Cutaneous Rosai-Dorfman disease with MAP2K1 mutation, initially mimicking an infection with parasitized histiocytes.

Rarely, Rosai-Dorfman disease (RDD) manifests exclusively in the skin, typically as nodules on the trunk and extremities. Recognition of characteristic histopathologic features enables diagnosis of RDD. A 55-year-old female presented with a 7-year history of cutaneous nodules involving the trunk and extremities. A prior skin biopsy specimen at a different institution had demonstrated a dense dermal lymphohistiocytic infiltrate with histiocytes containing GMS+ forms, favored to represent cryptococcal organisms, with a differential diagnosis including other infections with parasitized histiocytes. Despite antibiotic therapy, lesions persisted. After a presentation to our institution, a biopsy specimen showed a diffuse infiltrate, including histiocytes with voluminous pale cytoplasm with focal emperipolesis of inflammatory cells and S100 immunohistochemical positivity. Clinical and radiologic examinations did not identify significant extracutaneous involvement. A genetic study performed on the biopsy specimen identified a K57Q mutation of MAP2K1. The presence of this mutation correlated with prior reports of MAP2K1 mutation in classic RDD, thereby supporting our histopathologic diagnosis of RDD over an infectious process and further illuminating options for targeted therapies. At 3-year follow-up, the patient has been managed with a course of systemic corticosteroids and excision of bothersome lesions. Consideration of systemic therapy is ongoing.

Association Between E-Cigarettes, Cognition and Mood in Adolescents.

OBJECTIVE: Research has indicated potentially neutral or even positive cognitive effects of e-cigarette usage in adults, but whether these findings extend to adolescents remains uncertain. This study aimed to examine the interplay between e-cigarette use, mind wandering and self-efficacy, and mood. METHOD: The responses of 432 adolescents aged 11-18 years from an online survey were analyzed. Among them, 88 adolescents had used e-cigarettes. RESULTS: Adolescents who have used e-cigarettes reported poorer academic self-efficacy, t (430) = 3.26, 95% CI [1.12, 4.51], p < 0.001; greater mind-wandering tendencies t(430) = -3.38, 95% CI [-4.14, -1.10], p < 0.001; and greater severity of depression, t(430) = -3.38, p < 0.001, anxiety t(430) = -2.67, p = 0.01, and stress t(430) = -3.32, p < .001. Increased frequency of e-cigarette use was also associated with attitudes toward e-cigarette use, r (86) = 0.31, p = 0.003 and lower academic self-efficacy, r (86) = -0.27, p = .010. However, there was no significant correlation between frequency of use and mind-wandering. Further network analysis suggested negative relationships between frequency of e-cigarette use, academic self-efficacy and mind-wandering. CONCLUSION: Our findings suggest a potential adverse impact of e-cigarette use on mind-wandering and academic confidence among adolescents. However, the direct or indirect relationship between e-cigarette use and these effects could not be definitively determined due to the cross-sectional survey design employed in our study. Nonetheless, our findings underscore the importance of considering developmental differences and the unique vulnerabilities of adolescents when assessing the impact of e-cigarette use.

The effect of e-cigarettes on cognitive function: a scoping review.

AIM: Much research has been conducted on the acute effects of nicotine on human cognitive performance, demonstrating both enhancing and impairing cognitive effects. With the relatively recent introduction of electronic cigarettes ('e-cigarettes') as a smoking cessation device, little is known about the cognitive effects of e-cigarettes specifically, either as a nicotine replacement device or in the absence of nicotine. The purpose of this review was to present an overview of evidence from empirical studies on the effect of e-cigarettes on cognitive function. APPROACH: Guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines (PRISMA-ScR), SCOPUS, PubMed, and EBSCOhost were searched from 2006, the year e-cigarettes were introduced, to June 2023 for relevant papers, along with reference lists checked for additional papers. KEY FINDINGS: Seven experimental and four cross-sectional survey studies were identified and included. The majority of the studies only include regular and current cigarette smokers and primarily assessed the acute cognitive effect of e-cigarettes relative to nicotine. While the findings primarily suggest either no or positive effect of e-cigarettes on cognition in cigarette smokers, associations between e-cigarettes and cognitive impairments in memory, concentration and decision making were reported in both cigarette smokers and never-smokers. IMPLICATIONS AND CONCLUSIONS: The acute cognitive effect of e-cigarettes on regular cigarette smokers appears minimal. However, long-term cognitive effect and their effects on never-smokers are unclear. Given that the increased numbers of e-cigarette users are non-smokers and/or adolescents, research with those naïve to nicotine and a developmentally vulnerable adolescent population on its long-term effect is needed.