Diagnóstico prenatal de ictiosis arlequín. Comunicación de caso

La ictiosis arlequín, también conocida como queratosis difusa fetal, es un trastorno cutáneo hereditario, extremadamente raro y grave desde el punto de vista fenotípico, con herencia autosómica recesiva. La enfermedad es causada por mutaciones en el gen de la proteína transportadora de casetes de unión a trifosfato de adenosina (ABCA12). La ecografía prenatal y el análisis genético son importantes para el diagnóstico prenatal. El diagnóstico ecográfico prenatal es difícil y los hallazgos incluyen placas de ectropión, pabellón auricular anormal, nariz plana, piel engrosada con apariencia de armadura, labios engrosados con estado sostenido de boca abierta (boca de pez) y fijación en flexión de las extremidades. Estas generalmente son encontradas durante el tercer trimestre. La ecografía tridimensional contribuye a la evaluación de la morfología facial. El pronóstico es generalmente desfavorable. Los neonatos afectados no suelen sobrevivir más allá de los primeros días de vida. Se presenta un caso de diagnóstico prenatal de ictiosis arlequín.

Harlequin ichthyosis, also known as diffuse fetal keratosis, is an extremely rare and phenotypically severe hereditary skin disorder with autosomal recessive inheritance. This disease is caused by mutations in the adenosine triphosphate-binding cassette transporter protein (ABCA12) gene. Prenatal ultrasonography and genetic analysis are important for prenatal diagnosis. Prenatal ultrasonographic diagnosis is difficult, and findings include ectropion plates, an abnormal auricular pinna, a flat nose, thickened skin with an armor-like appearance, thickened lips with sustained open mouth (fish mouth) status, and flexion fixation of the extremities. These are usually found during the third trimester. Three-dimensional ultrasonography contributes to the evaluation of facial morphology. The prognosis is generally poor. Affected neonates usually do not survive beyond the first days of life. A case of prenatal diagnosis of harlequin ichthyosis is presented.

Indicadores morfométricos del carcinoma basocelular sólido con valor diagnóstico y pronóstico

Introducción: El carcinoma basocelular sólido es el tumor más frecuente de piel con un grado de malignidad limitada que rara vez metastiza, a pesar de esto se detectan cada vez más personas que sufren este tipo de cáncer, lo que indica una falla en su diagnóstico y tratamiento oportuno. Los estudios morfométricos se hacen necesarios por el valor que aportan en el diagnóstico histológico y el pronóstico de la enfermedad. Objetivo: Describir el comportamiento de indicadores morfométricos como el área nuclear, volumen nuclear y factor de forma nuclear de las células tumorales del carcinoma basocelular sólido. Métodos: Se realizó un estudio de serie de casos de siete pacientes con el diagnóstico de carcinoma basocelular sólido de piel en el período septiembre 2018 a septiembre 2019 en la provincia Holguín. Se seleccionaron 300 campos y se midieron 1 777 núcleos celulares, lo que constituyó la muestra. Se caracterizaron indicadores morfométricos nucleares como el área, el volumen y el factor de forma. Se emplearon métodos teóricos y empíricos fundamentalmente, estos últimos basados en técnicas morfométricas. Resultados: La media aritmética del área nuclear es 130 µm2 y del volumen nuclear es 923 µm3, ambos están aumentados si se comparan con otros estudios realizados en piel sana envejecida. El factor de forma nuclear es 0,77, se acerca al valor 1 por lo que el pleomorfismo es bajo en el carcinoma basocelular. Conclusiones: Las células tumorales en el carcinoma basocelular sólido de piel se caracterizan por presentar núcleos que muestran un bajo pleomorfismo y un gran volumen, mayor que en el melanoma maligno, aunque menor que en la piel normal de personas mayores de 40 años.

Introduction: Solid basal cell carcinoma is the most frequent tumor of the skin with a limited degree of malignancy that rarely metastasizes, despite the fact that more and more people suffering from this type of cancer are being detected, which indicates a failure in its diagnosis and timely treatment. The morphometric studies are necessary due to the value they bring to the histological diagnosis and prognosis of the disease. Objective: To describe the behavior of morphometric indicators such as nuclear area, nuclear volume and nuclear shape factor of tumor cells from solid basal cell carcinoma. Methods: A study was carried out on a series of cases of 7 patients diagnosed with solid basal cell carcinoma of the skin from September 2018 to September 2019 in the province of Holguín. 300 fields were selected and 1 777 cell nuclei were averaged, which constituted the sample. Nuclear morphometric indicators such as area, volume and shape factor were characterized. Theoretical and empirical methods were used, the latter fundamentally based on morphometric techniques. Results: The arithmetic average of the nuclear area is 130 µm2 and of the nuclear volume is 923 µm3, both are increased if compared to other studies carried out on healthy, aged skin. The nuclear form factor is 0.77, it approaches the value 1 for that reason the pleomorphism is low in the basal cell carcinoma. Conclusions: The tumoral cells in solid basal cell carcinoma of the skin are characterized by presenting nuclei that show a low pleomorphism and a large volume, larger than in malignant melanoma, even smaller than in normal skin of people older than 40 years.

Afecciones perianales no infecciosas, no neoplásicas, del adulto / Noninfectious, non-neoplasic adult perianal affections

Las enfermedades perianales del adulto, de carácter no infeccioso y no neoplásico, son un motivo de consulta poco frecuente. Se caracterizan por la variedad de su etiología y de su sintomatología clínica, y plantean dificultad en el diagnóstico y en la terapéutica. El objetivo del presente trabajo es abordar una patología que plantea la necesidad de una intervención interdisciplinaria. Se incluyen consideraciones anatomopatológicas, clínicas y terapéuticas. (AU)

Noninfectious, non- neoplasic perianal affections are uncommon diseases. They are characterized by the variety of the etiology and clinical symptomatology, posing difficulty in diagnosis and therapeutics. The objective of this paper is to address a pathology that raises the need for interdisciplinary intervention anatomopathological, clinical and therapeutic considerations are included. (AU)

The anti-clockwise spiralization of the linea nigra sign / O sinal do espiralamento anti-horário da linea nigra

ABSTRACT Objective: To describe the morphology of the supra- and infraumbilical linea nigra in puerperal women. Methods: The study was conducted from September 2017 to April 2018, and included 157 puerperal women admitted for childbirth care at the Obstetrics Department of a public maternity hospital of the city of São Paulo (SP), Brazil. The abdomen of subjects was photographed on the first or second day postpartum, with the patient lying symmetrically in dorsal decubitus at a standardized distance. Contrast was slightly adjusted and the morphological pattern of supra and infraumbilical linea nigra in the proximity of the umbilical scar was characterized. The images were independently analyzed by two researchers and only the matching results from both observers were used. Results: Of the 157 observed cases, 139 (88.5%) images provided concordant results between the two researchers. Excluding 41 cases of absence or poor definition of the linea nigra, 98 images were analyzed. Supra- and infraumbilical linea nigra were analyzed separately and classified according to three directions (left, center and right of the umbilical scar). The combination of the supra- and infraumbilical images resulted in the formation of nine distinct patterns, being the most prevalent, in primiparous (72.2%) and multiparous women (50.0%), and the authors named as "anticlockwise spiralization of the linea nigra". Conclusion: The analysis of supra- and infraumbilical linea nigra in puerperal women showed a predominance of what the authors named "anti-clockwise spiralization of the linea nigra sign".

RESUMO Objetivo: Descrever a morfologia da linea nigra supra e infraumbilical em puérperas. Métodos: O estudo foi realizado no período de setembro de 2017 a abril de 2018 e incluiu 157 puérperas admitidas para o parto no Serviço de Obstetrícia de uma maternidade pública da cidade de São Paulo (SP). O abdome das pacientes foi fotografado no primeiro ou segundo dia pós-parto, com a paciente deitada simetricamente em decúbito dorsal a uma distância padronizada. O contraste foi ligeiramente ajustado, e o padrão morfológico da linea nigra supra e infraumbilical na proximidade da cicatriz umbilical foi caracterizado. As imagens foram analisadas independentemente por dois pesquisadores, e apenas os resultados concordantes dos dois observadores foram utilizados. Resultados: Dos 157 casos observados, 139 (88,5%) imagens apresentaram resultados concordantes entre os dois pesquisadores. Excluindo 41 casos de ausência ou má definição da linea nigra, 98 imagens foram analisadas. As linea nigra supra e infraumbilicais foram analisadas separadamente e classificadas de acordo com três direções (esquerda, centro e direita da cicatriz umbilical). A combinação das imagens supra e infraumbilicais resultou na formação de nove padrões distintos, sendo os mais prevalentes nas primíparas (72,2%) e multíparas (50,0%), o que os autores denominaram "espiralamento anti-horário da linea nigra". Conclusão: A análise das linea nigra supra e infraumbilical em puérperas mostrou predominância do que os autores denominaram "sinal do espiralamento anti-horário da linea nigra".

Application and development of artificial intelligence in dermatology / 中华皮肤科杂志

Artificial intelligence,known as the science and engineering of manufacturing intelligent machines,is one of the frontier science and technology that affects the development of modern society.With the progress of computer science and internet technology,artificial intelligence has gradually formed 3 main branches:cognitive computing,machine learning and deep learning.In recent years,the cooperation between artificial intelligence and medicine has been applied in many aspects,such as image recognition,assistant diagnosis,medical robots,drug research and development.Furthermore,characteristics of dermatology and advantages of artificial intelligence in image recognition make the application of artificial intelligence in dermatology become a focus nowadays.The authors summarize the application scope of artificial intelligence in dermatology,such as skin imaging,skin pathology and medical robots,analyze the current situation of artificial intelligence application in dermatology,and make prospects for the trend of development in the future.

Study on Immunological Components and Their Contents in Subcutaneous Exudate Induced by Cutaneous Scraping Method / 广州中医药大学学报

Objective To investigate the changes of the immunological factors in subcutaneous exudate and blood components of the rats receiving cutaneous scraping method,and to compare the changes of skin histopathological features before and after cutaneous scraping under microscope.Methods SD rats were randomly divided into two groups,cutaneous-scraping group and non-cutaneous-scraping group.And then each group was divided into three subgroups.The observation indexes included the levels of interleukin (IL)-1β,IL-6 and interferon gamma (IFN-γ) in the blood and the skin,routine blood examination,and skin histopathological features.Results In cutaneous-scraping group,the number of white blood cells in the blood and the levels of IL-1 β and IFN-γ in skin tissues were increased (P ＜ 0.05),the hemolysis rate was increased (P ＜ 0.05).However,the levels of IL-1β,IL-6 and IFN-γin the blood showed no obvious changes.Under the microscope,severe skin edema,vascular congestion and dilatation,and infiltration of inflammatory cells were found in the skin after cutaneous scraping.Conclusion The cutaneous scraping method can activate the immune response rapidly,and the immunological components of the subcutaneous exudate after cutaneous scraping are helpful to the disease treatment.

Imaging and Pathologic Characterization of the Skin Thickening or Enhancement under the Breast MRI

The purpose of this paper is to show the radiologic features of various lesions appearing as skin thickening or enhancement under the breast MRI. And histopathologic results of the skin lesions were correlated. Radiologist must be familiar with normal appearance of the breast skin under the MRI and a wide variety of conditions may affect the skin of the breast.

Study on Repairing Skin Defect with Pelnac Tissue Engineering Skin / 广州中医药大学学报

Objective To explore the feasibility of repairing skin defect with Pelnac tissue engineering skin and cultured epidermal stem cells ( ESCs) and fibroblasts. Methods ESCs and fibroblasts in SD rats were isolated and cultured in vitro, and then were detected by immunohistochemistry. Fibroblasts were seeded in Pelnac material to construct dermis, and ESCs were seeded on the surface of dermis to construct tissue engineering skin. Thirty BALC/c nude mice were randomly divided into groups A, B and C. After mouse back skin defect model was established, group A was transplanted with Pelnac material, group B was transplanted with compound of Pelnac and fibroblasts, and group C was transplanted with Pelnac tissue engineering skin. The wound healing was observed after operation. The wound tissues were sampled for pathological histology test on the 5th and 7th day after transplantation. Results The expression of cytokeratin 15 and β1 integrin in ESCs was positive, and the expression of laminin ( LN) and fibronectin ( FN) in fibroblasts was positive. In group C, the wound healing of nude mice was the best, characterized by the proliferation of fibroblasts, obvious new capillaries and regularly arranged epidermal cells at the transplantation sites. Conclusion Pelnac tissue engineering skin has good effects on promoting repair of skin defect of nude mice.

Effects of Tripterygium hypoglaucum(Level) Hutch Extract on T Lymphocyte Subpopulations in Mice with Graft-versus-host Disease / 广州中医药大学学报

Objective To observe the preventive effects of Tripterygium hypoglaucum(Level)Hutch(THH)extract on T lymphocyte subpopulations in mice with graft-versus-host disease(GVHD)and to explore its protective mechanism.Methods 2?107 bone marrow cells mixed with 2?107 spleen cells from C57BL/6 mouse were transplanted into the myeloablative irradiated inbred BALB/c mouse.The experiment groups were designed as follows:model control group,cyclosporine A(CsA,10 mg?kg-1?d-1)group,THH(400 mg?kg-1?d-1)group,combination group(CsA 5 mg?kg-1?d-1 + THH 100 mg?kg-1?d-1).The ocurrence of GVHD was assessed by signs of weight loss,diarrhea,ruffled fur,hunched posture and histologic changes of skin,liver and small intestines.Chimerism was detected by monitoring the H-2b molecule in bone marrow cells of recipient mice with flow cytometer.The percentages of CD+3CD+4 and CD+3CD+8 T cells in peripheral blood were detected by flow cytometer.Results The survival time of CsA group,THH group and combination group were prolonged as compared with that of the model control group(P

Intervention of Acupuncture on Guinea Pig Models of Allergic Reaction Type Ⅳ / 广州中医药大学学报

Objective To observe the intervention of acupuncture on guinea pig models of allergic reaction type Ⅳ.Methods Thirty-six albino guinea pigs were randomized into blank control group,model group,and acupuncture group.The guinea pig models of allergic reaction type Ⅳ were established by external application of dinitrochlorobenzene.The acupuncture group received acupuncture on acupoints of Quchi and Xuehai for 10 days.After treatment,the auricular thickness and weight,the number of intradermal inflammatory cells,and the auricular pathological changes in guinea pigs were observed.Results In the model group,the auricular thickness and weight were increased,and the number of intradermal monocytes,lymphocytes,neutrophils,and fibrocytes was also increased(P0.05),and the pathological changes of chronic eczema were relieved.Conclusion Acupuncture exerts an intervention on allergic reaction type Ⅳ.