Merkel cell carcinoma after liver transplantation: a case report and review of the literature.

Merkel cell carcinoma is a rare type of highly aggressive cutaneous malignant neuroendocrine tumor. The incidence of Merkel cell carcinomas is higher in organ transplant recipients than healthy controls. There are some reports of Merkel cell carcinomas after kidney transplantation, but few reports of Merkel cell carcinomas after liver transplantation are available. We present a 64-year-old Chinese woman with an asymptomatic nodule on her right tibia 6 years after liver transplantation. The nodule appeared as a purulent scab on the surface and measured 2.4×2.5 cm in diameter. Histopathologic and immunohistochemistry examinations confirmed the nodule to be a Merkel cell carcinoma. No residual Merkel cell carcinoma was detected at the surgical margins after surgical resection. No metastases were detected in a sentinel lymph node biopsy specimen. The wound was suctioned with negative pressure. The patient had an uneventful recovery and was discharged 16 days after surgery. Then, she underwent postsurgical adjuvant radiotherapy. No relapse was observed for approximately 24 months of follow-up. Merkel cell carcinoma may severely impact health, especially among transplant recipients. Immunosuppressants that must be administered after transplantation can increase the risk of Merkel cell carcinoma and physicians should be aware of Merkel cell carcinomas occurring in liver transplant recipients.

Risk factors of recurrent erysipelas in adult Chinese patients: a prospective cohort study.

BACKGROUND: Erysipelas is a common skin infection that is prone to recur. Recurrent erysipelas has a severe effect on the quality of life of patients. The present study aimed to investigate the risk factors of recurrent erysipelas in adult Chinese patients. METHODS: A total of 428 Chinese patients with erysipelas who met the inclusion criteria were studied. The patients were divided into the nonrecurrent erysipelas group and the recurrent erysipelas group. Clinical data were collected on the first episode and relapse of erysipelas. The patients were followed up every 3 months. Statistical analysis was performed to analyze and determine the risk factors of erysipelas relapse. RESULTS: Univariate analysis was performed to analyze the data, including surgery, types of antibiotics administered in the first episode, obesity, diabetes mellitus, venous insufficiency, lymphedema, and malignancy. The differences between the groups were statistically significant (p < 0.05). The Cox proportional hazards regression model analysis showed that the final risk factors included surgery, obesity, diabetes mellitus, venous insufficiency, and lymphedema. CONCLUSIONS: Surgery, obesity, diabetes mellitus, venous insufficiency, and lymphedema are considered as risk factors for recurrent erysipelas.

Extracellular vesicle-encapsulated microRNA-424 exerts inhibitory function in ovarian cancer by targeting MYB.

BACKGROUND: Recent studies have suggested a crucial role of mesenchymal stem cell (MSC)-derived extracellular vesicles (EVs) in ovarian cancer treatment. We, therefore, set out to explore the mechanism through which MSC-derived EVs delivered microRNA-424 (miR-424) to influence the development of ovarian cancer. METHODS: Bioinformatics analyses were first performed to screen ovarian cancer-related differentially expressed genes and to predict regulatory miRNAs. Then, dual-luciferase reporter gene assay was carried out to verify the relationship between miR-424 and MYB. Subsequently, the characterized MSCs and isolated EVs were co-cultured with ovarian cancer cells, followed by determination of the expression patterns of miR-424, MYB, vascular endothelial growth factor (VEGF), and VEGF receptor (VEGFR), respectively. In addition, the effects of EVs-delivered miR-424 on the proliferation, migration, invasion and tube formation of ovarian cancer cells were assessed using gain- and loss-of-function approaches. Lastly, tumor xenograft was induced in nude mice to illustrate the influence of EVs-loaded miR-424 on ovarian cancer in vivo. RESULTS: Our data exhibited that MYB was highly-expressed and miR-424 was poorly-expressed in ovarian cancer. More importantly, MYB was identified as a target gene of miR-424. Additionally, the transfer of miR-424 by MSC-derived EVs was found to repress the proliferation, migration, and invasion of ovarian cancer cells, with a reduction in the expressions of VEGF and VEGFR. Furthermore, MSC-derived EVs over-expressing miR-424 could inhibit the proliferation, migration, and tube formation of human umbilical vein endothelial cells, and also suppressed tumorigenesis and angiogenesis of ovarian tumors in vivo. CONCLUSION: Collectively, our findings indicate that MSC-derived EVs transfer miR-424 to down-regulate MYB, which ultimately led to the inhibition of the tumorigenesis and angiogenesis of ovarian cancer. Hence, this study offers a potential prognostic marker and a therapeutic target for ovarian cancer.

Pregabalin-associated stuttering and frequent blepharospasm: case report and review.

Herpes zoster is an acute, painful, herpes skin disease caused by varicella-zoster virus, which may cause viral meningitis. Pregabalin has been shown to be efficacious in the treatment of pain in patients with herpes zoster. However, it has the side effects of neurotoxicity. We describe a 68-year-old female patient with herpes zoster, and she was treated with pregabalin. The patient presented with stuttering and frequent blepharospasm after 3 days of pregabalin treatment. Pregabalin was discontinued, the symptoms of stuttering and frequent blepharospasm completely resolved without any special treatment after one week. In this case, the etiology of stuttering and frequent blepharospasm may be related to pregabalin. Clinicians should be alert to the rare symptoms associated with the use of pregabalin. Graphical abstract .

Diagnostic value of detection of serum ß-HCG and CT-IgG combined with transvaginal ultrasonography in early tubal pregnancy.

The diagnostic value of detection of serum ß-human chorionic gonadotropin (ß-HCG) and Chlamydia trachomatis immunoglobulin G (CT-IgG) combined with transvaginal ultrasonography in early tubal pregnancy was investigated. A total of 55 patients with early tubal pregnancy were selected as the tubal pregnancy group, while 55 subjects of normal intrauterine pregnancy were enrolled as the intrauterine pregnancy group. Transvaginal ultrasonography and quantitative detection of serum ß-HCG and CT-IgG were performed for all patients, and the clinical examination results were analyzed and compared. The endometrial thickness and serum ß-HCG level of patients with early tubal pregnancy were significantly lower than those of women with intrauterine pregnancy (6.7±1.5 vs. 11.6±1.2 mm; 776±109 vs. 5,598±187 U/l), and the differences were statistically significant (p<0.01); the serum CT-IgG antibody positive rate of patients in tubal pregnancy group (49.1%) was significantly higher than that in intrauterine pregnancy group (12.7%) (p<0.01); the serum CT-IgG antibody positive rates of patients with degree I, II and III of pelvic adhesion intubal pregnancy group were 28.6, 75.0 and 81.8%, respectively; the more severe the pelvic adhesion was, the higher the CT-IgG positive rate would be. The diagnostic coincidence rate of combined detection was significantly higher than that of single detection of serum ß-HCG, progesterone and endometrial thickness. The detection of serum ß-HCG and CT-IgG combined with transvaginal ultrasonography can diagnose the early tubal pregnancy soonest possible, and help choose the appropriate therapeutic methods depending on the situation to reduce the tubal damage of patients, so as to provide a reliable basis for the diagnosis, treatment and prognosis, and it has important clinical application value.

Erythrodermic psoriasis with bullous pemphigoid: combination treatment with methotrexate and compound glycyrrhizin.

We report a case of erythrodermic psoriasis with bullous pemphigoid (BP) in a 68-year-old male. The patient had a history of psoriasis for 35 years and tense, blisterlike lesions for 4 months. He presented with diffuse flushing, infiltrative swelling, and tense blisterlike lesions on his head, trunk, and limbs. This patient was successfully treated by a combination of methotrexate and compound glycyrrhizin. We also discuss the clinical manifestations, histopathological features, and differentiation of erythrodermic psoriasis with BP and present a review of the pertinent literature. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1853737109114076.

Induction of vitiligo after imiquimod treatment of condylomata acuminata.

BACKGROUND: Condylomata acuminata (genital warts) is the most common sexually transmitted disease, and imiquimod is the sole FDA-approved medication for combating this condition. Vitiligo associated with imiquimod treatment of condylomata acuminata is rare. CASE PRESENTATION: A 28-year-old male with condylomata acuminata of the penis presented to our clinic. After removing his condylomata acuminata, we advised him to use imiquimod 5% cream to prevent relapse. When he presented to our clinic again about 12 weeks later, he complained of vitiligo patches on his penis and scrotum. Physical examination showed vitiligo patches involving the glans penis, shaft of the penis, and scrotum, and remaining pigmented areas within the plaques of vitiligo.A skin biopsy of the dorsal surface of the penis showed a complete absence of melanocytes and melanin granules in the basal layer; the dermis was normal. CONCLUSION: This is the first report of a case of imiquimod-induced vitiligo diagnosed by histopathological examination. This adverse effect should be considered when dermatologists prescribe this medication.