Background Metastases to the skin are found with increased frequency at certain sites, such as the scalp, but the biological factors that influence this distribution are not understood. Objective We ...aimed to compare the proportional frequency of metastases at various cutaneous locations with the immunologic microenvironments at those sites. Methods We retrospectively identified all biopsy specimens of cutaneous metastases diagnosed at our institution from 1991 to 2014 (n = 1984) and mapped their anatomic distribution while controlling for regional surface area. Using a separate, mapped cohort of normal-appearing skin samples (n = 140), we measured the density of regulatory T cells, CD4+ effector T cells, and CD8+ T cells by flow cytometry. Results Per unit surface area, cutaneous metastases arise most commonly on the head and neck, followed by the trunk, upper extremities, and lower extremities, respectively. Sites with more frequent metastases tend to contain a greater density of regulatory T cells and a lower proportion of CD8+ T cells ( P < .05). Limitations Immunologic factors were only assessed in control tissue and were not measured from patients with metastatic disease in this correlative single-center study. Conclusion The distribution of cutaneous metastases follows the distribution of regulatory and effector T cells in skin. Further studies are required to prove a mechanistic association between local immunologic factors and the development of cutaneous metastases.
Tobacco smoking and dermatologic surgery Gill, Jing F., MD; Yu, Siegrid S., MD; Neuhaus, Isaac M., MD
Journal of the American Academy of Dermatology,
01/2013, Letnik:
68, Številka:
1
Journal Article
Recenzirano
Background Cigarette smoking is the leading cause of preventable death and a major public health concern. Numerous clinical and experimental studies have examined the effect of nicotine on wound ...healing and surgical procedures, but there are limited published reports in the dermatologic surgery literature. Objective This article seeks to develop evidence-based recommendations regarding the effect of tobacco use in patients undergoing dermatologic surgery procedures. Methods This article reviews the existing published English-language literature pertaining to the effects of tobacco on wound healing and surgical complications. Results Tobacco use is associated with a higher incidence of postoperative complications including wound dehiscence, flap or graft necrosis, prolonged healing time, and infections. Limitations This review article only summarizes past reports and studies. Conclusion Recommendations for smoking cessation before dermatologic surgery are provided based on the available data.
Individuals of Asian heritage are predisposed to congenital and acquired pigmentary disorders. Cosmetic enhancement is frequently the primary treatment goal for these benign lesions. Accurate ...diagnosis of the nature of the pigmentary disorder is fundamental for administering safe and effective therapy. Before the advent of modern laser technology, such reported treatments as cryotherapy, dermabrasion, chemical peeling, and surgical excision resulted in unpredictable results. This article focuses on the diagnosis of disorders of pigmentation in Asian patients and reviews laser and light treatment modalities.
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