Clinical series of patients with cutaneous melanoma followed-up at the Novara Melanoma Centre from 1983 to 2009: description of the cohort and prognostic factors.

AIM: The aim of this study was to review our experience with regards to patients with cutaneous melanoma diagnosed from 1983 to 2009, followed-up in our Dermatological Department of Novara. METHODS: A retrospective study of 762 patients diagnosed with cutaneous melanoma in the Dermatological Department of Novara between 1983 and 2009 was conducted. Information was extracted from our melanoma patient database. The database included demographical, clinical and pathological variables of the patient. Clinical and pathological factors predicting survival were analyzed using the Kaplan-Meier curves and the Log-Rank Test (univariate analysis). RESULTS: Staging (American Joint Committee on Cancer 2001) of patients (P=0.000), Breslow thickness (P=0.000), primary ulceration and regression of the lesion (P=0.000), type of first (P<0.039) and second recurrence (P<0.011) were strongly correlated with overall and disease free survival. Sentinel lymph node biopsy was not correlated with disease free survival (P=0.153), it influences only overall survival (P=0.007) CONCLUSION: Our results confirms that sentinel node biopsy, Breslow thickness, ulceration, regression, staging, first and second recurrence are important variable for overall survival and disease free survival, sentinel lymph node status influence only overall survival instead.

Pigmented basal cell carcinomas in Gorlin syndrome: two cases with different dermatoscopic patterns.

We describe two nonconsanguineous white patients with multiple pigmented basal cell carcinomas (BCCs) that were histopathologically confirmed. The first patient had calcification of the cerebral falx, multiple keratocysts in the jaw, and other malformations of the cranial and finger bones. The second patient presented with multiple dermoid cysts, calcification of the cerebral falx, keratocysts of the mandible, and agenesis of left kidney. Both patients had palmar pits. Both denied any family history of cutaneous tumours. On dermatoscopic examination of patient 1, multiple, bluish, confluent and large globules were seen. The second patient had blue ovoid globules, arborizing vessels, and areas shaped like maple leaves and spoke-wheels. Based on the clinical and radiological features we diagnosed both patients as having Gorlin syndrome (GS). To our knowledge, there are no previous reports of white patients with GS showing only pigmented BCCs. The dermatoscopic patterns were different in the two patients, and to our knowledge, this is the first report of a patient with GS showing a spoked-wheel dermatoscopic pattern.

Calcipotriol induces apoptosis in psoriatic keratinocytes.

In recent years, vitamin D3 analogues have become one of the most widely prescribed topical treatments for mild or moderate chronic plaque psoriasis. These molecules are effective and safe, but their exact mechanism of action is not completely understood. In vitro studies have shown that D3 analogues decrease proliferation and induce differentiation of keratinocytes, and have strong immunomodulating effects, but there are no conclusive data about apoptosis. The aim of this study was to evaluate differences in apoptotic response between lesional and perilesional keratinocytes of patients with psoriasis before and after treatment with calcipotriol, a synthetic vitamin D3 analogue. Keratinocytes were isolated from psoriatic plaques including lesional and perilesional skin, and cultured. Cells were treated with calcipotriol for 20 h and examined under confocal microscopy after staining with propidium iodide. The number of apoptotic cells after incubation with calcipotriol was significantly higher in lesional than in perilesional keratinocytes (P < 0.05) or non-treated psoriatic keratinocytes (P < 0.05). In conclusion, calcipotriol seems to induce apoptosis in psoriatic keratinocytes.