Basal cell carcinoma of the nipple: a case report and review of the literature.

Background: The nipple is an extremely unusual location for basal cell carcinoma (BCC).

Objective: To report a case of BCC originating on the areola and nipple region in a 47-year-old Dominican woman treated with Mohs micrographic surgery (MMS).

Methods: We discuss a case of BCC originating on the areola and nipple region treated with MMS and review the literature regarding treatment of BCC of the nipple.

Merkel cell carcinoma in the setting of HIV infection.

Merkel cell carcinoma has been found to have an increased incidence among immunosuppressed patients, specifically organ transplant recipients receiving immunosuppressive therapy. HIV similarly depresses the immune response of infected persons. We report a case of Merkel cell carcinoma (MCC) in an HIV-infected patient who died from liver metastases 2 years after his tumor was diagnosed.

PTCH mutations in squamous cell carcinoma of the skin.

Ultraviolet light exposure is the major risk factor for the development of squamous cell carcinoma in Caucasians. Mutations in the tumor suppressor gene p53 have been identified in both squamous cell carcinomas and basal cell carcinomas. The human homolog of the Drosophila patched gene, has been shown to be mutated in sporadic basal cell carcinomas; however, mutations in the patched gene have not been found in squamous cell carcinoma.

UV-specific p53 and PTCH mutations in sporadic basal cell carcinoma of sun-exposed skin.

UVB irradiation is known to produce DNA damage at mutation hotspots in the p53 tumor suppressor gene, leading to the development of skin cancers. Mutations in the PTCH tumor suppressor gene, which is known to be responsible for the development of nevoid basal cell carcinoma syndrome, have also been identified in sporadic basal cell carcinomas (BCCs). We describe the case of an 80-year-old welder in whom 3 novel p53 mutations, as well as UV-specific PTCH mutations, were detected in two BCC samples from sun-exposed skin.

Role of PTCH and p53 genes in early-onset basal cell carcinoma.

Basal cell carcinoma (BCC) is the most common skin cancer in the Western world. Ultraviolet (UV) exposure, race, age, gender, and decreased DNA repair capacity are known risk factors for the development of BCC. Of these, UVB irradiation from sunlight is the most significant risk factor.

Real photographic prints from digital images.

Background: Digital photography is emerging as a standard method of documenting preoperative, intraoperative, and postoperative results in the clinical setting. While hard copies of these electronic images can be quickly and easily generated on color laser or inkjet printers, there are times when it is necessary to generate a true photographic print of an image, either for insurance documentation or to meet the publication requirements of a peer-reviewed journal. Standard inkjet and laser printers are unable to generate true photographic prints.

Use of the double-bladed scalpel in peripheral margin control of dermatofibrosarcoma protuberans.

Background: The double-bladed scalpel previously has not been cited in the published literature for use in Mohs micrographic surgery.

Objective: To allow for maximum tissue conservation and greatest possible intraoperative efficiency for peripheral margin control of a massive tumor.

Methods: We describe the use of the double-bladed scalpel during Mohs surgery for peripheral margin control of a large dermatofibrosarcoma protuberans (DFSP).

Principles of CO2/erbium laser safety.

Background: There are a variety of potential hazards with laser technology.

Methods: A review of the literature.

Objective: To summarize the potential hazards of CO2 and erbium laser technologies and the safety guidelines and equipment developed to minimize them.

Perineural spread of basal cell carcinomas treated with Mohs micrographic surgery.

Background: Perineural spread is a well-documented feature of cutaneous tumors and may portend a more aggressive course. The incidence of perineural invasion in basal cell carcinoma (BCC) is reportedly 1%. The authors sought to determine whether perineural spread occurs more commonly than previously thought.

Universal PCR amplification of mouse immunoglobulin gene variable regions: the design of degenerate primers and an assessment of the effect of DNA polymerase 3' to 5' exonuclease activity.

Degenerate primers were designed for PCR amplification of unknown mouse immunoglobulin (Ig) light (L) and heavy (H) chain variable (V) genes. Each subgroup of mouse Ig gene sequences [Kabat, E.A.

The regulative capacity of prespore amoebae as demonstrated by fluorescence-activated cell sorting and green fluorescent protein.

The ability of prespore Dictyostelium discoideum amoebae to undergo redifferentiation so as to reestablish normal spore/stalk proportioning has been demonstrated in various ways over the years, beginning with the classic microdissection work of K. Raper. The discovery of anterior-like cells in the slug posterior, however, cast doubt on that ability, and more recent experiments using a cell-specific toxin suggested that prespore redifferentiation may not in fact occur.

The uses of digital photography in dermatology.

Digital photography is a powerful tool that is transforming the specialty of dermatology by integrating patient and practice management. The fundamentals of digital imaging are discussed, and an approach to the selection of a digital camera and its associated hardware and software is provided. The applications of this technology to patient and practice management are addressed, and the ethical implications of digital tampering are also discussed.

Cutaneous laser resurfacing.

Unlabelled: Cutaneous resurfacing with the new generation of carbon dioxide and erbium lasers has recently come into favor for the treatment of facial rhytides, photodamage, and scarring. The precise control of these resurfacing lasers over the extent of tissue vaporization minimizes thermal damage to the skin while maximizing therapeutic efficacy. Proper use of resurfacing lasers is contingent upon a complete understanding of their clinical, histologic, and ultrastructural effects, as well as an appreciation of the principles of laser safety.

Pilot ultrastructural evaluation of human preauricular skin before and after high-energy pulsed carbon dioxide laser treatment.

Background: Carbon dioxide laser resurfacing has recently come into favor for the treatment of photodamaged skin. While the clinical and histologic effects of high-energy short-pulse carbon dioxide lasers on human skin have been investigated, the ultrastructural effects of these lasers have not been documented. Our objective was to study the ultrastructural effects of a high-energy pulsed carbon dioxide laser on photodamaged human skin.

Skin grafting. From here to there.

Free skin grafts for soft tissue reconstruction can be classified into four types: full-thickness skin grafts, split-thickness skin grafts, composite grafts, and free cartilage grafts. The indications, techniques, donor site considerations, and postoperative complications of each type of skin graft are reviewed.

Blocking the ends of transforming DNA enhances gene targeting in Dictyostelium.

Eukaryotic gene targeting by means of gene replacement vectors is often complicated by unwanted plasmid insertion events involving the ends of transforming DNA molecules. These undesirable and often multiple insertions occur both randomly (i.e.

Mohs micrographic surgery for the treatment of dermatofibrosarcoma protuberans. Results of a multiinstitutional series with an analysis of the extent of microscopic spread.

Background: Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft-tissue tumor of the skin; its microscopic extent of invasion beyond the grossly visible tumor is frequently difficult to appreciate. Although wide local excision has been the standard treatment of DFSP, recurrence rates range from 11% to 53%. Because Mohs micrographic surgery allows the extent of excision to be tailored to the microscopic extent of tumor, we evaluated this technique for the treatment of primary and recurrent DFSP.

A method to risk-adjust rehabilitation outcomes using functional related groups.

In our rapidly changing and increasingly expensive health care environment, payers, patients, and other consumers are beginning to demand that rehabilitation providers demonstrate their value through outcomes data. Although self-assessment is not new to rehabilitation, the instruments and databases at our disposal generally do not fully adjust for severity of disability, health status, or other factors that may affect outcomes. This paper demonstrates a technique using functional related groups (FRGs) to adjust inpatient length of stay and treatment efficiency to reflect relative risk.

Angiographic evolution of intracoronary thrombus and dissection following percutaneous transluminal coronary angioplasty (the Thrombolysis and Angioplasty in Unstable Angina [TAUSA] trial).

The evolution and progression of thrombus and dissection after percutaneous transluminal coronary angioplasty (PTCA) are unknown. As part of the protocol of the Thrombolysis and Angioplasty in Unstable Angina (TAUSA) trial, 1 and 15 minutes post-PTCA angiograms were routinely performed and evaluated by the core laboratory for the presence of thrombus and either minor or major dissection. Thrombus was present at 1 minute in 4.