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Dermoscopy of lipidized dermatofibromas. An Bras Dermatol 2023; 98:387-390. [PMID: 36803559 PMCID: PMC10173079 DOI: 10.1016/j.abd.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/02/2021] [Accepted: 12/19/2021] [Indexed: 02/19/2023] Open
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Tukenmez Demirci G, Atis G, Kivanc Altunay I, Sakiz D. The Epidemiology of Non-Melanocytic Benign and Malignant Skin Tumors in Pediatric Patients Attending to the Dermatology Department. J Clin Med Res 2015; 7:770-4. [PMID: 26345722 PMCID: PMC4554216 DOI: 10.14740/jocmr2190w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 11/11/2022] Open
Abstract
Background Non-melanocytic skin tumors are rarely seen in pediatric patients; although they are mostly benign, they remain to be elucidated by histopathological examination. The objective of the study was to describe the epidemiology of non-melanocytic skin tumors in children attending to our dermatology department. Method The histopathologic studies of all skin punch and excisional biopsies of children up to 16 years old referred to our dermatology department between January 2007 and January 2012 were reviewed retrospectively. Melanocytic tumors and cystic and infectious lesions were excluded. Age, sex, location, and histopathologic diagnosis were recorded. The skin tumors were categorized. Results A total of 4,126 skin tumors were analyzed histopathologically, and 203 of the lesions were from children up to 16 years of age. Ninety-seven of the lesions from 91 patients were non-melanocytic skin tumors. Forty-seven (51.64%) were male, 44 (48.36%) were female, and mean age was 10.55 ± 4.31 years. Malignant tumor was 1.03% (one tumor) and benign tumors were 98.97% (96 tumors) of all. The most frequent non-melanocytic skin tumor was pilomatricoma with 22 lesions (22.68%), followed by pyogenic granuloma with 18 lesions (18.54%), and nevus sebaceous with 10 (10.3%) lesions. Cutaneous leukemic infiltrate was found to be the only malignant skin tumor in the study group. The most frequently affected age group was children aged > 13 to ≤ 16 years, which included 38 patients (41.7%). The majority of lesions were on head and scalp (32 tumors, 32.96%), followed by trunk (28 tumors, 28.84%) and upper limbs (22 tumors, 22.75%). Conclusion The ratio of malignant to benign skin tumors in pediatric patients is found to be small. Pilomatricoma, pyogenic granuloma and nevus sebaceous are found to be the most frequent non-melanocytic skin tumors of children. The ratio of malignant tumors is very rare.
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Affiliation(s)
| | - Guldehan Atis
- Dermatology Department, Siyami Ersek Cardiovasculer Surgery Hospital, Istanbul, Turkey
| | - Ilknur Kivanc Altunay
- Dermatology Department, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Damlanur Sakiz
- Pathology Department, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Abstract
Juvenile xanthogranulomas (JXGs) are benign cutaneous lesions of childhood that often spontaneously involute. They rarely present as a noncutaneous tumors. However, JXG tumors have been described in numerous noncutaneous anatomic sites, presenting with a variety of symptoms. The severity of symptoms and accurate preoperative diagnosis of JXG should determine operative and nonoperative treatment options of these uncommon, benign, and self-limiting tumors. We report 3 cases of symptomatic, noncutaneous JXG from disparate anatomic sites all treated with aggressive surgical resection.
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Hulsmann AR, Oranje AP. Educational paper: neonatal skin lesions. Eur J Pediatr 2014; 173:557-66. [PMID: 23385854 DOI: 10.1007/s00431-013-1956-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 01/22/2013] [Indexed: 01/20/2023]
Abstract
Although most skin lesions in neonates are transient or benign, they may also be the presenting symptom of a life-threatening disease such as herpes neonatorum. In the present review, we present a short overview of neonatal skin lesions and a practical table to guide the general paediatrician in the diagnosis and management of neonatal skin lesions. Recent reviews are cited for further reading.
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Affiliation(s)
- Anthon R Hulsmann
- Department of Paediatrics, Amphia Ziekenhuis, Breda, the Netherlands,
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Reserva J, Chamlin SL. An 8-month-old girl with an enlarging lesion on her face. Juvenile xanthogranuloma. Pediatr Ann 2014; 43:e22-4. [PMID: 24549084 DOI: 10.3928/00904481-20131223-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An otherwise healthy 8-month-old girl presented to the pediatric dermatology clinic for evaluation of an enlarging lesion on her right cheek. The child's mother first noticed this "bump" a month prior to presentation and denied any inciting event. The lesion had increased in size since it was first noted but was not symptomatic. No bleeding was noted. Perinatal history and review of systems were unremarkable. On physical examination, a solitary, well-demarcated, 3-mm yellow erythematous papule with central erosion was noted on the right upper cheek. No other lesions were identified. Lymph node examination was unremarkable. Clinical observation was recommended, with excision if significant enlargement or atypical features developed. Two months later, the lesion remained asymptomatic but had grown to 9 mm in size. The central erosion persisted, but no bleeding occurred.
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Hassan SF, Stephens E, Fallon SC, Schady D, Hicks MJ, Lopez ME, Lazar DA, Rodriguez MA, Brandt ML. Characterizing pilomatricomas in children: a single institution experience. J Pediatr Surg 2013; 48:1551-6. [PMID: 23895971 DOI: 10.1016/j.jpedsurg.2012.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 08/10/2012] [Accepted: 08/10/2012] [Indexed: 01/17/2023]
Abstract
BACKGROUND/PURPOSE Pilomatricomas, or calcifying epitheliomas of Malherbe, are among the most common superficial cutaneous soft tissue lesions in children. Familiarity with the presenting signs and symptoms allows for the diagnosis to be made on physical examination alone in most patients, avoiding expensive and unnecessary diagnostic imaging. METHODS A retrospective IRB-approved review of surgical pathology archives and medical records of all patients undergoing excision of pilomatricomas between 1982 and 2010 was performed to determine the characteristics of the pilomatricoma tumors. Data regarding gender, age, location, size of tumor, and histopathology were collected. RESULTS There were 916 pilomatricomas resected in 802 patients. Fifty-five percent of the patients were girls (441 patients). The median age at the time of resection was 6 years (range 5 months to 18 years). Multiple lesions were found in 43 patients (5%). The most common location was head and neck (n = 529, 58%), followed by upper limbs (n = 214, 23%), trunk (n = 130, 14%), and lower limbs (n = 43, 5%). Information on size was available for 674 lesions; mean lesion diameter was 14.0 ± 7.4 mm. Twenty-eight patients (3%) had either recurrent (n = 11) or metachronous (n = 17) lesions resected at our institution, with a median interval of 12 months after initial resection (range 5 weeks to 5 years). No cases of pilomatrix carcinoma were observed. CONCLUSION The majority of pilomatricomas occur in the head and neck, although they can present in any location. Approximately 5% of children have multiple lesions. Pilomatricomas occur slightly more commonly in girls, and 66% of lesions occur in children < 10 years of age. Complete surgical excision is necessary to prevent recurrence. Recurrences and pilomatrix carcinoma are very rare if complete excision is achieved.
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Affiliation(s)
- Saif F Hassan
- Division of Pediatric Surgery, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
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7
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Abstract
This article briefly reviews some of the most common skin lesions in the head and neck of a child. Benign "lumps and bumps" are very common in children and it is prudent for the pediatric maxillofacial surgeon to be familiar with their presentation, workup (including radiographic studies), and definitive surgical management. Inflammatory and infectious lesions require prompt treatment to avoid more serious sequelae of progressive infection and scarring.
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Affiliation(s)
- Joli C Chou
- Department of Oral and Maxillofacial Surgery and Pharmacology, University of Pennsylvania School of Dental Medicine, Schattner Building, 240 South, 40th Street, Philadelphia, PA 19104, USA.
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Zeller KA, Billmire DF. Trichoblastoma: management of a rare skin lesion. J Pediatr Surg 2012; 47:250-2. [PMID: 22244425 DOI: 10.1016/j.jpedsurg.2011.10.068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 10/25/2011] [Accepted: 10/26/2011] [Indexed: 11/30/2022]
Abstract
A 15-year-old girl presented with a 2-year history of an enlarging parietal scalp lesion. Excisional biopsy revealed trichoblastoma, a benign secondary tumor arising from a nevus sebaceous. There is no consensus in the literature about the surgical management of nevus sebaceous in children owing to the low incidence of secondary malignancy. There is a 20% lifetime risk of transformation to a soft tissue neoplasm, most of which are benign; but malignant neoplasms have also been reported. At minimum, these lesions need to be followed clinically over the patient's lifetime if left in situ. Recurrence after excision is rare.
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Affiliation(s)
- Kristen A Zeller
- Department of General Surgery, Section of Pediatric Surgery, Wake Forest Baptist Medical Center, Winston Salem, NC 27157, USA.
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Hamm H, Höger PH. Skin tumors in childhood. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:347-53. [PMID: 21655460 DOI: 10.3238/arztebl.2011.0347] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 08/24/2010] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. METHODS Selective literature review. RESULTS Only 1-2% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of malignancy include rapid growth, firm consistency, diameter exceeding 3 cm, ulceration, a non-movable mass, and presence in the neonatal period. The more common malignant skin tumors in adults-basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma-are very rare in childhood. Congenital melanocytic nevi and sebaceous nevi bear a lower malignant potential than previously believed; nevertheless, their excision is often indicated. A Spitz nevus can mimic a melanoma both clinically and histologically. Some benign skin tumors of childhood tend to regress spontaneously within a few years but may cause complications at particular locations and when multiple. For infantile hemangiomas requiring systemic treatment because of imminent obstruction or ulceration, propranolol seems to have a far more favorable risk-benefit ratio than corticosteroids. CONCLUSION Physicians need specialized knowledge in order to decide whether a skin tumor in a child should be excised, non-surgically treated, or further evaluated, or whether it can be safely left untreated because of the likelihood of spontaneous remission.
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Affiliation(s)
- Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie,Universitätsklinikum Würzburg.
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Mahé E, Guéro S, Fraitag S. [Lipofibromatosis in the finger of a child]. Ann Dermatol Venereol 2011; 138:391-4. [PMID: 21570563 DOI: 10.1016/j.annder.2010.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 08/27/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Lipofibromatosis is a recently classified form of benign tumor in children; it is of non-specific clinical presentation and is seen mainly on the extremities. We report a case involving the index finger of a child. PATIENTS AND METHODS An 8-year-old boy consulted for a nodule on the palmar surface of the left index finger that had appeared 6 months earlier. The nodule, which adhered to the deeper skin, measured 1cm in diameter and was bluish and firm on palpation. Histological examination of the resected specimen revealed fatty tissue associated with a proliferation of spindle cells. Immunohistochemical analysis showed that certain of these cells expressed smooth muscle actin, suggesting partial myofibroblastic differentiation. A diagnosis of lipofibromatosis was made. DISCUSSION Lipofibromatosis is a rare tumor. The main problem in terms of severity is its locally invasive development, which frequently causes problems for resection. Due to the age at onset, its course with deep invasion, the frequency of recurrence and the histological aspect, lipofibromatosis is classed as a form of childhood fibromatosis.
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Affiliation(s)
- E Mahé
- Service de dermatologie, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, université Versailles-Saint-Quentin-en-Yvelines, 9 avenue Charles-de-Gaulle, Boulogne-Billancourt, France.
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Fassina A, Olivotto A, Cappellesso R, Vendraminelli R, Fassan M. Fine-needle cytology of cutaneous juvenile xanthogranuloma and langerhans cell histiocytosis. Cancer Cytopathol 2011; 119:134-40. [PMID: 21491610 DOI: 10.1002/cncy.20132] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 11/12/2010] [Accepted: 11/15/2010] [Indexed: 11/08/2022]
Abstract
BACKGROUND In pediatric patients, a cutaneous nodule is usually diagnosed by performing an excisional biopsy, but fine-needle cytology (FNC) is a safer and noninvasive diagnostic method widely used to obtain diagnostic specimens with little stress to the patient. The authors compared the ability of FNC and biopsy to differentiate Langerhans cell histiocytosis (LCH) from juvenile xanthogranuloma (JXG). METHODS Correlating cytological results with histological findings, the authors reviewed 27 patients (15 males and 12 females; mean age, 37 months; range, 1 month to 14 years) admitted to the University of Padua Department of Pediatrics from 1998 to 2010. RESULTS Cytology smears were adequate in all 27 (100%) patients: 14 (52%) were classified as having JXG, 12 (44%) as having LCH, and 1 (4%) as having a doubtful finding. A biopsy was also performed in 20 of these patients, and in all but 1, the 2 methods were completely concordant. CONCLUSIONS FNC is safe and useful in the diagnostic workup of pediatric patients with cutaneous nodules and has no contraindications to its use as the initial diagnostic procedure.
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Affiliation(s)
- Ambrogio Fassina
- Department of Diagnostic Medical Sciences and Special Therapies, Surgical Pathology and Cytopathology Unit, University of Padua, Padua, Italy.
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Chen W, Mempel M, Traidl-Hofmann C, Al Khusaei S, Ring J. Gender aspects in skin diseases. J Eur Acad Dermatol Venereol 2011; 24:1378-85. [PMID: 20384686 DOI: 10.1111/j.1468-3083.2010.03668.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Gender differences in medicine have been recognized in anatomy, physiology, as well as in epidemiology and manifestations of various diseases. With respect to skin disorders, males are generally more commonly afflicted with infectious diseases while women are more susceptible to psychosomatic problems, pigmentary disorders, certain hair diseases, and particularly autoimmune as well as allergic diseases. Significantly, more female sex-associated dermatoses can be identified than the male sex-associated dermatoses. Dermatoses in the genital area differ between men and women. Gender differences also exist in the occurrence and prognosis of certain skin malignancies. The mechanisms underlying gender differences in skin diseases remain largely unknown. Differences in the skin structure and physiology, effect of sex hormones, ethnic background, sociocultural behaviour and environmental factors may interact to exert the influences. A better understanding of gender differences in human health and diseases will allow the development of novel concepts for prevention, diagnosis and therapy of skin diseases.
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Affiliation(s)
- W Chen
- Department of Dermatology and Allergy, Helmholtz Zentrum Munchen/TUM, ZAUM-Center for Allergy and Environment, Technische Universität München, Germany.
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Bibliography. Current world literature. Systemic lupus erythematosus and Sjögren's syndrome. Curr Opin Rheumatol 2008; 20:631-2. [PMID: 18698190 DOI: 10.1097/bor.0b013e3283110091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bibliography. Current world literature. Hematology and oncology. Curr Opin Pediatr 2008; 20:107-13. [PMID: 18197049 DOI: 10.1097/mop.0b013e3282f572b6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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