Keratosis

Blaschko's lines are the pattern assumed by many different naevoid and acquired skin diseases on the human skin and mucosae. They were described and drawn by Blaschko 75 years ago. These lines are to be distinguished from other linear patterns such as Voight's lines, Langer's lines, and the lines of innervation of the spinal nerves. They do not follow any known nervous, vascular or l5rmphatic structures in the skin. The epidermis and its appendageal structures, the melanocytes, the vascular system, and the fatty hypoderm, all, separately or in combination, may be involved in the morpho-logical manifestations which follow Blaschko's lines. Many of the naevoid skin conditions are lifelong (e.g. linear sebaceous naevus, unilateral naevoid telangiectasia); many of the acquired skin diseases (e.g. lichen striatus, linear psoriasis) are of relatively short duration (e.g. 1–2 years). The cause of the distribution pattern is unknown. It is possibly a form of human‘mosaicism’ where certain specific cells or groups of cells react differently from other cells due to chromosomal abnormalities. The embryological explanation of Blaschko's lines is not at all clear. Other markers in addition to the skin findings are needed to determine the time and the nature of the change responsible for these lines. The main purpose of this article is to introduce the concept of Blaschko's lines into the medical, paramedical, and general biological fields of science. In this way, it is hoped that some inter-reaction can occur between those who regularly see Blaschko's lines and those who regularly see and study other chromosomal and embryological abnormalities.

Keratolytic winter erythema (KWE) is a rare autosomal-dominant skin disorder characterized by recurrent episodes of palmoplantar erythema and epidermal peeling. KWE was previously mapped to 8p23.1-p22 (KWE critical region) in South African families. Using targeted resequencing of the KWE critical region in five South African families and SNP array and whole-genome sequencing in two Norwegian families, we identified two overlapping tandem duplications of 7.67 kb (South Africans) and 15.93 kb (Norwegians). The duplications segregated with the disease and were located upstream of CTSB, a gene encoding cathepsin B, a cysteine protease involved in keratinocyte homeostasis. Included in the 2.62 kb overlapping region of these duplications is an enhancer element that is active in epidermal keratinocytes. The activity of this enhancer correlated with CTSB expression in normal differentiating keratinocytes and other cell lines, but not with FDFT1 or NEIL2 expression. Gene expression (qPCR) an...

Precancer or intraepithelial neoplasia (IEN) is a noninvasive lesion that has genetic abnormalities, loss of cellular control functions, and some phenotypic characteristics of invasive cancer and that predicts for a substantial likelihood of developing invasive cancer. The AACR Task Force on the Treatment and Prevention of IEN has delineated the relationship between IEN and cancer risk as well as the clinical benefit that can be derived from reducing IEN burden. Although several effective endoscopic and surgical treatments for IEN have become standard medical practice, these interventions can confer morbidity and do not treat the entire epithelial field at risk. The incidence of many epithelial cancers is continuing to rise, the number of individuals at risk is increasing with the aging population, and the rapid advancement of imaging and molecular diagnostics is bringing to light precancers that were heretofore clinically silent. There is therefore an urgent need to rapidly develop...

The implementation of information technology in healthcare is a significant focus for many nations around the world. However, information technology support for clinical care, research and education in oral medicine is currently poorly developed. This situation hampers our ability to transform oral medicine into a 'learning healthcare discipline' in which the divide between clinical practice and research is diminished and, ultimately, eliminated. This paper reviews the needs of and requirements for information technology support of oral medicine and proposes an agenda designed to meet those needs. For oral medicine, this agenda includes analyzing and reviewing current clinical and documentation practices, working toward progressively standardizing clinical data, and helping define requirements for oral medicine systems. IT professionals can contribute by conducting baseline studies about the use of electronic systems, helping develop controlled vocabularies and ontologies, and designing, implementing, and evaluating novel systems centered on the needs of clinicians, researchers and educators. Successfully advancing IT support for oral medicine will require close coordination and collaboration among oral medicine professionals, information technology professionals, system vendors, and funding agencies. If current barriers and obstacles are overcome, practice and research in oral medicine stand ready to derive significant benefits from the application of information technology.

In this article, we propose to study and to conceive a programmable signal generator allowing inhibition of certain types of pain. This system would be provided with an electrode which could be applied in the periphery level of the patient's spinal cord in order to excite the nervous zone responsible for pain transmission. The conceived system would be commanded with variable voltages and piloted by a dedicated microcontroller. This would allow us to have different possibilities in conceiving various shapes of stimulating waves. The purpose is to offer flexibility during clinical adjustments especially when programming the various parameters of electrical stimuli. A PC connection was also provided in order to visualize and to adjust stimulating wave parameters. Our system could be then considered as an original one since it is enhanced by flexibility and maneuverability during clinical trials.

Actinic keratoses (AKs) are evolving malignant cutaneous neoplasms. They are also known as solar keratosis, squamous cell carcinoma in situ-solar keratotic type, or keratinocytic intraepidermal neoplasia. Actinic keratoses can be treated by two general methods: by physical/destructive methods and with topical therapies. This article will review current and evolving topical therapeutic options for AKs. Several topical treatment options have been shown to offer some significant benefit in the alleviation of these lesions. The therapies include 5-fluorouracil, imiquimod, diclofenac, colchicine and retinoids.

Literature data analysis, providing an exact explanation of the lichen planus pathogenesis, as well as its transition into other rare forms such as Keratosis lichenoides chronica or Graham Lassueur Piccardi Little Syndrome are scant, or totally missing. The chronological course of the disease, known in the literature as lichen planus, varies. Some patients develop Lichen planus or lichen nitidus and there is no logical explanation why. It is also not clear why single patients initially develop ulcerative lesions in the area of the mucosa and only in a few of them these lesions affect the skin. Antigen Mimicry and Epitope Spreading could be the possible pathogenic inductor in cases of lichenoid dermatoses, as well as the cause for their transition into ulcerative, exanthematous or other rare forms. The Epitope Spreading is probably not the leading pathogenetic factor in lichen planus but a phenomenon which occurs later. This manuscript analyzes some basic pathogenic aspects and prese...

Background  Unilesional mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma (CTCL), characterized clinically by a solitary lesion and by histopathological features indistinguishable from multilesional MF. The photodynamic therapy (PDT) is a new and effective treatment of precancerous lesions and non-melanoma skin cancers. In recent years it has been used successfully for the treatment of MF.Methods  We present two cases of unilesional MF treated with 5-Aminolevulinic acid-PDT (ALA-PDT). We used twenty per cent ALA, applied topically to the lesion, and a well defined laser irradiation at 585 nm wavelength from C-Beam laser. Treatment was repeated three times at monthly intervals. Skin biopsies were taken before and after therapy.Results  Both patients showed clinical remission. The biopsies confirmed a regression of the infiltrate after treatment.Conclusions  PDT is effective and can be used successfully for MF treatment, particularly for patch and plaque stage MF, including unilesional MF.

The authors describe a technique of infusing 1 ml (typically) to 3ml (occasionally) of saline and 1/10000 epinephrine into the superficial lamina propria of the vocal fold. A specialised needle attached to a 3ml Luer-lock syringe was used to enhance the surgery in 75 vocal fold ...