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ABSTRACT: BACKGROUND: The periocular skin is susceptible to numerous benign and malignant neoplasms. Periocular malignancies may present differently, behave more aggressively, and pose greater challenges for treatment and repair than malignancies at other cutaneous sites. Between 5% and 10% of cutaneous malignancies occur periorbitally, with basal cell carcinoma reported as the most common malignant periocular tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma, cutaneous melanoma, Merkel cell carcinoma, and other rare tumors. OBJECTIVE: To review the current literature on cutaneous malignancies of the periocular region pertaining to etiology, incidence, clinical presentation, differential diagnosis, complications, and treatment options. MATERIALS AND METHODS: An extensive literature review was conducted using PubMed, searching for articles on periocular and periorbital cutaneous malignancies. CONCLUSIONS: Timely diagnosis and management of periocular malignancies is essential because of their proximity to and potential to invade vital structures such as the orbit, sinuses, and brain. Surgical excision remains the standard of care for the majority of periorbital malignancies, but given the sensitive anatomic location, tissue-sparing techniques with margin control such as Mohs micrographic surgery are the preferred method for most nonmelanoma skin cancers. Depending on tumor type, other treatment modalities may include radiation, chemotherapy, cryosurgery, topical medications, and photodynamic therapy.
Dermatologic Surgery 03/2012; · 1.80 Impact Factor
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Archives of dermatology 08/2011; 147(8):1008. · 4.76 Impact Factor
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Archives of dermatology 12/2010; 146(12):1444. · 4.76 Impact Factor
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ABSTRACT: There is a long history of using topical coal tar for the treatment of psoriasis and atopic dermatitis (AD).
To review the literature on coal tar and its derivatives, without the use of ultraviolet light, for the treatment of psoriasis or AD.
MEDLINE/PubMed and Cochrane Database of Systematic Reviews literature searches were performed to identify randomized controlled trials and clinical trials of topical coal tar for the treatment of psoriasis or AD. Studies were graded according to a modified version of Sackett's criteria for clinical evidence and evaluated to determine if they support or do not support the use of coal tar therapy.
Twenty-five studies meeting the authors' search criteria were identified, only two of which were placebo-controlled. The majority (21, or 84%) supported the use of coal tar products in the treatment of psoriasis or AD, while four (16%) did not support the use of coal tar products.
Most studies support the use of coal tar products, although their level of evidence is not strong. Topical coal tar was found to be efficacious in the treatment of psoriasis in two placebo-controlled trials. Coal tar products appear to be therapeutic in psoriasis and AD, are well tolerated with few side effects, and are cost-effective. Staining and odor are deterrents to coal tar therapy. Large, randomized, double-blind, placebo-controlled studies with precise point estimates of treatment effect are needed to establish the efficacy of coal tar preparations.
Journal of drugs in dermatology: JDD 10/2010; 9(10):1258-64. · 1.57 Impact Factor
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Archives of dermatology 09/2010; 146(9):1037-42. · 4.76 Impact Factor
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ABSTRACT: Large congenital melanocytic nevi (LCMN) in neonates can cause considerable concern for parents, family members, and physicians. A detailed understanding of the medical risks, including cutaneous melanoma (CM), extracutaneous melanoma (ECM), and neurocutaneous melanocytosis (NCM), as well as the psychological stress that these lesions can cause in patients, will guide informed management decisions as well as provide comfort to parents. Current data indicate that LCMN greater than 20 cm, and more likely greater than 40 to 60 cm, are the lesions at greatest risk for complications such as CM, ECM, and NCM. Additionally, lesions on the trunk are at greater risk for developing CM, and LCMN in association with numerous satellite nevi are at greatest risk for NCM. Individualized management plans, including clinical observation, magnetic resonance imaging (MRI), and possibly surgery should be based on the risk versus benefit ratio, taking into account the size of the LCMN, its location, the number of satellite nevi, symptoms, and numerous other factors which will be reviewed. This paper will provide a detailed analysis of the risks associated with LCMN, as well as a discussion regarding management and treatment options.
Seminars in cutaneous medicine and surgery 06/2010; 29(2):79-84. · 1.81 Impact Factor
