1/14. Excision of multiple eyelid apocrine hidrocystomas via an en-bloc lower eyelid blepharoplasty incision.A 39-year-old man presented with upper and lower eyelid apocrine hidrocystomas that had recurred after each of three prior attempts at excision. These multiple, cystic tumors were adherent to the epidermis, thus precluding complete dissection and excision of each individual lesion. We report a surgical technique using a lower eyelid blepharoplasty incision to remove the confluent tumors of the lower eyelids en-bloc. We paid careful attention to both removing the lesions without rupturing the cysts and to achieving adequate depth of excision. histology revealed features typical of apocrine hidrocystomas. The patient has remained free of recurrence three years since the en-bloc excision of the lesions.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
2/14. Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid: a case report.BACKGROUND: Syringocystadenoma papilliferum is an unusual benign tumor most commonly located on the scalp or face, which frequently arises from a nevus sebaceous. Transition of SP to basal cell carcinoma and, rarely, to metastatic adenocarcinoma may occur. CASE REPORT: A 28-year-old female patient had been suffering from a pinkish, painless nodule for 25 years. physical examination revealed a pinkish, non-tender, painless nodule, 5mm in diameter, on the lower eyelid. The nodular lesion was excised, and the lower eyelid was reconstructed with V-Y advancement flap. Histopathologic examination revealed hyperkeratosis with papillomatosis of epidermis. The dermis showed several cystic invaginations extending downwards from the epidermis. One year later, the postoperative result was cosmetically and functionally acceptable. CONCLUSON: Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid is of interest, since there were scanty skin appendages. Our paper considers the issue of differentiating between SP and BCC, since SP is asymptomatic and may have similar appearance. We believe that SP may be a transitional step from nevus sebaceous to basal cell carcinoma, since molecular studies show PTCH gene in all three lesions, the origins of SP are still debatable, and both SP and BCC can arise in nevus sebaceous of Jadassohn.- - - - - - - - - - ranking = 2keywords = epidermis (Clic here for more details about this article) |
3/14. Superficial epithelioma with sebaceous differentiation.In 1980, Rothko, Farmer, and Zeligman first described the disease entity "Superficial epithelioma with sebaceous differentiation" as a histologically distinct, rare, benign lesion. We report here the first Japanese case fitting this description. The patient is a 38-year-old Japanese woman, who had a small, yellow, flat-topped, well-defined plaque on her right upper eyelid. Histologically, the lesion was a multilobular, superficial, dermal tumor with numerous broad attachments to the overlying epidermis. The overall configuration was a plate-like proliferation of tumor cells with well-defined borders. The tumor cells were basically uniform basaloid cells with single or clustered sebocytes in the upper part of the tumor and multiple well differentiated sebaceous lobules in the middle and lower parts of the tumor. Multiple cystic spaces were formed in the lobules. Differential diagnosis of several tumors with sebaceous differentiation is discussed.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
4/14. Basal cell-signet-ring squamous cell carcinoma of the eyelid.A 93-year-old woman developed a mass on her right lower eyelid that was present for more than 6 months but underwent rapid expansion during several weeks prior to her ophthalmological evaluation. Examination revealed an approximately 1.8 cm in diameter, fleshy, fungating growth involving more than 60% of the right lower eyelid. Excisional biopsy disclosed a neoplasm arising from the epidermis composed of adjoining basal cell and signet-ring squamous cell carcinoma, without a transition zone. The cells comprising the basal and squamous cell carcinomas were distinct immunophenotypically, with only the basal cell carcinoma reacting with Ber-EP4 and CAM 5.2 antibodies. To our knowledge, this case represents the first example of a collision tumor composed of basal cell and signet-ring squamous cell carcinoma.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
5/14. Unspecific redness of the eyelid--two malignant tumours.BACKGROUND: Chronic, non- or little pigmented reddish or brownish lesions on the lid margin and the surrounding skin are frequently underestimated and thus carry a clear risk of malignancy. history AND SIGNS: A 61-year-old lady was referred with a chronic, reddish lesion in the medial third of the left lower lid after a topical therapy over a period of 4 months had not improved the situation. She noticed the lesion for the first time 10 previously. Recurrent trichiasis and a slight ulceration had developed during the last year. THERAPY AND OUTCOME: After an unclear result of the biopsy (2)/ (3) of the left lower lid were removed because of atypical cells ascending into the epidermis. A superficial spreading melanoma 0.4 mm depth in the Breslow classification was detected and right next to it a superficial basal cell carcinoma. The lid defect was reconstructed with a tarsoconjunctival flap and a free full thickness skin graft as described by Hughes. CONCLUSION: Chronic redness at or around the lid margin which does not respond to therapy should be biopsied as malignant tumours may well be hidden behind it.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
6/14. Large-cell acanthoma of the eyelid. Report of two cases.We describe two cases of large-cell acanthoma that involved the skin of the upper eyelid. Patient 1 was a 71-year-old white man with a pale, well-demarcated papillomatous plaque of 3 months' duration. Patient 2 was a 62-year-old white man with a sharply demarcated plaque-like thickening of the pretarsal skin involving the eyelid margin of 2 years' duration. In both cases, the histopathologic findings were similar and showed an abrupt transition at the edge of the lesion between the normal epidermis and the acanthotic plaque, which displayed hyperkeratosis, hypergranulosis, and focal parakeratosis. The localized epidermal thickening showed enlarged keratocytes that appeared twice their normal size. To our knowledge, this is the first report of large-cell acanthoma involving the eyelid.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
7/14. Hidradenoma papilliferum of the upper eyelid arising from the apocrine gland of Moll.Hidradenoma papilliferum is derived from apocrine sweat glands and was originally described as a tumor located in the anogenital area. The authors recently examined a 78-year-old man with a hidradenoma papilliferum at the margin of the upper eyelid. While the tumor was located in the dermis, serial sections showed a connection to the epidermis and neoplastic cells partially replacing a gland of Moll. There were glandular structures with luminal cells that showed apical decapitation-type secretion, indicating the apocrine origin of the tumor. The luminal cells also contained granules that stained with periodic acid-Schiff (PAS) stain and were diastase resistant. Results of examination of the duct-forming cells by transmission electron microscopy showed adluminal villi, focal decapitation secretion, luminal cytoplasmic debris, and electron-dense cytoplasmic secretory granules. Because the apocrine glands of Moll are localized adjacent to the eyelid cilia, hidradenoma papilliferum and other tumors of apocrine origin should be considered in the clinical setting of a mass at the eyelid margin.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
8/14. Small cell carcinoma of skin: a report of two cases.We present two cases of small cell carcinoma of skin and review the evidence for the origin of these tumours from merkel cells situated in the basal layers of the epidermis. The aggressive behaviour of these tumours makes their initial histological diagnosis important if careful follow-up is to be instituted and we suggest that more radical primary treatment might improve results. We emphasise the need to exclude an origin from other sites apart from skin and the role of electron microscopy and immunohistochemistry in identifying these tumours as being distinct from other poorly differentiated carcinomas.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
9/14. Familial syringoma. Case history and application of monoclonal anti-eccrine gland antibodies.We studied a family with dominantly inherited eruptive syringoma. The father and the older daughter had chest and neck as well as eyelid lesions. The chest lesions seemed to develop continuously by new formation of eccrine germlike budding from the epidermis. Monoclonal antikeratin antibody EKH4, which predominantly labels the basal layers of the epidermis, stained positively in the cordlike epithelial structure and peripheral cells of the walls of cystic lesions. Staining with EKH6, which recognizes normal eccrine secretory and ductal structures--particularly luminal borders--was positive along the luminal borders of the cystic lesions; staining with EKH5, which labels eccrine secretory portion, was entirely negative in the lesions. These findings further supported the theory that syringoma of the eyelids and eruptive syringoma, which mainly involves the anterior neck and upper chest, are essentially the same tumor and that these appendage tumors are of eccrine ductal differentiation.- - - - - - - - - - ranking = 2keywords = epidermis (Clic here for more details about this article) |
10/14. Syringocystadenoma papilliferum of the eyelid.Two patients presented with slowly developing papillated or hyperkeratotic lesions of their lid margins that began early in the fourth decade. Upon excision, these tumors were discovered to be examples of syringocystadenoma papilliferum, a lesion not previously well documented in the ophthalmic literature. By light microscopy, each tumor displayed surface poral openings where the epidermis underwent a transition into duct-like epithelium, which ramified as luminal channels throughout the tumor. Papillae projected into many of the duct-like spaces and were lined by columnar to multilaminar nonkeratinizing epithelium. A plasma cell-rich infiltrate was present in the connective tissue cores of the papillae. Electron microscopy performed on one of the lesions revealed that the channels were true ducts, with the innermost cells displaying microvilli, small numbers of tonofilaments, and apical junctional complexes composed of a zonula occludens and zonular adherens. These findings, coupled with the location of the tumors at the lid margin and the presence of dilated apocrine glands of Moll deep to one of the tumors, support an apocrine origin. The clinical differential diagnosis of syringocystadenoma papilliferum with respect to other more common lid tumors is discussed.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
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