- tissue pathologist. Four months after the initial surgery, local recurrencewas noted. The recurrent tumor demonstrated findings of a high- grade MFS, with a diffuse and cellular proliferation of atypical spindle cells set in a prominent myxoid stroma. Multiple mitoses, including atypical ones, were present. In light of these findings, the original specimen was reexamined and the initial diagnosis was amended to MFS. MFS may mimic or be confused with several benign soft- tissue lesions. Cases mimicking PHAT have not been previously reported. We describe a unique case of a high- grade MFS that initially showed characteristic features of a PHAT, to illuminate the fact that MFS may rarely arise in, or have areas that masquerade as, PHAT. It is also conceivable, although speculative, that at least some cases of PHAT, currently considered a benign tumor by the WHO, may actually represent or evolve into a unique form of MFS of low malignant potential.
