Male anorectal malformation: Case study
Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt in Pediatric Colorectal and Pelvic Surgery, 2017
This chapter presents a case study of a newborn male infant with an anorectal malformation seen at 26 hours of age. He has undergone his routine VACTERL screening as per the protocol. In this patient there is a rectourethral fistula and the colon needs to be separated from the urinary tract. The raised area (skin tag) marks the center of the sphincter complex and the anoplasty should be centered here. It is somewhat anterior, and close to the scrotum, typical of a bladder neck or prostatic fistula. A mucous fistula is required to perform the distal colostogram in order to identify the level of the site of the fistula (e.g., rectobulbar or rectoprostatic). A loop colostomy should be avoided because fecal material can potentially spill into the mucous fistula.
Curettage, cautery, snip, shave, trichloroacetic acid
Graham Colver in Outcomes of Skin Surgery, 2008
Curettage and cautery are used when the material being removed is softer than the surrounding skin or there is a natural plane to separate the diseased tissue from the normal. Electrocautery and electrodessication are used to destroy small areas of abnormal skin such as tags and prominent blood vessels, and also to cauterize vessels after curettage and shave excision. At low power this can be done without local anaesthetic. Because it is a destructive method there is always the likelihood of some permanent scar or indentation. Lesions on stalks, such as skin tags, are often best treated by snipping the base with sharp scissors. The small amount of bleeding stops with a little pressure. Large tags and fibroepithelial polyps have a broad base and anaesthetic is used, not only because the snip itself will be more painful but also because cautery may be needed to stop the bleeding.
Benign lesions
Richard P. Usatine, Daniel L. Stulberg, Graham B. Colver in Cutaneous Cryosurgery, 2014
This chapter deals with the management of benign lesions and constitutes a major part of cryosurgical practice. Some benign lesions with an increased melanin content, such as solar lentigines and labial melanotic macules, and vascular lesions often respond well, but those containing much connective tissue will be resistant. Skin tags are common, benign, pedunculated tumors that occur predominantly in the flexural aspects of the body, and most often in overweight and older adults. A benign lichenoid keratosis may have similar features to cutaneous cancers so it is often diagnosed after a biopsy is performed. Chondrodermatitis nodularis helicis presents as a painful nodule on the pinna and is likely related to the pressure that develops on the ear while lying in bed. For benign lentigines, cryosurgery is one quick and effective treatment option. Other options include lasers, intense pulsed light, and topical trichloroacetic acid.
Colorectal Cancer Implant in an External Hemorrhoidal Skin Tag
Published in Baylor University Medical Center Proceedings, 2016
Lampros Liasis, Harry T. Papaconstantinou
External hemorrhoidal skin tags are generally benign. Colorectal cancer metastases to the squamous epithelium of perianal skin tags without other evidence of disseminated disease is a very rare finding. We present the case of a 61-year-old man with metastasis to an external hemorrhoidal skin tag from a midrectal primary adenocarcinoma. This case report highlights the importance of close examination of the anus during surgical planning for colorectal cancers. Abnormal findings of the perianal skin suggesting an implant or metastatic disease warrant biopsy, as distal spread and seeding can occur. In our patient, this finding appropriately changed surgical management.
Immunohistochemical Evaluation of Leptin Role in Skin Tags
Published in Ultrastructural Pathology, 2015
Iman Seleit, Ola Ahmed Bakry, Rehab Munir Samaka, Marwa Samy
Skin tags (STs) are common benign dermal connective tissue neoplasms that are mainly composed of loose fibrous tissue. However, their exact etiology is not fully understood. Leptin is a major player in the biology and pathology of the skin and its appendages. It is linked to cell differentiation, proliferation, migration, and survival with pronounced effects on angiogenesis, blood flow, and tissue perfusion. This study aimed at investigating the possible role of leptin in STs pathogenesis and correlating its expression with different clinical and histopathological parameters. Using immunohistochemical techniques, we examined 90 subjects. These included 60 non-obese cases with STs and 30 age-, gender- and Body Mass Index-matched normal subjects as a control group. Leptin was overexpressed in STs compared with normal skin (p
Immunolocalization of Androgen Receptor and Estrogen Receptors in Skin Tags
Published in Ultrastructural Pathology, 2014
Ola Ahmed Bakry, Rehab Monir Samaka, Mohamed Abdel Moneim Shoeib, Aziza Maher
Skin tags (STs) are benign connective tissue tumors of the dermis. Several clinical observations suggested the involvement of sex steroids in their development. This study aimed at investigating the possible role of androgen receptor (AR) and estrogen receptors (ERs) in STs pathogenesis through their immunohistochemical (IHC) localization in skin biopsies of this disease and to correlate their expression with different clinical and histopathological parameters. Using IHC techniques, we examined 62 cases with STs and 30 gender- and age-matched, healthy subjects, representing the control group. ERα, ERβ, and AR were upregulated in STs compared to normal skin in epidermis and dermis (p