RESUMO
BACKGROUND: No studies are available in the literature on the distribution of different melanoma features and risk factors in the Italian geographical areas. OBJECTIVE: To identify the differences in clinical-pathological features of melanoma, the distribution of risk factors and sun exposure in various Italian macro-areas. METHODS: Multicentric-observational study involving 1,472 melanoma cases (713 north, 345 centre, 414 south) from 26 referral centres belonging to the Italian Multidisciplinary Group for Melanoma. RESULTS: Melanoma patients in northern regions are younger, with thinner melanoma, multiple primaries, lower-intermediate phototype and higher counts of naevi with respect to southern patients; detection of a primary was mostly connected with a physician examination, while relatives were more involved in the south. Northern patients reported a more frequent use of sunbeds and occurrence of sunburns before melanoma despite sunscreen use and a lower sun exposure during the central hours of the day. CONCLUSIONS: The understanding of differences in risk factors distribution could represent the basis for tailored prevention programmes.
Assuntos
Melanoma/epidemiologia , Melanoma/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Humanos , Itália/epidemiologia , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Mycosis fungoides (MF), which represents the most common subtype of primary cutaneous T-cell lymphoma (CTCL), is an epidermotropic lymphoma included as an indolent form in the recent WHO/EORTC classification. From a clinical point of view, the classic disease progression usually is slow and takes over years or even decades, and characterized by the evolution from patches to more infiltrated plaques and eventually to tumours or erythroderma. However, the analysis of the MF disease course has been greatly impaired by the rarity of the disease, thus data about the time course of disease progression and pattern of relapse during time are not well known. In this review, a summary of published data on MF large patients cohorts will be presented, together with the results obtained by a retrospective analysis of clinical features and follow-up data of 1,422 MF patients diagnosed and followed-up from 1975 to 2010 in 27 Italian Centres (Italian Study Group for Cutaneous Lymphoma). From a clinical perspective, the amount of data support the relevance of a stage-tailored, differentiated follow-up strategy, in as much as the TNMB staging appears not only to be associated with different progression rates, but also shows as a new finding a relationship with different patterns of disease progression. From a biological point of view, there is the need to understand the molecular basis of the different clinical pathways of disease progression, to be able to potentially identify at an earlier phase of disease evolution, the patients who are more likely to develop erythroderma or tumour-stage progression. In conclusion, if MF is indeed a true "lion queen", as dermatologists we need to be expert and wise tamers to keep it under control.
Assuntos
Micose Fungoide , Neoplasias Cutâneas , Progressão da Doença , Humanos , Micose Fungoide/patologia , Neoplasias Cutâneas/patologiaRESUMO
We report a case of erysipeloid in a 73-year-old woman. The disease was characterized clinically by erythematous and erosive lesions on three fingers of the left hand. Diagnosis was made based on the patient's occupation (housewife), history of previous traumatic contact with a scorpion fish, typical inflammatory lesions located on one hand, lack of severe systemic features, mild laboratory abnormalities and rapid remission after specific treatment.
Assuntos
Erisipeloide/microbiologia , Peixes/microbiologia , Dermatoses da Mão/microbiologia , Idoso , Animais , Antibacterianos/administração & dosagem , Ceftriaxona/administração & dosagem , Erisipeloide/tratamento farmacológico , Feminino , Dedos , Dermatoses da Mão/tratamento farmacológico , Humanos , Injeções Intramusculares , Resultado do TratamentoRESUMO
Erysipeloid is an occupational infection of the skin caused by traumatic penetration of Erysipelothrix rhusiopathiae. The disease is characterized clinically by an erythematous oedema, with well-defined and raised borders, usually localized to the back of one hand and/or fingers. Vesicular, bullous and erosive lesions may also be present. The lesion may be asymptomatic or accompanied by mild pruritus, pain and fever. In addition to cutaneous infection, E. rhusiopathiae can cause endocarditis, which may be acute or subacute. Endocarditis is rare and has a male predilection. It usually occurs in previously damaged valves, predominantly the aortic valve. Endocarditis does not occur in patients with valvular prostheses and is not associated with intravenous drug misuse. Diagnosis of localized erysipeloid is based on the patient's history (occupation, previous traumatic contact with infected animals or their meat) and clinical picture (typical skin lesions, lack of severe systemic features, slight laboratory abnormalities and rapid remission after treatment with penicillin or cephalosporin).
Assuntos
Erisipeloide , Doenças Profissionais , Criação de Animais Domésticos , Animais , Diagnóstico Diferencial , Erisipeloide/tratamento farmacológico , Erisipeloide/etiologia , Erisipeloide/patologia , Humanos , Controle de Infecções/normas , Doenças Profissionais/tratamento farmacológico , Doenças Profissionais/etiologia , Doenças Profissionais/patologia , Exposição OcupacionalRESUMO
Lymphogranuloma venereum (LGV) is a sexually transmitted infection endemic in Central Africa, South-East Asia and in some countries of Central and South America. In Italy LGV has been sporadically reported in patients coming from abroad. The etiological agent of LGV is Chlamydia trachomatis serovars L1, L2, L3, differentiating by pathogenetic action. The clinical course of LGV can be divided into three stages with a initial small papule, which may ulcerate, at the site of inoculation, followed by massive lymphadenopathy, which is usually unilateral, and eventually by lymphatic obstruction, causing elephantiasis. During 2004 a LGV ano-rectal clinical variant has been described as an erosive proctitis among homosexual HIV-positive men in some countries of Western Europe, not coming from endemic areas. Until now this syndrome has been often explained as chronic intestinal inflammatory disease. This report describes a case of proctitis caused by CT serovar L2; to Authors' knowledge this is the first case reported in Italy.
Assuntos
Linfogranuloma Venéreo/diagnóstico , Proctite/diagnóstico , Adulto , África do Norte , Chlamydia trachomatis/classificação , Chlamydia trachomatis/isolamento & purificação , Diagnóstico Diferencial , Doenças Endêmicas , Infecções por HIV/complicações , Humanos , Itália/epidemiologia , Linfogranuloma Venéreo/complicações , Linfogranuloma Venéreo/epidemiologia , Linfogranuloma Venéreo/microbiologia , Masculino , Proctite/complicações , Proctite/epidemiologia , Proctite/microbiologia , Sorotipagem , ViagemRESUMO
In this research the importance of several choice attributes of beef for Piedmontese consumers was examined. The survey was conducted on a sample of consumers in sixteen meat stores in Piedmont, Northwest Italy. A choice experiment (Best-Worst scaling methodology) was used to identify consumer preferences and five clusters of purchaser. The responses were also analyzed on the basis of two variables, the frequency of meat consumption and the place of purchase. Piedmontese consumers considered "price" as the most important factor in meat purchasing, but "animal welfare" considerations played some part too.
Assuntos
Comportamento de Escolha , Comportamento do Consumidor , Preferências Alimentares , Qualidade dos Alimentos , Carne , Adulto , Bem-Estar do Animal , Animais , Bovinos , Análise por Conglomerados , Comportamento do Consumidor/economia , Inquéritos sobre Dietas , Comportamento Alimentar/etnologia , Feminino , Rotulagem de Alimentos , Preferências Alimentares/etnologia , Alimentos Orgânicos/economia , Humanos , Itália , Masculino , Carne/economia , Pessoa de Meia-Idade , Especificidade da EspécieRESUMO
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered to be severity variants of the same disease, which is almost always associated with drug intake. In contrast, erythema multiforme (EM) is a disorder regarded as only rarely caused by drugs. Keratinocyte apoptosis has been shown to play an important part in the pathogenesis of SJS and TEN, whilst its role in EM remains controversial. To determine the expression of apoptosis-associated molecules Fas, Fas ligand (FasL), Bcl-2 and Bax in the above disorders, an immunohistochemical analysis was performed. We studied both lesional skin from thirty patients having drug-induced EM and 5 cases classified within the SJS/TEN spec nottrum and normal skin samples. We found a keratinocyte overexpression of Fas antigen, an important molecule mediating apoptosis, not only in SJS and TEN but also in EM. Another noteworthy finding was the strong expression of Bcl-2, a protein known as blocking apoptosis, along the basal layer and in the dermal infiltrate both in SJS/TEN and in EM. Taken together, these findings suggest that Fas-dependent keratinocyte apoptosis may play a part in the pathogenesis of both SJS/TEN and EM. Fas-mediated cell death may be partially suppressed by the Bcl-2 protein.
Assuntos
Antígenos/biossíntese , Apoptose/efeitos dos fármacos , Eritema Multiforme , Pele/efeitos dos fármacos , Síndrome de Stevens-Johnson , Antígenos/imunologia , Apoptose/imunologia , Biomarcadores/análise , Linfócitos T CD8-Positivos/imunologia , Eritema Multiforme/induzido quimicamente , Eritema Multiforme/imunologia , Eritema Multiforme/patologia , Proteína Ligante Fas/biossíntese , Proteína Ligante Fas/imunologia , Humanos , Imuno-Histoquímica , Proteínas Proto-Oncogênicas c-bcl-2/biossíntese , Proteínas Proto-Oncogênicas c-bcl-2/imunologia , Pele/imunologia , Pele/metabolismo , Pele/patologia , Síndrome de Stevens-Johnson/induzido quimicamente , Síndrome de Stevens-Johnson/etiologia , Síndrome de Stevens-Johnson/imunologia , Síndrome de Stevens-Johnson/patologia , Proteína X Associada a bcl-2/biossíntese , Proteína X Associada a bcl-2/imunologia , Receptor fas/biossíntese , Receptor fas/imunologiaAssuntos
Cromossomos Humanos Par 5/genética , Granuloma/genética , Linfoma Cutâneo de Células T/genética , Neoplasias Cutâneas/genética , Adulto , Biópsia , Deleção de Genes , Rearranjo Gênico do Linfócito T , Genótipo , Granuloma/imunologia , Granuloma/patologia , Humanos , Linfoma Cutâneo de Células T/imunologia , Linfoma Cutâneo de Células T/patologia , Masculino , Músculos/patologia , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologia , Tela Subcutânea/patologia , Linfócitos T/imunologiaAssuntos
Infecções Oportunistas Relacionadas com a AIDS/imunologia , Doenças do Ânus/imunologia , Condiloma Acuminado/imunologia , Terapia Antirretroviral de Alta Atividade , Neoplasias do Ânus/imunologia , Carcinoma in Situ/imunologia , Progressão da Doença , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do PacienteRESUMO
We developed an in vitro contact through-feet blood brain barrier (BBB) model built using type IV collagen, rat astrocytes, and human umbilical vein endothelial cells (HUVECs) cocultured through Transwell porous polycarbonate membrane. The contact between astrocytes and HUVECs was demonstrated by electron microscopy: astrocytes endfeet pass through the 8.0 µm pores inducing HUVECs to assume a cerebral phenotype. Using this model we evaluated transmigration of melanoma cells from two different patients (M1 and M2) selected among seven melanoma primary cultures. M2 cells showed a statistically significant higher capability to pass across the in vitro BBB model, compared to M1. Expression of adhesion molecules was evaluated by flow cytometry: a statistically significant increased expression of MCAM, αvß3, and CD49b was detected in M1. PCR array data showed that M2 had a higher expression of several matrix metalloproteinase proteins (MMPs) compared to M1. Specifically, data suggest that MMP2 and MMP9 could be directly involved in BBB permeability and that brain invasion by melanoma cells could be related to the overexpression of many MMPs. Future studies will be necessary to deepen the mechanisms of central nervous system invasion.