Bullous pemphigoid and milia: prevalence and clinical laboratory findings in a Brazilian sample

Abstract Background: Bullous pemphigoid (BP) associated with milia lesions has been increasingly reported, but its prevalence has not been reported in a Brazilian BP population yet. Objectives: To describe the occurrence and clinical-laboratorial findings of BP-milia association in a southeastern Brazilian sample. Methods: A descriptive study based on the medical charts of 102 BP patients was accomplished. Clinical and laboratory data of BP-milia patients were compiled. Total serum IgE measurements, immunoblot assays based on basement membrane zone antigens, and HLA-DQ alleles typing were performed. Results: Milia was evident in 8 (7.8%) BP patients, five males, aged between 46 and 88 years. Increased total IgE levels were determined in 7 (87.5%) of the eight patients. In five of eight patients, immunoblotting showed IgG reactivity against the BP180-NC16a domain but not against collagen VII or laminin-332; it also revealed reactivity against the BP180 C-terminal domain or LAD-1, or both in four of them. The HLA-DQB1*03:01 and HLA-DQA1*05:05 alleles were identified in three of five BP-milia patients. Moreover, three of five cases presented the HLA-DQB1*06 allelic group. Study limitations: HLA determination was performed in five patients. Conclusions: Milia formation in BP patients seems to be less uncommon than previously admitted. Laboratory data revealed increased IgE; autoantibodies against the BP180 C-terminal domain or LAD-1, or both; and the HLA-DQB1*06 allelic group, described for the BP-milia association. Careful determination of antibodies against basement membrane zone molecules and HLA characterization in different populations may provide further insights into this association. © 2022 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

Paracoccidioidomycosis and cryptococcosis with localized skin manifestations: report of two cases in the elderly

Abstract Distinct cases of Paracoccidioidomycosis and Cryptococcosis with atypical and localized skin manifestation on the upper limbs of two elderly patients are reported. In the 2nd one, he presented asymptomatic pulmonary cancer; the blood tests for fungal infection were negative, and the etiologic agents were seen in skin biopsy samples. This report emphasizes the importance of the differential diagnosis of infectious diseases in elderly patients.

A superexpressão de metalotioneínas em células-tronco de áreas cancerígenas na gênese de glioma experimental / Superexpresión de metalotioneínas, nichos de células madre y campos de cancerización en gliomagénesis experimental / Overexpression of metallothioneins, stem cell niches and field cancerization in experimental gliomagenesis

INTRODUCTION: stem cells may originate and perpetuate the tumor growth, but they are poorly known in gliomagenesis. Metallothioneins (MTs) are proteins involved in oncogenesis and immunopositivity, for MT may be used as a stem cell mutation marker. OBJECTIVE: to study the MT expression in the ENU experimental model and to establish an experimental model to track glioma stem cells in early oncogenesis. METHODS: Thirty-six male Wistar rats were divided into two groups; the experimental group was treated within 24 hours after birth (neonate rats) with a single dose of subcutaneously injected N-ethyl N-nitrosourea ENU (40 mg/kg body weight). The control animals were injected with the same volume of saline. These experimental animals were subdivided into three groups according to the euthanize time, as follows: the Group 1 (G1) was euthanized at the age of 30 days; the Group 2 (G2), at the age of 180 days and the Group 3 (G3) was euthanized soon after the appearing of signs of the existence of nervous system tumors, at an average age of 321 days. Immunohistochemical detection of MT protein in cold acetone-fixed paraffin embedded spine cord sections was performed by the streptavidin-avidin-biotin-immuno peroxidase complex method. RESULTS: by using the experimental model of gliomagenesis induced by the N-ethyl N-nitrosourea, it was possible to detect putative tumor stem cells in early oncogenesis, to analyze a field cancerization process and to observe a close morphological relationship between MT positive cells and blood vessels. CONCLUSIONS: this reproducible experimental model allows further studies on the origins, development and regulating factors involved in gliomagenesis.

INTRODUÇÃO: células-tronco podem originar e perpetuar o crescimento tumoral, porém são pouco conhecidas na gliomagênese. As metalotioneínas (MTs) são proteínas envolvidas na oncogênese, e sua a imunopositividade pode ser utilizada como marcador de mutação de células-tronco. Objetivo: estudar a expressão de MT no modelo experimental da ENU e estabelecer um modelo experimental para monitorar as células-tronco glioma na oncogênese. MÉTODOS: Trinta e seis ratos machos da raça Wistar foram divididos em dois grupos; o grupo de animais experimental foi tratado dentro de 24 horas após o nascimento (ratos neonatos) com uma dose única de N-etil N-nitrosoureia (ENU) (40 mg/kg). Nos animais do grupo controle, injetou-se o mesmo volume de solução salina. Os animais do grupo experimental foram subdivididos em três grupos de acordo com o tempo da eutanásia, como se segue: o Grupo 1 (G1) sofreu eutanásia com a idade de 30 dias; o Grupo 2 (G2), com 180 dias e o Grupo 3 (G3) sofreu eutanásia logo após o surgimento de sinais de existência de tumor do sistema nervoso, com uma média de idade de 321 dias. A detecção imunohistoquímica da proteína MT em cortes da medula espinhal fixadas em acetona fria e embebidas em parafina foi realizada pelo método do complexo streptavidina-avidina-biotina-imuno peroxidase. RESULTADOS: por meio de modelos experimentais de gliomagenese induzida pela N-etil N-nitrosoureia, foi possível detectar células-tronco de tumor putativo no início da oncogênese, analisar um processo de cancerização de campo e observar uma relação morfológica entre células positivas para MT e vasos sanguíneos. CONCLUSÕES: este modelo experimental reprodutível permite outros estudos sobre a origem, desenvolvimento e fatores reguladores da gliomatogênese.

INTRODUCCIÓN: células madre pueden originar y perpetuar el crecimiento tumoral, sin embargo son poco conocidas en la gliomagénesis. Las metalotioneínas (MTs) son proteínas involucradas en la oncogénesis, y la inmunopositividad de las MTs puede ser utilizada como marcador de mutación de las células madres. Objetivo: estudio de la expresión de MT en el modelo experimental de la N-etil N-nitrosoureia (ENU) y establecer un modelo experimental para el seguimiento de las células madre en la oncogénesis glioma. MÉTODOS: treinta y seis ratas machos Wistar fueron divididas en dos grupos, un grupo de animales experimentales fue tratado dentro de 24 horas después del nacimiento (ratas neonatas) con una dosis única de ENU (40 mg/kg). Los animales del Grupo Control fueron inyectados con el mismo volumen de solución salina. Los animales del Grupo Experimental fueron subdivididos en tres grupos de acuerdo con el tiempo de eutanasia, así como sigue: el Grupo G1 sufrió eutanasia con la edad de 30 días; el Grupo G2, con 180 días y el Grupo G3, después del surgimiento de señales de existencia de tumor del sistema nervioso, con un promedio de edad de 321 días. La detección inmunohistoquímica de la proteína MT en cortes de médula espinal fijados en acetona fría y embebidos en parafina fue realizada por el método del complejo estreptovidina-avidina-biotina-inmuno peroxidase. RESULTADOS: por medio de modelos experimentales de gliomagénesis inducida por la ENU fue observado que es posible detectar células madre de tumor putativo en el inicio de la oncogénesis, para realizar un proceso de cancerización de campo y observar una relación morfológica entre células positivas para MT y vasos sanguíneos. CONCLUSIÓN: este modelo experimental reproductible permite otros estudios involucrando el origen, desarrollo y factores reguladores de la gliomatogénesis.