Malignant lesions
Richard P. Usatine, Daniel L. Stulberg, Graham B. Colver in Cutaneous Cryosurgery, 2014
When treating skin cancers with cryosurgery the goal is destruction of the lesion at the first treatment. To accomplish this, the tumor must be frozen to a sufficient depth and with adequate peripheral margins so that no focus of malignancy remains untreated. Most failures in cryosurgical treatment of skin cancers are due to the following: poor tumor selection and poor technique. With appropriate selection of patients and tumors, adequate equipment, and proper techniques, cryosurgery is an excellent therapeutic modality for the treatment of skin malignancies. The tissue-sparing value of cryosurgery has special relevance for tumors on the eyelids. Lentigo maligna is a term for melanoma in situ occurring on sun-exposed areas, especially on the face of elderly individuals. Excisional surgery is the treatment of choice for invasive malignant melanoma.
Melanoma
Aimilios Lallas, Zoe Apalla, Elizabeth Lazaridou, Dimitrios Ioannides, Theodosia Gkentsidi, Christina Fotiadou, Theocharis-Nektarios Kirtsios, Eirini Kyrmanidou, Konstantinos Lallas, Chryssoula Papageorgiou in Dermatoscopy A–Z, 2019
Melanoma is a malignant melanocytic tumor that represents the most frequent cause of deaths associated with skin cancer. Several classifications have been proposed, based on clinical features, histopathologic alterations, and different anatomical locations. Traditionally, four main types of melanoma are described: superficial spreading, nodular, lentigo maligna melanoma, and acral lentiginous melanoma. The differential diagnosis of conventional melanoma includes other pigmented skin tumors, mainly nevi, seborrheic keratosis, and pigmented basal cell carcinoma. The clinical discrimination between nevi and melanoma is basically based on the natural symmetry of nevi, in contrast to the irregular morphology that typifies melanoma after a certain progression point. Acral melanoma (AM) is the most common subtype of melanoma in dark-skin and Asian populations. AM has long been associated with a worse prognosis compared to other melanoma subtypes, but recent data highlighted that this is rather a result of delayed diagnosis than indicative of more aggressive biological behavior.
Problems with pigmentation
Manu Shah, Ariyaratne de Silva in The Male Genitalia, 2018
The male genitals are normally more pigmented than other areas of skin. This is particularly noticeable in the pigmentation of the scrotum. Genital pigmentation may be isolated or may be a part of a widespread pigmentation disorder. Systemic disorders such as Addison's disease will give hyperpigmentation over various parts of the body, not just the genitals. A lentigo (plural lentigines) is a melanocytic lesion of the skin clinically similar to a freckle. Lentigines on the genitals and mucosal surfaces may indicate a genetic disorder. Vitiligo is a common skin condition resulting in destruction of melanocytes. It occurs in all races at a rate of 1–2%. It commonly presents between 10 and 30 years of age. Diagnosis is made clinically but may be facilitated by the use of the Wood's light in order to visualise areas of pigment loss. Treatment options on the genitals are limited. There are some normal variants that may present as a pigmentary problem.
Periocular lentigo maligna treated with imiquimod
Published in Journal of Dermatological Treatment, 2011
Jennifer O'Neill, Dominic Ayers, John Kenealy
Topical imiquimod 5% cream has been used successfully to treat eyelid basal cell carcinoma, Bowen's disease of the eyelid and eyelid lentigo maligna. We report a case of borderline lentigo maligna on the eyelid that proved difficult to treat with surgery and, when the patient deferred surgery for personal reasons, imiquimod 5% cream was used with complete resolution of the lesion and no recurrence so far over a 3-year period of follow-up. The use of imiquimod in lentigo maligna and around the eye is discussed.
Acute Exacerbation of Myasthenia Gravis with Topical Imiquimod Use
Published in Baylor University Medical Center Proceedings, 2017
Saadeddine Saad, Bobbak Mansouri, Chad Housewright
Imiquimod activates the immune system when applied to a local area. We report a patient with a history of well-controlled myasthenia gravis who was prescribed imiquimod for lentigo maligna. Treatment was halted after 2 weeks when the patient reported itching and irritating sensations in his throat, consistent with previous myasthenia exacerbations. The symptoms improved once imiquimod use was discontinued. We advise clinicians to be cautious when prescribing imiquimod to a patient with a history of myasthenia gravis.
A 71-Year-Old Woman with a Pigmented Nail Bed, which Persisted after Trauma
Published in Acta Chirurgica Belgica, 2010
A 71-year-old woman presented in our out-patients department with pigmentation of the nail bed of her left large toe, which had persisted after a trauma two years earlier. An inconclusive biopsy showed melanoma in situ. The lesion was excised with amputation of the big toe at the IP-joint and closed primarily. The pathological diagnosis was melanoma in situ and lentigo maligna. The lesion had been radically excised.