phenylephrine-hydrochloride and Carcinoma-in-Situ

This article evaluates malignant transformation of lesions presenting in the periocular skin under the eye spectacle nose pad. A non-comparative retrospective chart review of clinical features and pathological findings of patients presenting with periocular malignancies in the exact vicinity where the nose pads of their eye spectacles rested was completed. The study took place in one tertiary oculoplastic referral center between 2007-2013. Ten patients were included, six of whom were male. All subjects wore eye spectacles while awake for at least 15 years, and had an evident suspicious lesion in the exact area that coincided with the resting place of the nose pad. The mean age was 73.5 years (range 65-85 years) and all patients had the lesion present for at least one year. Most cases were squamous skin malignancies (five squamous cell carcinomas [SCC], 2 intra-epidermal carcinomas [IEC], while 3 basal cell carcinomas [BCC]). Treatment involved surgical excision of the lesion with frozen section for margin control and reconstruction with a myocutaneous flap. Periocular malignancies of the inferior medial canthal area, where the nose pad of eye spectacle places pressure, can be easily missed or misdiagnosed. Marjolin ulcers (MU) classically present as an aggressive SCC in area of chronic inflammation, which has been previously correlated to constant pressure, repetitive trauma, or non-healing wounds in other areas of the body. We propose that the traumatic chronic pressure in the infero-medial canthal region from long-term eye spectacle nose pad use, may induce poor lymphatic regeneration leading to an immune system deficiency that predisposes this skin to a malignant transformation. The presence of chronic eye spectacle nose pads also prevents proper and timely detection of such malignancies. Complete excision of these lesions with margin control, adequate follow-up for possible recurrence, and surveillance for new lesions on the patient's contralateral side, is crucial for adequate management.

Topics: Aged; Aged, 80 and over; Carcinoma in Situ; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Eyeglasses; Female; Humans; Male; Nose; Retrospective Studies; Skin Neoplasms

The occurrence of neoplasms in injury scars--as consequence of occupational accidents--may lead to compensation according to the statutory accident insurance regulations. According to newer regulatory attempts in occupational dermatology, certain criteria have to be met before the diagnosis of a neoplasm induced by a scar is accepted and compensation is due.. Based on a retrospective analysis of 217 dermatological claim files between 2007 and 2009 of the IPA (including 22 follow-ups), medical opinions on neoplasms developing in possible occupational scars were re-evaluated using criteria of the German social accident insurance and the Bamberg medical bulletin, part II (Bamberger Merkblatt, BM II) to see how well they qualified for recognition as an occupational or accident-related disorder.. Three cases were identified where a neoplasm was suspected of having developed in an occupationally-related scar. One of the insured events entitled for compensation. Following the guidelines of the BM II, this case was approved as an occupational disease secondary to injuries with resultant reduction in earning capacity, whereas the others did not meet the requirements.. Two problems in evaluating malignant tumors in occupational scars are the long latency period and the documentation of a scar. The tumor excision specimen should be histologically re-examined to document the presence of an associated scar.

Topics: Accidents, Occupational; Arm Injuries; Burns; Carcinoma in Situ; Carcinoma, Basal Cell; Cell Transformation, Neoplastic; Cicatrix; Expert Testimony; Germany; Head and Neck Neoplasms; Humans; Insurance, Accident; Melanoma; Nose; Nose Neoplasms; Retrospective Studies; Skin; Skin Neoplasms; Workers' Compensation

Topics: Administration, Cutaneous; Aged; Aged, 80 and over; Aminoquinolines; Antineoplastic Agents; Carcinoma in Situ; Carcinoma, Squamous Cell; Female; Humans; Imiquimod; Keratosis; Male; Middle Aged; Nose; Photosensitivity Disorders; Precancerous Conditions; Skin Neoplasms; Thorax

Topics: Carcinoma in Situ; Carcinoma, Transitional Cell; Diagnosis, Differential; Ethmoid Sinus; Frontal Sinus; Humans; Male; Maxillary Sinus; Middle Aged; Nasal Polyps; Neoplasm Recurrence, Local; Nose; Nose Neoplasms; Papilloma; Paranasal Sinus Neoplasms