Abstract:
BACKGROUND:There is growing evidence that Mohs micrographic surgery (MMS) is the treatment of choice for dermatofibrosarcoma protuberans (DFSP). OBJECTIVE:This study retrospectively compared the recurrence rates of DFSP after MMS with those after wide surgical excision; results at the Mayo Clinic and in the world literature were evaluated. In addition, preoperative tumor sizes and postoperative defect sizes after MMS were compared to determine whether MMS conserved more normal tissue than wide surgical excision. METHODS:The medical records of 84 patients with DFSP who had been treated at the Mayo Clinic were reviewed. They were categorized into two treatment groups: MMS and surgical excision. RESULTS:Fifteen patients with DFSP who underwent MMS had follow-up data available; one of these patients had local recurrence (recurrence rate, 6.6%; average duration of follow-up, 40 months). Thirty-nine patients had wide excision; four of these patients had local recurrences and one had pulmonary metastases (recurrence rate, 10%; average duration of follow-up, 36 months). A review of the world literature revealed neither local recurrences nor metastases in the 11 studies in which DFSP was treated with MMS. Overall, including our results, the average recurrence rate of DFSP after MMS was 0.6% (range, 0% to 6.6%) and the total recurrence rate was 1.6% (1 of 64). Including our series, DFSP was treated with wide excision in 15 studies; the average recurrence rate was 18% (range, 0% to 60%) and the total recurrence rate was 20% (100 of 489). In eight published studies, DFSP was surgically resected with undefined or conservative excisional margins; the average recurrence rate was 43% (range, 26% to 60%) and the total recurrence rate was 44% (140 of 317). A surgical margin of 2.5 cm to deep fascia was required for complete clearance of all tumors treated with MMS. Twenty-two percent of tumors were removed with a 0.5 cm margin, 50% with a 1.0 cm margin, 67% with a 1.5 cm margin, and 89% with a 2.0 cm margin. CONCLUSION:On the basis of our results and data compiled from the literature, MMS may be the treatment of choice for DFSP because of its high cure rate and maximal conservation of tissue.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Gloster HM Jr,Harris KR,Roenigk RKsubject
Has Abstractpub_date
1996-07-01 00:00:00pages
82-7issue
1eissn
0190-9622issn
1097-6787pii
S0190-9622(96)90501-0journal_volume
35pub_type
杂志文章,评审abstract:BACKGROUND:Curcuminoids are components of turmeric (Curcuma longa) that possess anti-inflammatory properties. OBJECTIVE:We sought to study the efficacy of curcuminoids in controlling the signs and symptoms of oral lichen planus, at doses of 6000 mg/d (3 divided doses), and their safety at this dose. METHODS:Twenty co...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jaad.2011.04.022
更新日期:2012-05-01 00:00:00
abstract::In autosomal dominant skin disorders, a pronounced mosaic involvement may sometimes be found to be superimposed on the ordinary nonsegmental lesions. Such "type 2 segmental manifestation" reflects loss of heterozygosity occurring at an early developmental stage, giving rise to a cell clone that lacks the corresponding...
journal_title:Journal of the American Academy of Dermatology
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.jaad.2008.12.049
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Onychomycosis is an increasing problem with limited therapeutic options. OBJECTIVE:We evaluated the safety and efficacy, of oral terbinafine, a new fungicidal antimycotic, in patients with toenail onychomycosis. METHODS:A North American multicenter, double-blind, placebo-controlled study evaluated the myco...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0190-9622(97)70111-7
更新日期:1997-11-01 00:00:00
abstract::Recent advances in our basic understanding of immunology, specifically the roles of various cell types involved in immune response and the action of cytokines they produce, has radically changed our understanding of the origin of inflammatory dermatoses, and other autoimmune diseases. Broadened comprehension of the im...
journal_title:Journal of the American Academy of Dermatology
pub_type: 信件,评审
doi:10.1016/j.jaad.2005.10.059
更新日期:2006-03-01 00:00:00
abstract::We discuss a metastatic dermatofibrosarcoma protuberans on the occiput of a 53-year-old man whose initial tumor appeared on his forehead 23 years previously. The pathology of the tumor that recurred at the initial site was fibrosarcomatous dermatofibrosarcoma protuberans, whereas the metastatic tumor was a pigmented d...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2008.10.053
更新日期:2009-07-01 00:00:00
abstract::A panel of antibodies reactive in routinely fixed, paraffin-embedded tissue sections was compared with a panel of antibodies reactive in frozen sections for the immunophenotyping of cutaneous lymphoproliferative disorders. Three T cell-associated markers (UCHL1, MT-1, MT-2, six B cell-associated markers (MB-1, MB-2, L...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(90)70055-m
更新日期:1990-03-01 00:00:00
abstract::A number of dermatologic conditions may have associated esophageal manifestations. Teleologically, this may be because both the skin and the esophagus are lined by stratified squamous epithelium. Bullous dermatoses that may produce blisters, erosions, and/or stricture of the esophagus include cicatricial pemphigoid, H...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(81)70070-7
更新日期:1981-06-01 00:00:00
abstract::Longitudinal pigmentation of the nail is very common. The differential diagnosis varies from subungual hematoma, to a fungal infection, to a melanocytic lesion (lentigo, nevus melanoma, etc.) to others. Often, dermatologists do not feel at ease with these pathologies and management is often not clear. In many cases, a...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2006.12.021
更新日期:2007-05-01 00:00:00
abstract::Two patients with the benign type of follicular mucinosis (FM) are presented. Their clinical features and course were characteristic for this subgroup of FM. Light and electron microscopy, direct immunofluorescence, and immunoperoxidase cell marker studies were undertaken to characterize the nature of the disease proc...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(84)70091-0
更新日期:1984-05-01 00:00:00
abstract::Infantile acropustulosis (IA) is a syndrome characterized by recurrent crops of 1- to 2-mm intensely pruritic vesicopustules that are found primarily on the distal extremities of infants. It is reportedly responsive to sulfones and unresponsive to other therapy, but if left untreated spontaneously resolves at about 2 ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(83)70187-8
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Little is known about how individuals with a predisposition for rosacea appear in childhood. This retrospective, matched control, longitudinal study examined the relationship between childhood stye and adult rosacea. METHODS:The records of the Rochester Epidemiology Project were examined to identify patient...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2006.03.023
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:The efficacy of combination therapy with topical corticosteroids and tacrolimus in the treatment of atopic dermatitis remains to be established. OBJECTIVE:Our aim was to determine whether a regimen of sequential application of topical corticosteroids and topical tacrolimus is effective in the treatment of p...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jaad.2008.09.034
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:The mature psoriatic lesion does not necessarily demonstrate changes relevant to early phases of the lesion. OBJECTIVE:In a model for relapsing psoriasis we examined the epidermal phenotype by means of a panel of immunohistochemical parameters: keratins 14 and 16, epidermal growth factor receptor (EGFR), Ki...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(99)70077-0
更新日期:1999-06-01 00:00:00
abstract::A 22-month-old boy had xanthomatous skin lesions, neurofibromatosis, and chronic granulocytic leukemia. Histologic examination of the xanthomatous skin lesions disclosed juvenile xanthogranulomas. Twenty-three previously published cases of this association are reviewed. ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/0190-9622(90)70136-6
更新日期:1990-05-01 00:00:00
abstract::In recognition of continuing increases in the incidence of skin cancer, including malignant melanoma, the American Academy of Dermatology has encouraged dermatologic communities nationwide to offer free skin cancer screening to the public. Memorial Sloan-Kettering Cancer Center took part in one such effort last spring...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(86)70169-2
更新日期:1986-08-01 00:00:00
abstract::As the most common human cancer worldwide and continuing to increase in incidence, basal cell carcinoma is associated with significant morbidity and cost. Continued advances in research have refined both our insight and approach to this seemingly ubiquitous disease. This 2-part continuing medical education article wil...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2018.03.060
更新日期:2019-02-01 00:00:00
abstract::Cicatricial pemphigoid is a chronic, presumed autoimmune, blistering disease of the mucous membranes and occasionally of the skin. The characteristic feature is scarring at the sites of healing. We report the use of thalidomide as a therapeutic agent to control previously resistant disease. ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/mjd.2002.109255
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Focal atrichia is a common clinical finding in female pattern hair loss, the specificity and histologic findings of which need further clarification. OBJECTIVE:To determine the frequency of focal atrichia in various types of hair loss and its histologic characteristics in female pattern hair loss. METHODS:...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2017.09.064
更新日期:2019-06-01 00:00:00
abstract::Punctate hyperkeratosis of the palms and soles is an uncommon autosomal dominant condition. We report a 65-year-old man with this condition and review the literature. With electron microscopy, we have examined both clinically affected and adjacent clinically unaffected palmar skin. The only ultrastructural differences...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(80)80223-4
更新日期:1980-07-01 00:00:00
abstract::Digital squamous cell carcinoma (SCC) presents a diagnostic challenge because of its relatively rare occurrence and mimicry of benign conditions. Although low-risk human papillomavirus (HPV) subtypes are commonly associated with benign digital verrucae, digital SCC can be associated with high-risk, oncogenic HPV subty...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2009.10.044
更新日期:2011-05-01 00:00:00
abstract::An intensely pruritic dermatosis that occurred in a woman during the third trimester of pregnancy is described. The clinical manifestations included red follicular papules symmetrically distributed on the skin of the forearms, abdomen, thighs, and legs. The histopathologic findings were not specific. However, immunopa...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(88)70059-6
更新日期:1988-02-01 00:00:00
abstract::The number of physicians who provide ambulatory care for patients with skin diseases is rapidly increasing. Current and proposed changes in health care financing may limit direct access to dermatologists. We provide recent data on volume of visits for cutaneous diagnoses, including the types of medical practitioners w...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(93)70243-m
更新日期:1993-11-01 00:00:00
abstract::To evaluate the sensitivity of histologic criteria 396 hematoxylin-eosin-stained step sections of 150 randomly sampled thin malignant melanomas (tumor thickness, less than or equal to 1.5 mm; level of invasion, I-III) were analyzed. The highest sensitivity was determined for nuclear atypia (84%), followed by the asymm...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(89)70143-2
更新日期:1989-06-01 00:00:00
abstract::The PA Patch, a new multiple-antigen, predispensed patch testing device, was compared to the Finn Chamber in subjects with previous positive patch tests. After pressing the PA Patch well, the PA Patch performed as well as the Finn Chamber in nine subjects tested. ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0190-9622(87)70121-2
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Secukinumab is a first-in-class interleukin 17A monoclonal antibody that has demonstrated an excellent safety and efficacy profile in phase 3 studies. OBJECTIVE:To evaluate the effectiveness of secukinumab in daily clinical practice and to understand the clinical and epidemiologic characteristics of patient...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jaad.2019.02.062
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Confirmation of mild bites caused by Loxosceles reclusa with swab testing has not been previously documented, to our knowledge. METHODS:We report a case using an enzyme-linked immunosorbent assay (ELISA) test. RESULTS:A lesion lacking necrosis or other specific signs of loxoscelism was confirmed by identif...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2006.04.065
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Despite multiple therapeutic approaches for nephrogenic systemic fibrosis (NSF), no single treatment has convincingly shown consistent benefit. The most successful outcomes have been associated with recovery of renal function, although evidence remains limited and past studies have been inconclusive. OBJECT...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2017.02.003
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Kaposi varicelliform eruption (KVE), or herpes simplex virus (HSV) superinfection of pre-existing skin lesions, may complicate Darier disease. OBJECTIVE:We sought to compare the clinical features and outcomes of patients with Darier disease who developed KVE superinfection with those who did not. METHODS:A...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2014.12.001
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Cutaneous basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) have poorer outcomes if treated when large. OBJECTIVE:We sought to estimate the growth rate of BCCs and SCCs and examine the relationship of personal, pathway, and cancer factors with cancer size (diameter). METHODS:We surveyed pati...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2013.11.009
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma, typically presents in middle-aged to elderly individuals. OBJECTIVE:We sought to study the demographics, clinicopathologic features, treatment response, and prognosis of patients with biopsy-proven MF diagnosed before 20 years of age...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2014.07.049
更新日期:2014-12-01 00:00:00