Chang, Michael B.

AbstractBackgroundPatients with hypertrophic lichen planus (HLP) and squamous cell carcinoma (SCC) diagnoses present clinicians with diagnostic and disease management challenges.ObjectiveTo better define the clinical and treatment outcomes of patients with concomitant diagnoses of HLP and SCC.Methods and MaterialsA retrospective review was performed from January 1, 2008, to July 31, 2015, at Mayo Clinic. Patients with a histologic diagnosis of HLP and SCC were included. Patient demographics, associated comorbidities, histopathologic characteristics, treatment, and outcomes were evaluated.ResultsThirty‐three patients were identified; 79% were female, and mostly the lower extremities were involved. Most of the SCCs were well‐differentiated and in situ with the majority treated with destruction or excision. There were no cases of local recurrence, metastasis, or disease‐specific death during the follow‐up period (mean 55.8 months).ConclusionPatients with diagnoses of both HLP and SCC appear to be a distinct population that is predominantly female with lesion predilection for the lower extremities. However, regardless of treatment modality or tumor size, there were no adverse outcomes. An initial trial of more conservative treatment measures with close follow‐up may be reasonable with biopsy of lesions unresponsive to conventional treatment.

Abstract Background Acquired lymphangiectasia of the vulva ( ALV ) is a rare condition thought to be secondary to pelvic lymphatic obstruction. Although benign, this entity often occurs after previous malignancy and can be confused with conditions such as genital warts. We sought to clarify the clinicopathologic features of ALV by studying affected patients from our institution and from the existing literature. Methods We reviewed retrospectively the clinical and histopathologic characteristics of patients with ALV from our institution and performed an extensive literature search to identify all published cases of ALV . Results Eleven patients with ALV were identified from our institution. Three patients had Crohn disease, three had malignancies involving the pelvic region (rectal adenocarcinoma, cervical carcinoma, endometrial carcinoma), and three (two with pelvic malignancy) had previous radiation therapy. One patient had Proteus syndrome. Of 67 distinct cases of ALV identified in the literature, 41 (61%) had a history of malignancy. Conclusions In any acquired or clinically unusual lymphatic process in the skin and soft tissues, a lesion or obstructive process of the draining lymphatics should be investigated.

AbstractBackgroundMerkel cell carcinoma (MCC) is a rare, aggressive, often cutaneous malignancy. The incidence has been estimated from national registries in the USA and elsewhere, and data indicate variations depending on the region studied. The objective of this study was to determine the incidence of MCC in Olmsted County (MN, USA).MethodsUsing the Rochester Epidemiology Project, which contains health records for all the residents of Olmsted County, we retrospectively reviewed the records for all cases of MCC from 1976 to 2011.ResultsThe overall annual age‐ and sex‐adjusted incidence of MCC in Olmsted County during 1976–2011 was 0.35 per 100,000 person‐years (95% CI, 0.14–0.57). The incidence tended to be higher among men than women with 0.69 per 100,000 (95% CI, 0.24–1.14) and 0.10 per 100,000 (95% CI, 0–0.24), respectively.ConclusionsThese data are within the range of previous MCC incidence reports, and the incidence of MCC in Olmsted County is consistent with rates reported in the remainder of the USA.

AbstractBackgroundWe examined the course of cutaneous T‐cell lymphoma (CTCL), which has been associated with chronic lymphocytic leukemia (CLL) in patients withCLL.Materials and methodsA search was conducted of the master diagnosis index at our institution to identify patients with bothCLLandCTCLfrom 1980 to 2010. A retrospective chart review was then conducted.ResultsOf the 14 patients withCTCLandCLL, eight had mycosis fungoides (MF; two with patch stage, two with plaque stage, two with tumor stage, and two with erythrodermic stage), four had Sézary syndrome, one had natural killer cell lymphoma involving the skin, and one had peripheral T‐cell lymphoma involving the skin. Eight had concurrent diagnoses, five received aCLLdiagnosis first, and one received aCTCLdiagnosis first. Ten patients were deceased at the time of data abstraction due to unknown causes (n = 4), lymphoma (n = 2), pneumonia (n = 2),MF(n = 1), or respiratory failure (n = 1). Of the nine patients with concurrent or priorCTCL, seven were deceased, with a median time to death of 10.2 months (range, 6–89 months). Of the five patients withCLLprior toCTCL, three were deceased at 18, 27, and 47 months, respectively, after theCTCLdiagnosis. The median survival for the two groups was 12 and 47 months, respectively.ConclusionsPatients withCTCLconcurrent with or prior toCLLhave a worse overall survival than patients withCLLin whomCTCLlater develops. Larger studies are needed.