Sarcoma de células claras del pie. Presentación de un caso / Clear cell sarcoma of the foot. Case presentation

RESUMEN El sarcoma de células claras fue descrito por primera vez por Franz M. Enzinger en 1965. Está íntimamente asociado a tendones y aponeurosis, excepcionalmente compromete la epidermis. Afecta fundamentalmente a pacientes jóvenes y se caracteriza por múltiples recurrencias locales y metástasis tardías. Se presenta un paciente de 22 años de edad, masculino que fue sometido a tratamiento quirúrgico radical (amputación transmetatarseana del 1er y 2do rayo). Los estudios anatomopatológicos confirmaron el diagnóstico de un sarcoma de células claras. El paciente se encuentra libre de la enfermedad después de 6 años de operado e incorporado a su vida social (AU).

ABSTRACT The clear cell sarcoma was firstly described by Franz M. Enzinger in 1965. It is intimately associated to tendons and aponeurosis, exceptionally compromising the epidermis. It mainly affects young patients and is characterized by multiple local recurrences and late metastases. We present a male patient, aged 22 years, who underwent a radical surgical treatment (transmetatarsal amputation of the 1st and 2nd rays). The anatomic-pathological studies confirmed the diagnosis of clear cell sarcoma. 6 years after surgery, the patients is free of the disease and reincorporated to his social life (AU).

Sarcoma de células claras del pie. Presentación de un caso / Clear cell sarcoma of the foot. Case presentation

RESUMEN El sarcoma de células claras fue descrito por primera vez por Franz M. Enzinger en 1965. Está íntimamente asociado a tendones y aponeurosis, excepcionalmente compromete la epidermis. Afecta fundamentalmente a pacientes jóvenes y se caracteriza por múltiples recurrencias locales y metástasis tardías. Se presenta un paciente de 22 años de edad, masculino que fue sometido a tratamiento quirúrgico radical (amputación transmetatarseana del 1er y 2do rayo). Los estudios anatomopatológicos confirmaron el diagnóstico de un sarcoma de células claras. El paciente se encuentra libre de la enfermedad después de 6 años de operado e incorporado a su vida social (AU).

ABSTRACT The clear cell sarcoma was firstly described by Franz M. Enzinger in 1965. It is intimately associated to tendons and aponeurosis, exceptionally compromising the epidermis. It mainly affects young patients and is characterized by multiple local recurrences and late metastases. We present a male patient, aged 22 years, who underwent a radical surgical treatment (transmetatarsal amputation of the 1st and 2nd rays). The anatomic-pathological studies confirmed the diagnosis of clear cell sarcoma. 6 years after surgery, the patients is free of the disease and reincorporated to his social life (AU).

Toll like receptors gene expression of human keratinocytes cultured of severe burn injury.

PURPOSE: To evaluate the expression profile of genes related to Toll Like Receptors (TLR) pathways of human Primary Epidermal keratinocytes of patients with severe burns. METHODS: After obtaining viable fragments of skin with and without burning, culture hKEP was initiated by the enzymatic method using Dispase (Sigma-Aldrich). These cells were treated with Trizol(r) (Life Technologies) for extraction of total RNA. This was quantified and analyzed for purity for obtaining cDNA for the analysis of gene expression using specific TLR pathways PCR Arrays plates (SA Biosciences). RESULTS: After the analysis of gene expression we found that 21% of these genes were differentially expressed, of which 100% were repressed or hyporegulated. Among these, the following genes (fold decrease): HSPA1A (-58), HRAS (-36), MAP2K3 (-23), TOLLIP (-23), RELA (-18), FOS (-16), and TLR1 (-6.0). CONCLUSIONS: This study contributes to the understanding of the molecular mechanisms related to TLR pathways and underlying wound infection caused by the burn. Furthermore, it may provide new strategies to restore normal expression of these genes and thereby change the healing process and improve clinical outcome.

Propranolol impairs the closure of pressure ulcers in mice.

AIMS: ß-Adrenoceptors modulate acute wound healing; however, few studies have shown the effects of ß-adrenoceptor blockade on chronic wounds. Therefore, this study investigated the effect of ß1-/ß2-adrenoceptor blockade in wound healing of pressure ulcers. MAIN METHODS: Male mice were daily treated with propranolol (ß1-/ß2-adrenoceptor antagonist) until euthanasia. One day after the beginning of treatment, two cycles of ischemia-reperfusion by external application of two magnetic plates were performed in skin to induce pressure ulcer formation. KEY FINDINGS: Propranolol administration reduced keratinocyte migration, transforming growth factor-ß protein expression, re-epithelialization, and necrotic tissue loss. Neutrophil number and neutrophil elastase protein expression were increased in propranolol-treated group when compared with control group. Propranolol administration delayed macrophage mobilization and metalloproteinase-12 protein expression and reduced monocyte chemoattractant protein-1 protein expression. Myofibroblastic differentiation, angiogenesis, and wound closure were delayed in the propranolol-treated animals. Propranolol administration increased neo-epidermis thickness, reduced collagen deposition, and enhanced tenascin-C expression resulting in the formation of an immature and disorganized collagenous scar. SIGNIFICANCE: ß1-/ß2-Adrenoceptor blockade delays wound healing of ischemia-reperfusion skin injury through the impairment of the re-epithelialization and necrotic tissue loss which compromise wound inflammation, dermal reconstruction, and scar formation.

Toll like receptors gene expression of human keratinocytes cultured of severe burn injury

PURPOSE: To evaluate the expression profile of genes related to Toll Like Receptors (TLR) pathways of human Primary Epidermal keratinocytes of patients with severe burns. METHODS: After obtaining viable fragments of skin with and without burning, culture hKEP was initiated by the enzymatic method using Dispase (Sigma-Aldrich). These cells were treated with Trizol(r) (Life Technologies) for extraction of total RNA. This was quantified and analyzed for purity for obtaining cDNA for the analysis of gene expression using specific TLR pathways PCR Arrays plates (SA Biosciences). RESULTS: After the analysis of gene expression we found that 21% of these genes were differentially expressed, of which 100% were repressed or hyporegulated. Among these, the following genes (fold decrease): HSPA1A (-58), HRAS (-36), MAP2K3 (-23), TOLLIP (-23), RELA (-18), FOS (-16), and TLR1 (-6.0). CONCLUSIONS: This study contributes to the understanding of the molecular mechanisms related to TLR pathways and underlying wound infection caused by the burn. Furthermore, it may provide new strategies to restore normal expression of these genes and thereby change the healing process and improve clinical outcome. .

Frequency and extent of thickening of the nucleated epidermis in leprosy lesions

Using 28 specimens of clinically normal skin from lepromatous leprosy subjects as a standard for comparison, the mean thickness of the nucleated epidermis was found to be significantly increased in untreated lesions from 16 borderline tuberculoid, 21 erythema nodosum leprosum (ENL), and 14 reversal reaction patients, but was unchanged in borderline lepromatous and lepromatous patients. Using specimens from 36 untreated lepromatous and borderline lepromatous lesions as the standard for comparison with the lesions of reversal reactions or ENL which these patients eventually developed, there was a significant thickening of the nucleated epidermis in both reactional states. In both comparison groups, there was a greater mean increase and a larger frequency of thickening in the ENL lesions than in those with reversal reactions. In the borderline tuberculoid and reversal reaction lesions the increase can be understood as secondary to the presence of gamma interferon or interleukin-2. The increase in thickness in the ENL lesions is more difficult to explain, but it is not inconsistent with a role for these same two cytokines.

Tokelau: contribuicao ao estudo de uma dermatomicose do indigenas do Brasil / Tokelau: contribution to the one study dermatomycose of the aboriginals of Brazil

"Tokelau" e uma molestia tropical, em que grandes areas do corpo sao cobertas com aneis concentricos e anulares, pardacentos com grande numero de escamas. O rosto e o couro cabeludo, de um modo geral, sao isentos. A mesma, e proveniente de um fungo vegetal, encontrado na epiderme, particularmente na camada cornea. O micelio e abundante, os esporos mais raros. Ele e formado por longos e finos filamentos bifurcados, juntos uns aos outros. Os esporos sao arredondados, altamente refrataveis, variando no tamanho. Para observa-los e aos esporos, as escamas epidermicas, sao raspadas com um objeto cortante e postas em uma lamina microscopica, com uma gota de potassa caustica (10 a 40 por cento). Uma laminula e aplicada com certa pressao para aplanar as escamas. O fungo e estudado melhor com uma lente de imersao, entretanto pode ser visto com lentes comuns a seco. O "tokelau" foi observado pela primeira vez por William Dampier no Arquipelago Malaio. Manson, em 1876, descreveu as principais caracteristicas da dermatose, considerando-a uma micose epidermica, designando-a pelo nome "Tinea imbricata". Roquette Pinto observou a existencia de Mal no Brasil conforme e relatado em seu livro "Rondonia", Estado do Mato Grosso. Isso foi confirmado por Olimpio da Fonseca e outros. A cultura desse fungo foi obtida por muitos autores, como por exemplo Langeron, Sabouraud, Olimpio da Fonseca, etc. Admite-se em geral que o fungo isolado das escamas e o "Trichophyton concentricum", Blanchard 1896. Vicente Grieco observou no Mato Grosso, Alto Xingu, 11 casos de "tokelau", que sao descritos no artigo junto