Document Detail


Variations in presentation of squamous cell carcinoma in situ (Bowen's disease) in immunocompromised patients.
MedLine Citation:
PMID:  18440666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although cutaneous malignancy is well known to occur at a higher rate in organ transplant recipients, limited data exist regarding the presentation of squamous cell carcinoma (SCC) in situ in patients with immunosuppression from any cause. OBJECTIVE: To characterize the presentation of SCC in situ in immunosuppressed patients compared with patients with normal immune function. METHODS: A retrospective comparative university-based study, reviewing charts with histologically confirmed Bowen's disease diagnosed between January 1999 and January 2003. RESULTS: Two hundred ninety-nine patients (193 men, 106 women) with 407 SCC in situ tumors were included. Fifty-seven patients (19%) were immunocompromised, including 43 organ transplant recipients, 7 patients with acute and chronic leukemia, and 6 patients with immune-suppressing infections or autoimmune disease. Immunocompromised patients were significantly younger (mean, 61.7 years) than non-immunocompromised patients, 72.6 years, P < .0001) and were more often male (P = .0115). Immunocompromised patients were significantly more likely to have multiple SCC in situ tumors (33% vs 15%; P = .012). Immunocompromised patients were also more likely to present with tumors on the trunk and extremities (odds ratio [OR], 2.03; P = .0019) and particularly on the neck (OR 3.7; P = .00075) than were non-immunocompromised patients. Overall, 11 patients (3.7%) developed a histologically confirmed recurrence of SCC in situ after apparently adequate surgical treatment. The rate of recurrence was higher in immunocompromised (9%) than in non-immunocompromised patients (3%; P = .039). LIMITATIONS: The mean follow-up duration of 35 months may underestimate the recurrence rate. CONCLUSIONS: Immunocompromised patients are at significant risk of SCC in situ, and SCC in situ in this population is likely to occur multiply and behave more aggressively. Close dermatologic surveillance of these patients is warranted.
Authors:
Ashley L Drake; Hobart W Walling
Related Documents :
12797186 - Postmenopausal intrauterine fluid collection: correlation between ultrasound and hyster...
18187986 - Tuberculous parotitis: a review of seven cases.
12426676 - Accuracy of 3-d needle navigation in interstitial brachytherapy in various body regions.
3508696 - Infantile myositis: a case diagnosed in the neonatal period.
22583316 - Effects of lipoprotein-associated phospholipase a2 on arginase/nitric oxide pathway in ...
2073646 - Effects of training on the electrophysiologic properties of atrium and accessory pathwa...
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-28
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  59     ISSN:  1097-6787     ISO Abbreviation:  J. Am. Acad. Dermatol.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-23     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-71     Citation Subset:  IM    
Affiliation:
Department of Dermatology, University of Iowa, Iowa City, Iowa, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bowen's Disease / diagnosis*,  epidemiology,  immunology*
Carcinoma in Situ / diagnosis*,  epidemiology,  immunology*
Female
Humans
Immunocompromised Host / immunology*
Incidence
Male
Middle Aged
Neoplasm Recurrence, Local / epidemiology
Neoplasms, Multiple Primary / epidemiology
Retrospective Studies
Skin Neoplasms / diagnosis*,  epidemiology,  immunology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Estimating first-order reaction rate coefficient for transport with nonequilibrium linear mass trans...
Next Document:  The role of scalp dermoscopy in the diagnosis of alopecia areata incognita.