RESUMO
We report the case of a 94-year-old man with a rapidly growing nodule on the preauricular area, which on histology showed a poorly differentiated spindle cell tumor with negative p63 and p40 antibody immunostains, negative high- and low-molecular-weight cytokeratins albeit for a focal expression of cytokeratin AE1/AE3. Spindle cell melanoma, angiosarcoma, and leiomyosarcoma were excluded. We explore the diagnostic approach to this challenging conundrum. Certain authors have suggested that sarcomatoid carcinoma and atypical fibroxanthoma (AFX) may lie within a spectrum of "sarcoma-like tumors of the head and neck" and that they may all run a similarly indolent clinical course. However, AFX appears to remain a diagnosis of exclusion, and expert consensus is that by definition AFX cannot express any cytokeratin antigens.
Assuntos
Biomarcadores Tumorais/análise , Carcinoma/diagnóstico , Queratinas/análise , Neoplasias Cutâneas/diagnóstico , Pele/patologia , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Carcinoma/patologia , Carcinoma/cirurgia , Diagnóstico Diferencial , Face , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/patologia , Humanos , Queratinas/metabolismo , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/patologia , Masculino , Melanoma/diagnóstico , Melanoma/patologia , Cirurgia de Mohs , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgiaRESUMO
Fillers are generally considered safe. However side effects may happen and hence a practicing dermatologist need to be aware of such side effects, contraindicatons and precaution to be adopted while using fillers.
Assuntos
Indústria Química , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Maleatos/toxicidade , Exposição Ocupacional/efeitos adversos , Pintura/toxicidade , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Testes do EmplastroAssuntos
Imunoglobulina G/efeitos adversos , Micose Fungoide/patologia , Neoplasias Cutâneas/patologia , Artrite Psoriásica/tratamento farmacológico , Etanercepte , Humanos , Imunoglobulina G/uso terapêutico , Masculino , Pessoa de Meia-Idade , Micose Fungoide/diagnóstico , Receptores do Fator de Necrose Tumoral/uso terapêutico , Neoplasias Cutâneas/diagnósticoRESUMO
In lampreys as in other vertebrates, brainstem centres play a key role in the initiation and control of locomotion. One such centre, the mesencephalic locomotor region (MLR), was identified physiologically at the mesopontine border. Descending inputs from the MLR are relayed by reticulospinal neurons in the pons and medulla, but the mechanisms by which this is carried out remain unknown. Because previous studies in higher vertebrates and lampreys described cholinergic cells within the MLR region, we investigated the putative role of cholinergic agonists in the MLR-controlled locomotion. The local application of either acetylcholine or nicotine exerted a direct dose-dependent excitation on reticulospinal neurons as well as induced active or fictive locomotion. It also accelerated ongoing fictive locomotion. Choline acetyltransferase-immunoreactive cells were found in the region identified as the MLR of lampreys and nicotinic antagonists depressed, whereas physostigmine enhanced the compound EPSP evoked in reticulospinal neurons by electrical stimulation of this region. In addition, cholinergic inputs from the MLR to reticulospinal neurons were found to be monosynaptic. When the brainstem was perfused with d-tubocurarine, the induction of swimming by MLR stimulation was depressed, but not prevented, in a semi-intact preparation. Altogether, the results support the hypothesis that cholinergic inputs from the MLR to reticulospinal cells play a substantial role in the initiation and the control of locomotion.
