bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Cutaneous Melanoma of the Face by Mohs Micrographic Surgery
Authors: Bienert Tasha N. , Trotter Martin J. , Arlette John P. 
Published: July 2017

Background: The treatment of cutaneous malignant melanoma of the face presents a challenge to ensure eradication of disease with maximum preservation of tissue. Mohs micrographic surgery provides a means for histologically controlled removal of malignant melanoma. Objective: This study evaluates the efficacy of Mohs micrographic surgery, at a single institution, for the treatment of facial melanoma and assesses the accuracy of margin control by frozen section techniques. Methods: Ninety-seven patients with biopsy-confirmed melanoma in situ or invasive melanoma of the face were treated by Mohs micrographic surgery over a 6-year period. In 25 patients, tissue margins defined as negative for melanoma at the time of frozen section were re-evaluated on permanent section histology of formalin-fixed, paraffin-embedded tissue. Results: Ninety-two of 97 patients had followup information available (8–72 months; mean 33 months). There were no cases of local recurrence. Eighty-nine of the 92 patients were alive and well with no evidence of disease. One patient died of metastatic melanoma. In situ or invasive melanoma was not identified on permanent sections of 117 tissue margins which had been interpreted as negative on frozen section. Conclusion: Mohs micrographic surgery appears to be an effective treatment for facial melanomas. Our study showed complete correlation between frozen section tissue margins and permanent section controls.
Metastatic Melanoma in a Patient with Clouston Syndrome Successfully Treated with Isolated Hyperthermic Limb Perfusion
Authors: Parhizkar Nooshin , Jones Vicky E. , McClay Edward F. , Yi Eunhee S. , Bouvet Michael 
Published: July 2017

Background: Clouston syndrome is an autosomal dominant disorder characterized by nail dystrophy, partial or total alopecia, and hyperkeratosis of the palms and soles. Objective: Although a variety of unusual cutaneous manifestations have been described, the incidence of melanoma in this population is unknown. Methods: This article reports a case of in-transit metastatic subungual melanoma in a patient with Clouston syndrome successfully treated with hyperthermic limb perfusion with melphalan. Results: Six months postperfusion, the patient is doing well, with resolution of the extremity erythema and edema. Followup ultrasonography revealed reduction in size of the eight subcutaneous nodules, with the largest measuring 3.3 cm in maximum diameter, representing nearly a 50% reduction in tumor volume postperfusion. Conclusion: Although melanoma has also been associated with some forms of ectodermal dysplasia, such as ectrodactyly—ectodermal dysplasia—clefting (EEC) syndrome, the incidence of melanoma in patients with Clouston syndrome is unknown. Thus far, to our knowledge, this is the first case report of melanoma arising in a patient with Clouston syndrome.
Hidradenitis Suppurativa
Authors: Jemec Gregor B. E. 
Published: July 2017

Background: Hidradenitis suppurativa is a clinically defined disease that causes considerable morbidity for patients. The results of recent studies, which have increased the understanding of this disease, are reviewed. Objective: The epidemiology, risk factors, pathogenesis, and treatment of this disease are summarized to help clinicians with practical patient management. Conclusion: Hidradenitis suppurativa remains a clinical challenge to patients and physicians alike. Physicians should be familiar with the impact this disease has on the patient and with the range of treatments available. Use of simple incisions as treatment is strongly discouraged. Additional pathogenic as well as therapeutic studies are necessary.
Leukemia Cutis Presenting with Fingertip Hypertrophy
Authors: Freiman Anatoli , Muhn Channy Y. , Trudel Michel , Billick Robin C. 
Published: July 2017

Background: Patients with leukemia often manifest cutaneous findings, which include nonspecific lesions and specific leukemic infiltrates termed leukemia cutis. Objective: A case of leukemia cutis involving distal finger pads is reported and literature describing hand involvement of specific leukemic infiltrates is reviewed. Methods and Results: An 80-year-old woman with a 10-year history of chronic lymphocytic leukemia developed painful symmetric tumors of her distal finger pads. Histopathological examination of the biopsy specimen revealed infiltration by neoplastic lymphocytes. Only a few cases of leukemia cutis involving the hands have been reported in the literature, none with this particular presentation. The clinical and histopathologic features of leukemia cutis are reviewed. Conclusion: This case emphasizes the importance of obtaining a biopsy specimen for histopathological examination of any suspicious skin lesion in a patient with leukemia.
Mutations of Fas (APO-1/CD95) and p53 Genes in Nonmelanoma Skin Cancer
Authors: Boldrini Laura , Loggini Barbara , Gisfredi Silvia , Zucconi Ylenia , Baldinotti Fulvia , Fogli Antonella , Simi Paolo , Cervadoro Gregorio , Barachini Paolo , Basolo Fulvio , Pingitore Raffaele , Fontanini Gabriella 
Published: July 2017

Background: There is considerable evidence that apoptosis plays an important role in the pathogenesis of a wide variety of skin diseases. Apoptosis failure may ensure the survival of transformed cells prone to sustain further genetic damage and it plays an important part in the development of tumors. Genetic alterations of Fas and p53, with consequent inactivation of gene protein products, may be involved in transcriptional downregulation of Fas. Objective: We investigated Fas and its ligand expression in 30 cases of nonmelanoma skin cancer, 19 basal cell and 11 squamous cell carcinomas, and we also analyzed Fas and p53 status, in an attempt to detect putative alterations. Method: Fas and its ligand expression were evaluated by RT-PCR; the promoter and the entire coding region of Fas, and the coding exons 4–9 of p53 were investigated by polymerase chain reaction, single strand conformation polymorphism, and DNA sequencing. Results: Fas alterations were found in 3/19 (15.8%) basal cell and in 4/11 (36.4%) squamous cell carcinomas. Five out of 25 cases (3/19 basal cell and 2/11 squamous cell carcinomas) were p53-mutated, and in the majority of these cases there were concomitant mutations of the Fas gene (χ2 test; p = 0.035). Conclusion: Taken together, our findings highlight an involvement of the Fas/Fas-ligand system in the development of skin cancer, suggesting that the loss of its apoptotic function, in some cases linked to p53 alterations, may contribute to the self-maintenance of cancer cells.
UV Induces GADD45 in a p53-Dependent and -Independent Manner in Human Keratinocytes
Authors: Maeda Tomoko , Sim Adrian B. , Leedel Duane A. , Chua Prescillia P. S. , Chomey Eugene G. , Luong Le , Tron Victor A. 
Published: July 2017

Background: GADD45 is a multifunctional protein involved in DNA repair and in cell cycle checkpoint control. p53 plays an important role in regulating DNA repair and in response to UVB in keratinocytes. Objective: GADD45 and p53 expression was examined and compared at the mRNA and protein level after exposure to UV irradiation. Methods: Human keratinocytes were exposed to increasing doses of UVB, and an RNA protection assay and a Western blot analysis were performed. Results: The RNase protection assays using human keratinocytes showed that GADD45 mRNA increases after 4 h and remains elevated for 24 h in cells irradiated at 100, 300, or 600 J/m2 UVB. The level of GADD45 protein increases after 8 h and remains elevated for 48 h, with maximal induction at 300 J/m2. p53 mRNA did not rise in concert with GADD45 at any dose used, and p53 protein was not up-regulated at the lower dose of 100 J/m2. Conclusion: GADD45 is regulated in both a p53-dependent and a p53-independent manner in keratinocytes after UV exposure.
Presentation of Telangiectasia Macularis Eruptiva Perstans as a Long-Standing Solitary Plaque Associated with Renal Carcinoma
Authors: Pascual José Carlos , Bañuls José , Albares Ma Pilar , Vergara Gloria , Belinchón Isabel , Silvestre Juan Francisco , Betlloch Isabel 
Published: July 2017

Background: Mastocytosis is a rare disease characterized by a primary pathological increase in mast cells in different tissues. The skin is the most frequently affected organ. Cutaneous mastocytosis, including urticaria pigmentosa, solitary mastocytoma, diffuse cutaneous mastocytosis, and telangiectasia macularis eruptiva perstans (TMEP), is usually distinguished from systemic mastocytosis. TMEP is characterized mainly by telangiectatic macules. Objective and Methods: We report a case of TMEP with an unusual clinical presentation as a solitary plaque of telangiectatic macules. A renal clear cell carcinoma was detected in a workup for systemic mastocytosis. We discuss the clinical and histological findings and treatment of TMEP. Conclusions: TMEP is a rare form of mastocytosis, which occurs mainly in adults, generally has a good prognosis, and little tendency to urticate or show constitutional symptoms. Clinicians should consider this disorder when confronted with a progressive atypical telangiectatic lesion. However, the malignant neoplasm also found in this patient is of uncertain significance.
Narrow Resection of Cutaneous Melanoma
Authors: Beasley K. , Cartotto R.C. 
Published: July 2017

Background: There has been a progressive reduction in the extent of resection of primary cutaneous melanoma. Although overall survival appears to have been unaffected by this trend, the effect of narrow resection on local recurrence is not entirely clear. Objective: To examine the relationship between narrow resection margins and local recurrence of primary cutaneous melanoma. Methods: Primary melanoma, 104 cases, treated by surgical resection were reviewed retrospectively. Results: “Thin” (< 1 mm) melanomas (31 cases) were resected with a mean margin of 0.87 cm; “intermediate” (1–4 mm) melanomas (37 cases) were resected with a mean margin of 1.26 cm; and 14 “thick” (> 4 mm) melanomas were resected with a mean margin of 1.25 cm. Local recurrence rates were 6.5%, 16.2%, and 42.9%, respectively. In the “intermediate” group, two local recurrences occurred in melanomas < 2 mm thick despite use of margins of 1.7 cm and 2.4 cm. Conclusions: The results do not support the use of excessively narrow resection margins around primary cutaneous melanoma. Additionally, we question the true safety of currently accepted 1 to 2 cm margins for 1 to 2 mm thick melanomas.
Status of Cytokine and Antigen Presentation Genes in Merkel Cell Carcinoma of the Skin
Authors: Arany Istvan , Tyring Stephen K. 
Published: July 2017

Background: Merkel carcinoma (MCC) of the skin is an aggressive form of skin cancer, morphologically demonstrating both epithelial and neuroendocrine properties. However, little is known about its molecular characteristics. Objective: The aims of the study were to explore growth characteristics and immune responses of MCCs at the molecular level. Methods: A reverse transcription-polymerase chain reaction (RT-PCR) technique was employed to study those parameters in biopsies of MCCs and their adjacent areas. Results: Analyzing mRNA levels of various epithelial genes (c- myc, cdc2 kinase, E2F, PCNA, p53, and RB, cytokeratins 5 and 10) we concluded that MCCs express markers of epithelial hyperproliferation together with markers of neuroendocrine differentiation (NSE). On the other hand, there is a lack of cytokines (IL-2, IFN-γ) typical for a specific, T cell-mediated immune response in MCCs. However, several cytokines (e.g., IL-12) are produced that are required for the initial steps of that type of immune response. Conclusion: The epithelial hyperproliferation and impaired local immune responses might contribute to the aggressive behaviour of the tumour.
Role of the Cyclin-Dependent Kinase Inhibitor CDKN2A in Familial Melanoma
Authors: Hogg David , Brill Herbert , Liu Ling , Monzon Jose , Summers Anne , From Lynn , Lassam Norman J. 
Published: July 2017

Background: Approximately 8 to 12% of melanoma appears to be inherited in an autosomal dominant form. Although most early stage melanomas can be treated successfully by simple surgical excision, patients with advanced disease are rarely cured even with aggressive chemotherapy and/or immunotherapy. Objective: There is now compelling evidence that germline mutations of the CDKN2A gene on chromosome 9p21 predispose to melanoma in a subset of melanoma-prone families. In this article the evidence for the role of CDKN2A in the genesis of familial melanoma is reviewed and the implications of genetic testing in families with this disease are discussed. Conclusion: The identification and subsequent surveillance of unaffected individuals who have a genetic predisposition to melanoma may lead to the detection of early (curable) melanomas and to a reduction in mortality.
Hair Transplantation Update
Authors: Bertucci Vince , Berg Daniel , Pollack Sheldon V. 
Published: July 2017

Background: Since the first published description in 1959, hair transplantation has progressed tremendously. Objective: This article provides an overview of hair transplantation and a discussion of selected controversies in hair transplantation. Methods: A review of the literature was undertaken to identify current controversies. Results: Hair transplantation has been refined considerably since it was first performed. As new methods are described, controversies arise. In hair transplantation, these include use of various forms of anaesthesia, the planning of the recipient site, method of harvesting the donor area, megatransplant sessions, isolated frontal forelock transplantation, and use of lasers in hair transplantation. Conclusion: Hair transplantation is a time-tested, highly effective, permanent and natural method of improving male-pattern baldness and female alopecia. Improvements in technique continue to be developed, requiring one to keep abreast of changes in the field in order to provide patients with the best hair coverage possible while maintaining a natural appearance.
Geographic Pathology of Skin Cancer
Authors: Jackson Robert 
Published: July 2017

Background: The development of knowledge concerning the role of sun exposure in causing skin cancer has been a gradual one. Objective: This article reviews the article by Urbach who used manikin coated with an ultraviolet dosimeter to see exactly where on the head and neck the exposure was greatest. Conclusion: Urbach showed that the areas of greatest sun exposure on his manikins corresponded with the location of 95% of squamous cell carcinoma and 66% of basal cell carcinoma. He also clearly showed the importance of scattered sky and reflected radiation.
Treatment of Multiple Glomangioma with Tuneable Dye Laser
Authors: Sharma Jasdeep K. , Miller Rob 
Published: July 2017

Background: Multiple glomangiomas are a rare clinical occurrence. In the past, various treatments have been proposed for eradication of these tumours. Objective: An alternative and effective therapy for multiple glomangioma is proposed. Results: The effective clinical response of multiple, painful, bluish-black lesions on the soles of the feet and the hands, diagnosed as multiple glomangioma, to flashlamp tuneable dye laser is reported. Conclusion: The flashlamp tuneable dye laser is an effective modality in the treatment of multiple glomangioma.
Mohs' Surgery as an Approach to Treatment of Multiple Skin Cancer in Rhinophyma
Authors: Tamir Gabriel , Murakami Craig , Berg Daniel 
Published: July 2017

Background: Skin cancer arising within a rhinophyma is rare, less than would be expected from the coexisting chronic active inflammatory process. In rhinophyma, multiple coexisting tumours of different histologic types present an unusual challenge and have never been described in the literature. Objective: The treatment approach to multiple tumours occurring in rhinophyma, utilizing Mohs' surgery, is reported and discussed. Patient: The case of a 64-year-old farmer with basal cell carcinoma, squamous cell carcinoma, and basosquamous carcinoma occurring in the setting of longstanding rhinophyma is described. Conclusion: Skin cancer, especially basal and squamous cell carcinoma, diagnosed simultaneously in a rhinophyma creates a challenge; the enlarged, inflamed, and hypertrophied tissue masks their margins. In our opinion, Mohs' micrographic surgery is the treatment of choice and should be primarily considered in view of the malignant potential of these tumours, as is shown by the substantial tumour extension in the case described.
Impact of a Sun Awareness Curriculum on Medical Students' Knowledge, Attitudes, and Behaviour
Authors: Gooderham Melinda J. , Guenther Lyn 
Published: July 2017

Background: Physicians teach sun awareness to their patients, but frequently have no formal training in this area. A week-long dermatology curriculum during Sun Awareness Week that included skin cancer and sun awareness education to first-year medical students was introduced in May 1998 at the University of Western Ontario, London, Canada. Objective: The purpose of this study was to determine the baseline knowledge, attitudes, and behaviour of the first-year medical students towards sun awareness before and after the new curriculum. Method: This study used a pre- and post-test design to determine the impact of the curriculum on the medical students' knowledge, attitudes, and intent to change behaviour. It also reports any influence of demographic variables on these parameters. Results: The students demonstrated a substantial improvement in their knowledge of sun-related topics despite some baseline knowledge. Many students reported unhealthy behaviour prior to the curriculum, but demonstrated an intent to adopt more healthy behaviour after the curriculum. Minor differences in knowledge and behaviour due to demographic characteristics disappeared upon completion of the curriculum. Conclusions: An undergraduate medical curriculum with skin cancer and sun awareness education can improve the medical students' knowledge, attitudes, and behaviour towards sun awareness.
Increased Soft Tissue in the Posterior Cervical and Upper Back Area of Patients on HIV-1 Protease Inhibitors
Authors: Smith Kathleen , Germain Marguerite , Decker Catherine , Yeager Josef , Skelton Henry 
Published: July 2017

Background: Corticosteroids as well as sex hormones affect the redistribution of subcutaneous fat and the percentage of lean body mass. In addition, some stromal cells express steroid receptors, and the quantity and distribution of these receptors vary at different body sites and between sexes. Inhibitors of HIV-1 protease may affect steroid hormone metabolism through their effect on cytochrome P450. Objectives: To determine the changes in the tissue of the back in three HIV-1+ patients who developed increased soft tissue in posterior cervical and upper back areas while on HIV-1 protease inhibitors. Methods: Punch biopsies of the involved posterior cervical and upper back areas were done. These included subcutaneous adipose tissue. Routine hematoxylin and eosin-stained sections, along with special stains for elastic and stromal mucin, and immunohistochemical stains for CD34 (HPCA-1 and Factor XIIIa) were evaluated. Results: Histologically all three patients showed identical features. There was expansion of the dermis with decreased periadnexal fat and marked widening of the fibrous septa within the expanded subcutaneous fat. Conclusions: The posterior cervical and upper back area appears to be a common site for localization of mesenchymal tumours that show some fat differentiation and produce an increase in stromal matrix material. Mesenchymal cell populations within this area are also affected by systemic diseases. A male predominance pattern occurs with these conditions, and steroid receptors are expressed on some mesenchymal cells, that vary with the body location. Thus, this observation may be related to the effects of protease inhibitors on steroid hormone metabolism through their inhibition of cytochrome P-450.
Beyond Advertising: Marketing and Critical Communication Research
Authors: Sinclair John 
Published: July 2017

Exclusive attention to the analysis of meaning in advertising often displaces the more fundamental understanding of marketing, its place in the productive system and its tangible socio-cultural influence. Advertising analysis must become an entry point for inquiry into marketing campaigns. Marketing has emerged as a form of social communication actively mediating between the national and transnational interests involved in the spheres of production, distribution and exchange on one hand; and cultural changes we experience historically as a society, both material and ideological, on the other. Marketing practices and ideologies are reviewed from this perspective. Critical communication research must look at the meanings circulated by advertising in terms of the concrete interests and practices which motivate them.
The Ethnic Broadcasting Commission — Almost
Authors: Patterson Rosalind 
Published: July 2017

The Whitiam Labor Government founded ethnic radio in June. 1975, initially as a 13-week experiment to be extended for six months to establish it permanently. Three months after the beginning of the second experiment a proposal for the long-term structure for ethnic radio recommending the establishment of an Ethnic Broadcasting Commission (EBC) was announced. But it was never acted upon. The constitutional crisis of October-November 1975 culminating in the Governor General sacking the Whitlam Government, followed by the Fraser Government being installed, changed the direction of ethnic radio. It took another two years before the conservative coalition Government decided on a permanent structure for ethnic radio. On 1 January, 1978, ethnic radio commenced broadcasting under the auspices of the Special Broadcasting Service. The proposal to establish an EBC, little known, is considered in its context. Specifically, the EBC would have meant: domination by larger communities, few languages, focus on culturai maintenance, and conflict between conmmunities and directors.