Bartonella henselae Detected in Malignant Melanoma, a Preliminary Study.

Bartonella bacilliformis (B. bacilliformis), Bartonella henselae (B. henselae), and Bartonella quintana (B. quintana) are bacteria known to cause verruga peruana or bacillary angiomatosis, vascular endothelial growth factor (VEGF)-dependent cutaneous lesions in humans. Given the bacteria's association with the dermal niche and clinical suspicion of occult infection by a dermatologist, we determined if patients with melanoma had evidence of Bartonella spp. infection. Within a one-month period, eight patients previously diagnosed with melanoma volunteered to be tested for evidence of Bartonella spp. exposure/infection. Subsequently, confocal immunohistochemistry and PCR for Bartonella spp. were used to study melanoma tissues from two patients. Blood from seven of the eight patients was either seroreactive, PCR positive, or positive by both modalities for Bartonella spp. exposure. Subsequently, Bartonella organisms that co-localized with VEGFC immunoreactivity were visualized using multi-immunostaining confocal microscopy of thick skin sections from two patients. Using a co-culture model, B. henselae was observed to enter melanoma cell cytoplasm and resulted in increased vascular endothelial growth factor C (VEGFC) and interleukin 8 (IL-8) production. Findings from this small number of patients support the need for future investigations to determine the extent to which Bartonella spp. are a component of the melanoma pathobiome.

Efficacy and safety of 532-nm and 1,064-nm Q-switched Nd:YAG laser treatment of frictional dermal melanosis over bony prominences (Lifa disease).

BACKGROUND: Frictional dermal melanosis over bony prominences (Lifa disease) is a common pigmentary skin disorder in Iraqi patients. Q-switched lasers are the gold standard treatment of correcting pigmentation; among them are the 532-nm and 1,064-nm lasers. OBJECTIVE: To evaluate the efficacy of these lasers in the treatment of hyperpigmentation due to Lifa disease. PATIENTS AND METHODS: A prospective, comparative, controlled, split-lesion clinical trial study was designed. Nineteen female patients with clinical diagnosis of Lifa disease were enrolled. Each patient was treated for 3 sessions at 2-week intervals. A 532-nm Q-switched Nd:YAG laser was used on the left side and 1,064-nm on the right side of each lesion. Both objective and subjective parameters were assessed 1 and 3 months after the last treatment session. Darkness score, photographic assessment and patient satisfaction, and improvement of itch were recorded, respectively. RESULTS: Seventeen patients completed the study. The color score changes of both sides demonstrated that although both lasers were effective in reducing the pigmentation, the 1,064-nm wavelength had a more significant response. Similar results were obtained for the photographic evaluations and patient satisfaction scores. These changes were sustained throughout the 3 month follow-up. CONCLUSION: Both lasers were effective in the treatment of pigmentation abnormalities caused by Lifa disease. However, the efficacy was greater with the 1,064-nm wavelength.