RESUMO
Desmoplastic fibroblastoma is a rare fibrous tumor that usually presents as a painless, slow-growing mass in the subcutaneous tissues and skeletal muscles. It has a wide anatomic distribution, with the most common involvement being the arm and shoulder. Here, we report a case of a tiny painful desmoplastic fibroblastoma arising on the scalp. According to a microscopic examination, this tumor was composed of spindle-shaped fibroblasts in the dense collagenous stroma. On immunohistochemical staining, tumor cells were positive for vimentin and negative for smooth muscle actin, CD34, and S100. Our case is unique in that desmoplastic fibroblastoma developed on the scalp and there was presence of pain despite its small size.
Assuntos
Actinas , Braço , Colágeno , Fibroblastos , Músculo Esquelético , Músculo Liso , Couro Cabeludo , Ombro , Tela Subcutânea , VimentinaRESUMO
BACKGROUND: Kaempferol (3,4′,5,7-tetrahydroxyflavone) is a flavonoid known to have a wide range of pharmacological activities. The 3-OH group in flavonoids has been reported to determine antioxidant activities. OBJECTIVE: We tested whether kaempferol can affect the expression of integrins and the stem cell fate of interfollicular epidermal stem cells. METHODS: Skin equivalent (SE) models were constructed, and the expression levels of stem cell markers and basement membrane-related antigens were tested. The immunohistochemical staining patterns of integrins, p63, and proliferating cell nuclear antigen (PCNA) were compared between kaempferol- and apigenin-treated SE models. Reverse transcription-polymerase chain reaction (RT-PCR) was used to evaluate the mRNA expression of integrins. RESULTS: Kaempferol increased the thickness of the epidermis when added to prepare SEs. In addition, the basal cells of kaempferol- treated SEs appeared more columnar. In the immunohistological study, the expression of integrins α6 and β1 and the numbers of p63- and PCNA-positive cells were markedly higher in the kaempferol-treated model. However, apigenin showed no effects on the formation of three-dimensional skin models. RT-PCR analysis also confirmed that kaempferol increased the expression of integrin α6 and integrin β1. CONCLUSION: Our findings indicated that kaempferol can increase the proliferative potential of basal epidermal cells by modulating the basement membrane. In other words, kaempferol can affect the fate of interfollicular epidermal stem cells by increasing the expression of both integrins α6 and β1. These effects, in particular, might be ascribed to the 3-OH group of kaempferol.
Assuntos
Apigenina , Membrana Basal , Epiderme , Matriz Extracelular , Flavonoides , Integrinas , Antígeno Nuclear de Célula em Proliferação , RNA Mensageiro , Pele , Células-TroncoRESUMO
BACKGROUND: Severity grading is important for the assessment of psoriasis treatment efficacy. This is most commonly achieved by using the psoriasis area and severity index (PASI), a subjective tool with inherent inter-rater and intra-rater variability. PASI-naive dermatologists require training to properly conduct a PASI assessment. OBJECTIVE: In the present study, we aimed to investigate whether photographic training improves inter-rater and intra-rater variabilities. We also determined which PASI component has the greatest impact on variability. METHODS: Twenty-one dermatologists received 1 hour of PASI training. They were tested before and after the training to evaluate intra-rater variability. The physicians were further tested after training by using a reference photograph. RESULTS: The mean of each PASI component was underevaluated compared with scoring by a PASI expert. The concordance rate with the expert's grading was highest for thickness followed by erythema, scaling, and area. The scaling score showed the greatest improvement after training. After training, the distribution of deviation from the expert's grading, which signifies inter-rater variability, improved only for the PASI area component. The deviation of scaling grading improved upon retesting by using a reference photograph. CONCLUSION: PASI assessment training improved variabilities to some degree but not for every PASI component. The development of an objective psoriasis severity assessment tool will help overcome the subjective variabilities in PASI assessment, which can never be completely eliminated via training.
Assuntos
Superfície Corporal , Educação , Eritema , Psoríase , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
BACKGROUND: Severity grading is important for the assessment of psoriasis treatment efficacy. This is most commonly achieved by using the psoriasis area and severity index (PASI), a subjective tool with inherent inter-rater and intra-rater variability. PASI-naive dermatologists require training to properly conduct a PASI assessment. OBJECTIVE: In the present study, we aimed to investigate whether photographic training improves inter-rater and intra-rater variabilities. We also determined which PASI component has the greatest impact on variability. METHODS: Twenty-one dermatologists received 1 hour of PASI training. They were tested before and after the training to evaluate intra-rater variability. The physicians were further tested after training by using a reference photograph. RESULTS: The mean of each PASI component was underevaluated compared with scoring by a PASI expert. The concordance rate with the expert's grading was highest for thickness followed by erythema, scaling, and area. The scaling score showed the greatest improvement after training. After training, the distribution of deviation from the expert's grading, which signifies inter-rater variability, improved only for the PASI area component. The deviation of scaling grading improved upon retesting by using a reference photograph. CONCLUSION: PASI assessment training improved variabilities to some degree but not for every PASI component. The development of an objective psoriasis severity assessment tool will help overcome the subjective variabilities in PASI assessment, which can never be completely eliminated via training.