keratoacanthoma

角化棘皮瘤
  • 文章类型: Journal Article
    本勘误表涉及以下文章:https://doi.org/10.2340/actadv。v104.13381.
    This Corrigendum relates to the following article: https://doi.org/10.2340/actadv.v104.13381.
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  • 文章类型: Case Reports
    2020年12月,欧洲开始了一项针对COVID-19的主要疫苗接种计划,包括辉瑞的mRNABNT162b2(Comirnaty®)等疫苗。随后出现了立即和延迟皮肤反应的报告。这项研究介绍了一例64岁的男性,该男性在接受第二次加强剂量的辉瑞疫苗后约两周出现了多发性角化棘皮瘤。病人,有明显的高血压和糖尿病病史,出现红斑,他四肢上的圆形病变。体格检查和组织病理学分析证实了广泛性破裂性角化棘皮瘤(GEKA)的诊断。治疗涉及cemiplimabI.v.每三周给予350mg。两个月内,患者表现出明显的改善,随着所有病变的消失。皮肤镜检查和组织病理学检查支持GEKA诊断,这是多发性角化棘皮瘤的罕见变种。这种情况表明了由COVID-19疫苗引发的潜在免疫介导机制,导致角化棘皮瘤的快速发展。用cemiplimab治疗显示出希望,强调免疫检查点抑制剂在治疗多发性角化棘皮瘤中的潜力。需要进一步的研究来探索这种治疗的有效性和安全性。
    In December 2020, a major vaccination program against COVID-19 commenced in Europe with vaccines such as Pfizer\'s mRNABNT162b2 (Comirnaty®). Subsequent reports of immediate and delayed skin reactions emerged. This study presents a case of a 64-year-old male who developed multiple keratoacanthomas approximately two weeks after receiving a second booster dose of the Pfizer vaccine. The patient, who had significant medical history of hypertension and diabetes, presented with erythematous, crateriform lesions on his limbs. A physical examination and histopathological analysis confirmed the diagnosis of Generalized Eruptive Keratoacanthoma (GEKA). Treatment involved cemiplimab I.v. 350 mg administered every three weeks. Within two months, the patient showed significant improvement, with the disappearance of all lesions. Dermoscopy and histopathological exams supported the GEKA diagnosis, which is a rare variant of multiple keratoacanthomas. This case suggests a potential immune-mediated mechanism triggered by the COVID-19 vaccine, leading to the rapid development of keratoacanthomas. Treatment with cemiplimab showed promise, highlighting the potential of immune checkpoint inhibitors in managing multiple keratoacanthomas. Further research is needed to explore the efficacy and safety of such treatments.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    在进行鳞状细胞癌及其前体的皮肤镜检查时,我们区分与角蛋白相关的,血管,和颜料相关的标准。非色素光化性角化病的特征是“草莓图案”。色素性光化性角化病显示皮肤镜检查与恶性扁桃体明显重叠,但是色素鳞片的存在,红斑,和突出的卵泡有利于其诊断。Bowen病的特点是聚集的肾小球血管,白色黄色鳞片,和棕色或灰色的点排列在其色素变体中的线条。最后,皮肤镜检查使我们能够在早期发现浸润性鳞状细胞癌,并将其与前体区分开来。此外,它的表现可能会有所不同,取决于分化的程度,与角蛋白相关的标准在明确界定的肿瘤中占主导地位,而不典型的血管模式将在低分化肿瘤中占主导地位。
    When the dermoscopy of squamous cell carcinoma and its precursors we differentiate among keratin-related, vascular, and pigment-related criteria. Non-pigmented actinic keratoses are characterized by the \"strawberry pattern\". Pigmented actinic keratosis shows a significant dermatoscopic overlap with lentigo maligna, but the presence of pigmented scales, erythema, and prominent follicles favors its diagnosis. Bowen\'s disease is characterized by clustered glomerular vessels, white-yellowish scales, and brown or grey dots arranged in lines in its pigmented variant. Finally, dermoscopy allows us to detect invasive squamous cell carcinoma in its early stages and differentiate it from its precursors. Furthermore, its presentation may vary depending on the degree of differentiation, with keratin-associated criteria predominating in well-differentiated tumors, while an atypical vascular pattern will predominate in poorly differentiated tumors.
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  • 文章类型: Journal Article
    背景:当手术切除可能导致功能或美容缺陷时,甲氨蝶呤内注射(IL-MTX)是治疗上皮样肿瘤(ECT)的适当策略;但是,并非所有的ECT都对这种治疗有反应。
    目的:本研究旨在评估IL-MTX对ECT的有效性,并根据病理特征确定临床反应的差异。
    方法:回顾性分析使用IL-MTX治疗ECT患者的病历。在尺寸减小和展平方面评价有效性。
    结果:本研究纳入了25例ECT活检病例。确定了8例角化棘皮瘤(KA)和15例鳞状细胞癌(SCC)。但2例无法明确区分。17名患者(68%)在注射后表现出反应,KA和SCC的反应率分别为75%(6/8)和60%(9/15),分别。9例患者显示IL-MTX完全消退。患者接受了3次注射,在第一次注射后7.56周观察到消退。根据组织病理学结果,KA和SCC患者接受2次和3.33次注射,分别,在7周和7.67周后观察到完全消退,分别。
    结论:IL-MTX是安全有效的,并且可以被认为是ECT的一种有用的非手术治疗选择。KA和梭形SCC均表现出良好的反应;然而,KA表现出更好的反应。
    BACKGROUND: Intralesional methotrexate injection (IL-MTX) is an appropriate strategy for treating epithelial crateriform tumors (ECTs) when surgical excision can result in functional or cosmetic defects; however, not all ECTs are responsive to this treatment.
    OBJECTIVE: This study aimed to evaluate the effectiveness of IL-MTX for ECTs and to determine the differences in clinical response according to the pathological features.
    METHODS: The medical records of patients treated with IL-MTX for their ECTs were retrospectively reviewed. Effectiveness was evaluated in terms of size reduction and flattening.
    RESULTS: Twenty-five cases of ECTs with biopsy were included in this study. Eight cases of keratoacanthoma (KA) and 15 cases of squamous cell carcinoma (SCC) were identified, but 2 cases could not be clearly distinguished. Seventeen patients (68%) showed a response after injection, and response rate in KA and SCC were 75% (6/8) and 60% (9/15), respectively. Nine patients showed complete resolution with IL-MTX. Patients received 3 injections, and regression was observed in 7.56 weeks after the first injection. According to histopathological results, patients with KA and SCC received 2 and 3.33 injections, respectively, and complete resolution was observed after 7 and 7.67 weeks, respectively.
    CONCLUSIONS: IL-MTX is safe and effective, and could be considered as a useful non-surgical treatment option for ECTs. Both KA and crateriform SCC showed good response; However, KA showed a better response.
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  • 文章类型: Journal Article
    纹身,将外源性色素引入皮肤,有着几千年的悠久历史,文化,化妆品,和医学意义。随着纹身的流行,了解他们潜在的并发症和禁忌症越来越重要。最常见的并发症是过敏反应,可能在形态和时间上有所不同。感染性并发症通常是由于纹身过程或愈合期间的无菌和卫生习惯不足。纹身色素可能会带来诊断挑战,影响癌症诊断和成像。CME的这篇文章探讨了历史,文化意义,流行病学,化学,技术,禁忌症,纹身的并发症。欣赏这些因素可以帮助考虑纹身的个人了解其人体艺术的安全性和潜在风险,如果咨询,并为医生提供对纹身的透彻了解。
    Tattooing, the introduction of exogenous pigments into the skin, has a rich history spanning thousands of years, with cultural, cosmetic, and medical significance. With the increasing prevalence of tattoos, understanding their potential complications and contraindications is of growing importance. The most common complications are hypersensitivity reactions, which may vary in morphology and timing. Infectious complications are often due to inadequate aseptic and hygienic practices during the tattooing process or healing period. Tattoo pigment can present diagnostic challenges, affecting cancer diagnosis and imaging. This CME article explores the history, cultural significance, epidemiology, chemistry, technique, contraindications, and complications of tattoos. Appreciating these factors can help individuals considering tattoos understand the safety and potential risks of their body art, and provide physicians with a thorough understanding of tattooing if consulted.
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  • 文章类型: Journal Article
    纹身是一种普遍的做法,并且随着时间的推移越来越受欢迎。已经描述了许多与纹身有关的病变,包括恶性肿瘤.
    本综述的主要目标是确定纹身中已发表的皮肤癌病例的频率是否随着时间的推移而增加。
    我们的审查符合系统审查和荟萃分析指南和报告标准的首选报告项目。通过PubMed的MEDLINE数据库,Embase通过Elsevier,和Scopus通过Elsevier进行了搜索,从成立到2023年2月23日。没有数据或发布日期限制。
    我们的审查确定了160例出现在纹身中的皮肤肿瘤。观察到已发表的病例随着时间的推移而增加。大多数报告的肿瘤在红色纹身色素中发展(36.9%),其中贡献最大的是鳞状细胞癌和角化棘皮瘤病变。
    已发布的病例报告缺乏信息的一致性,这限制了我们的分析范围。小样本量也是本综述的局限性。
    随着纹身的普及,继续报告纹身中的皮肤恶性肿瘤病例是有帮助的。对纹身中肿瘤的频率和严重程度的认识可以传达给公众。
    UNASSIGNED: Tattooing is a widespread practice and has increased in popularity over time. Many lesions have been described in relation to tattoos, including malignant tumors.
    UNASSIGNED: The primary goal of this review is to determine whether the frequency of published cases of skin cancers within tattoos has been increasing over time.
    UNASSIGNED: Our review is in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and reporting criteria. The databases MEDLINE via PubMed, Embase via Elsevier, and Scopus via Elsevier were searched from inception to February 23, 2023. No data or publication date limits were imposed.
    UNASSIGNED: Our review identified 160 cases of cutaneous tumors arising within tattoos. An increase in published cases over time was observed. Most reported tumors developed within red tattoo pigment (36.9%), with the largest contribution by squamous cell carcinoma and keratoacanthoma lesions.
    UNASSIGNED: There was a lack of consistency of information in published case reports which limited the scope of our analysis. Small sample size was also a limitation of this review.
    UNASSIGNED: With the increased popularity of tattoos, it is helpful to continue reporting cases of cutaneous malignancies within tattoos. Awareness of the frequency and severity of tumors within tattoos may be communicated to the public.
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  • 文章类型: Journal Article
    背景:角化棘皮瘤(KA)是一种主要影响光损伤皮肤的良性肿瘤。它具有局部破坏性,很少传播。手术并不总是合适的,通常会毁容。因此,非手术方式代表了很好的替代方案。
    目的:评估和比较甲氨蝶呤(MTX)和5-氟尿嘧啶(5-FU)治疗KA的疗效。
    方法:随机对照试验包括20例活检证实为KA的患者,分为2组;(A)组接受病灶内MTX,25mg/ml,(B)组接受病灶内5-FU,50mg/ml每2周直到完全清除或最多5个疗程。
    结果:在MTX组中,5-FU组有7例患者(70%)完全清除率,8例患者(80%)无统计学差异.然而,MTX组达到完全缓解所需的中位注射次数为3次,而5-FU组只有2次.
    结论:由于我们人群中KAs的发生率相对较低,因此样本量较小。
    结论:在选定的KA病例中,病灶内治疗是替代手术的好方法。两种药物都显示出相当的疗效,但是5-FU可能会给出更快的结果,从而提高患者的满意度和依从性。
    BACKGROUND: Keratoacanthoma (KA) is a benign neoplasm that affects mainly photodamaged skin. It is locally destructive and may rarely spread. Surgery is not always suitable and usually disfiguring. Thus, non-operative modalities represent good alternatives.
    OBJECTIVE: To assess and compare the efficacy of intralesional methotrexate (MTX) and 5-flurouracil (5-FU) in the treatment of KA.
    METHODS: Randomized controlled trial included 20 patients with biopsy proven KA divided into 2 equal groups; group (A) received intralesional MTX, 25 mg/ml and group (B) received intralesional 5-FU, 50 mg/ml every 2 weeks till complete clearance or for a maximum 5 sessions.
    RESULTS: In the MTX group, complete clearance was observed in 7 patients (70%) compared to 8 patients (80%) in the 5- FU group with no statistically significant difference. However, the median number of injections needed to achieve complete response in the MTX group was 3 sessions versus only 2 sessions in the 5-FU group.
    CONCLUSIONS: the small sample size due to the relatively low incidence of KAs in our population.
    CONCLUSIONS: Intralesional therapy is a good alternative to surgery in selected cases of KA. Both drugs showed comparable efficacy, but 5-FU may give faster results, hence increasing patient satisfaction and compliance.
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  • 文章类型: Journal Article
    为了研究驱动/抑制皮肤癌发生的机制,在激活的rasHa/fos表达驱动的皮肤癌发生中分析了14-3-3σ(Stratifin)的阶段特异性表达(HK1。ras/fos)和PTEN介导的AKT调节的消融(K14。creP/Δ5PTENflx/flx)。与14-3-3σ在表皮分化中的作用一致,HK1.ras增生和乳头状瘤在超基底角质形成细胞中显示14-3-3σ表达升高,与超基础p-MDM2166激活和散发性p-AKT473表达平行。在双基因HK1中。fos/Δ5PTENflx/flx增生,基底层出现14-3-3σ表达,与p53/p21一起,与角质形成细胞分化和角化棘皮瘤的病因有关。三基因HK1。ras/fos-Δ5PTENflx/flx增生/乳头状瘤最初显示基底层14-3-3σ增加,建议尝试维持基底上p-MDM2166并保护基底层p53。然而,HK1.ras/fos-Δ5PTENflx/flx乳头状瘤表现出增加的基底层p-MDM2166激活,从而降低了p53,这与恶性转化相吻合。尽管p53丢失,14-3-3σ表达在高分化鳞状细胞癌(wdSCC)中持续存在,并伴随着p21升高,通过抑制p-AKT1473表达限制了恶性进展;直到14-3-3σ/p21缺失促进了进展为侵袭性SCC,表现出均匀的p-AKT1473。TPA促进的HK1分析。ras-Δ5PTENflx/flx小鼠皮肤,在增生和乳头状瘤中显示14-3-3σ/p53/p21的早期丢失,p-MDM2166/p-AKT1473增加,导致快速恶性转化和进展为低分化SCC。在2D/3D文化中,在单层培养的恶性T52ras61/v-fosSCC细胞中意外检测到正常HaCaT和SP1ras61乳头状瘤角质形成细胞中观察到的膜14-3-3σ表达,但不是侵入性的3D细胞。总的来说,这些数据提示14-3-3σ/Stratifin通过MDM2/p53依赖性机制在乳头状瘤形成中发挥抑制作用;而在早期wdSCC中持续的p53非依赖性表达可能涉及p21介导的AKT1抑制,从而限制恶性进展.
    To study mechanisms driving/inhibiting skin carcinogenesis, stage-specific expression of 14-3-3σ (Stratifin) was analyzed in skin carcinogenesis driven by activated rasHa/fos expression (HK1.ras/fos) and ablation of PTEN-mediated AKT regulation (K14.creP/Δ5PTENflx/flx). Consistent with 14-3-3σ roles in epidermal differentiation, HK1.ras hyperplasia and papillomas displayed elevated 14-3-3σ expression in supra-basal keratinocytes, paralleled by supra-basal p-MDM2166 activation and sporadic p-AKT473 expression. In bi-genic HK1.fos/Δ5PTENflx/flx hyperplasia, basal-layer 14-3-3σ expression appeared, and alongside p53/p21, was associated with keratinocyte differentiation and keratoacanthoma etiology. Tri-genic HK1.ras/fos-Δ5PTENflx/flx hyperplasia/papillomas initially displayed increased basal-layer 14-3-3σ, suggesting attempts to maintain supra-basal p-MDM2166 and protect basal-layer p53. However, HK1.ras/fos-Δ5PTENflx/flx papillomas exhibited increasing basal-layer p-MDM2166 activation that reduced p53, which coincided with malignant conversion. Despite p53 loss, 14-3-3σ expression persisted in well-differentiated squamous cell carcinomas (wdSCCs) and alongside elevated p21, limited malignant progression via inhibiting p-AKT1473 expression; until 14-3-3σ/p21 loss facilitated progression to aggressive SCC exhibiting uniform p-AKT1473. Analysis of TPA-promoted HK1.ras-Δ5PTENflx/flx mouse skin, demonstrated early loss of 14-3-3σ/p53/p21 in hyperplasia and papillomas, with increased p-MDM2166/p-AKT1473 that resulted in rapid malignant conversion and progression to poorly differentiated SCC. In 2D/3D cultures, membranous 14-3-3σ expression observed in normal HaCaT and SP1ras61 papilloma keratinocytes was unexpectedly detected in malignant T52ras61/v-fos SCC cells cultured in monolayers, but not invasive 3D-cells. Collectively, these data suggest 14-3-3σ/Stratifin exerts suppressive roles in papillomatogenesis via MDM2/p53-dependent mechanisms; while persistent p53-independent expression in early wdSCC may involve p21-mediated AKT1 inhibition to limit malignant progression.
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  • DOI:
    文章类型: Journal Article
    目的:为了确定角化棘皮瘤(KA)和普通疣(CW)之间的等位基因和基因型频率的变化,与对照组相比,在TLR2,TLR3和TLR9基因内的三个单核苷酸多态性(SNP)中。
    方法:这项病例对照研究涉及161例KA患者的样本,152例CW患者,和469个控件。从福尔马林固定的石蜡包埋的组织切片中分离DNA。三个SNP-TLR2中的rs4696480,TLR9中的rs7657186和TLR3中的rs35213-在7500实时PCR系统上用TaqMan基因分型分析进行了基因分型。
    结果:与对照组相比,KA和CW中的TLR2rs4696480和TLR3rs7657186明显偏高(P<0.001)。CW的关联比KA的关联更强,rs4696480的A等位基因和AA基因型的频率更高。KA和CW患者rs7657186的G等位基因和GG基因型频率均高于对照组。rs7657186与KA和CW中度相关,随着G等位基因和GG基因型在CW病例中更普遍,在那里没有发现AA纯合子。
    结论:TLR2(rs4696480)和TLR3(rs7657186)基因的遗传变异可能会影响KA和CW的发育,影响免疫反应和对这些皮肤损伤的易感性。需要进一步的研究来阐明TLR的表达模式及其在KA发育中的作用。
    OBJECTIVE: To determine variations in allele and genotype frequencies between keratoacanthoma (KA) and common warts (CW), compared with the control group, in three single nucleotide polymorphisms (SNPs) within the TLR2, TLR3, and TLR9 genes.
    METHODS: This case-control study involved samples from 161 patients with KA, 152 patients with CW, and 469 controls. DNA was isolated from formalin-fixed paraffin-embedded tissue sections. Three SNPs - rs4696480 in TLR2, rs7657186 in TLR9, and rs35213 in TLR3 - were genotyped with TaqMan Genotyping Assays on the 7500 Real-Time PCR System.
    RESULTS: TLR2 rs4696480 and TLR3 rs7657186 were significantly overrepresented in KA and CW compared with controls (P<0.001). The association was stronger for CW than for KA, as evidenced by higher frequencies of the A allele and AA genotype for rs4696480. Both KA and CW patients had higher frequencies of the G allele and GG genotype for rs7657186 than controls. rs7657186 was moderately associated with KA and CW, with the G allele and GG genotype being more prevalent in CW cases, where no AA homozygotes were found.
    CONCLUSIONS: Genetic variants in TLR2 (rs4696480) and TLR3 (rs7657186) genes may affect KA and CW development, influencing immune responses and susceptibility to these skin lesions. Further research is required to elucidate TLR expression patterns and their role in KA development.
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