Retrospective Study of a Patient with Multiple de Novo Skin Tumor Formations.

In Romania, the incidence of malignant melanocytic tumors is continuously increasing. According to the World Health Organization, the incidence of melanocytic and non-melanocytic skin neoplasms has increased considerably and globally, in the last decade. We present the case of a 49-year-old patient who, over the course of 7 years, came in the Plastic Surgery Clinic of the Emergency County Hospital of Craiova for the excision of a number of 25 skin tumor formations, located on the face, cervical region, trunk and upper limbs. Treatment included complete microsurgical excision and supervision. In the end, the patient's treatment compliance decreased significantly.

Immunohistochemical expression of p53, Ki67, α-SMA, CD44 and CD31 in different histological subtypes of basal cell carcinoma.

Basal cell carcinoma (BCC) is a common, locally invasive tumor that arises within sun-damaged skin and rarely develops on the palms and soles or mucous membranes. Men generally have higher rates of BCC than women. Incidence also increases with age and the median age of diagnosis is 68 years old. Mortality from BCC is rare and cases of aggressive, local destructive, metastatic BCCs are more likely from tumors with aggressive histopathological (HP) patterns. The aim of this study was to investigate and correlate the immunohistochemical expression of p53, Ki67, alpha-smooth muscle actin (α-SMA), cluster of differentiation (CD)44 and CD31 with both aggressive and nonaggressive types of BCCs. In our study, we observed a varied staining pattern for p53, with the highest reactivity noticed in the peripheral palisading zone. The staining pattern for Ki67 was similar to p53, with a more pronounced reaction in the periphery of the tumor. We found different Ki67 and p53 expression among the various subtypes of BCC. The CD31 reactivity, mostly seen in the stroma, was positive in all BCCs and varied significantly between its different HP subtypes. Regarding stromal expression of α-SMA, the adenoid and basosquamous types had the most intense reaction in our study. The CD44 tumor expression was correlated in our study to the aggressive pattern of BCCs.

Treatment of skin defects with PRP enriched with hyaluronic acid - histological aspects in rat model.

Tissue healing is a complex, dynamic process, characterized by the replacement of devitalized and absent cell and tissue structures. This can be obtained by different methods, these being found in the "reconstructive scale", which although it is very rich does not offer a universally valid solution for closing skin wounds. In plastic surgery, platelet-rich plasma (PRP) has proven effective in the treatment of skin graft donor areas, burn wounds, skin grafts, tendons, or varicose ulcers. Also, hyaluronic acid (HA) has found its utility in different areas of medicine, other than the esthetics field, with satisfactory results after its use in various lesions. The aim of our study was to find a method of healing wounds with skin defect that shortens the time of complete epithelialization compared to native healing, which is accessible to any patient both by its simplicity and by the lowest possible costs. So, we decided to test a preparation consisting of PRP and granular HA in this type of wounds on a group of 30 Wistar rats. Corroborating the macroscopic data with the microscopic ones, an important similarity can be observed between the healing of the adjuvant-treated lesion at 14 days postoperatively and the healing of the lesion left to natural healing at 21 days, thus shortening the healing period by seven days.

Study on the Application of PRP Enriched with Hyaluronic Acid to Skin Wounds-Macroscopic Result.

Tissue healing is a complex process of replacing damaged tissue structures, being a dynamic process with spatial and temporal involvement. In practice, there are three types of healing: primary, secondary and tertiary. Since even tertiary healing can cause different problems depending on the individual patient, the medical world has always strived for new, easier, more effective, faster, and low cost-effective methods to cover skin wounds. This experiment aims to find a method that is as efficient and fast as possible, with minimal costs, of native healing of skin wounds and the development of a protocol that is as reliable and safe as possible for the patient. The experiment was carried out within the animal facility of the University of Medicine and Pharmacy of Craiova, with the agreement of our institutional Ethics Committee. The experimental group consisted of 30 individuals (Wistar laboratory rats), clinically healthy, male and female, being divided into 3 sublots of 10 individuals each. Each sublot was sacrificed at different time intervals: 7, 14 and 21 days, respectively. The local evolution of each individual was monitored during the experimental days, as well as their general state of health. Before slaughter, the lesions were examined macroscopically, following their size, whether or not the infection was present and the presence of other self-inflicted lesions later. Macroscopically, a faster wound healing was found where PRP enriched with hyaluronic acid was applied from the 7th day, so we can say that at first glance the "free" healing period in the case of enhanced epithelialization was about 7 days shorten. This fact will be confirmed or refuted following histopathological examinations and immunohistochemistry.

A Rare Case of Neglected Giant Basal Cell Carcinoma in a Nurse-Case Report and Literature Review.

Basal cell carcinoma (BCC) is the most common skin cancer in the fair-skinned adult population over 50 years of age and the incidence is rising. Generally, BCC has an indolent course, low mortality and a good prognosis due to low rates of metastasis. Giant basal cell carcinoma is a rare reported oncological entity which accounts for 0.5% to 1% of all cases of BCC and has a diameter larger than 5cm. Basosquamous carcinoma is a rare high-risk type of BCC with clinical and histopathological features of both BCC and squamous cell carcinoma. A 61-year-old female presented to our clinic for a giant bleeding tumor located under her left breast. She initially noted the tumor almost 15 years ago. Although the patient was a nurse, she was afraid to seek medical advice until an episode of significant bleeding. At presentation the tumor was a 15/7cm in size, was invading the underlying structures and had a central ulceration. The margins of the tumoral plaque had several nodules and pearly structures suggesting the possible clinical diagnosis of BCC.

PRP Enriched with Hyaluronic Acid -PRP from Rat Protocol and Method of Preparation.

Observing the positive effects of PRP (platelet-rich plasma) used in various pathologies, both in traumatology, orthopedics, sports medicine, and in plastic and reconstructive surgery, we decided to develop an improved product, using granular hyaluronic acid. The paper aims at establishing a protocol for obtaining PRP enriched with hyaluronic acid, which can be used in the current practice of treatment of skin defects, safely, with minimal side effects and limited possible, but to provide a shorter healing period as compared to native, "free" healing. The experiment aims to find an effective and rapid method of healing wounds with skin defects, by using a local adjuvant (PRP enriched with hyaluronic acid), which is available to any plastic surgeon. Following the combination of PRP with granular hyaluronic acid, we obtained a product that macroscopically has a gelatinous, viscous consistency, with a good adhesion to the tissues. The potential benefits of this experiment could be the basis for the development of treatment protocols for various pathologies, which result in wounds with skin defects, the most important aspect being the shortening of the classic healing period.

Basal Cell Carcinoma and its Impact on Different Anatomical Regions.

Basal cell carcinoma (BCC) is the most common skin cancer. We conducted a retrospective study over a period of two years (2018-2019), on 214 patients from the Plastic Surgery clinic in order to identify the clinical and histopathological aspects of the disease: the case distribution according to sex, living environment, age, histopathological subtype, location. Results. The F/M ratio was of 1.03 in favour of women. The incidence was higher for patients from rural areas (55.14%). The most affected group age was between 70-80 years old, with 76 patients (35.51%). The most frequent histological type was nodular basal cell carcinoma (65.42%), followed by micronodular subtype (17.29%). We observed the association of basal cell carcinoma with a number of other conditions such as: high blood pressure (92 cases), diabetes (19 cases), chronic kidney disease (2 cases), liver disease (5 cases), epilepsy (2 cases). Correlating the histopathological subtype and the invasion of the edges of the surgical excision specimen, we noticed that edge invasion was present: in the case of nodular basal cell carcinoma (15.71%), micronodular subtype (43.24%), superficial subtype (50%), morpheaform subtype (40%). Dividing the cases by location, we highlighted the risk areas: nasal region (29.44%), cheek (10.75%), orbital region (13.55%), scalp (10.75%), auricular region (7.48%), forehead (8.41%), etc. Thus, 89.72% of cases were located on photo-exposed areas (head and neck). Patients from rural areas registered a higher number of cases both in photo-exposed and non-exposed areas.