Friday, October 19, 2012

Papillomatosis


Papillomatosis


These are small usually round nodules that seem to literally pop out of the skin on late stage lymphedema patients.  Normally, they are skin colored, can grow singularly or in clusters.  For the population at large, these are almost always benign growths that really require no followup or special care.

However, in lymphedema patients these can become angiosarcoma and thus need to be promptly removed with the nodules sent to pathology lab for examination.  

I have had many removed over the years and in fact just recently had well over twenty removed from the knee areas of both legs.  The surgeon "snips" the stem that these grow on and removes them.  For the most part, they can be removed on an outpatient basis.  There are no stitches involved either and after healing there is practically no scar either.

The dressing is simple.  I used an antibiotic ointment covered with a smooth bandage to go directly over the wound, then a layer of gauze.  Since my skin will not tolerate any type of tape, I keep it in place using my short stretch bandage on the leg.  Don't put gauze directly onto the wound as it will get stuck in the seepage of the wound and can cause damage to the wounds healing processes.

I would also recommend an antibiotic to be taken as a preventative measure to help insure there is no infection or cellulitis due to the immunocompromised state of a lymphedematous limb.  

Pat

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Abstracts:


Stasis papillomatosis. Clinical features, etiopathogenesis and radiological findings.


1993

Source

University Department of Dermatology, St. Josef Hospital, Bochum, Germany.

Abstract 


Stasis papillomatosis can be divided into localized and widespread forms. Ten patients with this disease are discussed with emphasis on their clinical and lymphoradiological findings. Using isotope lymphography we were able to find an overall lymphostasis in only four patients. In all patients, local lymphatic disturbances were detected by means of indirect lymphography with intradermal lymph cysts as the most specific sign. Local dermal lymphostasis seems to be the common final pathogenesis in spite of different etiologies (ie, primary lymphedema, chronic venous insufficiency, trauma recurrent erysipelas, and local lymphangiodysplasia of unknown origin). A maximum variant was seen, following en-bloc resection of subcutaneous tissue in a patient suffering from congenital lymphedema.
PubMed


Ileostomy-Associated Chronic Papillomatous Dermatitis Showing Nevus Sebaceous-Like Hyperplasia, HPV 16 Infection, and Lymphedema: A Case Report and Literature Review of Ostomy-Associated Reactive Epidermal Hyperplasias.



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