Chemosurgical reports: myxoid dermatofibrosarcoma protuberans

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.

Injectable collagen implant: histopathologic identification and longevity of correction

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 other must be judged subjective. This study reports both kinds of results and proposes a new theory to explain the duration of the improvement.

Basal-cell carcinoma resulting from radiation therapy for hypertrophic tonsils

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.

Laboratory evaluation of skin refrigerants used in dermabrasion

Six skin refrigerants were evaluated for maximum cooling temperature. The temperatures produced correlated well with the chemical components and also the gelatin freeze-thaw times. Freon 114 and Freon 114-ethyl chloride mixtures are time-tested, safe skin refrigerants. Some of the newer skin refrigerants are pure sources of Freon 12 or mixtures of Freon 12 and Freon 11. These newer, colder products have the potential to damage the skin and represent a hazard to successful dermabrasion.

Glucagonoma syndrome: case report and literature review

The glucagonoma syndrome is characterized by dermatitis, glucose intolerance, hypoaminoacidemia, and hyperglucagonemia secondary to an alpha-cell tumor of the pancreas. Other clinical features include anemia, glossitis, and weight loss. A 62-year-old woman with the syndrome sought medical attention for a chronic dermatitis. A skin biopsy was suggestive of necrolytic migratory erythema. A glucagonoma was surgically removed from the tail of the pancreas. Review of the literature indicates that 56 proven and 33 probable cases of glucagonoma syndrome have been reported.

High frequency ultrasonic imaging of skin: experimental results

Experimental results are presented demonstrating the application of pulse echo ultrasound to imaging the skin. A laboratory prototype B-mode mechanical scanner was employed to obtain images of human skin, both in vitro and in vivo, using broadband pulsed ultrasound at 25 MHz. Images were formed by processing digitized A-mode waveforms and displaying the resulting two-dimensional cross sections using a digital imaging system. Images obtained by rectifying the A-modes are compared to those derived using a software-based cross-correlation technique. Scans of test targets demonstrate that an axial resolution of 100 m can be achieved at 25 MHz when the digital correlation method is employed. Lateral resolution is limited by the 0.25 mm half-power focal beamwidth of the transducer. Seventeen in vitro ultrasonic scans of human skin were compared to frozen section histology. Average skin depth was well correlated between the two techniques ( = 0.99, p less than 0.001). Application of cross-correlated processing to 25 MHz in vivo images produced good delineation of epidermis, papillary, and reticular dermis. Conversion to a 50 MHz transducer did not delineate skin layers as well as the 25 MHz transducer due to inherent difficulties with transducer reverberations.

Chemosurgical reports: super widefield microscopy in Mohs surgery

The super widefield microscope can increase the efficiency of the Mohs surgeon in evaluating frozen tissue sections. The increased microscopic viewing area allows more of the operator's visual fields to be used. The super widefield microscope is especially useful when multiple and/or large frozen sections are to be examined.

Chemosurgical reports: perineural spread of basal-cell carcinoma

Basal-cell carcinoma with perineural invasion is a rare occurrence. Ten patients with this phenomenon are described. Review of our cases and cases in the literature indicates that perineural spread of basal-cell carcinoma is most common in men with recurrent tumors. The horizontally cut frozen sections that are utilized in Mohs surgery maximize the chances of discovering basal-cell carcinoma with undiagnosed involvement.

Complications of fiber implantation for baldness

Several methods of fiber implantation have been used to reduce pattern baldness, and similar results have been reported: fiber breakage, foreign-body reaction, infection and scarring. Since one method or another tends to predominate in different geographic areas, the physician often is unable to compare the results of the various methods. The two patients described in this article underwent different methods of fiber implantation; serious complications occurred in both. Fiber implantation is an unsafe technique and must be discouraged.