povidone-iodine and Skin-Neoplasms

Over the last decade, studies have compared the use of sterile gloves (SGs) versus nonsterile gloves (NSGs) on surgical site infection (SSI) rates in Mohs micrographic surgery (MMS). In this study, we sought to determine SSI rates before and after employment of NSGs for dermatologic procedures. Infection data were collected from January 2009 to December 2015 on 7365 tumors treated with MMS and 1620 tumors treated by surgical excision. For MMS procedures using chlorhexidine as the antiseptic, the SSI rate with SGs was 3.39% compared to 3.06% with NSGs. For surgical excisions, the SSI rate was 3.02% with SGs and 4.17% with NSG. Using NSGs for MMS tumor resection and reconstruction can provide cost savings without adversely affecting SSI rates, and could also be considered in dermatologic procedures, including electrodessication and curettage and surgical excisions.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Cost Savings; Cost-Benefit Analysis; Gloves, Surgical; Humans; Mohs Surgery; Povidone-Iodine; Skin Neoplasms; Sterilization; Surgical Wound Infection

While dermatoscopy improves diagnostic accuracy for raised nonpigmented lesions, those with white surface keratin can be problematical. We investigated whether retention of povidone-iodine by surface keratin provides a clue to benignity.. We performed a retrospective pilot study (n = 57) followed by a prospective study (n = 117) on raised nonpigmented lesions with white surface keratin. An initial dermatoscopic image was taken of each lesion, povidone-iodine was applied and another image taken. Following lavage with 70% ethanol, a third image was acquired. The percentage surface area of residual povidone-iodine staining after lavage was recorded, and the results analysed.. The optimal cut-off point of residual staining was 80%, where values of ≤80% pointed to malignancy. At this cut-off, the OR for lesions with values ≤80% to be truly malignant in the retrospective set was 4.03 (95% CI: 2.1-7.6) and the AUC was 0.7 (95% CI: 0.62-0.78). For the prospective set, the corresponding OR was 2.3 (95% CI: 1.4-3.7) and the AUC was 0.62 (95% CI: 0.55-0.68).. This study presents evidence that povidone-iodine retention may have a degree of efficacy in distinguishing benign from malignant keratotic lesions. Further study is warranted.

Topics: Aged; Aged, 80 and over; Area Under Curve; Carcinoma, Squamous Cell; Coloring Agents; Dermoscopy; Diagnosis, Differential; Female; Humans; Keratoacanthoma; Male; Middle Aged; Pilot Projects; Povidone-Iodine; Prospective Studies; Retrospective Studies; ROC Curve; Skin Neoplasms

Topics: Anti-Infective Agents, Local; Carcinoma, Squamous Cell; Humans; Margins of Excision; Neoplasm Recurrence, Local; Povidone-Iodine; Skin Neoplasms; Sodium Chloride; Surgical Wound; Therapeutic Irrigation; Water

A 5-year-old Japanese boy visited our clinic for treatment of a dark bluish papulonodular lesion on his right thigh. The histopathology of the lesion indicated angiokeratoma corporis circumscriptum naeviforme. Topical antibiotics were prescribed for occasional bleeding from the site. Frequent bleeding started in April of 1992, when erythema and itching were observed around the angiokeratoma. Histopathology of the lesion showed heavy lymphoid cell infiltration around dilated capillaries and irregular acanthosis engulfing dilated capillaries. Interestingly, there were confined masses of red blood cells in the epidermal layer as well as both in and on the horny layer. This is a feature of transepidermal elimination. This transepidermal elimination appeared to be triggered or enhanced by the concomitant contact dermatitis due to topical antibiotics. To the best of our knowledge, this is the first report of angiokeratoma in which the angiokeratoma itself reduced in size through transepidermal elimination, possibly caused by contact dermatitis.

Topics: Angiokeratoma; Capillaries; Child, Preschool; Dermatitis, Contact; Epidermis; Erythrocytes; Humans; Male; Neomycin; Povidone-Iodine; Skin Neoplasms