Case report: Laparoscopic treatment of gastro-omental hemangioma with hemorrhage: two cases reports and review of literature.

Background: Spontaneous hemorrhage of gastro-omental hemangioma is a rare disease. The treatment strategy for this disease changes as it develops. In the acute stage, surgery is the first priority, among which laparoscopic treatment should be the most frequently considered option in large general hospitals. Due to the rarity of this disease, such cases have rarely been reported. Case description: We present the first report of two eldely cases with gastro-omental hemangioma with hemorrhage by laparoscopic treatment. Both cases were initially admitted with upper abdominal pain, and abdominal computed tomography (CT) scan revealed masses alongside the greater curvature of the stomach. Laparoscopic surgery was conducted immediately in both patients. The two cases recovered well after surgery, and no obvious abnormalities were observed in the follow-up period. Conclusion: Gastro-omental hemangioma rupture remains an uncommon cause of intraperitoneal hemorrhage. Timely diagnosis and surgery are paramount for treatment. Medical institutions with the correct technology and equipment should perform laparoscopic treatment to minimize surgical trauma and promote rapid recovery of patients with abdominal apoplexy.

Epidermal Cyst on the Scalp Induced by Forceps Injury During Delivery: A Case Report and Epidemiological Analysis of 3949 Patients.

Background: Epidermal cysts are common benign epithelial tumors. They are known to result from penetrating-type injuries or infection of human papillomavirus. The differential diagnosis commonly includes multiplex steatocystoma, lipoma, and neurofibroma. Pathological examination is essential for diagnosis, and surgical excision is the recommended treatment. Objective: We report a case in a man who presented with a cystic lesion on the scalp over 22 years to provide clinical evidence for mechanism of epidermal cysts. We conducted epidemiological analysis of 3949 patients with epidermal cysts to clarify the epidemiological characteristics and clinical features of epidermal cysts. Patients and Methods: A total of 3949 individuals with confirmed epidermal cysts were collected for analysis. Data were expressed as mean ± SEM and analyzed using Student's t-test. Results: Our data showed that the mean age of diagnosis of males was statistically earlier than that of females (P<0.001), but no significant difference in sex predilection was observed (P=0.55). The high incidence age of males and females was in the young and middle stage. Lesion locations were a bit different among age groups, but the face was the most common site of epidermal cyst at all age stages. Conclusion: Our case offers clinical evidence to the theory which refers trauma as one of the main causes of epidermal cysts in hair-bearing area. According to analysis of large number of samples, we can further support the idea that epidermal cyst has equal sex predilection and mainly occurs on the young and middle-aged adults. It is usually solitary and most likely to be found on face and trunk.

Serum Proteomics Combined with Metabolomics Analysis Explore the Molecular Biological Characteristics of Eruptive Syringoma.

Background: Eruptive syringoma (ES) is a clinical variant of the appendageal tumor syringoma. Around 75% of ES arise in the head or neck, which makes them unsightly. ES is common in patients with amyloidosis, diabetes, and Down's syndrome, suggesting that it may be associated with potential systemic effects. ES is a rare tumor with the unclear pathogenesis and no effective treatment. Methods: A PubMed search of ES was conducted. Plasma samples of patients with ES were acquired from the Department of Dermatology at Xi'an Jiaotong University's Second Affiliated Hospital. After removing highly abundant proteins, plasma samples were subjected to proteomics and metabolomics analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: LC-MS/MS revealed 71 differentially expressed proteins and 18 differentially abundant metabolites. The functional analysis highlighted the importance of complement binding, coagulation, secretory granules and vesicle lumen. Further, the study revealed 15 hub genes associated with FGG, GC, APOE, FGA, FGB, C4A, C3, CRP, C4B, FLNA, TAGLN2, ANXA5, MYL6, MYL12B, and TLN1 organized into three clusters. The seed genes in each cluster were GC, FLNA, and MYL6. In addition, glycol metabolism was associated with variable abundance of serum metabolites, which explains the relatively high rate of ES among diabetics. Conclusion: This study suggests that immunological inflammation and tumor glycol metabolism may play significant role in the pathophysiology of ES.

Eruptive syringomas: Summary of ninety cases and a brief literature review.

BACKGROUND: Eruptive syringomas is a rare variant of syringoma, which is a benign adenoma differentiated from the terminal ducts of the eccrine glands. Nowadays, it's widely valued because of obvious skin lesions, large scope of influence, and high misdiagnosis rate. OBJECTIVES: We aim to explore the clinical features of eruptive syringomas and the current research progress. MATERIALS AND METHODS: We firstly summarized the clinical features of 90 cases of eruptive syringomas. Then, the chi-square test was used to analyze the relationship between the onset site of eruptive syringomas and age, as well as gender. Finally, we briefly reviewed the previous literature. RESULTS: During 12 years, 90 cases of eruptive syringomas were diagnosed in our hospital, including 28 males (31.1%) and 62 females (68.9%). The average diagnosed age was 28.8. Patients from 20 to 40 years old is 63 (70%), which is the most. 60 (66.7%) patients had the course for more than 1 year. Among onset sites, the neck, chest, and abdomen were in the top three. The chi-square test showed that there were no significant differences in the onset sites of patients aged ≤ 20 and >20 years old (p-value = 0.181), as well as male and female (p-value = 0.363). CONCLUSION: We found that more female than male was affected, and the most common onset sites were the neck, chest, and abdomen. Neither age nor gender was significantly associated with onset site distribution. Our study provides some data support for the research of eruptive syringomas.

Descending colon cancer in a patient with situs inversus totalis: a case report and literature review.

Situs inversus totalis (SIT) is a congenital disorder of anatomical position, and the operation of patients with total visceral inversion often brings great challenges to surgeons. Although there have been previously documented on patients with SIT and colonic cancer, this is the first case report of descending colon cancer in patient with SIT. The current report presents a case of a 67-year-old female patient with descending colon cancer and SIT. After preoperative preparation and discussion, open left hemicolectomy was performed for the patient. The postoperative recovery of the patient was smooth; however, there was a mild lymphatic leakage in the patient, which was cured by conservative treatment for 5 days. The patient was discharged on postoperative Day 10. There was no tumor recurrence or other discomfort in 1 year follow-up period.

Novel missense mutations of MVK and FDPS gene in Chinese patients with disseminated superficial actinic porokeratosis.

BACKGROUND AND AIMS: Porokeratosis (PK) is a heterogeneous group of cutaneous keratinization disorders and has five clinical subtypes. DSAP is the most common clinical subtype and is characterized by multiple small, annular, anhidrotic, keratotic lesions predominantly on sun-exposed areas of the skin. It is an autosomal dominantly inherited epidermal keratinization disorder. However, studies on its molecular basis is limited. MATERIALS AND METHODS: We performed mutation analysis of genes in four pedigrees and three sporadic cases of DSAP in the Chinese population. Genomic DNA was extracted from blood samples obtained from patients, unaffected family members, and 100 unrelated individuals. All exons and flanking intron sequences of the mevalonate kinase (MVK) and farnesyl diphosphate synthase (FDPS) genes were amplified. RESULTS: One missense mutation in exon 7 (C.G677A) of the MVK gene was identified in pedigree 3, and one missense mutation in exon 5 (C.C535T) of the FDPS gene was identified in sporadic case 3. No mutation was detected in the MVK and FDPS genes in the remaining three pedigrees and two sporadic cases with DSAP. CONCLUSION: Our results may be useful for genetic counseling and prenatal diagnosis of affected families and for expanding the repertoire of MVK and FDPS mutations underlying DSAP.

Keratin 17 is Not Always a Marker of Proliferation of Keratinocytes in Skin Diseases.

PURPOSE: Keratin 17 (K17) is an embryonic keratin and overexpression is seen in psoriasis, which is a hyperproliferation skin disease. Nonetheless, whether it is also highly expressed in other proliferative skin diseases remains unclear. The aim of this study is to explore the expression of K17 in cutaneous lichen planus (CLP), lichen simplex chronicus (LSC), and prurigo nodularis (PN). METHODS: A total of 20 skin samples from CLP lesions, 20 from LSC lesions, 20 from PN lesions, and 10 healthy adult skin tissues were obtained. Then, the expression of K17 was analyzed using immunohistochemistry on paraffin-embedded tissue sections. Furthermore, quantitative and semi-quantitative immunohistochemical scores of K17 were independently evaluated under a microscope by 2 dermatologists. RESULTS: Immunohistochemical analysis revealed that in normal skin, K17 was minimally expressed. Nevertheless, it was highly expressed in all epidermal layers in CLP lesions (P-value <0.01), and negatively expressed in LSC and PN lesions (all P-value >0.05). The average gray value of K17 in CLP was 151.153±13.985 (P-value <0.001), while the average values of K17 in LSC and PN were 178.720±12.001 and 181.316±8.920, respectively (all P-value >0.05). CONCLUSION: K17 is potentially expressed in certain inflammatory skin diseases, including psoriasis and lichen planus. Besides, it is not always a marker of hyperproliferation of keratinocytes in skin diseases.

Eccrine poroma presented as spindle-shaped plaque: A case report.

RATIONALE: Eccrine poroma, a benign cutaneous neoplasm originating from the intraepidermal portion of the eccrine sweat duct, is relatively common in clinical practice. Nevertheless, the 1 presenting as spindle-shaped plaque is extremely rare and easily misdiagnosed as seborrheic keratosis or other dermatoses. Thus, the current study demonstrates a case of eccrine poroma with unique clinical manifestation. PATIENTS CONCERNS: A 47-year-old man presented with a spindle-shaped plaque on his left sole for 6 years. DIAGNOSES: Based on the clinical and histopathological manifestations, diagnosis of eccrine poroma was established. INTERVENTIONS: Surgical excision under local anesthesia was performed. OUTCOMES: No recurrence or malignant transformation occurred within 6-month follow-up. LESSONS: Eccrine poroma typically presents as a dome-shaped nodule on palm or sole. But this case reminded us the lesion presenting as a spindle-shaped plaque on sole can not rule out the possibility of eccrine poroma.

Pilar cyst on the dorsum of hand: A case report and review of literature.

RATIONALE: Pilar cyst mainly occurs on the scalp, but pilar cyst on the dorsum of hand has not been reported. Herein, we provide information to improve the clinical cognition of pilar cyst location. PATIENTS CONCERNS: A 76-year-old man presented with a round nodule on the opisthenar of his right hand for two months without any subjective symptoms. DIAGNOSES: Histological features of the lesion biopsy indicated the diagnosis of pilar cyst. INTERVENTIONS: Surgical resection was made under local anesthesia. OUTCOMES: Complete recovery was achieved after surgery. CONCLUSION: Pilar cyst rarely occurs on the dorsum of hand and its diagnosis depends on histopathological examinations. Surgical resection is the only way to treat it.

A nodule on the forearm.

Glomus tumors are benign tumors of the skin. Clinically, these tumors can present as solid, painful subcutaneous nodules, frequently seen on the hand (particularly subungual region). Glomangiomyomas are the least common histological type of glomus tumor. In the literature, there are only a few glomangiomyoma cases of the forearm location. We report a patient with a painful nodule, diagnosed as glomangiomyoma. Surgical excision was performed and no recurrence was observed after 5 years' follow-up.

A melanotic malignant melanoma presenting as a keloid: A case report.

RATIONALE: Amelanotic malignant melanoma (AMM) is a rare subtype of malignant melanoma (MM) that manifests atypically and is easily misdiagnosed or missed altogether. The keloid type of AMM has rarely been reported. Herein, we provide information to improve the clinical diagnosis of AMM types and raise awareness to ensure early diagnosis and timely treatment. PATIENT CONCERNS: A 20-year old woman presented with a mass on her left shoulder of 1 year's duration that had been treated surgically. The lesion recurred 1 month before the present case, along with lymph node enlargement on the left supraclavicular fossa. DIAGNOSES: Histopathology and immunohistochemistry findings suggested AMM. INTERVENTIONS: The original tumor recurred 1 month later after chemotherapy, and an extended resection and a second round of chemotherapy were performed. However, the patient exhibited suspected epileptic symptoms during chemotherapy and was required to return to the local hospital for treatment. OUTCOMES: No tumor recurrence occurred within a 6-month follow-up period. LESSONS: Early AMM diagnosis has a very significant effect on prognosis. For some persistent and growing proliferative lesions, obliterative treatments should be avoided before a definitive histopathological diagnosis has been made.

[Genetic diversity of peanut bradyrhizobia estimated by culture-independent vs. culture-dependent approaches].

OBJECTIVE: To develop a rapid technique for estimating the percentage of bradyrhizobial nodule occupancy, we comparaed the differences of genetic diversity of peanut bradyrhizobia with culture-independent and culture-dependent methods. METHODS: We used the traditional media plate technique for isolation of peanut bradyrhizobia and directly collected the bacteroids from peanut nodules. The BOX-PCR fingerprintings were compared after amplification with the DNAs of peanut bradyrhizobial isolates by culture-dependent approach and bacteroids by culture-independent approach. RESULTS: The percentage of testing for peanut bacteroids was 81.8% with culture-independent method, and 85 genotypes of BOX-PCR were obtained. The percentage of isolation for peanut bradyrhizobia strains was 72.7% and 71 genotypes of BOX-PCR were produced. There were totally 17 corresponding BOX-PCR genotypes obtained by both methods. CONCLUSION: The culture independent method for direct analysis of genetic diversity from bacteroids in nodules can much more rapidly and clearly find the dominant genetic groups in different soil samples and fast figure out the.percent of the rhizobia nodule occupancy.

Wnt/ß-Catenin and Wnt5a/Ca Pathways Regulate Proliferation and Apoptosis of Keratinocytes in Psoriasis Lesions.

BACKGROUND / AIMS: Wnt5a is overexpressed in psoriasis lesions, however the mechanism by which Wnt5a is involved in the pathogenesis of psoriasis is not clear. To address this, the expression of Wnt5a in psoriatic lesions and its effect on keratinocyte cell proliferation and apoptosis was examined in vitro. METHODS: The expression levels of WNT5A, and genes encoding its receptors frizzled2 (FZD2) and frizzled5 (FZD5) were examined in samples obtained from individuals with psoriasis and healthy controls. Knockdown of Wnt5a with short interfering (si)RNAs was performed in cultured HaCaT keratinocytes and normal human keratinocytes (NHK), and the expression of Wnt5a, protein kinase C (PKC), and ß-catenin were determined, and cell cycle activity, proliferation and apoptosis were assessed. RESULTS: The expression of WNT5A, FZD2 and FZD5 mRNA and protein were increased in psoriatic lesions. Wnt5a knockdown suppressed proliferation and induced apoptosis in HaCaT and NHK cells. Additionally, expression of PCNA, MKI67, CCND1, BCL2, CTNNB1, and genes encoding PKC and survivin were downregulated, whereas CASP3 was upregulated. The mRNA levels of the Wnt pathway inhibitors DKK1 and SFRP1 were upregulated, Western blotting analyses demonstrated reduction in ß-catenin and PKC protein levels. CONCLUSION: Knockdown of Wnt5a suppresses the proliferation of keratinocytes and induces apoptosis by inhibiting the Wnt/ß-catenin or Wnt5a/Ca(2+) pathways.

A large hyperplastic nodule on the abdomen.

A 65-year-old man presented with a slowly enlarging, hyperplastic cutaneous nodule on the abdomen that developed over a period of 20 years. Based on the clinical manifestation and typical histopathology, the patient received a diagnosis of giant basal cell carcinoma.

Congenital eccrine nevus on the neck.

Eccrine nevus (EN) is a very rare hamartoma of the skin and with varying clinical manifestations. Histologically, these neoplasms present as a proliferation of normally structured eccrine sweat glands in the dermis. There have been no more than 20 cases previously have been reported in the English literature. Herein we report a 25-year-old man with eccrine nevus on the neck. To our best knowledge, this is the first case that the lesion affecting the neck.

Differential diagnosis of eccrine spiradenoma: A case report.

Eccrine spiradenoma (ES) is a rare, benign adnexal neoplasm that may easily be mistaken for glomus lesions or angioleiomyoma due to its painfulness and florid vascularization. A 44-year-old male with a blue-colored, nodular tumor on the left knee, present for 10 years, was submitted for diagnosis. Dermatological examination was undertaken, followed by surgical excision of the subcutaneous lesion and histopathological examination of the tissue. Subjective symptoms included tenderness upon palpation and routine investigations were within normal limits. Immunohistochemical analysis of the tumor cells demonstrated positive staining for CK5/CK6, CK8/CK18, S100, as well as small vacuole-like positive for EMA, and was therefore diagnosed as ES. The results of the present study suggest that immunohistochemical assays may be helpful to clarify the diagnosis and differentiate ES from other painful subcutaneous tumors exhibiting similar clinical and histological presentations.

Vitiligo nonsurgical treatment: a review of latest treatment researches.

Vitiligo is a common depigmenting acquired disorder affecting about 1-2% of the world population, regardless of race, ethnic background, or gender. It is characterized by the appearance of milky white maculae because of a loss of melanocytes. The disfiguring nature of vitiligo causes high psychosocial morbidity. This is especially pronounced in populations with darker skin tone, likely because of the marked contrast. A variety of nonsurgical treatment regimens are currently employed in vitiligo. We reviewed the latest studies carried out on different nonsurgical treatment modalities used in vitiligo. All nonsurgical treatment aid to repigment or depigmentation the skin, however, many of them require a prolonged treatment course and may yield minimal results as well as carry unwanted side effects. There is a need for further research into the causes of vitiligo and into discovering better treatments.

Predictive factors for adverse dermatological events during pegylated/interferon alpha and ribavirin treatment for hepatitis C.

BACKGROUND: Treatment of chronic hepatitis C (CHC) with pegylated interferon-alpha/ribavirin is associated with well-characterized dermatological adverse events (AEs), which can lead to premature discontinuation of treatment. OBJECTIVE: To investigate the incidence and spectrum of dermatological AEs during CHC treatment with interferon-alpha plus ribavirin and analyzed factors predisposing patients to such reactions. STUDY DESIGN: Between January 2008 and December 2012, 152 CHC patients who had received interferon/pegylated interferon plus ribavirin therapy were enrolled in this retrospective study. To determine which factors were associated with dermatological AE development, a Cox proportional-hazards regression analysis was performed. RESULTS: Thirty dermatological AEs were recorded in 28 (18.4%) patients. These reactions included 14 (9.2%) patients with eczematous reactions, four (2.6%) patients with xerosis, three (2.0%) patients with new-onset or exacerbation of psoriasis, two (1.3%) patients with lichenoid eruption, two (1.3%) patients with diffuse folliculitis and one patient with lichen planus, alopecia areata, hypermelanosis, and necrosis of the skin and toenails. Application of the Cox proportional-hazards model revealed that age older than 60 years (HR=1.070; 95% CI: 1.043-1.096), pre-existing anaphylaxis/skin disease (HR=2.612; 95% CI: 1.593-3.324), cirrhosis (HR=1.863; 95% CI: 1.047-3.013), and treatment with pegylated interferon formulations (HR=1.930; 95% CI: 1.052-3.687) were associated with occurrence of dermatologic AEs. Twenty-seven (90%) skin conditions were classified as mild to moderate, while one case (3.3%) warranted premature discontinuation of treatment. CONCLUSION: Dermatological AEs resulting from interferon-alpha/ribavirin treatment of CHC contribute to a wide spectrum involve the skin, mucous membrane, hair, and nails. These dermatological AEs correlated with older age, previous skin condition, cirrhosis, and use of pegylated interferon formulations.