bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Report: Prolonged Cure of Extensive Primary and Recurrent Cancers of the Skin by Aggressive Cryosurgery
Authors: III SPENCER D. ALBRIGHT
Published: June 2013

Abstract. A prolonged cure of extensive primary and recurrent cancers of the skin by cryosurgery is reported. The patient had involvement of approximately 95 cm2 of her face with carcinomas, primarily of basal‐cell type, which had been refractory to all previous x‐ray and conventional surgical therapies rendered during a 6‐year span. Aggressive cryosurgery utilizing six systematically designed “overlapping fields” of ice blocks was rendered to this entire area during a 1‐month period as office surgical procedures under local anesthesia.
Radical Excision and Reconstruction of Axillary Skin
Authors: HILL THOMAS G.
Published: June 2013

Abstract. Radical excision and reconstruction of axillary skin is an excellent surgical therapy for a selected group of patients: those for whom all attempts at medical management have been unsuccessful. Each patient should be adequately prepared with an extended discussion of the operation, probable postoperative course, and expected result. This operation, when carefully performed in properly selected patients, can produce satisfying results for both patient and doctor. Technical considerations, dressings and postoperative care, and complications are discussed. Three case reports are presented.
Malignant Melanoma Prognostic Factors 1: Use of Photography
Authors: DAY CALVIN L. , LEW ROBERT A. , SOBER ARTHUR J.
Published: June 2013

Abstract. Superior prognostic scores are obtained by adding the data from melanoma photographs to standard clinical and histologic factors.
Keratoacanthoma Following Pneumococcal Vaccination: A Case Report
Authors: BART ROBERT S. , LAGIN SHERI
Published: June 2013

Abstract. A woman with chronic pulmonary disease was immunized with polyvalent pneumococcal polysaccharide vaccine. She developed a keratoacanthoma at the injection site. Such an occurrence would seem to be a rare complication of pneumococcal vaccination.
The Square‐to‐Z Flap
Authors: FIELD LAWRENCE M.
Published: June 2013

Abstract. Square‐to‐Z flaps can sometimes be more useful than O‐to‐Z flaps. This slight modification of surgical design saves time and may improve the final appearance of some surgical scars. The procedure is described and illustrated.
SURGICAL GEM: Donor Plug Replacement: The Final Common Pathway in Hair Transplantation
Authors: MARLEY WAYNE M. , BLUNT CINDY , YARBOROUGH JOHN M.
Published: June 2013

Abstract. A technique for placing donor plug autografts into recipient sites is described. This method has been used successfully in numerous hair transplants for over 18 years.
Increased Androgen Binding in Keloids: A Preliminary Communication
Authors: FORD LARRY C. , KING D. FRIDAY , LAGASSE LEO D. , NEWCOMER VICTOR
Published: June 2013

Abstract. Sex hormone binding protein analyses were performed on six keloids, the adjacent skin, and on six simple scars. A high level of androgen binding (510 to 1149 Fm/mg of cytosol protein) was found in the keloids. The estrogen and progesterone binding activities were low. Para‐keloid tissues were found to have androgen binding of 177 to 476 Fm/mg of cytosol protein. Once again, estrogen and progesterone binding activities were low. In six simple scars, androgen binding was less than 1/10 of that found in the keloids (37 to 60 Fm/mg of cytosol protein); estrogen and progesterone binding was so low that it was almost undetectable. We believe this data suggests that localized hyperandrogen metabolism may play a causal or at least contributory role in the pathogenesis of keloids.
Pulmonary Carcinoid Associated with a Parathormone Producing Melanoma
Authors: WAGNER R. F. , KULKARNI G. A. , LANE B. P. , SKLAREK H. M. , MISHRIKI Y. Y. , NATHANSON L.
Published: June 2013

Abstract. A rare presentation of hypercalcemia secondary to the probable ectopic production of parathormone by a malignant melanoma associated with a pulmonary carcinoid is discussed. We suggest the association of melanoma with multiple endocrine neoplasia.
The Relationship of Seborrheic Keratosis and Basal‐Cell Carcinoma?
Authors: WHITE STEPHEN W. , BESCANCENEY CHARLES F.
Published: June 2013

Abstract. Adjoining basal‐cell carcinoma (BCC) and seborrheic keratosis (SK) are rarely reported despite the frequency of the two tumors. Unusual ulcerative changes in an SK are indications for biopsy.
Basal‐Cell Carcinomas of the Temple
Authors: CARRUTHERS J. ALASTAIR , STEGMAN SAMUEL J. , TROMOVITCH THEODORE A. , GLOGAU RICHARD G. , ROBERTSON DIRK B.
Published: June 2013

Abstract. A size comparison of basal‐cell carcinomas on the temple referred for microscopically controlled excision (chemosurgery, fresh‐tissue type) with those on the cheek confirms that tumors in the former area are larger than those in the latter. Possible reasons for this size difference are considered. Of the most interest is the fact that the size differential was not due to a higher incidence of larger, sclerosing tumors. The temple should probably be considered a “high risk” location similar to the peri‐nasal, periocular, and periauricular areas and the scalp.
Malignant Melanoma Prognostic Factors 5: Clinical Staging
Authors: DAY CALVIN L. , LEW ROBERT A.
Published: June 2013

Abstract. Regional lymph node enlargement, as determined by palpation, is a useful prognostic factor—even if these nodes are histologically free of metastases. This is true not only for malignant melanoma but also for mycosis fungoides and carcinoma of the vulva.
Concepts of Lymphoma Classification
Authors: KRÜGER GERHARD R. F.
Published: June 2013

Abstract Three major classification schemes for malignant non‐Hodgkin's lymphomas are widely applied today: Rappaport's classification, the Kiel classification, and the New Working Formulation for Clinical Usage. All three classifications define prognostically relevant lymphoma entities yet can only partly be translated one into the other. This is because morphologically defined lymphomas still include certain inhomogeneic entities, which again applies to all three classifications. It is therefore strongly suggested that supplemented morphologic methods of lymphoma classification be by immunologic and cytochemical investigations to improve on the scientific definition of malignant lymphomas and also to obtain the most solid basis for therapeutic planning.
Some Statistical Data, Diagnosis, and Staging of Cutaneous B‐Cell Lymphomas
Authors: BURG GÜNTER , KERL HELMUT , PRZYBILLA BERNHARD , BRAUN‐FALCO OTTO
Published: June 2013

Abstract Cutaneous B‐cell lymphomas represent a considerable number of skin lymphomas (about one‐third) primarily showing skin manifestation without any extranodal involvement detectable using routine and special staging procedures. Differentiation from cutaneous T‐cell lymphomas can be achieved clinically; histologically, due to the distinct growth pattern in the skin; and by immuno‐ or enzymophenotyping of the proliferating cells. Further differentiation of subtypes of cutaneous B‐cell lymphomas is based primarily on cytomorphologic phenotyping of the cells. Classification of B‐cell lymphomas with “primary” cutaneous manifestation according to the TNM system discloses a more adequate basis for prognostic and therapeutic considerations than the Ann Arbor classification for nodal lymphomas.
Immunoenzymatic Typing of Lymphoplasmacytoid Skin Infiltrates
Authors: BURG GÜNTER , KERL HELMUT , KAUDEWITZ PETER , BRAUN‐FALCO OTTO , MASON DAVID Y.
Published: June 2013

Abstract Monoclonal immunoglobulin‐producing lymphomas (immunocytomas, plasmacytomas, and immunoblastomas) constitute 15 to 20% of all cutaneous lymphomas. Their differentiation from polymorphous lymphoplasmacytoid inflammatory or pseudolymphomatous infiltrates may be difficult if sections are stained for a single light chain only.

It was the aim of the study to elucidate the ratio of the ‐ to Λ‐positive cells in 10 lymphoproliferative, 5 pseudolymphomatous, and 42 inflammatory lymphoplasmacytoid cutaneous infiltrates and to characterize them by the type of Ig (α, γ, μ,; or Λ) synthesized intracellularly.

An indirect immunoenzymatic double‐labeling method (alkaline phosphatase and peroxidase) was used for the simultaneous demonstration of and Λ light chains and α, γ, and μ heavy chains in paraffin sections. Ig‐producing lymphomas of the skin show patchy monoclonal proliferations of cells synthesizing IgM in almost 50% of the cases (5 of 10). Monoclonality is claimed if the ratio of Λ‐ to ‐positive cells is at least 1:10, or vice versa. In polyclonal inflammatory and pseudolymphomatous infiltrates, the Λ/ ratio never exceeds 1:5. The most common cell type found in these reactive infiltrates produces γ heavy chain; some produce α chain, but only a few produce μ chain. In high‐grade malignant lymphomas, the tumor cells may lose their capacity for Ig production.
Cryosurgical Treatment of Dysplastic Lentigo of the Glans Penis
Authors: ARONSON PETER J. , WHITNEY DAVID H. , SOLTANI KEYOUMARS , MEDENCIA MARIA
Published: June 2013

Abstract A lesion showing hyperplasia of atypical basal‐layer melanocytes on the glans penis was repeatedly frozen with 4‐mm margins repeatedly blistering the lesions. Fourteen months after therapy the patient remains free of apparent disease.
Evaluation of Donor Harvesting Techniques in Hair Transplantation
Authors: ALT THOMAS H.
Published: June 2013

Abstract Ultra close‐up photography shows that an ideal donor graft in hair transplantation is harvested using a sharp carbon steel punch driven at approximately 5000 rpm by an electrically powered hand engine. Skin distortion at the donor site is minimized by firm infiltration using physiologic saline. Dull punches, hand driven punches, or flaccid donor skin all increase distortion which is detrimental to the harvesting of superior quality donor grafts. Carbon steel punches attain and maintain a sharper cutting edge than stainless steel punches.
Recurrent Dysplastic Nevus Following Shave Excision
Authors: DURAY PAUL H. , LIVOLSI VIRGINIA A.
Published: June 2013

Abstract Distinguishing benign from malignant melanocytic lesions is an on‐going challenge for the clinician and the histopathologist. The regrowth of benign melanocytic nevi at the dermoepidermal junction following inadequate excision has been shown to be confused with superficial spreading melanoma. The dysplastic nevus has atypical features in and of itself, which become even more compounded when the lesion recurs in the dermoepidermal junction following inadequate resection by shave excision. The use of Monsel's solution to achieve hemostasis at the biopsy site can itself also produce a clinically irregular area of hyperpigmentation, accompanied by a pathologic pigmented and cellular dermal reaction.

A case of a dysplastic nevus recurring after inadequate shave excision is reported here. The resultant atypia were further compounded by the use of Monsel's solution for hemostasis in the initial excision, which could have led to a mistaken diagnosis of malignant melanoma. The spectrum of dysplastic nevi is reviewed.
Stellate Subperichondrial Repair of a Double Ear Cancer
Authors: MALINER JEROME S.
Published: June 2013

Abstract Cancer disguised as dermatitis involved both the anterior and posterior auricular perichondrium, necessitating excision of the middle third of the ear. Closure of this larger defect was effected by a three‐pronged subperichondrial wedge excision of cartilage, leaving overlying skin intact. The reconstructed ear, therefore, had fewer scar lines than would have resulted from open‐wedge excisions.
Melanosis of the Vulva
Authors: JACKSON ROBERT
Published: June 2013

Abstract Four patients who had extensive melanosis of the peri‐urethral area, vulvar mucosae, introitus, and perineum are presented. No cause was found.
Chemical Peeling with Trichloroacetic Acid
Authors: RESNIK SORREL S.
Published: June 2013

Abstract Trichloroacetic acid for deep and superficial chemical peeling can be effectively utilized by experienced physicians. It is an excellent alternative if phenol chemical peel is contraindicated.
Blue Nevus of the Lymph Node Capsule
Authors: MASCI P. , CIARDI A. , DI TONDO U.
Published: June 2013

Abstract An infrequent case of inguinal node capsule blue nevus is presented along with morphologic and etiopathogenic observations.
Electrocoagulation in a Sterile Surgical Field
Authors: SEBBEN JACK E.
Published: June 2013

Abstract A useful technique for the electrocoagulation of bleeders while maintaining a sterile surgical field is outlined. The method is fast and efficient, and no special equipment is required.
Malignant Melanoma Prognostic Factors 6: Distant Metastases and Length of Survival
Authors: DAY CALVIN L. , LEW ROBERT A.
Published: June 2013

Abstract Surgical resectability is the most important prognostic factor for determining the length of survival following distant metastases. Other important factors that derive prognostic significance from their correlation with surgical resectability include (1) number of metastatic sites, (2) performance status, (3) initial site of metastases, (4) interval between initial diagnosis of primary tumor and onset of distant metastases. Factors which have little or no prognostic value include location of the primary tumor, sex, age and histological characteristics of the primary tumor.
Cutaneous Metastatic Squamous‐Cell Carcinoma in Zosteriform Distribution
Authors: BUECKER JOSEPH W. , RATZ JOHN L.
Published: June 2013

Abstract A renal transplant patient on immunosuppressives with a history of multiple premalignant and malignant skin tumors developed cutaneous metastatic squamous‐cell carcinoma in a typical zosteriform distribution on the right arm and chest. This distribution of a squamous‐cell carcinoma is unique to the English literature and serves to emphasize the necessity for frequent follow‐up and aggressive treatment in this high‐risk population.
Histologic Control of Excised Tissue Edges in the Operative Treatment of Basal‐Cell Carcinomas
Authors: BREUNINGER HELMUT
Published: June 2013

Abstract The edges of 742 basal‐cell carcinoma specimens were evaluated histologically to assess subclinical extension and to ensure radical excision. This procedure is considerably simpler and faster than the time‐consuming standard method of microscopically controlled surgery. No recurrences of lesions excised with this method were observed during a 3 1/2‐year observation period.
Transplanting Temporal Points, Sideburns, and Feminine Hairlines
Authors: NORWOOD O'TAR T.
Published: June 2013

Abstract
Techniques for transplanting temporal points, sideburns, and feminine hairlines are described. Variations unique to these areas are highlighted.
Hair Transplantation with Microsurgical Free Scalp Flap
Authors: OHMORI KITARO
Published: June 2013

Abstract
The operative procedure of microsurgical free scalp flap is described. The importance of the natural hair direction on the grafted scalp to obtain a natural appearance after the hair transplantation is emphasized.
The Lower Eyelid Curved V‐T Plasty
Authors: FIELD LAWRENCE M.
Published: June 2013

Lesions of the middle third of the lower eyelid lend themselves to removal and reconstruction using the V–T plasty technique. A case utilizing this method is photographically demonstrated, including a new design consideration—the curved V–T plasty. To date, we have performed 32 such operations without complication.
Treatment of a Large, Ulcerating, Granular‐Cell Tumor by Microscopically Controlled Excision
Authors: DZUBOW LEONARD M. , KRAMER E. MICHAEL
Published: June 2013

Malignant granular‐cell tumors with benign histologic appearance are normally identified only following nodal and metastatic spread. Local recurrence following conventional excision of both the benign and malignant variant is not uncommon. A patient with a large, rapidly growing, spontaneously ulcerating granular‐cell tumor was treated by microscopically controlled (Mohs) surgery. The rationale for this treatment, as well as criteria for the differentiation of the benign from the malignant variant, is discussed.
Residents' Corner: Bleomycin Sulfate—Postoperative Intralesional Usage for Giant Condylomata
Authors: BUECKER JOSEPH W. , HEATON CHARLES L.
Published: June 2013

Abstract A patient with giant condyloma of the glans penis was successfully treated with conservative surgical excision. Postoperatively, intralesional bleomycin sulfate was utilized in an attempt to prevent tumor recurrence. Follow‐up to 2 years has been unremarkable for clinical regrowth.
Chemical Face Peeling Without Taping
Authors: BEESON WILLIAM H. , McCOLLOUGH E. GAYLON
Published: June 2013

Abstract Chemical face peeling is a simple surgical procedure which usually provides dramatic results. The potential for serious complications does exist and cautious assessment and management is essential. Aesthetically pleasing long‐term results can be obtained by using chemexfoliation without taping, when employed with a “moist dressing” technique. This technique eliminates the need for repeated anesthetics and postoperative visits in order to remove facial taping, and provides an atmosphere for accelerated wound healing.
A Simplified Method of Focal Salabrasion for Removal of Linear Tattoos
Authors: JOHANNESSON ANDERS
Published: June 2013

Abstract A simple method for the removal of linear tattoos is described, where tissue destruction is limited to tattooed skin and the resulting necrosis does not extend more than 1 mm into non‐tattooed skin. The epidermis overlying tattooed skin can easily be scraped after heat separation. Table salt is rubbed into and left on the area where epidermis has been removed. The achieved necrosis appears only in the heat‐treated skin and heals with an acceptable scar.
Basal Cell Carcinomas Arising in Seborrheic Keratoses
Authors: GOETTE DETLEF K.
Published: June 2013

Seborrheic keratoses are the most common benign epithelial neoplasms. They are not considered pre‐cancerous lesions, in contrast to actinic keratoses. Nevertheless, malignant tumors in seborrheic keratoses are seen on rare occasions. This report documents a patient who had two basal cell carcinomas (BCC) arising in two separate seborrheic keratoses.
H, Peanut Lectin Receptor, and Carcinoembryonic Antigen Distribution in Keratoacanthomas, Squamous Dysplasias, and Carcinomas of Skin
Authors: ARIANO MOIRA C. , WILEY ELIZABETH L. , ARIANO LARRY , COON JOHN S. , LINDA TETZLAFF Ph. D.
Published: June 2013

Abstract The distribution of blood group antigen H(O), peanut lectin receptor (PNL‐R) (a precursor to the MN blood group antigens), and carcinoembryonic antigen (CEA) was examined in 15 squamous cell carcinomas, 30 keratoacanthomas, 17 squamous dysplasias, and 5 normal controls using immunoperoxidase techniques.

All controls and 8 carcinomas, 10 keratoacanthomas, 14 dysplasias expressed H antigen. All controls and 9 carcinomas, 10 keratoacanthomas, 16 dysplasias expressed PNL‐R antigen. CEA was present in 15 carcinomas, in trace amounts in 3 keratoacanthomas, in 6 dysplasias, and in 0 controls. The staining for H antigen and PNL‐R in the carcinomas and dysplasias was disorganized, patchy, and less than that of normal epithelium, while staining in keratoacanthomas was uniform, with normal to increased intensity as compared to controls in 9 cases. CEA showed weak focal staining in 5 carcinomas, 8 dysplasias and 3 keratoacanthomas, and more intense and extensive cytoplasmic and membrane staining in 10 carcinomas and 5 dysplasias, and no cellular staining in 4 dysplasias and 7 keratoacanthomas. CEA was present in greatest amounts in the well‐differentiated carcinomas and focal in the less‐differentiated tumors. The well‐differentiated carcinomas had a greater percentage of cells staining for H antigen and PNL‐R.

The pattern of staining for H, PNL‐R, and CEA appears to distinguish keratoacanthomas from carcinomas and squamous dysplasias, and may be a useful adjunct to diagnosis.
The Indeterminate Cell Proliferative Disorder: Report of a Case Manifesting as an Unusual Cutaneous Histiocytosis
Authors: WOOD GARY S. , HU CHUNG‐HONG , BECKSTEAD JAY H. , TURNER RODERICK R. , WINKELMANN R. K.
Published: June 2013

Abstract A patient with an unusual, distinctive cutaneous histiocytosis is described. Extensive morphologic, antigenic, and enzymatic studies indicate that this histiocytosis represents a proliferative disorder of cutaneous indeterminate cells. Features that distinguish this disorder from other histiocytoses are discussed.
Neurotropic Malignant Melanoma: A Novel Treatment Approach Combining Modified Microscopically Controlled Surgery and S100 Immunohistochemical Staining
Authors: NOODLEMAN F. RICHARD , ROTH ROBERT J. , MILLER A. CHRISTINE , NICKOLOFF BRIAN J.
Published: June 2013

Abstract Treatment of neurotropic malignant melanoma of the nasal ala combining microscopically controlled surgery and examination of formalin‐fixed paraffin‐embedded tissue cut in the horizontal plane followed by S100 immunohistochemical staining is described. The spindle‐shaped cells were strongly S100 positive and detection of the melanoma cells, which were embedded in a dense collagenous stroma and infiltrating into the neurovascular spaces, was greatly accentuated by the S100 immunohistochemical stain. The coordinated skills of the dermatologic surgeon, dermatopathologist, and plastic surgeon contributed toward the best treatment for neurotropic melanoma in this patient.
Radical Wedge Resection for Ingrown Toenail: Long‐Term Results
Authors: HEROLD H. Z. , BARUCHIN A. M. , SHMUELI G. , DANIEL D. , NAOUM A.
Published: June 2013

Abstract. This paper describes an operation for ingrown toenail that is simple, has a low recurrence rate, leaves patients with an intact, pain‐free, cosmetically acceptable nail‐bearing toe, and permits the wearing of normal shoes within a short period of time. Among the numerous techniques devised for the treatment of ingrown toenail, no other operation fulfills all of these criteria. It is usual to sacrifice appearance in the hope of cure. During the last 20 years we have adopted a radical wedge resection that has the advantage of resulting in permanent healing and a good‐looking toe. After a first series of 67 cases thus treated without a single recurrence, the technique was used in a further series of 339 cases reported here.
Basal‐Cell Carcinoma Occurring in an Axilla: A Case Presentation and a Review of Factors Related to Tumor Development
Authors: SUSONG C. RODNEY , RATZ JOHN L.
Published: June 2013

Abstract. A patient with basal‐cell epithelioma of the axillary vault is presented. The literature on possible etiologies of this tumor is also reviewed.
Adjunctive Surgical Management of Cutaneous Mycobacterium Fortuitum Infection
Authors: MADJAR DAVID D. , CARVALLO EDWARD , PROPER STEVEN A. , FENSKE NEIL A.
Published: June 2013

Atypical mycobacteria of the fortuitumchelonei complex are being identified with increasing frequency as causes of resistant, cutaneous infection. We report a case of Mycobacterium fortuitum infection of the face, unresponsive to conventional antimicrobial therapy, which resolved following adjunctive surgical resection.

We believe that prompt surgical debridement of affected tissue in such infections, combined with appropriate antimicrobial therapy, will shorten both the duration and morbidity often associated with this disease.
Residents’Corner: Multiple Pyogenic Granuloma‐like Lesions Following Hair Transplantation
Authors: SARNOFF DEBORAH S. , GOLDBERG DAVID J. , GREENSPAN ALAN H. , ALBOM MICHAEL J.
Published: June 2013

Abstract. Multiple pyogenic granuloma‐like lesions occurring at punch graft sites are an unusual complication of hair transplantation heretofore unreported. While the etiology and pathogenesis of such lesions remain elusive, physicians performing hair transplantations should be aware of this potential sequela.
Estrogen and Progesterone Receptors in Primary Cutaneous Melanoma
Authors: ELLIS DARREL L. , WHEELAND RONALD G. , SOLOMON HERMAN
Published: June 2013

Abstract. Using a variety of techniques, estrogen and progesterone receptors have previously been identified in variable percentages of malignant melanomas. We examined 10 primary superficial spreading melanomas (SSM) with a fluorescent hormone‐binding technique for estrogen and progesterone cytoplasmic receptors. Of these 6 SSM were markedly positive for estrogen and progesterone binding. Patients with dysplastic nevus syndrome (DNS) or a family history of DNS were markedly positive for estrogen and progesterone binding. A single patient with lentigo maligna and another patient with lentigo maligna melanoma were negative for estrogen and progesterone binding. None of the 21 control intradermal nevi examined for estrogen and progesterone binding exhibited marked positivity.
Wedge Resection of the Lip: Minimizing Problems
Authors: SEBBEN JACK E.
Published: June 2013

Abstract. The basics of wedge resection of the lower lip are reviewed. The use of an intraoral mental nerve block greatly decreases the pain for the patient. The procedure is simplified by the isolation and ligation of the labial artery prior to excision of the wedge. The best cosmetic results are obtained when the orbicularis oris muscle and vermilion border are carefully repaired.
Jadassohn's Sebaceous Nevus
Authors: SERPAS DE LÓPEZ RITA MARÍA E. , HERNÁNDEZ‐PÉREZ ENRIQUE
Published: June 2013

Abstract. A total of 29 case reports of sebaceous nevus were filed for the years 1970 to 1980 in the Department of Pathology of the National Medical Center of El Salvador. In 2 cases (6.8%), association with basal‐cell carcinomas were found. In 1 case, there was also a solitary pilar leiomyoma. Sebaceous nevus was found more frequently in females than in males (2:1 ratio), and the average age was 23.8 years at the time of the consultation. All diagnosed sebaceous nevi were located on the head (48.2% on the scalp), and 82.7% of the patients were under 30 years of age. In connection with the analysis of these cases, a brief review of the clinical, histologic, and evolutionary facts of the sebaceous nevus was carried out.
Chemosurgical Reports: Basal‐Cell Carcinoma Resulting from Radiation Therapy for Hypertrophic Tonsils
Authors: HANKE C. WILLIAM , O'BRIAN JEFFREY J. , SHIDNIA HOMAYOON , BECKER JEFFREY M.
Published: June 2013

Abstract. Benign dermatologic conditions are no longer treated with therapeutic radiation because of the late complications that can result. One of the most serious complications that may occur is the development of skin cancer of various types. In this report, a patient received radiation for hypertrophic tonsils and later developed basal‐cell carcinomas in the irradiated areas.
Residents' Corner: Pedunculated Pigmented Basal‐Cell Carcinoma on the Buttock of a Black Man
Authors: MORIMOTO SANDRA S. , GUREVITCH ARNOLD W.
Published: June 2013

Abstract. A pedunculated pigmented basal‐cell carcinoma on the buttock of a black male is presented. Unusual features of this case include an atypical pendunculated appearance, suggesting nevus or neurofibroma, atypical location on a covered area of the body, and occurrence in a low‐incidence racial group.
Injectable Collagen Implant: Histopathologic Identification and Longevity of Correction
Authors: ROBINSON JUNE K. , HANKE C. WILLIAM
Published: June 2013

Abstract. This prospective study reports the results of the longevity of the correction achieved in 312 patients receiving injectable collagen implant and the histopathologic identification of the implant in the six who experienced reactions at the treatment sites. In reporting results in cosmetic patients, certain ones can be considered objective or factual, and others must be judged subjective. This study reports both kinds of results and proposes a new theory to explain the duration of the improvement.
Malignant Melanoma Prognostic Factors 7: Elective Lymph Node Dissection
Authors: DAY CALVIN L. , LEW ROBERT A.
Published: June 2013

Abstract.Every prospective study published to date, whether randomized or nonrandomized, shows that the survival rate for patients with clinical stage I melanoma is the same, irrespective of whether they have an elective lymph node dissection (ELND). All the studies that purport to show a survival benefit from ELND have been based on retrospective data and are therefore subject to selection bias. Nevertheless, the data support the notion that there may be a small, select group of melanoma patients whose lives can be saved by ELND. This subgroup is made up of those patients who have epithelioid in small nests (ESN) melanomas. In the early stages of its evolution, this type of malignant melanoma metastasizes to regional lymph nodes and often does not have coexistent distant metastases. Other types of melanomas, when they metastasize, either bypass the lymph nodes or metastasize to the lymph node and simultaneously send distant metastases elsewhere, nullifying the anticipated benefit from an ELND. We encourage dermatologists, when they have a choice, to be supportive of those surgeons who are actively participating in ongoing randomized trials designed to select patients who might benefit from ELND.
Ophthalmologic Oncology: Sebaceous Carcinomas of the Eyelids
Authors: PANG PIERRE , RODRÍGUEZ‐SAINS RENÉ S.
Published: June 2013

Abstract. Sebaceous carcinomas are rare, and deadly, adnexal tumors with a distinct predilection for eyelid skin. A chronic blepharoconjunctivitis and/or a recurrent chalazion are the most common clinical presentations that should alert the clinician to the diagnosis. Great care and skill are needed in interpreting these lesions histopathologically as they can be easily confused with basal‐ and squamous‐cell carcinomas.
Chemosurgical Reports: Myxoid Dermatofibrosarcoma Protuberans
Authors: HESS KRISTINE A. , HANKE C. WILLIAM , ESTES NORMAN C. , SHIDELER STEPHEN J.
Published: June 2013

Abstract. Dermatofibrosarcoma protuberans (DFSP) is a fibroblastic tumor characterized by a high rate of recurrence following conventional surgical treatment. Several different histopathologic patterns exist, with the “cartwheel”pattern the most common. In this report, a patient with the unusual myxoid histopathologic pattern was successfully treated with Mohs surgery.
Congenital‐Nevus‐Like Nevi, Nevi Spili, and Café‐Au‐Lait Spots in Patients with Malignant Melanoma
Authors: KOPF ALFRED W. , LEVINE LAURIE J. , RIGEL DARRELL S. , FRIEDMAN ROBERT J. , LEVENSTEIN MARCIA
Published: June 2013

Abstract. The prevalence of congenital‐nevus‐like nevi (CNLN) in a group of 105 adults who had malignant melanoma (MM) was compared with that in a control group of 601 adults not afflicted by MM. Total cutaneous examinations were performed on both groups. The control group presented with complaints other than pigmented lesions. In this series, 10 (9.5%) of the group with MM had clinically diagnosed CNLN 1.5 cm or larger in diameter. These CNLN were not in contiguity with the MM sites. The 9.5% prevalence of CNLN in the group with MM was significantly higher (p < 0.005) than the 2.5% CNLN observed in the control population. None of the patients in either group had large congenital nevocytic nevi (≥20 cm).

In addition, in the group with MM, 5 patients (4.8%) had nevi spili (NS) and 13 (12.4%) had café‐au‐lait spots (CLS). The prevalence rates for these two types of pigmented lesions were not significantly different from those observed in the nonmelanoma control group (2.3% for NS; 13.8% for CLS).

The relative risk for developing MM is 4.1 in people with CNLN compared with those without CNLN, which indicates that these nevi may be markers for individuals prone to develop malignant melanoma.
Wound Healing 1985: An Update
Authors: POLLACK SHELDON V.
Published: June 2013

Abstract. The past decade has given rise to significant advances in our knowledge of the wound‐healing process. Work performed by basic scientific investigators and clinical researchers has resulted in new insights into certain biologic aspects of wound healing. The thoughtful application of some of these findings has led to the development of modern, physiologically sound wound‐healing products and improved patient care.
Lasers in Dermatology—1985
Authors: BAILIN PHILIP L.
Published: June 2013

Abstract. Since the introduction of medical lasers in 1960, the skin has been a major site for applied laser research and therapy. Argon and carbon dioxide lasers have been the most widely used in clinical practice, and many diseases that were impossible or difficult to manage are now being effectively treated with these. Exciting developments today involve other systems, including tunable dye, ruby, neodymium‐YAG, and low‐energy lasers. Photodynamic therapy for cancer may provide a selective method of destroying clinically inapparent malignant cells. Lasers now seem to have become an integral part of the dermatologic surgeon's armamentarium.
Low Skin Temperatures Produced by New Skin Refrigerants
Authors: STRICK RICHARD A. , MOY RONALD L.
Published: June 2013

Abstract. Temperatures produced by Cryosthesia – 30°C, Cryosthesia – 60°C, and Frigiderm were measured in mini pigs. Cryosthesia – 60°C and Cryosthesia – 30°C were both found to rapidly lower skin temperatures to levels that have been shown to cause cell injury, necrosis, and loss of melanocytes. Use of these agents requires extreme caution in dermabrasion.
Complications of Dermabrasion Resulting from Excessively Cold Skin Refrigeration
Authors: HANKE C. WILLIAM , ROENIGK HENRY H. , PINKSI J. B.
Published: June 2013

Abstract. Three patients developed complications following dermabrasion with a new potent skin refrigerant mixture. Freezing can usually be performed more rapidly with such mixtures, but the risk of complications may be greater.
The Bilobed Flap in Sole Surgery
Authors: SANCHEZ‐CONEJO‐MIR J. , MONTES J. BUENO , GIMENEZ J. C. MORENO , CAMACHO‐MARTINEZ F.
Published: June 2013

Abstract. The bilobed flap is a simple reconstructive technique principally used to correct substantial defects in the facial region. We present our experience with this local flap in the difficult plantar area, with excellent short‐term functional results. We describe the special characteristics of the bilobed flap in this zone, and comment on its indications and possible complications.
Invasion of Parotid Gland by Basal Cell Carcinoma: Implications for Therapy
Authors: HANKE C. WILLIAM , WEISBERGER EDWARD C.
Published: June 2013

Abstract. A review of 1,146 cases of basal cell carcinoma of the head and neck revealed that twelve (1.05%) involved the parotid gland by direct extension. The male to female ratio was 5:1 and the average age was 70.1 years. Tumor size, site of origin, and duration prior to treatment were factors influencing secondary parotid involvement by these neoplasms. Mohs micrographic surgery was found to be an effective method of treatment with a high cure rate.
Use of Scleral Eye Shields for Periorbital Laser Surgery
Authors: WHEELAND RONALD G. , BAILIN PHILIP L. , RATZ JOHN LOUIS , SCHREFFLER DALE E.
Published: June 2013

Abstract. A description of the technique used in preventing inadvertent injury to the eye during periorbital or eyelid laser surgery is given.
Combined Carbon Dioxide Laser Excision and Vaporization in the Treatment of Rhinophyma
Authors: WHEELAND RONALD G. , BAILIN PHILIP L. , RATZ JOHN LOUIS
Published: June 2013

Abstract. The carbon dioxide laser can be successfully used in its two different modes of operation to treat rhinophyma in a relatively bloodless fashion. With the focused mode, layers of excess soft tissue are precisely shaved away until the approximate size and shape of the nose has been achieved. Then with the defocused mode, extremely thin layers of soft tissue can be vaporized to provide the final countouring. Minimal blood loss in most cases, rapid healing, and little postoperative pain are significant advantages of this technique.
Epidermal Langerhans Cell Density in Patients with Pulmonary Malignancies and Chronic Obstructive Pulmonary Disease
Authors: SHAIEB ANNETTE M. , BERMAN BRIAN , SMITH BONNIE , KRUMPE PETER
Published: June 2013

Abstract. To evaluate the relationship between ELC density and pulmonary malignancies, as reported in previous investigations, we examined the nonsun‐exposed epidermis of 18 patients with pulmonary cancer (CA) not receiving immunosuppressive therapy, 20 patients with chronic obstructive pulmonary disease (COPD‐S), and 10 patients with COPD receiving glucocorticosteroid (GCS) therapy (COPD + S).

The ELC density was not significantly different between lung tumor patients (1024 ± 167) and COPD‐S (1072 ± 200, p <0.4) control patients, and we found no significant correlation between ELC density and tumor cell type, presence or absence of metastases, tumor stage, or present smoking status. Although we did detect that systemic GCS therapy significantly reduced the ELC density in COPD + S patients (910 ± 211, p < 0.05), use of inhaled or chronic low dose (≤20 mg daily) GCS did not appear to significantly alter ELC density. In addition, anergy to epicutaneous dinitrochlorobenzene in CA and COPD + S patients positively correlated with a reduction in ELC density, suggesting a possible functional deficit arising from the numerical change. Further investigation is needed to elucidate whether factor(s) other than a reduction in ELC density are involved in the anergic state.
Comparison of Cosmesis following Healing by Surgical Closure and Second Intention
Authors: ELLNER KENNETH M. , GOLDBERG LEONARD H. , SPERBER JAY
Published: June 2013

Abstract. When deciding on whether to surgically close a wound or allow granulation and epithelialization to occur, it is necessary to evaluate each patient individually. The patient's needs and desires, along with cost effectiveness, immediate versus delayed gratification, and convalescent time must all be considered. Also, the skill of the surgeon and the resources available to both the surgeon and the patient must be taken into consideration.
Cooperative Frozen Section Surgery
Authors: GROSS DANIEL A. , FIELD LAWRENCE M.
Published: June 2013

Abstract Utilization of the office setting for frozen section evaluation of tumor removal in the treatment of skin cancer is of considerable value. The impact of such surgery includes (1) enhanced quality of surgery by reducing the possibility of incomplete removal of tumor, (2) decreased financial cost to the patient when compared to hospital treatment, (3) better utilization of the doctor's time and facilities, (4) decreased disruption in the life of the patient and his family in terms of time off from work, surgery schedule flexibility, and a decrease in patient anxiety.
An Interdisciplinary Approach to the Management of Basal Cell Carcinoma of the Head and Neck
Authors: BAKER SHAN R. , SWANSON NEIL A. , GREKIN ROY C.
Published: June 2013

Abstract At the University of Michigan the dermatologic surgeon works closely with the head and neck surgeon in resecting extensive cutaneous malignancies that could benefit from the combined skills of both surgical specialists. Mohs surgery offers complete microscopic controlled resection of the cutaneous portion of skin cancers. Tumors extending deeply from the skin into underlying bone and soft tissue are resected with the assistance of the head and neck surgeon familiar with the anatomy and trained in the protection of the vital structures of the head and neck. It is evident that patients with large or aggressive basal cell carcinomas will best be served when this interdisciplinary approach has become commonplace.
The Impact of Intradermal Lymphoscintigraphy on Surgical Management of Clinical Stage I Truncal Malignant Melanoma
Authors: KRAMER ELISSA LIPCON , SANGER JOSEPH J. , GOLOMB FREDERICK , KOPF ALFRED W. , POSTEL ALLEN
Published: June 2013

Abstract Lymphoscintigraphy results in 35 stage I melanoma patients were compared with primary location and surgical management. Six of 25 primaries with potentially multidirectional lymphatic drainage had drainage to one regional node group. Three of 10 with expected unidirectional drainage showed multidirectional drainage. With unidirectional drainage, decision concerning lymphadenectomy was simplified.
Verrucous Carcinoma in Penile Lichen Sclerosus et Atrophicus
Authors: WLBLR PAUL , RABINOVITZ HAROLD , GARLAND LARRY
Published: June 2013

Abstract A patient presented with a venucous carcinoma within a lesion of penile lichen sclerosus et atrophicus. We report a case of lichen sclerosus and the specific squamous cell carcinoma variant, verrucous carcinoma, treated by Mobs surgerv.
The Association of Basal Cell Carcinomas with Other Tumors
Authors: COSKEY RALPH J. , MEHREGAN AMIR H.
Published: June 2013

Abstract We report the case of a patient who had a lesion on the back that clinically resembled a basal cell carcinoma, but histologically showed changes of a basal cell carcinoma and a nodular malignant melanoma. We also review the literature on the association of basal cell carcinomas with other tumors.
Flexible Sclerotherapy
Authors: WEBER PAUL J. , DZUBOW LEONARD M.
Published: June 2013

Abstract. A low‐cost, easy‐to‐use, and readily available addition to the syringe‐needle unit commonly employed in sclerotherapy is described. A small‐bore plastic tube inserted between needle and syringe will increase mobility and accessibility when performing sclerotherapy.
The Large Flap Sculptured Facelift
Authors: SHIRE JAMES R. , JOHNSON CALVIN M. , ORR JAMES B.
Published: June 2013

Abstract. The large flap sculptured facelift is a redraping rather than a pinching or pulling operation. The skin flaps are redraped over the tightened, sculptured underlying fat‐musculoaponeurosis. This procedure can be performed on a majority of patients with minimal complications.
Sterile Technique and the Prevention of Wound Infection in Office Surgery—Part I
Authors: SEBBEN JACK E.
Published: June 2013

Abstract. Surgical infection and associated complications are minimized by a combination of appropriate sterile technique and careful surgical technique. This review covers the essential elements of infection control for the office‐based surgical practice. Recommendations are made concerning operating room facilities, instrument sterilization, and tray setup (Part I). Part II addresses surgical prepping, surgical technique, and prophylactic antibiotics.
Five Primary Disparate Melanomas: A Case Report (The Spectrum of Melanoma)
Authors: SHAPIRO MARSHALL A.
Published: June 2013

Abstract. A 75‐year‐old Caucasian female presented with a 20‐year history of five primary disparate malignant melanomas and one small desmoplastic amelanotic satellite. In three generations, there was no family history of dysplastic nevi or malignant melanoma. Likewise, the patient had no history of dysplastic nevi or any other condition previously reported in the literature as being allied with melanoma. Dr. George Pack first reported that malignant melanoma may be multifocal.1 The wide spectrum of this disease and increased incidence of multiple primaries demand thorough, long term, follow‐up.
Cryotherapy for Multiple Trichoepithelioma
Authors: DUHRA P. , PAUL J.C.
Published: June 2013

Abstract. Multiple trichoepithelioma is an uncommon disorder for which treatment is usually bedeviled by the recurrence of tumors. A case of multiple trichoepithelioma is described occurring in the retroauricular area; the condition cleared completely and without relapse following cryotherapy.
Mohs Surgery Report: Spindle Cell Fibrohistiocytic Tumors: Classification and Pathophysiology
Authors: DZUBOW LEONARD M.
Published: June 2013

Abstract. Four patients with spindle cell cutaneous fibrohistiocytic neoplasms are presented. A classification scheme for this group of tumors is discussed along with the histologic and immunohistochemical criteria needed to establish the diagnosis. Cutaneous malignant fibrous histiocytoma (atypical fibroxanthoma) may behave biologically as a neoplastic rather than reactive mesenchymal tumor with definite invasive and metastatic potential.
The Use of a Combination Skin Hook and Tissue Forceps: A New Instrument for Dermatologic Surgery (“Frankel‐Adson Forceps”*)
Authors: FRANKEL DAVID H.
Published: June 2013

Abstract. The dermatologic surgeon frequently uses both skin hook and tissue forceps to accomplish atraumatic wound closure. Since this requires the surgeon to change instruments frequently during the course of the procedure, a combination skin hook and tissue forceps has been developed to make possible the simultaneous use of these two instruments. In addition, using a new technique that combines the two capabilities of this instrument, the surgeon can further reduce the risk of tissue trauma during surgery. The instrument and this technique are described.
Wound Infection Rate in Dermatologic Surgery
Authors: WHITAKER DUANE C. , GRANDE DONALD J. , JOHNSON SALLY S.
Published: June 2013

Abstract. Most dermatologic surgery is performed in clinical settings and not in the rigorous sterile environment of a hospital operating room. This prospective study measures the wound infection rate over a 2 1/2 year period for cutaneous surgery performed in a clinical environment. This percent infection rate compares very favorably with that of formal operating room settings.
Postoperative Necrosis Following Bilateral Lateral Scalp Reduction
Authors: UNGER MARTIN G.
Published: June 2013

Abstract. Three cases of postoperative necrosis following a bilateral lateral reduction are presented. Due to the incidence and possible severity of this complication, the author has abandoned this procedure and cautions others to do the same.
Verrucous Carcinoma Arising in Ulcerative Lichen Planus of the Soles
Authors: MAYRON RICHARD , GRIMWOOD RONALD E. , SIEGLE RONALD J. , CAMISA CHARLES
Published: June 2013

Abstract. Verrucous carcinoma is a low‐grade squamous cell carcinoma. Chronic inflammation is an important factor in its pathogenesis. This is the first case of plantar verrucous carcinoma arising in a lesion of ulcerative lichen planus. This paper also lends further support to the successful use of Mohs micrographic surgical technique as the treatment of choice for verrucous carcinoma.
Planning and Staffing an Appropriate Outpatient Facility
Authors: CHRISMAN BRUCE B.
Published: June 2013

Abstract. Even a thoroughly trained, highly skilled cosmetic surgeon will lead a professional life of frustration without the ancillary staff and facilities appropriate to such a field. Planning and staffing an efficient outpatient facility is as important to the cosmetic surgeon as learning the technical skills of his trade.
A New, More Flexible Mechanism and Method of Liposuction
Authors: WEBER PAUL J. , DZUBOW LEONARD M.
Published: June 2013

Abstract. We present a new system for liposuction, formed from a blend of presently existing and simple parts. It is free of the mechanical breakdown problems and is not nearly as tiring as the recently developed “syringe‐cannula‐only” system. The system has other benefits that will be described. We will also discuss the full use of this simple instrument so that it may be mastered immediately by the reader. Because it is a major improvement over the “syringe‐cannula‐only” method, we expect this system to see vast clinical utility in the future. Now every physician who is appropriately trained can perform an efficient liposuction without expensive machinery, exhaustion, or fear of a mechanical breakdown.
Management Considerations for Cutaneous Neurophilic Tumors
Authors: BIRKBY CRAIG S. , WHITAKER DUANE C.
Published: June 2013

Abstract. The proper management of patients with neurophilic skin cancers is often quite difficult. When present, neurophilic invasion significantly worsens the prognosis. Important considerations for managing patients with cutaneous neurophilic tumors and illustrative cases are presented.