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An introduction to skin and skin disease
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
The apocrine sweat glands drain directly into hair follicles. They are found in axillae, areolae, periumbilical areas, prepuce, mons pubis, labia minora, etc. Modified apocrine glands include ceruminous glands of the ear, Moll’s glands on eyelids, and mammary glands. They are larger than eccrine sweat glands and the secretion is completely different, being semi-solid and containing odiferous materials that are thought to have the function of sexual attraction.
Mammary and extramammary Paget's disease
Published in Longo Caterina, Diagnosing the Less Common Skin Tumors, 2019
Riccardo Pampena, Giorgio La Viola, Alessandro Annetta
Paget's disease usually appears on the breast of adult women with an underlying breast cancer, as a unilateral erythematous/eczematous plaque, which slowly spreads from the nipple to the areola and sometimes to the surrounding skin. In a minority of cases Paget's disease may not be associated with breast cancer, and in 6% of cases it may also involve extramammary sites.1 Extramammary Paget's disease generally involves body sites with a high density of apocrine glands, primarily the anogenital region, followed by the axillary area. Anecdotic cases have also been reported deriving from modified apocrine glands, such as the ceruminous glands of the external ear and the Moll's glands located on the eyelid. Of note, the mammalian gland is also considered as a modified apocrine gland.2 The clinical aspect of extramammary Paget's disease is similar to the mammary form; however, crusts or scales are less frequently found because of the location on skin folds; and moreover, it is more frequently seen in elderly men. Rarely both mammary and extramammary Paget's disease may be pigmented.
Special Senses
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Kenneth A. Schafer, Oliver C. Turner, Richard A. Altschuler
The ear can be divided into three parts: the external ear, middle ear, and inner ear. The external ear consists of the pinna (auricle) and the external ear canal (external auditory meatus), which ends medially at the external surface of the tympanic membrane (ear drum). The structures of the external ear are supported by auricular cartilage, and the secretions from the sebaceous and ceruminous glands contribute to the formation of cerumen. In rodents, Zymbal’s gland is a sebaceous gland located anterior and ventral to the external ear canal. Pathologic changes of the external ear can involve the skin or specific structures of the external ear (Kelemen 1978). Inflammation of the external auditory canal is usually not an issue in toxicologic studies unless clinical signs, such as shaking of the head or ear scratching, are observed. When inflammation does occur, it is characterized by thickening of the wall of the external auditory canal from edema, and the presence of a tan or brown crusty exudate within the canal (Gad 2007). One cause can be ear mites (e.g., Psoroptes cuniculi in rabbits or Otodectes cynotis in dogs). Auricular chondritis is a spontaneous condition reported in several strains of rats that appears as nodular or diffuse thickening of the pinna by granulomatous inflammation of fibrochondrous to chondroosseous tissue (Chiu 1991; Kitagaki et al. 2003). Differential diagnoses include chondrolysis and neoplasms.
Pleomorphic adenoma of the external auditory canal: A common tumour in an uncommon site
Published in Acta Oto-Laryngologica Case Reports, 2020
S. O. Ayodele, O. A. Afolabi, O. O. Folaranmi, F. E. Ologe
Pleomorphic adenomas are the most common benign salivary gland neoplasm encountered in the major salivary glands [1,2]. They are also being known as benign mixed tumours [2]. They can also arise from minor salivary glands and in the head and neck region like the lip, nasal septum, turbinate, cheek, throat, lacrimal glands, palate, tongue, retromolar region, floor of the mouth, alveolar mucosa and the cheek [3]. In 1951, Mark and Rothberg reported the first case of pleomorphic adenoma of the external ear canal [4]. Primary tumours arising from the glandular structures of the external auditory canal are rare, with the majority arising from the ceruminous glands [5]. Previous studies have also shown that pleomorphic adenoma of the external auditory meatus is extremely rare and belongs to a group of benign tumours assumed to originate from the ceruminous glands of the external auditory canal [4,6]. Based on literature review, there has been no published report of similar finding in this region. We report herein an unusual case of pleomorphic adenoma of the left external auditory canal associated with chronic infection of the middle ear and we discussed its clinical presentation and treatment.
Liposuction-assisted circumferential trimming in treatment of axillary osmidrosis (AO)
Published in Journal of Dermatological Treatment, 2018
Xiaogen Hu, Bo Chen, Dingquan Yang
Apocrine glands of human body are generally confined to the axillae, areolae, anogenital region, external auditory canal (ceruminous glands) and eyelids (glands of Moll). It is believed that the apocrine glands are located in the axillary hair-bearing area, so the operative area is determined by the location of axillary hair growth. The glands are composed of columnar secretory cells surrounded by myoepithelial cells (5). The glands are innervated by adrenergic fibers of the sympathetic nervous system and respond to stress by an increase in production. Histologically, the apocrine glands in the axilla extend from the lower dermis, deep into the subcutaneous fat. The apocrine glands are located below skin surface (6). The greatest distribution is densely attached to the reticular dermis and is confined to the center of the axilla with less distribution at the peripheral area of the axillary hair. The gland is visible to the naked eye in the dissected specimen. The duct of the gland opens into the neck of the hair follicle, not directly to the skin surface. Apocrine glands secrete very small amount of an oily fluid which is odorless on the skin surface. The characteristic odor of AO is due to bacterial decomposition of the oily fluid. Trans-3- methyl-2-hexenoic acid is one of the odorants. The severity degree of AO is proportional to the increase in density of resident bacteria in the apocrine gland, most notably coryneform and Staphylococcus epidermidis which can function in the formation of odorous acids, thiols, and steroids that are transported by the ABCC11 protein (7). Although the exact pathogenesis for AO remains disputed, an increasing number of studies suggest that it is caused by abnormal apocrine glands characterized by hyperfunctioning, large size or quantity (2). Consequently, surgical removal of apocrine glands could be the most satisfactory and logical therapy of AO. Studies have evidenced that all or most of the apocrine glands are located in the subcutaneous tissue near the border to the dermis; therefore, only removing the subcutaneous tissue with skin reserved can also obtain a radical cure effect (3). To seek an ideal surgical treatment for AO, a good method for treating osmidrosis should include an outpatient operation with local anesthesia, short operation time, rapid recovery, low complication rate, inconspicuous scar, and durable results (8).