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1.
G Ital Dermatol Venereol ; 154(6): 714-716, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26349925

RESUMO

We report a case of a healthy 26-year-old male with multiple asymptomatic reddish papules and papule-nodules on the central area of the face, persisting from more than 2 months and gradually increasing in number. An incisional skin biopsy revealed a confluent dense granulomatous infiltrate centred by large areas of eosinophilic necrosis consistent with the diagnosis of lupus miliaris disseminatus faciei (LMDF). This is a rare dermatosis first described in 1878 by Fox, that often poses a clinical challenge as it is a disease process which is difficult to diagnose. In fact, in our case, a diagnosis of LMDF was made on skin biopsy. We think that collaboration among dermatologists and General Practitioners is very important for diagnosis of rare dermatosis and especially for management of it, in order to prevent the development of depressed scars.


Assuntos
Dermatoses Faciais/diagnóstico , Rosácea/diagnóstico , Adulto , Biópsia , Eosinofilia/patologia , Dermatoses Faciais/patologia , Humanos , Masculino , Rosácea/patologia
2.
G Ital Dermatol Venereol ; 152(3): 203-207, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28209051

RESUMO

BACKGROUND: Among older patients, melanoma in general presents biological features related to a more aggressive biology, such as more locally advanced tumor. Management of melanoma in elderly may be difficult, mainly due to comorbidities. We report the experience of the Melanoma Unit of ASST Spedali Civili in Brescia, Italy. METHODS: Study subjects were drawn from 3444 patients with histological confirmed melanoma. Data were extracted from electronic database of the Melanoma Unit of ASST Spedali Civili in Brescia, Italy. Patients who received diagnosis of cutaneous melanoma at age of 65 years or older were retrospectively evaluated. For each diagnosed melanoma, histological characteristics, treatment, and outcomes were evaluated. RESULTS: Of the 805 patients described in this study, 444 were males and 361 females. Statistically significant differences were found between patients aged 65-80 years and those aged >80 years considering melanoma prognostic factors, such as Breslow thickness, number of mitoses/mm2 and ulceration. CONCLUSIONS: Older age is recognized as an independent poor prognostic factor in melanoma patients, and melanoma in older patients have a distinct natural history. It was found that management of cancer in old person represents a major challenge to medical practice. We believe that the choice of therapy should be individualized and based upon the individual's overall health and that, particularly in these cases, management often requires interdisciplinary cooperation between dermatologist, surgical specialist, oncologist and geriatrician.


Assuntos
Melanoma , Neoplasias Cutâneas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Melanoma/patologia , Estudos Retrospectivos , Neoplasias Cutâneas/patologia
3.
Melanoma Res ; 27(2): 97-103, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28060055

RESUMO

Genetic susceptibility to primary cutaneous melanoma (PCM) may account for up to 12% of PCMs, presenting as the familial atypical mole/multiple melanoma syndrome (FAMMM), an autosomal dominant condition with incomplete penetrance and variable expressivity, characterized by PCM in at least two relatives and/or more than one PCMs in the same patient. To identify individuals at high genetic risk of PCM, from 1 January 2012 to 31 December 2015, we offered genetic counselling and molecular analysis of the two high-penetrance FAMMM susceptibility genes, cyclin-dependent kinase inhibitor 2A (CDKN2A) and cyclin-dependent kinase 4 (CDK4), to 92 consecutive, unrelated patients with FAMMM. Age at diagnosis and number of PCMs were obtained from medical records; the number of PCMs and affected relatives were recorded for each family. The diagnostic work-up consisted of genetic counselling and cascade genetic testing in patients and further extension to relatives of those identified as mutation carriers. All exons and exon/intron boundaries of CDKN2A and CDK4 genes were screened by direct bidirectional sequencing. We identified CDKN2A mutations in 19 of the 92 unrelated patients (20.6%) and in 14 additional, clinically healthy relatives. Eleven of these latter subsequently underwent excision of dysplastic nevi, but none developed PCM during a median follow-up of 37.3 months. In three patients from unrelated families, the novel CDKN2A p.D84V (c.251A>T) mutation was observed, associated with PCM in each pedigree. Genetic screening of FAMMM patients and their relatives can contribute towards specific primary and secondary prevention programmes for individuals at high genetic risk of PCM. The novel CDKN2A p.D84V (c.251A>T) mutation adds to the known mutations associated with FAMMM.


Assuntos
Quinase 4 Dependente de Ciclina/genética , Inibidor de Quinase Dependente de Ciclina p18/genética , DNA de Neoplasias , Aconselhamento Genético , Melanoma/genética , Penetrância , Neoplasias Cutâneas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biologia Computacional , Inibidor p16 de Quinase Dependente de Ciclina , Análise Mutacional de DNA , Feminino , Predisposição Genética para Doença , Haplótipos , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Linhagem , Medição de Risco , Adulto Jovem , Melanoma Maligno Cutâneo
5.
J Pediatr Hematol Oncol ; 35(5): 383-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23528903

RESUMO

Classically, dermatofibrosarcoma protuberans (DFSP) is a disease of adults. The world literature revision shows that several pediatric cases have been reported so far; this might suggest that the number of infants with the condition might be larger than that estimated previously. Here, we report the 183rd case of histologically confirmed DFSP in young age. A 14-year-old white male patient came under our care for a slowly growing, pale brownish lesion on the neck skin. A biopsy specimen showed a DFSP. Subsequently, a wide surgery excision with 3 cm of resection margins including the underlying fascia was performed. To date, the patient has been in follow-up for 6 years without evidence of recurrent disease. The clinical features and treatment of DFSP diagnosed in childhood and adolescence reported in the published literature are reviewed to provide new insights about this rare entity. The aim is to emphasize the importance of biopsy for histologic evaluation in the cases that show a persistent or a large cutaneous plaque or nodule without pathognomonic clinical features that permit a clinical diagnosis. An accurate knowledge of the disease is the prerequisite for a wider recognition and appropriate treatment.


Assuntos
Dermatofibrossarcoma/patologia , Neoplasias Cutâneas/patologia , Adolescente , Dermatofibrossarcoma/cirurgia , Humanos , Masculino , Cirurgia de Mohs , Neoplasias Cutâneas/cirurgia
6.
Photodermatol Photoimmunol Photomed ; 26(5): 263-5, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21175855

RESUMO

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumour of the skin. Though immunodeficiency is the most relevant risk factor, ultraviolet (UV) radiation is also involved, but as of yet we do not know the action spectrum, pattern or dose which would produce a dangerous exposure. A retrospective study of two immunosuppressed patients who developed MCC during, or soon after a treatment cycle with high dose UVA1 exposures was conducted, in order to understand wether repeated exposures to suberythemogenic UVA1 radiation may have a cancerogenic activity provoking MCC in immunosuppressed patients.


Assuntos
Carcinoma de Célula de Merkel/etiologia , Hospedeiro Imunocomprometido/efeitos da radiação , Neoplasias Cutâneas/etiologia , Raios Ultravioleta/efeitos adversos , Terapia Ultravioleta/efeitos adversos , Idoso , Carcinoma de Célula de Merkel/patologia , Carcinoma de Célula de Merkel/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
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