Cuterebra cutaneous myiasis: case report and world literature review.

BACKGROUND: Most cases of myiasis in North America are caused by fly larvae from South America or Africa, as these cases represent travelers returning from endemic regions. The etiology of creeping eruptions and furuncular lesions in North American patients who have no history of recent travel can therefore be a diagnostic problem. Among cases acquired in North America, Cuterebra species are the usual cause. Dermatologists and dermatopathologists should be aware that this unusual infestation may occur without a travel history. METHOD: Here we report a case of Cuterebra cutaneous myiasis acquired in New Jersey. A world literature review of articles on Cuterebra myiasis in humans, without age or year restriction, was performed. The pertinent references of those articles were also searched. RESULTS: Most cases occur in the skin, as a furuncle. Sometimes a cutaneous creeping eruption is present. Children account for at least half of the reported cases. The infestations tend to occur in the late summer, and most frequently in the north-eastern and southern states of the United States. An overview of the clinical and histopathologic diagnostic features are presented. CONCLUSIONS: Though rare, myiasis can occur in North America without a travel history. Awareness of this entity, its epidemiologic patterns and diagnostic characteristics, can prevent lengthy delays in diagnosis and unnecessary treatments.

Microcystic adnexal carcinoma.

A 71-year-old woman presented with a firm flesh-colored plaque with overlying whitish discoloration that had been present on her left cheek for at least 15 years (Figure 1). The lesion measured 1.6 x 1.1 cm in diameter. The patient had a history of radiation treatment for acne. What is your diagnosis? What should be the course of management?

Surgical capsules: diagnosis and management of liposarcoma.

A healthy, 53-year-old man presented with a small, soft, nontender mass of his right upper arm that progressively grew larger and more firm during the 6 weeks before evaluation.

Genome-wide examination of myoblast cell cycle withdrawal during differentiation.

Skeletal and cardiac myocytes cease division within weeks of birth. Although skeletal muscle retains limited capacity for regeneration through recruitment of satellite cells, resident populations of adult myocardial stem cells have not been identified. Because cell cycle withdrawal accompanies myocyte differentiation, we hypothesized that C2C12 cells, a mouse myoblast cell line previously used to characterize myocyte differentiation, also would provide a model for studying cell cycle withdrawal during differentiation. C2C12 cells were differentiated in culture medium containing horse serum and harvested at various time points to characterize the expression profiles of known cell cycle and myogenic regulatory factors by immunoblot analysis. BrdU incorporation decreased dramatically in confluent cultures 48 hr after addition of horse serum, as cells started to form myotubes. This finding was preceded by up-regulation of MyoD, followed by myogenin, and activation of Bcl-2. Cyclin D1 was expressed in proliferating cultures and became undetectable in cultures containing 40% fused myotubes, as levels of p21(WAF1/Cip1) increased and alpha-actin became detectable. Because C2C12 myoblasts withdraw from the cell cycle during myocyte differentiation following a course that recapitulates this process in vivo, we performed a genome-wide screen to identify other gene products involved in this process. Using microarrays containing approximately 10,000 minimally redundant mouse sequences that map to the UniGene database of the National Center for Biotechnology Information, we compared gene expression profiles between proliferating, differentiating, and differentiated C2C12 cells and verified candidate genes demonstrating differential expression by RT-PCR. Cluster analysis of differentially expressed genes revealed groups of gene products involved in cell cycle withdrawal, muscle differentiation, and apoptosis. In addition, we identified several genes, including DDAH2 and Ly-6A, whose expression specifically was up-regulated during cell cycle withdrawal coincident with early myoblast differentiation.