Background: Diffuse epidermal and periadnexal squamous cell carcinoma in situ (DEPS) is a condition in which large areas of skin are affected by atypical keratinocytes that grow beneath the epidermis and encase adnexa...Background: Diffuse epidermal and periadnexal squamous cell carcinoma in situ (DEPS) is a condition in which large areas of skin are affected by atypical keratinocytes that grow beneath the epidermis and encase adnexal epithelia. Normal differentiation of the overlying epidermis and adnexal epithelium is seen. Objective: Our aim was to describe the clinical features of DEPS. Methods: We undertook a retrospective case series of 13 patients with DEPS. Results: All 13 patients were fairskinned men older than 50 years with a history of significant sun exposure. The lesions were present on the scalp, face, and neck. Histologic examination showed a growth of atypical keratinocytes in the lower epidermis with encasement of adnexal structures by atypical neoplastic keratinocytes. In the 52 cumulative patient-years of follow-up, we treated 80 invasive squamous cell and 48 basal cell carcinomas in these patients. Despite improvement of DEPS with aggres sive topical and destructive therapy,multifocal recurrencewould typically develo p within a few months. Conclusion: DEPS is characterized by diffuse involvement of chronically sun-exposed skin with atypical keratinocytes that grow along the inferior portion of the basal layer of the epidermis and around adnexal structu res. The treatment of DEPS is challenging because of its widespread nature and d eeper periadnexal involvement. DEPS is also associated with the development of i nvasive squamous cell and basal cell carcinomas.展开更多
Background:Bowen’s disease (BD), also known as squamous intraepidermal carcinoma, is a malignant skin tumor with a potential to progress to invasive carcinoma. Objective:We sought to report a large series of patients...Background:Bowen’s disease (BD), also known as squamous intraepidermal carcinoma, is a malignant skin tumor with a potential to progress to invasive carcinoma. Objective:We sought to report a large series of patients with BD treated with Mohs micrographic surgery (MMS). Methods:This prospective, multicenter, case series included all patients in Australia treated with MMS for BD, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. Results:There were 270 cases; the majority (93.4%) were located in the head and neck area. In 50.7%of cases it was a recurrent tumor. In 20%the tumor was initially misdiagnosed as basal cell carcinoma or squamous cell carcinoma. No cases with perineural invasion were diagnosed. There were 6 cases of recurrence (6.3%) of 95 patients who completed a 5-year follow-up period after MMS. Conclusion:The low 5-year recurrence rate of BD with MMS emphasizes the importance of margin-controlled excision, especially in the head and neck area where tissue preservation is essential.展开更多
Background: Dermoscopy improves the diagnostic accuracy in pigmented skin lesions, but it is also useful in the evaluation of nonpigmented skin tumours as it allows the recognition of vascular structures that are not ...Background: Dermoscopy improves the diagnostic accuracy in pigmented skin lesions, but it is also useful in the evaluation of nonpigmented skin tumours as it allows the recognition of vascular structures that are not visible to the naked eye. Bowens disease (BD) or squamous cell carcinoma in situ is usually nonpigmented, but may also rarely be pigmented. Objective: To describe the dermoscopic features in a series of pigmented and nonpigmented BD. Methods: Dermoscopic images of 21 histopathologically proven BD were evaluated for the presence of various dermoscopic features. Each lesion was photographed using the Dermaphot (Heine Optotechnik, Herrsching, Germany), at 10-fold magnification, and the colour slides were scanned to digital format using a Kodak Photo CD system. Results: The majority of cases of BDrevealed a peculiar dermoscopic pattern characterized by glomerular vessels (90%) and a scaly surface (90%). In addition, in pigmented BD small brown globules regularly packed in a patchy distribution (90%), and structureless grey to brown pigmentation (80%) were observed. Conclusions: Dermoscopy can be helpful for diagnosing BD because of the presence of repetitive morphological findings such as glomerular vessels and a scaly surface. In pigmented BD, small brown globules and/or homogeneous pigmentation can be seen as well.展开更多
文摘Background: Diffuse epidermal and periadnexal squamous cell carcinoma in situ (DEPS) is a condition in which large areas of skin are affected by atypical keratinocytes that grow beneath the epidermis and encase adnexal epithelia. Normal differentiation of the overlying epidermis and adnexal epithelium is seen. Objective: Our aim was to describe the clinical features of DEPS. Methods: We undertook a retrospective case series of 13 patients with DEPS. Results: All 13 patients were fairskinned men older than 50 years with a history of significant sun exposure. The lesions were present on the scalp, face, and neck. Histologic examination showed a growth of atypical keratinocytes in the lower epidermis with encasement of adnexal structures by atypical neoplastic keratinocytes. In the 52 cumulative patient-years of follow-up, we treated 80 invasive squamous cell and 48 basal cell carcinomas in these patients. Despite improvement of DEPS with aggres sive topical and destructive therapy,multifocal recurrencewould typically develo p within a few months. Conclusion: DEPS is characterized by diffuse involvement of chronically sun-exposed skin with atypical keratinocytes that grow along the inferior portion of the basal layer of the epidermis and around adnexal structu res. The treatment of DEPS is challenging because of its widespread nature and d eeper periadnexal involvement. DEPS is also associated with the development of i nvasive squamous cell and basal cell carcinomas.
文摘Background:Bowen’s disease (BD), also known as squamous intraepidermal carcinoma, is a malignant skin tumor with a potential to progress to invasive carcinoma. Objective:We sought to report a large series of patients with BD treated with Mohs micrographic surgery (MMS). Methods:This prospective, multicenter, case series included all patients in Australia treated with MMS for BD, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. Results:There were 270 cases; the majority (93.4%) were located in the head and neck area. In 50.7%of cases it was a recurrent tumor. In 20%the tumor was initially misdiagnosed as basal cell carcinoma or squamous cell carcinoma. No cases with perineural invasion were diagnosed. There were 6 cases of recurrence (6.3%) of 95 patients who completed a 5-year follow-up period after MMS. Conclusion:The low 5-year recurrence rate of BD with MMS emphasizes the importance of margin-controlled excision, especially in the head and neck area where tissue preservation is essential.
文摘Background: Dermoscopy improves the diagnostic accuracy in pigmented skin lesions, but it is also useful in the evaluation of nonpigmented skin tumours as it allows the recognition of vascular structures that are not visible to the naked eye. Bowens disease (BD) or squamous cell carcinoma in situ is usually nonpigmented, but may also rarely be pigmented. Objective: To describe the dermoscopic features in a series of pigmented and nonpigmented BD. Methods: Dermoscopic images of 21 histopathologically proven BD were evaluated for the presence of various dermoscopic features. Each lesion was photographed using the Dermaphot (Heine Optotechnik, Herrsching, Germany), at 10-fold magnification, and the colour slides were scanned to digital format using a Kodak Photo CD system. Results: The majority of cases of BDrevealed a peculiar dermoscopic pattern characterized by glomerular vessels (90%) and a scaly surface (90%). In addition, in pigmented BD small brown globules regularly packed in a patchy distribution (90%), and structureless grey to brown pigmentation (80%) were observed. Conclusions: Dermoscopy can be helpful for diagnosing BD because of the presence of repetitive morphological findings such as glomerular vessels and a scaly surface. In pigmented BD, small brown globules and/or homogeneous pigmentation can be seen as well.
