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Premalignant Neoplasms
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Laboratory studies: A definitive diagnosis often requires histologic examination, which reveals hyperkeratosis with various degrees of atypia. Perivascular inflammation, solar elastosis, and vasodilation are the most commonly observed features. Epithelial dysplasia may be evident. Dermatoscopy can aid in the diagnosis, which reveals poorly defined borders, vascular telangiectasias, and white projections surrounding ulcerated areas.
Leg, foot and nail disease in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
M. Alam, R. K. Scher, P. I. Schneiderman
Hyperkeratotic lesions (Figures 5–8) occur focally and diffusely over bony prominences and areas of increased friction54. Hyperkeratosis is a normal reaction of the skin to internally or externally applied pressure55 and can present as a callosity, callus, or corn56. According to one definition, a callosity is a plaque caused by repeated friction or pressure; a corn is a sharply demarcated callosity over a bony prominence, especially of the hands or feet, that is painful; and a callus is a broad, diffuse hyperkeratosis under the metatarsal heads (Figures 5–8)57. Soft corns between the fourth and fifth toes may be extremely painful and accompanied by maceration and cellulitis58,59. The soles of the feet in the elderly are vulnerable owing to fat pad atrophy, asymmetric pressure load and impaired vascular supply60,61. Hyperkeratoses on the sole can erode to form ulcers, with up to 30% of leg ulcers in the elderly occurring on the foot or sole. In patients with vascular or neurologic impairment, hyperkeratoses should be debrided to see if they conceal a deep ulcer or osseous involvement54. For women especially, hyperkeratotic and other foot problems are frequently related to a lifetime of wearing shoes that are too small and narrow4,62.
Selected Heritable Skin Diseases of Domesticated Animals
Published in John P. Sundberg, Handbook of Mouse Mutations with Skin and Hair Abnormalities, 2020
Robert W. Dunstan, Robert A. Kennis
Comments — Sebaceous adenitis in Standard poodles represents a unique disease entity which offers the potential to study the effects of progressive loss of sebum production. A recent study by Jeromin32 identified a markedly different pattern, both quantitatively and qualitatively, in the sebaceous lipids of affected dogs. A curious feature of the disease is the presence of hyperkeratosis. Whether this represents a concurrent defect in cornification or develops because sebum is essential for the integrity of the stratum corneum is unknown. This is not the first genetic disease in which loss of sebaceous gland function has been associated with scaly skin. Hyperkeratosis is a feature of asebia (ab), a murine mutation in which the sebaceous glands fail to develop (Part II.A., Chapter 3).32 In tandem, these diseases suggest that normal sebaceous gland activity and epidermal cornification are interrelated. Another interesting aspect of sebaceous adenitis is the observation of alopecia. Although transient in most cases, it is not associated with damage to the hair bulb or destruction of the hair follicle other than periisthmic fibrosis. Perhaps this pattern of scarring inhibits the function of the follicular stem cells which are located in this region.
Upadacitinib for the treatment of concomitant psoriasis and atopic dermatitis: a case series
Published in Journal of Dermatological Treatment, 2023
Luigi Gargiulo, Luciano Ibba, Giulia Pavia, Jessica Avagliano, Andrea Cortese, Antonio Costanzo, Alessandra Narcisi
The third patient is a 50-year-old woman affected by psoriatic spondyloarthropathy and palmar psoriasis, previously treated with salazopyrin, methotrexate, ustekinumab, secukinumab and apremilast, unsuccessfully. She presented with palmoplantar hyperkeratosis and some fissures on the palms/soles and fingers. Histopathology of a right sole’s biopsy showed ortho-parakeratosis, epidermal hyperplasia and concomitant spongiosis with a mixed dermal infiltrate. The patient reported an itch-NRS of 10/10 and a pain-VAS (Visual Analogue Scale) of 80/100. Patch tests revealed a delayed hypersensitivity for carbamates. In accordance with the Rheumatologist, we prescribed upadacitinib 15 mg/day. After four weeks, the patient reported a subjective improvement in symptoms and a reduction of hyperkeratosis.
Preparation and optimization of silibinin-loaded chitosan–fucoidan hydrogel: an in vivo evaluation of skin protection against UVB
Published in Pharmaceutical Development and Technology, 2021
Masood Ali Karami, Behzad Sharif Makhmalzadeh, Mahsa Pooranian, Anahita Rezai
The histological changes in different skin sections affected by UVB are presented in Figure 6. The first notable change was the increase in the thickness of the epidermis due to the proliferation of spiny cells called acanthosis. Also, hyperkeratosis (increased keratin layers) was another change that was visible on the surface of the epidermis. Within the epidermis, cells with wrinkled, dark, and cytoplasmic nuclei are more abundant than other lateral cells called sunburn cells. In the dermis, the infiltration of inflammatory cells with hyperemia and disruption of collagen fibers wasalso observed. Dermal blood vessel dilation and vascular hyper-permeability were also found. These changes were previously reported in psoriasis lesions (Katayama 2018) and UVB-treated skin (Sharma and Katiyar 2010). These changes were also observed in groups receiving blank hydrogel and a positive control group.
Esophageal lichen planus: towards diagnosis of an underdiagnosed disease
Published in Scandinavian Journal of Gastroenterology, 2019
Franziska Schauer, Carmen Monasterio, Kristin Technau-Hafsi, Johannes Steffen Kern, Adhara Lazaro, Peter Deibert, Peter Hasselblatt, Henning Schwacha, Steffen Heeg, Volker Brass, Armin Küllmer, Arthur Robert Schmidt, Annette Schmitt-Graeff, Wolfgang Kreisel
Scarring stricture is a long-term sequela of untreated ELP. Katzka et al. [9] showed a high prevalence of this complication which required endoscopic dilation. The clinical course of three patients in our study suggested that symptoms due to inflammatory esophageal stenosis or scarring could be effectively alleviated by topical corticosteroids. This underscores the importance of early and reliable diagnosis of ELP. Esophageal lichen planus is associated with a significant increase in risk of squamous cell carcinoma [34,51–53] with an estimated rate of 6.1% [53]. Esophageal hyperkeratosis may be the precancerous condition. We monitored two patients with marked hyperkeratosis. Extensive biopsies during the 8-year observation period under topical therapy with budesonide did not show any progression to dysplasia or malignancy.