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Linfoma , Sífilis , Humanos , Sífilis/diagnóstico , Sífilis/complicações , Pele , Linfoma/complicaçõesRESUMO
Only a few cases of pityriasis rosea (PR)/pityriasis rosea-like eruption (PRLE) after anti-SARS-CoV-2 vaccination have been reported. In the period May 2021- February 2022 we observed five cases of clinically typical PR that appeared 2 to 3 weeks after anti-SARS-CoV-2 vaccination with BNT162b2 (3 patients) or mRNA- 1273 (2 patients). In 4 patients PR appeared after the first vaccination; in one patient after the second one. In 3 patients a biopsy for histopathological examinations was carried out. Results were typical for PR. In all patients laboratory examinations were within normal ranges. All patients were treated with cetirizine. Complete remission was observed within 14-30 days. Four patients were subjected to the second vaccination, but no skin lesions appeared. All patients are currently in good general health. It is possible that a relationship between anti- Sars-CoV-2 vaccination and PR/PRLE exists; however, it is very rare, in consideration of millions of vaccinated subjects and the low number of reported cases of PR/PRLE. The pathogenesis of this relationship is unknown. However, some hypotheses may be advanced: PR/PRLE following anti-Sars-CoV-2 vaccination may be just a coincidence; anti-Sars-CoV-2 vaccines cause a reactivation of HHV-6 and/or HHV-7; vaccines can induce a delayed hypersensitivity response clinically similar to drug-induced PRLE.
RESUMO
BACKGROUND: Syphilis is known as the "great imitator" because of its polymorphic clinical manifestations. Condyloma lata are an uncommon mucocutaneous manifestation of secondary syphilis, generally localized in intertriginous areas, such as the genitals and anus. Extragenital localization of condyloma lata is considered unusual. METHODS: A case study of extra-genital condylomata is presented. To contextualise the case, a literature review of extra-genital condylomata lata was subsequently undertaken. The authors searched MEDLINE/PubMed, Scopus and Excerpta Medica/EMBASE English-language sources using the following keywords: "condyloma lata", "condylomata lata", and "condyloma latum". RESULTS: Thirty-five papers (from 1940 to 2021) describing an extra-anogenital localization of condyloma lata were found and are summarized in Table 1. Patients were mainly males (82.1%), with a mean age of 31.9 years. Most of them showed other manifestations of secondary syphilis (53.9%). In a minority of cases (39.0%), concomitant anogenital condyloma lata were present, thus making the diagnosis easier. The toe web localization was the most documented (26.2%) followed by the oral cavity (23.8%). CONCLUSION: In the presence of extra-genital condyloma lata, the differential diagnosis is not always clear, especially when no other muco-cutaneous lesions are observed. In the case of eroded or wet lesions involving any cutaneous fold, associated or not with other cutaneous manifestations, a sexual history should be obtained, and syphilis must be considered.
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Condiloma Acuminado , Gastroenteropatias , Sífilis Cutânea , Sífilis , Masculino , Humanos , Adulto , Feminino , Sífilis/complicações , Sífilis Cutânea/diagnóstico , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/complicações , Genitália/patologia , Gastroenteropatias/complicaçõesAssuntos
Melanoma , Dermatopatias , Neoplasias Cutâneas , Proliferação de Células , Dermoscopia , HumanosAssuntos
Gamopatia Monoclonal de Significância Indeterminada/diagnóstico , Mieloma Múltiplo/complicações , Dermatopatias/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Células da Medula Óssea/patologia , Feminino , Humanos , Imunoglobulina G/análise , Mieloma Múltiplo/diagnóstico por imagem , Mieloma Múltiplo/tratamento farmacológico , Xantogranuloma Necrobiótico/diagnóstico , Xantogranuloma Necrobiótico/etiologia , Paraproteinemias , Plasmócitos/patologia , Tomografia Computadorizada por Raios X/métodosAssuntos
COVID-19 , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções por Chlamydia/epidemiologia , Condiloma Acuminado/epidemiologia , Gonorreia/epidemiologia , Infecções por HIV/epidemiologia , Herpes Genital/epidemiologia , Humanos , Itália/epidemiologia , Infecções por Mycoplasma/epidemiologia , Mycoplasma genitalium , SARS-CoV-2 , Sífilis/epidemiologiaRESUMO
Hyperkeratosis lenticularis perstans (HLP), or Flegel's disease (FD), is a rare disorder of keratinization first described in 1958 by Flegel. HLP is characterized by asymptomatic small papules distributed symmetrically on the dorsal feet and lower part of the legs. It typically presents in the fourth or fifth decade of life. FD has been reported more commonly in women, and little is known about the pathogenesis of this rare dermatosis. Histological examination is mandatory to confirm the diagnosis, and the characteristic features are: focal compact hyperkeratosis, thinned stratum malpighii, epidermal atrophy, and a dense, band-like lymphocytic infiltrate in the papillary dermis. The treatment of FD is challenging, and a fully effective standard therapy does not exist. We report four cases of HLP that have been diagnosed at the Dermatology Unit of IRCCS Ca' Granda Ospedale Maggiore Policlinico in Milan, Italy, and a literature review is enclosed.
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Ceratose/patologia , Idoso de 80 Anos ou mais , Feminino , Humanos , Ceratose/diagnóstico , Ceratose/terapia , Pessoa de Meia-IdadeRESUMO
Anogenital warts (AGWs) are an important issue for public health centers dealing with Sexually Transmitted Infections. They are epidemiologically relevant, with significant morbidity and an established effective treatment is lacking. In this article, we examine the epidemiological, diagnostic, and therapeutic aspect of the problem in order to give an up to date picture of the situation and a practical clue for the management of AGWs.
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Condiloma Acuminado/terapia , Infecções por Papillomavirus/terapia , Infecções Sexualmente Transmissíveis/terapia , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/epidemiologia , Humanos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologiaAssuntos
Hanseníase Virchowiana/diagnóstico , Mycobacterium leprae/isolamento & purificação , Pele/microbiologia , Adulto , Técnicas Bacteriológicas , Biópsia , Diagnóstico Diferencial , Humanos , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Virchowiana/microbiologia , Masculino , Mycobacterium leprae/efeitos dos fármacos , Valor Preditivo dos Testes , Pele/efeitos dos fármacos , Pele/patologia , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the oncological and functional outcomes of patients diagnosed with penile cancer undergoing conservative treatment through thulium-yttrium-aluminium-garnet (Tm:YAG) laser ablation. METHODS: Twenty-six patients with a penile lesion underwent ablation with a RevoLix 200 W continuous-wave laser. The procedure was carried out with a pen-like laser hand piece, using a 360 µm laser fiber and 15-20 W of power. Median (IQR) follow-up time was 24 (15-30) months. Recurrence rate and post-operative sexual function were assessed. RESULTS: Median age at surgery was 61 years. Median (inter quartile range) size of the lesions was 15 [10-20] mm. Overall, 11 (47.8%) and 12 (52.2%) at the final pathology presented in situ and invasive squamous cell carcinoma (SCC), respectively. The final pathological stage was pTis, pT1a, pT2, and pT3 in 11 (47.8%), 7 (30.4%), 3 (13.0%), and 2 (8.7%) patients, respectively. Moreover, four (17.4%) patients had a recurrence of which three (13.0%) and one (4.3%) patients developed an invasive or in situ recurrence, respectively. After treatment 6 (26.1%) patients reported a conserved penile sensitivity, while 13 (56.5%) and 4 (17.4%) patients experienced a better or worse sensitivity after ablation, respectively. Post-treatment sexual activity was achieved within the first month after laser ablation in 82.6% of the patients. CONCLUSION: Early stage penile carcinomas can be effectively treated with an organ preservation strategy. Tm:YAG conservative laser treatment is easy, safe and offers good functional outcome, with a minor impact on patient's quality of life.
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Carcinoma in Situ/cirurgia , Carcinoma de Células Escamosas/cirurgia , Terapia a Laser/métodos , Neoplasias Penianas/cirurgia , Idoso , Alumínio , Carcinoma in Situ/patologia , Carcinoma de Células Escamosas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Ereção Peniana , Neoplasias Penianas/patologia , Qualidade de Vida , Saúde Sexual , Túlio , Resultado do Tratamento , ÍtrioAssuntos
Técnicas Cosméticas/efeitos adversos , Doenças do Pênis/induzido quimicamente , Silicones/efeitos adversos , Úlcera Cutânea/induzido quimicamente , Infecções Cutâneas Estafilocócicas/induzido quimicamente , Infecções Estreptocócicas/induzido quimicamente , Superinfecção/induzido quimicamente , Antibacterianos/uso terapêutico , Biópsia , Coito , Humanos , Injeções , Masculino , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/microbiologia , Doenças do Pênis/patologia , Silicones/administração & dosagem , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/microbiologia , Úlcera Cutânea/patologia , Infecções Cutâneas Estafilocócicas/tratamento farmacológico , Infecções Cutâneas Estafilocócicas/microbiologia , Infecções Cutâneas Estafilocócicas/patologia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/patologia , Superinfecção/tratamento farmacológico , Superinfecção/microbiologia , Superinfecção/patologia , Resultado do Tratamento , Adulto JovemRESUMO
Buschke-Löwenstein tumor, or giant condyloma acuminatum, represents a rare, sexually transmitted disorder, with a slow evolution and the tendency to infiltrate in the adjacent tissues associated with human papillomavirus (HPV). This article reports the first case of male Buschke-Löwenstein tumor associated with HPV6 and HPV52.
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Tumor de Buschke-Lowenstein/patologia , Condiloma Acuminado/patologia , Papillomaviridae/genética , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto , Tumor de Buschke-Lowenstein/cirurgia , Condiloma Acuminado/cirurgia , Papillomavirus Humano 6/genética , Humanos , Masculino , Papillomaviridae/patogenicidade , Neoplasias Penianas/patologia , Neoplasias Penianas/cirurgia , Resultado do TratamentoAssuntos
Doença Iatrogênica , Imunossupressores/efeitos adversos , Neoplasias Bucais/induzido quimicamente , Pênfigo/tratamento farmacológico , Sarcoma de Kaposi/induzido quimicamente , Idoso , Biópsia , Evolução Fatal , Humanos , Hospedeiro Imunocomprometido , Masculino , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/imunologia , Neoplasias Bucais/terapia , Pênfigo/diagnóstico , Pênfigo/imunologia , Valor Preditivo dos Testes , Fatores de Risco , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/imunologia , Sarcoma de Kaposi/terapiaRESUMO
A single-nucleotide polymorphism in the MDM2 promoter (SNP309; rs2279744) causes elevated transcription of this major negative regulator of p53 in several cancer types. We investigated MDM2 SNP309 and CDKN1A (p21/Waf1/Cip1) codon 31 (rs1801270) polymorphisms in 86 cases of cutaneous Kaposi's sarcoma (KS) from African and Caucasian patients, and 210 healthy controls. A significant increase of the MDM2 SNP309 T/G genotype was observed among classic KS cases (odds ratio 2.38, 95% confidence interval 1.0-5.5). Frequencies of CDKN1A codon 31 genotypes were not significantly different between cases and controls. The results suggest that the MDM2 SNP309 G allele may act as a susceptibility gene for the development of classic KS in Caucasian patients.
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População Negra/genética , Inibidor de Quinase Dependente de Ciclina p21/genética , Polimorfismo de Nucleotídeo Único/genética , Proteínas Proto-Oncogênicas c-mdm2/genética , Sarcoma de Kaposi/genética , População Branca/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Sarcoma de Kaposi/diagnóstico , Proteína Supressora de Tumor p53/genética , Adulto JovemRESUMO
Molecular analyses of mip and ompA genes were performed on 20 Neisseria gonorrhoeae isolates. The genes were present with a high degree of conservation in all strains. Sera from patients with urethritis or disseminated gonococcal infections were able to recognize the purified Neisseria gonorrhoeae macrophage infectivity potentiator (Ng-MIP) and Neisseria gonorrhoeae outer membrane protein A (Ng-OmpA).
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Proteínas da Membrana Bacteriana Externa , Proteínas de Bactérias , Neisseria gonorrhoeae/patogenicidade , Fatores de Virulência , Sequência de Aminoácidos , Proteínas da Membrana Bacteriana Externa/química , Proteínas da Membrana Bacteriana Externa/genética , Proteínas da Membrana Bacteriana Externa/imunologia , Proteínas da Membrana Bacteriana Externa/metabolismo , Proteínas de Bactérias/química , Proteínas de Bactérias/genética , Proteínas de Bactérias/imunologia , Proteínas de Bactérias/metabolismo , Gonorreia/imunologia , Gonorreia/microbiologia , Humanos , Macrófagos/microbiologia , Dados de Sequência Molecular , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/imunologia , Neisseria gonorrhoeae/metabolismo , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/metabolismo , Análise de Sequência de DNA , Uretrite/imunologia , Uretrite/microbiologia , Fatores de Virulência/química , Fatores de Virulência/genética , Fatores de Virulência/imunologia , Fatores de Virulência/metabolismoRESUMO
Human herpesvirus-8 (HHV-8) variants have been found heterogeneously distributed among human populations living in diverse geographic regions, but their differential pathogenicity in Kaposi's sarcoma development remains controversial. In the present study, HHV-8 variant distribution has been analyzed in classic, iatrogenic, endemic as well as epidemic Kaposi's sarcoma (KS) during pre-AIDS and AIDS period (1971-2008) in countries with different KS incidence rate. DNA samples from cutaneous KS lesions of 68 patients living in Africa (n=23, Cameroon, Kenya and Uganda), Europe (n=34, Greece and Italy) and North America (n=11) have been subjected to PCR amplification of HHV-8 ORF 26, T0.7, K1 and K14.1/15, followed by direct nucleotide sequencing and phylogenetic analysis. Among the 23 African samples, the majority of HHV-8 ORF 26 variants clustered with the subtype R (n=12) and B (n=5). Conversely, the viral sequences obtained from 45 European and North European tumors belonged mainly to subtype A/C (n=36). In general, HHV-8 and K1 variant clustering paralleled that of ORF 26 and T0.7. Genotyping of the K14.1/15 loci revealed a large predominance of P subtype in all tumors. In conclusion, comparison of the HHV-8 sequences from classic or endemic versus AIDS-associated KS showed a strong linkage of the HHV-8 variants with specific populations, which has not changed during AIDS epidemic.
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Síndrome da Imunodeficiência Adquirida/virologia , Infecções por Herpesviridae/virologia , Herpesvirus Humano 8/genética , Sarcoma de Kaposi/virologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adulto , África/epidemiologia , Idoso , Europa (Continente)/epidemiologia , Feminino , Genes Virais/genética , Variação Genética/genética , Genótipo , Infecções por Herpesviridae/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Mutação Puntual/genética , Reação em Cadeia da Polimerase , Polimorfismo Genético/genética , Sarcoma de Kaposi/epidemiologiaRESUMO
OBJECTIVES: Several studies have examined the association of codon 72 polymorphism of the TP53 gene, encoding either arginine or proline, in several tumor types but none have investigated its role in Kaposi's sarcoma (KS) development. METHODS: In this prevalent case-control study, 67 cutaneous lesions of classic, iatrogenic, endemic as well as epidemic KS from African (n = 22) and Caucasian (n = 45) patients, and blood samples from 150 healthy controls (n = 57 African, n = 93 Caucasian) have been analyzed for arginine and proline allele distribution. RESULTS: Among African cases the proline homozygous, heterozygous and arginine homozygous genotype frequencies were 50.0, 31.8 and 18.2%, respectively, and among controls 54.4, 40.3, and 5.3%, respectively (p = 0.1872). Conversely, among Caucasian cases genotype distributions were 6.7, 55.6, and 37.8%, and among controls 7.5, 34.4, and 58.1%, respectively (p = 0.0567). No significant differences in arginine and proline allele distribution were observed when the cases were stratified by HIV status/tumor type. CONCLUSIONS: The results obtained in this study suggest that p53 polymorphism at codon 72 does not represent a risk factor for the development of all forms of KS, either among African or among Caucasian populations.