Melanoma diagnosis: traumatic impact of the event on the patient.

BACKGROUND: The aim of our study was to consider the distressing impact of the diagnosis in a group of patients with metastatic melanoma, and the effects it could have on the quality of life of the patients. METHODS: We proposed an Impact Event Scale (IES-R) to a group of 31 patients. The patients were positive to the distress thermometer (DS) and accepted the psychological support. After six months from the start of the treatment we made a semi-structured interview of 10 multiple choice questions. RESULTS: Sixty-five per cent of women and 50% of men report that all the event related to the disease, cause emotions that recall the disease. Eighty-two per cent of women compared to 50% of men, report that the thought of their medical condition tends to affect their quality of sleep; the patients report feelings of anger and irritation (41% of the women and 78% of the men). CONCLUSIONS: The traumatic aspects following the diagnosis of melanoma burst powerfully into the life of these patients, who show different reactions, also according to gender.

Elastosis perforans serpiginosa: causes and associated disorders.

BACKGROUND: Elastosis perforans serpiginosa (EPS) is an uncommon cutaneous disorder classified under perforating diseases (PD); a group of dermatoses with transepidermal extrusion of collagen or elastic tissue. Three EPS subtypes have been reported that differ according to aetiology, associated diseases, and histopathological features. Herein, we report a systematic review of the literature, as well as a case of a 41-year-old woman with Wilson disease treated with penicillamine (PCM), who developed EPS after 11 years of drug intake. OBJECTIVES: To analyse and characterise EPS subtypes based on an evaluation of potential different histological patterns. MATERIALS & METHODS: A systematic literature search in Pubmed was performed to identify articles describing EPS. RESULTS: A peculiar histological pattern was identified in EPS PCM-related patients, either in affected or unaffected skin samples. Using specific elastic fibre stains (Verhoeff-van Gieson, Weigert, and Orcein), fibres appeared with an irregular surface with thorn-like protrusion, probably due to weaker fibre cross-links, making them unable to re-expand after contraction along their long axis. Interestingly, similar histological patterns have also been reported in elastic tissues of vessel walls of the lungs and upper respiratory tract, joints, visceral adventitia, and kidney. CONCLUSIONS: A distinctive histological pattern of PCM-related EPS is observed in affected and normal-appearing skin, as well as extracutaneous elastic tissue, suggesting serious potential widespread drug-induced systemic elastolytic damage.

Body image and awareness in patients with advanced-stage melanoma.

BACKGROUND: Body image (BI) is a very important aspect to be taken care of, especially in cancer patients. METHODS: We administered the Body Image Scales, with a specifically created semi-structured questionnaire which includes items that investigate the level of awareness and the degree of acceptance of the disease of the patient, was administered to patients giving their written informed consent to participate to the study. RESULTS: The results show that our population sample got an average score of 17.25 showing precisely problems related to body image. CONCLUSIONS: An adequate psychological support is crucial, as it has been widely demonstrated that body-image-related issues have a negative impact on patients' quality of life, especially in the oncology field. Such support has the aim of dealing with those aspects which can compromise the patients' equilibrium and quality of life.