Intradermal melanocytic nevus of the external auditory canal

Cholesterol was identified as a biomarker in human melanocytic nevi using DESI and DESI/PI mass spectrometry imaging

The rapid differentiation between diseased tissue and healthy normal tissue is of great importance for the intraoperative diagnosis. Herein, desorption electrospray ionization (DESI) and DESI/post-photoionization (DESI/PI) mass spectrometry imaging were combined to in situ visualize the distribution of biochemicals within the tissue regions of human melanocytic nevi under the ambient condition with a spatial resolution of around 200 μm. Plenty of polar and nonpolar lipids were found to be specifically distributed in melanocytic nevi with statistical significance and could be used to differentiate the healthy normal tissue and melanocytic nevi. Cholesterol was further confirmed to be a potential biomarker for melanocytic nevi diagnosis by multivariate statistical analysis and immunohistochemistry of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) and translocator protein (TSPO) enzymes. This work provides a visual way for the diagnosis of human melanocytic nevi by lipid profiling, which benefits the understanding of the pathological mechanism of melanocytic nevi and provides a new insight to control melanin growth from the synthesis, transport, and metabolism of cholesterol.

Treatment of palpebral melanocytic nevi with a dual-wavelengths copper vapor laser

Acquired melanocytic nevi in aesthetically significant areas, especially palpebral nevi (PN), are becoming a frequent reason for patients to seek dermatologists. Surgical methods for removal of PN are reported to be associated with the risk of such side effects as scars and loss of eyelashes. Aim of the study. To evaluate the efficacy of the removal of PN on the eyelid area with dual-wavelength radiation of a copper vapor laser (CVL). Patients and methods. Laser removal of medium and large-sized PN (up to 10 mm) was performed in three fair-skin female patients. The procedures were carried out at an average CVL radiation power of 0.60.8 W, at a 3:2 ratio of radiation powers at wavelengths of 511 nm and 578 nm, exposure duration 0.3 s, light spot diameter 1 mm. The treatment was carried out during one session. Results. Removal of PN with dual-wavelength CVL radiation allowed achieving a significant lightening and reduction of the involved area, without scars. The skin healing after the procedure lasted 2 weeks. Conclusion. The high efficacy of the PN removing in the eyelid area using the dual-wavelength CVL radiation allows the introduction of this approach into dermatologists and cosmetologists clinical practice.

Treatment of palpebral melanocytic nevi with a dual-wavelengths copper vapor laser

Acquired melanocytic nevi in aesthetically significant areas, especially palpebral nevi (PN), are becoming a frequent reason for patients to seek dermatologists. Surgical methods for removal of PN are reported to be associated with the risk of such side effects as scars and loss of eyelashes. Aim of the study. To evaluate the efficacy of the removal of PN on the eyelid area with dual-wavelength radiation of a copper vapor laser (CVL). Patients and methods. Laser removal of medium and large-sized PN (up to 10 mm) was performed in three fair-skin female patients. The procedures were carried out at an average CVL radiation power of 0.60.8 W, at a 3:2 ratio of radiation powers at wavelengths of 511 nm and 578 nm, exposure duration 0.3 s, light spot diameter 1 mm. The treatment was carried out during one session. Results. Removal of PN with dual-wavelength CVL radiation allowed achieving a significant lightening and reduction of the involved area, without scars. The skin healing after the procedure lasted 2 weeks. Conclusion. The high efficacy of the PN removing in the eyelid area using the dual-wavelength CVL radiation allows the introduction of this approach into dermatologists and cosmetologists clinical practice.

Failed septal extension graft in a patient with a history of radiotherapy

Background

This report describes the authors’ experience of “melting” septal cartilage after placement of a septal extension graft in a nasopharyngeal cancer patient that had been previously undergone radiation therapy, and provides a review of the literature.

Methods

Electronic medical records were used to obtain details of the patient’s clinical history.

Results

A 32-year-old woman, who had previously undergone radiotherapy for nasopharyngeal cancer, visited our department to for rhinoplasty. Rhinoplasty was performed using a septal extension graft to raise the nasal tip (first operation). Five days after surgery, it was found that the septal extension graft was melting without any signs of infection, that is, the graft had softened, lost elasticity, thinned, and partially disappeared without any sign of infection at 5 days, and thus, the nasal tip was reconstructed with conchal cartilage (second operation). Five months after surgery, it was found that almost all septal cartilage had disappeared without any sign of infection, and thus, the entire nasal septum was reconstructed using 2-mm costal cartilage and an onlay graft was used for tip augmentation (third operation).

Conclusions

After cartilage has been exposed to radiotherapy, its patency should be viewed with suspicion. Further studies are needed for determine the mechanism responsible for cartilage damage after radiotherapy.

Clinical and histological characteristics of melanocytic nevus in external auditory canals and auricles

Nevi, which consist of nevus cells arising from external auditory canals (EACs) and auricles, are rare and their characteristics are not thoroughly understood. The purpose of this study was to analyze the clinicopathological characteristics of melanocytic nevus (MN) in EACs and auricles. Medical records were reviewed in 35 cases with junctional, compound and intradermal nevi treated in Ajou University Hospital, Korea between 2001 and 2011. Patient demographic, location, shape, and diameter of nevi, and pathologic results were analyzed according to the location, EACs (23 cases) and auricles (12 cases). Female predominance was noted in both EAC (60.9 %, 14 cases) and auricular (75 %, 9 cases) nevi. The mean age of EAC nevi (37.1 years) was younger than that of auricular nevi (42.2 years). The chief complaint was a symptomless mass in both groups, mostly in dome-like gross appearances. The mean diameter of EAC and auricular nevi was 9.6 (3-16) mm and 12.2 (3-25) mm, respectively. Histological findings chiefly presented intradermal nevi in EACs (78.3 %) and auricles (83.3 %) which showed preference to older patients, in contrast to the compound type. All nevi including five cases with skin grafts were completely excised without any recurrence within the follow-up period (average 5.3 months). A possible dysplastic nevus was detected in only one case. All MNs in EACs or auricles reveal similar characteristics. Early and complete excision is recommended to avoid skin graft, functional problems, and the risk of malignant melanoma.

Compound Nevus Occurring Near External Auditory Canal: Successful Treatment by CO2 Laser Abrasion

Melanocytic nevus is common pigmented skin tumor, but it has rare occurrence near the external auditory canal. A skin graft is required if a wide surgical excision is performed for the nevi occurring near the external auditory canal. A CO2 laser was considered to be a good alternative for the removal of melanocytic nevus in this area. We herein report a case of compound nevus occurring near the external auditory canal that was successfully treated by CO2 laser abrasion.