Blue rubber bleb nevus syndrome is a rare disorder that is characterized by multiple recurrent vascular malformations, such as hemangioma, and these primarily involve the skin and the gastrointestinal tract. It may also involve the brain, liver, lungs, and skeletal muscles. A 14-year-old female visited our hospital with a chief complaint of dizziness; upon examination, we found multiple recurrent hemangiomas on the skin and gastrointestinal tract. We were able to diagnose her as suffering from blue rubber bleb nevus syndrome and we treated her with methylprednisolone (2 mg/kg/day for 1 month and 1 mg/kg/day for additional 3 months). We report on this case along with a review of the literature.
Adolescent ; Female ; Gastrointestinal Neoplasms/*diagnosis/therapy ; Hemangioma/*diagnosis/therapy ; Humans ; Nevus, Blue/*diagnosis/therapy ; Skin Neoplasms/*diagnosis/therapy ; Syndrome

Betacoronavirus ; Coronavirus Infections ; epidemiology ; Humans ; Melanoma ; diagnosis ; therapy ; Pandemics ; Pneumonia, Viral ; epidemiology ; Skin Neoplasms ; diagnosis ; therapy

Alopecia due to metastatic skin cancer is a rare form of cutaneous metastasis and it should be considered as a diagnosis of localized alopecia. It also signifies the failure of treatment of the primary cancer. A 51-year-old Korean woman presented with multiple pea-sized smooth hairless nodules and an ulcerated nodule on the parietal scalp regions. About two and a half years ago, she underwent an operation and chemotherapy for cholangiocarcinoma. The tumor cells seen in the scalp nodule were the same as those seen in the primary tumor. To the best of our knowledge, this is the first reported case of secondary alopecia due to cutaneous metastasis of cholangiocarcinoma in Korean dermatological literature.
Alopecia* ; Cholangiocarcinoma* ; Diagnosis ; Drug Therapy ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Rabeprazole ; Scalp* ; Skin Neoplasms ; Ulcer

OBJECTIVETo emphasize the importance of correct and standardized surgical treatment on dermatofibrosarcoma protuberans (DFSP), and discuss the suitable synthesized therapy on it.

METHODS163 cases of DFSP, which were treated between January 1985 and September 2002,were submitted to a retrospective study.

RESULTSAmong the 163 cases, 150 (92.0%) were treated with local excision as benign tumors before accepted to Cancer Hospital, Fudan University. 69 cases (46.0%) were approved by pathological examination to have tumor remnants after they were treated with wide excision, and 49 (71.0%) of them couldn't be found to have any tumor remnants by physical examination or B-ultrasonic examination before that operation. It was easy for the tumor to recur after excision, especially the local excision. The recurrent rate after it was 45.1%, which was much higher than the one after wide excision (5.6%). Among the 142 cases which wide excision were performed, 99 ones had excision margins >/= 3 cm and 5 of them (5.1%) developed local recurrence while 36 ones had excision margins 1 approximately 2 cm and 3 of them (8.3%) developed local failure. 46 cases (32.4%) were given skin graft, 11 cases were given flap, and 1 case had dacron mending in skin defection area. The main complications after these operations were necrosis of the skin flap (20 cases) and infection of the wound (6 cases). They could all be cured in 2 months. 17 cases were given complimentary radiotherapy with the dose range from 3275 cGy to 7000 cGy because of their recurrences for times or positive resection margins after wide excision. Only one case had wet molting after radiotherapy and 2 developed local recurrence. Among all the 163 cases, only 2 (1.2%) were dead, and 1 of them was died of metastasis of lung and liver. 2 cases got lymph node metastasis, then were given surgical treatment and still alive now. 13 cases (8.0%) were DFSP-FS with their malignancies increased. 11 of them were the recurrent ones after local excision or wide excision.

CONCLUSIONSIn order to avoid misdiagnosis, it is necessary for the clinician to know much about DFSP. Once the tumor was diagnosed of DFSP after local excision, it is necessary to take wide excision. Because DFSP is a malignancy of a high recurrent rate after local excision, standardized wide excision is the key in reducing local failure. Adjuvant radiotherapy is an effective treatment for the patients with positive resection margin or the patients don't suit for surgical treatment. The DFSP-FS need to use more energetic treatment in curing it.

Adolescent ; Adult ; Aged ; Child ; Combined Modality Therapy ; Dermatofibrosarcoma ; diagnosis ; radiotherapy ; surgery ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Skin Neoplasms ; diagnosis ; radiotherapy ; surgery ; therapy

Kaposi's sarcoma is a rare and slowly progressive disease that primarily affects the skin but has an associated visceral involvement. It can occur in the HIV-positive patients or patients treated with immunosuppressants. However, it is extremely rare in the patients receiving the treatment for inflammatory bowel disease. We used corticosteroid for the treatment of ulcerative colitis in 60-year-old woman. Then, Kaposis's sarcoma occured in the skin and colon of the patient. Since she was HIV-negative, we believed that it was developed from the condition of corticosteroid-induced immunosuppression. We present a case of skin and colonic Kaposi's sarcoma in a HIV-negative woman following treatment with corticosteroid for ulcerative colitis.
Aged ; Colitis, Ulcerative/*complications/drug therapy ; Colonic Neoplasms/*complications/diagnosis ; English Abstract ; Female ; Humans ; Sarcoma, Kaposi/*complications/diagnosis ; Skin Neoplasms/*complications/diagnosis

Epithelial ovarian carcinoma is a high mortality neoplasm in gynecologic malignancy. It usually can metastasize to distant organs such as pleura, liver, lung, and lymph nodes. However, the skin metastases are not common and related to very poor prognosis. Here we report a 54-year-old patient with ovarian clear cell carcinoma with skin metastases on the anterior chest at 11 months after initial diagnosis. Although she received palliative chemotherapy, she expired due to disease progression 2 months later after the diagnosis of skin metastases.
Adenocarcinoma, Clear Cell* ; Diagnosis ; Disease Progression ; Drug Therapy ; Humans ; Liver ; Lung ; Lymph Nodes ; Middle Aged ; Mortality ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Pleura ; Prognosis ; Skin Neoplasms ; Skin* ; Thorax

Adult ; Drug Therapy, Combination ; Female ; Granuloma ; diagnosis ; drug therapy ; pathology ; Humans ; Interferon-gamma ; therapeutic use ; Lymphoma, T-Cell, Cutaneous ; diagnosis ; drug therapy ; pathology ; Prednisone ; therapeutic use ; Skin Neoplasms ; diagnosis ; drug therapy ; pathology

Systemic PUVA therapy can produce various acute reactions and potential long-term damage including benign and malignant skin tumors. Obviously the risk is related to DNA damage, but PUVA-induced down-regulation of immune responses may play an additional role. Keratoacanthoma is etiologically related to sunlight and immunosuppression. PUVA keratoses are raised warty papules with a broad base and a diameter of several millimeters to 1 centimeter, and they are associated with an increased risk of nonmelanoma skin cancer. We report a case of solitary keratoacanthoma and multiple PUVA keratoses all developing in vitiliginous areas in a patient receiving long-term, high-dose PUVA therapy for generalized vitiligo. A 57-year-old Korean female, who had undergone intermittent systemic PUVA therapy for 11 years, noted multiple asymptomatic, yellowish, hyperkeratotic papules on the dorsa of hands and feet 1 year previously, and a bean-sized raised painful nodule filled with keratin plug on the dorsum of right hand 1 month previously. Skin biopsy confirmed the diagnoses of PUVA keratoses and keratoacanthoma, respectively. PCR-SSCP analysis revealed no mutation of p53 tumor suppressor gene in this case.
Biopsy ; Diagnosis ; DNA Damage ; Down-Regulation ; Female ; Ficusin* ; Foot ; Genes, Tumor Suppressor ; Hand ; Humans ; Immunosuppression ; Keratoacanthoma* ; Keratosis* ; Middle Aged ; Photochemotherapy* ; PUVA Therapy ; Skin ; Skin Neoplasms ; Sunlight ; Vitiligo*

We herein present the case of a 55-year-old woman with a previous history of malignancies--uterine adenocarcinoma, basal cell carcinoma (which occurred twice consecutively), recurrent respiratory infections due to common variable immunodeficiency (CVID), and systemic granulomatous disease diagnosed at a later age. The patient suffered from diffuse large B cell lymphoma (DLBCL), which was successfully treated with R-CHOP chemotherapy, and continued with immunoglobulin supplementation. The patient was free of lymphoma and infectious complications for over 20 months despite her persistent immunodeficiency, but eventually developed colorectal adenocarcinoma. To the best of our knowledge, this is the first reported case of CVID associated with multiple solid tumours and DLBCL.
Adenocarcinoma ; etiology ; Carcinoma, Basal Cell ; etiology ; Common Variable Immunodeficiency ; complications ; diagnosis ; therapy ; Fatal Outcome ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; etiology ; Middle Aged ; Neoplasms, Multiple Primary ; etiology ; pathology ; therapy ; Respiratory Tract Infections ; etiology ; Skin Neoplasms ; etiology ; Uterine Neoplasms ; etiology

PURPOSE: To evaluate the sonographic, mammographic and MRI features of pregnancy-associated breast cancer with the major focus on the sonographic benefit in a diagnosis of pregnancy associated breast cancer. MATERIALS AND METHODS: From 1998 to 2002, sonography was performed on a total 7 patients (age 23 to 38 years), who were pathologically diagnosed with breast cancer during pregnancy. Six of those patients underwent mammography. Five patients underwent a breast MRI, preoperatively. The radiological findings were evaluated retrospectively. Six patients underwent surgery and 1 patient underwent a core biopsy and chemotherapy. The histological, nuclear grading and pathological staging were evaluated. RESULTS: The sonographic findings showed a mass with irregular shapes (n=6), irregular margins (n=6), a non-parallel orientation (n=5), complex echo patterns (n=5). Associated findings could be observed in 3 patients, including Cooper's ligament thickening (n=2), edema (n=2), skin thickening (n=1) and axillary lymphadenopathy (n=3). The sonographic findings were positive and showed masses in 6 patients. All the patients had a dense breast in mammography. The mammographic findings included masses (n=4), masses with microcalcifications (n=2), masses with axillary lymphadenopathy (n=3), calcifications alone (n=1), an asymmetric density alone (n=1), extremely dense breasts with negative findings (n=2). A breast MRI showed an irregular shaped mass (n=4) with a rim-like enhancement (n=3), linear ductal enhancement without a mass (n= 1), and the time intensity cure revealed the typical pattern and level of enhancement in the carcinoma. CONCLUSION: Sonography is a valuable tool for diagnosing pregnancy-associated breast cancer. However, mammography should be performed if there is a suspicious lesion on sonography in order to confirm the pregnancy-associated breast cancer. Mammography has a lower sensitivity during pregnancy due to the physiologic changes in the breasts. However, calcifications and associated findings are helpful in confirming pregnancy-associated breast cancer. physicians should not consider a rapidly growing lump in the breast during pregnancy to be benign and should perform radiological examinations and imaging-guided biopsies.
Biopsy ; Breast Neoplasms* ; Breast* ; Diagnosis ; Drug Therapy ; Edema ; Humans ; Ligaments ; Lymphatic Diseases ; Magnetic Resonance Imaging ; Mammography ; Pregnancy ; Retrospective Studies ; Skin ; Ultrasonography