Complete regression of primary melanoma associated with nevi involution under BRAF inhibitors: A case report and review of the literature.

Melanoma is one of the most immunogenic tumors among human neoplasms, with numerous clinical observations of partial or completely regressed tumors. It is an aggressive tumor, with the greatest reported number of somatic mutations, BRAF mutation being the most common one. BRAF mutation is also present in a higher percentage in benign nevi. Complete regression of primary tumor and involution of nevi are, however, rare phenomenon in melanoma that can appear in relation with UV exposure, surgical trauma, target therapy in melanoma, pregnancy or host immune response to an evolving melanoma tumor. We present the case of a 58-year-old man with a completely regressed metastatic melanoma who developed a second melanoma with concomitant involution of papillomatous nevi under BRAF inhibitors treatment. In reviewed literature we have found 53 cases of completely regressed primary melanomas, neither of them reporting nevi involution. Complete regression of primary tumor can occur as an immune response to tumor progression. Nevi can involute under BRAF inhibitor therapy, but development of new malignant lesions under BRAF inhibitors is linked to BRAF wild-type. Documentation of primary tumor and dynamic changes in nevi highlight the need of a good clinical skin examination and increase the utility of baseline and sequential dermoscopy in melanoma.

Sexual Behaviors, Attitudes, and Knowledge about Sexually Transmitted Infections: A Cross-sectional Study in Romania.

Sexually transmitted infections (STIs) are serious public health problems. Little is known about sex knowledge, attitudes, and sexual behaviors among young adults in Romania; an effective preventive campaigns should be based on an appropriate understanding of these factors. The aim of the present study was to obtain data about sexual behavior, attitudes, and knowledge about STIs among university students aged 18-25 in Romania. 3872 persons completed an internet-based questionnaire, advertised on Facebook, regarding sexual behavior, attitudes, and knowledge about STIs from January 28 to February 28, 2016. 6.01% of the respondents had no sexual experience; of the remaining (N=3639, 945 men and 2694 women) 94% were heterosexual, 1.5% homosexual, and 4.6% bisexual. 53.7% of the respondents started their sexual activity between 14 and 18 years of age; only 2.3% become sexually active before 14 years of age. 30% of both sexes reported multiple sexual partners during the previous year. 25.9% of men and 23.3% of women used no contraception at sexual onset, the proportion being higher among those with an early sexual debut. 98% of the respondents knew that HIV could be contracted sexually, 75.8% knew that gonorrhea and 61.1% that Chlamydia trachomatis were sexually transmitted, and approximately one third knew that trichomoniasis and hepatitis B or C were STIs. We found a relatively high proportion of students engaged in risky sexual behaviors and insufficient knowledge about STIs. The results are important in planning future sexual education campaigns and they call for new preventive strategies.

Regression and Sentinel Lymph Node Status in Melanoma Progression.

BACKGROUND The purpose of this study was to assess the role of regression and other clinical and histological features for the prognosis and the progression of cutaneous melanoma. MATERIAL AND METHODS Between 2005 and 2016, 403 patients with melanoma were treated and followed at our Department of Dermatology. Of the 403 patients, 173 patients had cutaneous melanoma and underwent sentinel lymph node (SLN) biopsy and thus were included in this study. RESULTS Histological regression was found in 37 cases of melanoma (21.3%). It was significantly associated with marked and moderate tumor-infiltrating lymphocyte (TIL) and with negative SLN. Progression of the disease occurred in 42 patients (24.2%). On multivariate analysis, we found that a positive lymph node and a Breslow index higher than 2 mm were independent variables associated with disease free survival (DFS). These variables together with a mild TIL were significantly correlated with overall survival (OS). The presence of regression was not associated with DFS or OS. CONCLUSIONS We could not demonstrate an association between regression and the outcome of patients with cutaneous melanoma. Tumor thickness greater than 2 mm and a positive SLN were associated with recurrence. Survival was influenced by a Breslow thickness >2 mm, the presence of a mild TIL and a positive SLN status.

Pyoderma gangrenosum with spleen involvement. Review of the literature and case report.

BACKGROUND: Pyoderma gangrenosum is a rare, ulcerative, destructive, non-infectious dermatologic disease and it is one clinical entity within the spectrum of neutrophilic dermatoses. Visceral involvement, manifesting as sterile neutrophilic infiltrates in sites other than skin and, is infrequent. Splenic involvement is very rare. MAIN OBSERVATIONS: We present a case of a 58-year-old woman with pyoderma gangrenosum with spleen involvement and review all reports of similar cases.We have found nine reported cases, our case being the tenth. CONCLUSION: Our review showed that spleen involvement in the course of pyoderma gangrenosum can occur at any age. It is slightly more frequent in men. An underlying or associated neutrophilic disorder is present in almost half of the patients. Skin manifestations were usually present before splenic involvement. In most cases the disese responds well to glucocorticosteroids.