ABSTRACT
BACKGROUND: Actin is largely responsible for cell motility and is only sparsely found in normal epithelial cells. An altered expression of actin in some malignancies may facilitate aggressive invasion. Micronodular basal cell carcinoma (BCC) has been shown to require more surgical stages, wider tissue margins, and deeper defects for extirpation during Mohs micrographic surgery relative to nodular BCC. OBJECTIVE: To provide preliminary data regarding a possible correlation between alpha-smooth muscle actin (alpha-SMA) expression within the cells or stroma of micronodular BCC and aggressive invasion. In addition, the incidence of alpha-SMA expression in micronodular, morpheaform, and nodular BCC is evaluated. METHODS: Nine micronodular basal cell carcinomas (7 primary, 2 recurrent) were evaluated for neural invasion, depth of tissue invasion, and alpha smooth muscle actin antibodies. The presence of alpha-smooth muscle actin antibodies was assessed using immunoperoxidase staining and compared with 13 morpheaform (13 primary, 0 recurrent) and 12 nodular (12 primary, 0 recurrent). RESULTS: Six of the nine micronodular (67%), eight of the 13 morpheaform (62%), and 0 of the 12 nodular (0%) BCCs stained positive for alpha-SMA. Of the six micronodular BCCs that stained positive for alpha-SMA, three invaded the fascia or muscle and three displayed neural invasion. In contrast, of the three micronodular BCCs that stained negative for alpha-SMA, none invaded the fascia or muscle and only one exhibited neural invasion. CONCLUSION: Actin was present in 66% of micronodular, 62% of morpheaform, and 0% of nodular BCC. The presence of actin in micronodular BCC may be a marker for aggressive invasion.
Subject(s)
Actins/metabolism , Carcinoma, Basal Cell/metabolism , Skin Neoplasms/metabolism , Carcinoma, Basal Cell/pathology , Humans , Immunoenzyme Techniques , Neoplasm InvasivenessSubject(s)
AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/therapy , Skin Diseases, Viral/diagnosis , Skin Diseases, Viral/therapy , Herpesviridae Infections , Humans , Papillomaviridae , Papillomavirus Infections , Poxviridae Infections , Tumor Virus InfectionsABSTRACT
UNLABELLED: The HIV epidemic has dramatically altered the field of sexually transmitted diseases (STDs). HIV infection is unique among sexually transmitted diseases because it can modify the clinical presentation and features of other STDs. Conversely, other STDs can affect the transmission of HIV. This review is the third part of a series that has provided a general overview of STDs. In this article, genital ulcer diseases (genital herpes, syphilis, chancroid, lymphogranuloma venereum, and granuloma inguinale), human papillomavirus infection (anogenital warts and subclinical infections), molluscum contagiosum, human herpesvirus 8 infection, viral hepatitis, and ectoparasitic infestations (scabies and pediculosis pubis) are discussed as they occur in HIV-infected hosts. Additional features as they relate to HIV-infected patients, such as epidemiology and transmission, are discussed when applicable. LEARNING OBJECTIVE: At the conclusion of this learning activity, participants should improve their understanding of sexually transmitted diseases in the HIV-infected host.
Subject(s)
HIV Infections/complications , Sexually Transmitted Diseases/pathology , Humans , Incidence , Sexually Transmitted Diseases/etiology , Sexually Transmitted Diseases/transmissionABSTRACT
Human herpesvirus 8 (HHV-8) has been causally linked to Kaposi's sarcoma (KS). There is significant homology between some HHV-8 genes and cellular genes including D-type cyclin (vCYC), G protein coupled receptor (vGCR), macrophage inflammatory proteins (vMIP-I, vMIP-II), bcl-2 (vBCL2), interferon regulatory factor-1 (vIRF1), interleukin-6 (vIL6), and complement-binding protein (vCBP). In this study, we analyzed expression of these viral homologs and HIV-1 Tat by reverse-transcriptase polymerase chain reaction (RT-PCR) coupled with Southern blot hybridization in AIDS-KS (AKS) tissue, classic KS tissue(CKS), and peripheral blood mononuclear cells, and phorbol ester (TPA)-treated and untreated HHV-8 positive lymphoma cells (BCBL1). While vCYC (AKS 6 of 6; CKS 3 of 3), vMIP-I (AKS 5 of 6, CKS 3 of 3), vBCL2 (AKS 6 of 6; CKS 3 of 3), and vIRF1 (AKS 5 of 6, CKS 3 of 3) transcripts were detected in both AKS and CKS, vGCR and HIV-1 Tat were expressed only in AKS samples (vGCR: AKS 3 of 6, CKS 0 of 3; Tat: AKS 4 of 6, CKS 0 of 3). vMIPII, vCBP, and vIL6 expression were not detected in any KS samples. Since vGCR expression is limited to AKS, it is possible that vGCR is activated by HIV-1 Tat. These results suggest that HIV-1 Tat may contribute to AKS pathogenesis through the tumorigenic and angiogenic effects of vGCR.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Herpesvirus 8, Human/genetics , Receptors, Cell Surface/genetics , Sarcoma, Kaposi/genetics , Cyclin D , Cyclins/genetics , Gene Expression Regulation, Viral , Gene Products, tat/genetics , Gene Products, tat/physiology , HIV-1/genetics , HIV-1/physiology , Humans , Leukocytes, Mononuclear/metabolism , Leukocytes, Mononuclear/virology , Oncogenes/genetics , RNA/genetics , Reverse Transcriptase Polymerase Chain Reaction , Sarcoma, Kaposi/complications , Sarcoma, Kaposi/virology , Tetradecanoylphorbol Acetate/pharmacology , Tumor Cells, Cultured/drug effects , Tumor Cells, Cultured/metabolism , Tumor Cells, Cultured/virology , Viral Proteins/genetics , tat Gene Products, Human Immunodeficiency VirusABSTRACT
UNLABELLED: Sexually transmitted diseases are a persistent problem in the United States and throughout the world. Many of these infections involve the skin and may be encountered in the field of dermatology. This 3-part review highlights the cutaneous features, diagnosis, and treatment of 11 of the most common sexually transmitted diseases, other than AIDS. The second part of this series focuses on anogenital warts, chronic viral hepatitis, molluscum contagiosum, scabies, and pediculosis pubis. Additional features, such as epidemiology and transmission of the organism, are discussed when applicable. (J Am Acad Dermatol 1999;41:661-77.) LEARNING OBJECTIVE: At the conclusion of this learning activity, participants should be familiar with the clinical features, diagnosis, and treatment of sexually transmitted diseases (excluding AIDS) which have cutaneous presentations or involvement.
Subject(s)
Sexually Transmitted Diseases , Anus Diseases/diagnosis , Anus Diseases/therapy , Condylomata Acuminata , Female , Genital Diseases, Female/diagnosis , Genital Diseases, Female/therapy , Genital Diseases, Male/diagnosis , Genital Diseases, Male/therapy , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/therapy , Hepatitis C, Chronic/diagnosis , Hepatitis C, Chronic/therapy , Humans , Lice Infestations/diagnosis , Lice Infestations/therapy , Male , Molluscum Contagiosum/diagnosis , Molluscum Contagiosum/therapy , Scabies/diagnosis , Scabies/therapy , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/therapyABSTRACT
Sexually transmitted diseases are a persistent problem in the United States and throughout the world. Many of these infections involve the skin and may be encountered in the field of dermatology. This 3-part review highlights the cutaneous features, diagnosis, and treatment of 11 of the most commonly encountered sexually transmitted diseases, other than AIDS. However, this review does not cover sexually transmitted diseases such as chlamydia, which do not regularly have cutaneous manifestations. Part 1 focuses on syphilis, disseminated gonococcal infection, chancroid, lymphogranuloma venereum, granuloma inguinale, and genital herpes. Additional features, such as epidemiology and transmission of the organism, are discussed when applicable.
