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4.
Acta Derm Venereol ; 97(6): 692-697, 2017 Jun 09.
Article in English | MEDLINE | ID: mdl-28224168

ABSTRACT

The aim of this study was to determine the clinical, histological and/or immunohistochemical features that enable differential diagnosis of regression of melanocytic naevi from regression of melanomas. All melanocytic neoplasms with histologically-confirmed regression diagnosed in our hospital between 2002 and 2009 were reviewed retrospectively. Lamellar and delicate fibrosis were associated with melanocytic naevi (p <0.0001 and p = 0.021, respectively). Compact fibrosis, high vessel density and higher number of granzyme B+ lymphocytes were associated with malignant melanoma (p = 0.011, p = 0.005 and p = 0.013, respectively). Density of inflammatory infiltrate (p = 0.016), vascular proliferation (p = 0.005), epidermal atrophy (p = 0.009), rate of apoptosis (p = 0.046) and granzyme B immunoreactivity (p = 0.013) was more common in severe-dysplastic naevi and melanomas than in the remaining melanocytic naevi. Logistic regression demonstrates that 5 variables (age, lamellar fibrosis, melanophages, vessel density, and granzyme B immunostaining) would serve to classify appropriately 87% of melanomas among melanocytic lesions with complete regression.


Subject(s)
Melanoma/pathology , Neoplasm Regression, Spontaneous , Nevus, Pigmented/pathology , Skin Neoplasms/pathology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Apoptosis , Atrophy , Biomarkers, Tumor/analysis , Chi-Square Distribution , Child , Child, Preschool , Diagnosis, Differential , Female , Fibrosis , Granzymes/analysis , Humans , Immunohistochemistry , Logistic Models , Male , Melanoma/chemistry , Middle Aged , Neovascularization, Pathologic , Nevus, Pigmented/chemistry , Predictive Value of Tests , Retrospective Studies , Skin Neoplasms/chemistry , Young Adult
6.
J Cutan Pathol ; 43(5): 456-60, 2016 May.
Article in English | MEDLINE | ID: mdl-26968131

ABSTRACT

Langerhans cell histiocytosis (LCH) and juvenile xanthogranuloma (JXG) are thought to originate from a common stem cell precursor, with divergent differentiation under different microenvironmental conditions. We describe an exceptional case of multiple cutaneous lesions in a 10-year-old boy, in which the coexistence of both LCH and JXG cell populations is found in every single lesion. The presence of Birbeck granules and CD207 (langerin) immunostaining in the LCH component would argue against the diagnosis of indeterminate cell histiocytosis (ICH). This unique case gives additional support to the hypothesis of a potentially common histogenesis for LCH and JXG.


Subject(s)
Antigens, CD/metabolism , Histiocytosis, Langerhans-Cell , Lectins, C-Type/metabolism , Mannose-Binding Lectins/metabolism , Skin , Xanthogranuloma, Juvenile , Child , Histiocytosis, Langerhans-Cell/complications , Histiocytosis, Langerhans-Cell/metabolism , Histiocytosis, Langerhans-Cell/pathology , Humans , Male , Skin/metabolism , Skin/pathology , Xanthogranuloma, Juvenile/complications , Xanthogranuloma, Juvenile/metabolism , Xanthogranuloma, Juvenile/pathology
7.
Pediatr Dermatol ; 32(6): e303-4, 2015.
Article in English | MEDLINE | ID: mdl-26447144

ABSTRACT

We report on a 3-year-old girl with a microvesicular generalized rash in whom primary infection by parvovirus B19 was demonstrated by seroconversion. To our knowledge, this is the first instance of an eruption arising from parvovirus B19 with this peculiar clinical pattern.


Subject(s)
Erythema Infectiosum/diagnosis , Parvovirus B19, Human/isolation & purification , Child, Preschool , Exanthema/diagnosis , Exanthema/etiology , Female , Follow-Up Studies , Humans , Remission, Spontaneous , Severity of Illness Index , Skin Diseases, Viral/diagnosis
8.
Anticancer Res ; 35(1): 439-44, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25550585

ABSTRACT

BACKGROUND/AIM: Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is a highly abundant housekeeping gene. GAPDH overexpression has been reported in diverse types of human cancers including cutaneous melanoma. Our goal was to quantify GAPDH mRNA and protein expression in the whole spectrum of primary and metastatic melanomas in the search for a specific role for this ubiquitous molecule during tumor progression. MATERIALS AND METHODS: Intratumoral GAPDH mRNA expression was quantified by real-time PCR in 71 cases, including 29 primary melanomas and 42 metastatic cases. Relative expression levels in thin (≤1 mm) and thick (>1 mm) primary tumors and 'in-transit', lymph node and distant metastases were compared. Similarly, protein expression was investigated by means of immunohistochemistry. Specific exons of GAPDH were analyzed by DNA sequencing. RESULTS: GAPDH mRNA expression was significantly up-regulated in thick melanomas when compared to primary thin melanomas. Similar differences were also encountered between metastatic melanomas when compared to lymph-node metastatic melanomas. Interestingly, GAPDH protein immunoexpression was higher in thick melanomas and distant metastases than in thin tumors and lymph node metastases, respectively. However, no specific point-mutations in GAPDH-specific exons were found in any patient. CONCLUSION: Deregulation of GAPDH during melanoma progression was demonstrated in our series by mRNA and protein expression studies.


Subject(s)
Gene Expression Regulation, Neoplastic , Glyceraldehyde-3-Phosphate Dehydrogenases/metabolism , Melanoma/enzymology , Skin Neoplasms/enzymology , Disease Progression , Gene Expression , Gene Expression Regulation, Enzymologic , Glyceraldehyde-3-Phosphate Dehydrogenases/genetics , Humans , Lymphatic Metastasis , Melanoma/secondary , Prognosis , Skin Neoplasms/pathology
9.
Am J Dermatopathol ; 36(11): e183-8, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25343215

ABSTRACT

Complete spontaneous regression of multiple melanocytic nevi after melanoma is an extremely rare phenomenon. We report 3 cases of patients with a history of melanoma that showed regression of almost all melanocytic nevi over time. One of the patients had 2 simultaneous primary cutaneous melanomas without metastasis. In the other 2 patients, regression of the melanocytic nevi was seen after the development of metastasis in lymph nodes. These patients had spontaneously developed an efficient immune response against melanocytes, and they would represent paradigmatic examples of the spontaneous immune responses in melanoma patients. Better understanding of the mechanisms involved in the complete regression of melanocytic lesions would lead to a better selection of melanoma patients for immunotherapy.


Subject(s)
Melanocytes/pathology , Melanoma/secondary , Neoplasm Regression, Spontaneous , Nevus, Pigmented/pathology , Skin Neoplasms/pathology , Adolescent , Adult , Biopsy , Dermoscopy , Disease Progression , Fatal Outcome , Female , Humans , Lymph Node Excision , Lymphatic Metastasis , Male , Melanocytes/immunology , Melanoma/immunology , Melanoma/surgery , Nevus, Pigmented/immunology , Nevus, Pigmented/surgery , Skin Neoplasms/immunology , Skin Neoplasms/surgery , Time Factors , Treatment Outcome , Melanoma, Cutaneous Malignant
17.
Dermatology ; 224(3): 193-7, 2012.
Article in English | MEDLINE | ID: mdl-22571959

ABSTRACT

Intense pulsed light (IPL) therapy using noncoherent broad-spectrum light has been reported to be effective for hair removal, and also for treating superficial pigmented lesions like ephelides and solar lentigines. We report complete regression of a pigmented melanocytic nevus, histologically confirmed, after hair removal treatment with IPL. The use of lasers and IPL is a common procedure used by dermatologists and even other professions for the treatment of cosmetically troubling skin conditions. The main advantage of such treatment is a reduction of surgical scars, thus producing a favorable cosmetic outcome, but a major limitation is that histopathologic diagnosis is not usually obtained prior to treatment. Such devices should be carefully used in patients with potentially dangerous melanocytic lesions. We also review the recent literature regarding inadequate treatment of melanocytic lesions with lasers.


Subject(s)
Nevus, Pigmented/therapy , Phototherapy/methods , Skin Neoplasms/therapy , Adult , Female , Hair Removal/methods , Humans , Nevus, Pigmented/diagnosis , Nevus, Pigmented/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Treatment Outcome
18.
Clin Exp Metastasis ; 29(6): 625-37, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22526457

ABSTRACT

CXCR4, CCR7 and CCR10 chemokine receptors are known to be involved in melanoma metastasis. Our goal was to compare the relative intratumoral mRNA expression of these receptors with that of their corresponding chemokine ligands, CXCL12, CCL19, CCL21, and CCL27 across the full spectrum of human melanoma progression: thin and thick primary melanomas, as well as "in transit", lymph node, and distant metastases. Expression was quantified by real-time RT-PCR in 103 melanoma samples: 51 primary tumors and 52 metastases. Particular emphasis was focused on chemokine ligand-receptor expression ratios. Immunohistochemistry was performed to identify the cell types expressing these molecules. CXCL12-CXCR4 and CCL27-CCR10 ratios were higher in thin than in thick primary melanomas, and all four chemokine-receptor ratios were higher in primary tumors than in melanoma metastases. CCL27-CCR10 and CXCL12-CXCR4 expression ratios in primary tumors were inversely associated with the development of distant metastases, and improved the predictive value of tumor thickness for distant metastasis, which is important since chemokine ligand-receptor ratios are not affected by the endogenous gene employed for normalizing mRNA expression. Both receptor and ligand immunolabeling were detected in neoplastic cells suggesting autocrine mechanisms. Our results support the concept that low CCL27/CCR10 and CXCL12/CXCR4 intratumoral mRNA ratios are associated with melanoma progression, and in combination with Breslow thickness, are the best predictive factors for the development of distant metastases in primary cutaneous melanoma.


Subject(s)
Chemokine CCL27/biosynthesis , Chemokine CXCL12/biosynthesis , Melanoma/metabolism , Receptors, CCR10/biosynthesis , Receptors, CXCR4/biosynthesis , Skin Neoplasms/metabolism , Aged , Chemokines/metabolism , Disease Progression , Female , Humans , Immunohistochemistry/methods , Ligands , Lymphatic Metastasis , Male , Middle Aged , RNA, Messenger/metabolism
20.
Metab Brain Dis ; 27(1): 51-8, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22072427

ABSTRACT

To assess the contribution of hyperammonemia and inflammation to induction of mild cognitive impairment (or MHE). We analyzed the presence of mild cognitive impairment (CI) by using the PHES battery of psychometric tests and measured the levels of ammonia and of the inflammatory cytokines IL-6 and IL-18 in blood of patients with different types of liver or dermatological diseases resulting in different grades of hyperammonemia and/or inflammation. The study included patients with 1) liver cirrhosis, showing hyperammonemia and inflammation; 2) non-alcoholic fatty liver disease (NAFLD) showing inflammation but not hyperammonemia; 3) non-alcoholic steatohepatitis (NASH) showing inflammation and very mild hyperammonemia; 4) psoriasis, showing inflammation but not hyperammonemia; 5) keloids, showing both inflammation and hyperammonemia and 6) controls without inflammation or hyperammonemia. The data reported show that in patients with liver diseases, cognitive impairment may appear before progression to cirrhosis if hyperammonemia and inflammation are high enough. Five out of 11 patients with NASH, without liver cirrhosis, showed cognitive impairment associated with hyperammonemia and inflammation. Patients with keloids showed cognitive impairment associated with hyperammonemia and inflammation, in the absence of liver disease. Hyperammonemia or inflammation alone did not induce CI but the combination of certain levels of hyperammonemia and inflammation is enough to induce CI, even without liver disease.


Subject(s)
Ammonia/blood , Cognitive Dysfunction/etiology , Hepatic Encephalopathy/complications , Hyperammonemia/complications , Inflammation/complications , Adult , Aged , Cognitive Dysfunction/metabolism , Fatty Liver/blood , Fatty Liver/metabolism , Female , Hepatic Encephalopathy/blood , Hepatic Encephalopathy/metabolism , Humans , Hyperammonemia/metabolism , Inflammation/metabolism , Interleukin-18/blood , Interleukin-6/blood , Keloid/blood , Keloid/complications , Keloid/metabolism , Liver Cirrhosis/blood , Liver Cirrhosis/complications , Liver Cirrhosis/metabolism , Male , Middle Aged , Neuropsychological Tests , Non-alcoholic Fatty Liver Disease , Psoriasis/blood , Psoriasis/complications , Psoriasis/metabolism , Severity of Illness Index
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