RESUMEN
BACKGROUND: The epidermis forms the barrier between an organism and its external environment. Although one of the major functional elements of the epidermis is the lipid-enriched extracellular matrix, containing mainly ceramides, cholesterol (CHOL) and free fatty acids, the data are limited regarding the lipid profile in the epidermis. The aim of the study was to determine the whole profile of fatty acids (FAs) in the epidermis and to examine any dependence according to the age of the subject and the site on the epidermis. MATERIALS AND METHODS: Epidermis extracts obtained from 10 adults and 6 children were analyzed by gas chromatography-mass spectrometry. RESULTS: In total, 74 FAs in the human epidermis were identified. We observed the highest amounts of neutral lipids (including CHOL) compared to other lipid fractions in the epidermis, regardless of age. However, we detected an age-dependent content of the major lipid fractions, where the main difference was in the levels of polyunsaturated fatty acids. There were also differences in the lipid profile between various sites of the body, e.g. samples from the breast and abdomen were enriched with very long-chain fatty acids compared to the limb. CONCLUSION: Our research provides novel data concerning the lipid profile in the epidermis, gives further insight into skin biology and proves that the epidermis is a highly dynamic structure.
Asunto(s)
Ácidos Grasos no Esterificados , Ácidos Grasos , Adulto , Ceramidas , Niño , Colesterol , Ácido Cólico , Epidermis , Ácidos Grasos/análisis , Ácidos Grasos no Esterificados/análisis , Femenino , HumanosRESUMEN
BACKGROUND: Large and giant congenital melanocytic nevi (CMN), benign naevomelanocytic proliferations derived from neural crests, with a projected adult size (PAS) ≥ 20 cm, are connected to a high risk of melanoma and neurocutaneous melanosis. Among several factors, genetic alterations seem to be involved in tumorigenesis. The aim of the present study was to analyse the mutation status of NRAS and BRAF genes in resection specimens from large or giant CMN in a group of Polish patients. MATERIAL AND METHODS: The formalin-fixed, paraffin-embedded resection specimens from 18 patients, fixed in the years of 2006 to 2017, were included in the study. The regions containing the highest load of melanocytes were macrodissected prior to DNA isolation. The NRAS and BRAF mutation status was evaluated using qPCR. RESULTS: We detected activating mutations in NRAS gene (codons: 12 and 61) in 7 out of the 18 (38.9%) patients. No BRAF mutations were found. CONCLUSION: Our study, the first molecular analysis of large/giant CMN in Polish patients, supports the hypothesis that NRAS mutation in codon 61 are frequent, recurrent mutations in large/giant CMN. Moreover, we show, for the first time, that NRAS mutations in codon 12 (p.Gly12Asp) can be also detected in giant CMN. The exact role of these genetic alterations in CMN formation remains to be elucidated.
Asunto(s)
Nevo Pigmentado , Neoplasias Cutáneas , Adulto , Niño , Humanos , Recurrencia Local de Neoplasia , Nevo Pigmentado/genética , Polonia , Estudios Retrospectivos , Neoplasias Cutáneas/genéticaRESUMEN
BACKGROUND: Patients with giant congenital melanocytic nevi (GCMN) have increased risk of neurocutaneous melanosis (NCM). Brain MRI is mandatory in GCMN. OBJECTIVES: To present the age related changes in brain MRI in children with NCM during several-year follow-up. METHODS: In 7 NCM children following data were analyzed: main nevus localization, surgical treatment phase, histology of excised nevi, time of NCM diagnosis, number of MRI studies, neurological symptoms, changes of melanin deposits in brain during follow-up. RESULTS: Four children had bathing trunk nevus, two main nevus on back, one on head. Surgical excision is finished in 3 patients, 4 are in the course of multistage surgery. In one melanoma arising in GCMN was diagnosed. Six patients are neurologically healthy, one suffers from seizures. Age of patients at first MRI ranged from 12days to 7 years. All patients underwent more than one MRI. Follow-up period ranges from 2.5 to 8.5 years. Most of T1-hyperintense foci in brains regressed with time. In one case new lesion appeared, in one more lesions were visible on second MRI. CONCLUSIONS: In all patients with NCM on subsequent MRI image changes were found with respect to original location and size of melanin deposits in CNS. Changes of NCM appearance on MRI with advancing age of patients reflect natural history of this disorder. Theory of gradual disappearance of intracerebral melanin deposits with age seems to be more likely than theory of their worse visualization on MRI with time.
Asunto(s)
Encéfalo/diagnóstico por imagen , Encéfalo/patología , Imagen por Resonancia Magnética , Melanosis/diagnóstico por imagen , Melanosis/patología , Síndromes Neurocutáneos/diagnóstico por imagen , Síndromes Neurocutáneos/patología , Nevo Pigmentado/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Factores de Edad , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Melanosis/complicaciones , Síndromes Neurocutáneos/complicaciones , Nevo Pigmentado/complicaciones , Nevo Pigmentado/patología , Nevo Pigmentado/cirugía , Riesgo , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patologíaRESUMEN
BACKGROUND: Treatment of giant melanocytic nevi (GMN) remains a multidisciplinary challenge. We present analysis of diagnostics, treatment, and follow- up in children with GMN to establish obligatory procedures in these patients. MATERIAL/METHODS: In 24 children with GMN, we analyzed: localization, main nevus diameter, satellite nevi, brain MRI, catecholamines concentrations in 24-h urine collection, surgery stages number, and histological examinations. The t test was used to compare catecholamines concentrations in patient subgroups. RESULTS: Nine children had "bathing trunk" nevus, 7 had main nevus on the back, 6 on head/neck, and 2 on neck/shoulder and neck/thorax. Brain MRI revealed neurocutaneous melanosis (NCM) in 7/24 children (29.2%), symptomatic in 1. Among urine catecholamines levels from 20 patients (33 samples), dopamine concentration was elevated in 28/33, noradrenaline in 15, adrenaline in 11, and vanillylmandelic acid in 4. In 6 NCM children, all catecholamines concentrations were higher than in patients without NCM (statistically insignificant). In all patients, histological examination of excised nevi revealed compound nevus, with neurofibromatic component in 15 and melanoma in 2. They remain without recurrence/metastases at 8- and 3-year-follow-up. There were 4/7 NCM patients with more than 1 follow-up MRI; in 1 a new melanin deposit was found and in 3 there was no progression. CONCLUSIONS: Early excision with histological examination speeds the diagnosis of melanoma. Brain MRI is necessary to confirm/rule-out NCM. High urine dopamine concentration in GMN children, especially with NCM, is an unpublished finding that can indicate patients with more serious neurological disease. Treatment of GMN children should be tailored individually for each case with respect to all medical/psychological aspects.
Asunto(s)
Nevo Pigmentado/congénito , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/terapia , Catecolaminas/orina , Niño , Preescolar , Progresión de la Enfermedad , Femenino , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética/métodos , Masculino , Melaninas/química , Melanosis/congénito , Melanosis/diagnóstico , Melanosis/terapia , Melanosis/orina , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Síndromes Neurocutáneos/congénito , Síndromes Neurocutáneos/diagnóstico , Síndromes Neurocutáneos/terapia , Síndromes Neurocutáneos/orina , Nevo Pigmentado/orinaRESUMEN
Twenty-four children with giant congenital melanocytic nevi underwent brain MRI at 1.5 T scanner. Melanin deposits in the brain were found in seven children (29.2%) located in temporal lobes, thalamus, cerebellum, and pons. One patient showed leptomeningeal involvement. Six patients were asymptomatic, and one had epilepsy. As opposed to previous reports, localization of skin nevi on anterior part of trunk was correlated to central nervous system involvement. In all patients with brain involvement skin nevi showed picture of compound nevus with neurofibromatic component.