Surface integrity could limit the potential of concrete as a bio-enhanced material in the marine environment.

Coastal sprawl is among the main drivers of global degradation of shallow marine ecosystems. Among artificial substrates, quarry rock can have faster recruitment of benthic organisms compared to traditional concrete, which is more versatile for construction. However, the factors driving these differences are poorly understood. In this context, this study was designed to compare the intertidal and subtidal benthic and epibenthic assemblages on concrete and artificial basalt boulders in six locations of Madeira Island (northeastern Atlantic, Portugal). To assess the size of the habitat, the shorelines in the study area were quantified using satellite images, resulting in >34 % of the south coast of Madeira being artificial. Benthic assemblages differed primarily between locations and secondarily substrates. Generally, assemblages differed between substrates in the subtidal, with lower biomass and abundance in concrete than basalt. We conclude that these differences are not related to chemical effects (e.g., heavy metals) but instead to a higher detachment rate of calcareous biocrusts from concrete, as surface abrasion is faster in concrete than basalt. Consequently, surface integrity emerges as a factor of ecological significance in coastal constructions. This study advances knowledge on the impact and ecology of artificial shorelines, providing a baseline for future research towards ecological criteria for coastal protection and management.

Evaluating Efficacy and Complications of Contour Intrasaccular Device in Cerebral Aneurysm Management: A Multicenter Analysis.

BACKGROUND: Intrasaccular devices provide a method for treating complex aneurysms without leaving metallic materials in the parent artery. Compared to other well-studied devices in neurointervention, the Contour device is relatively new as an intrasaccular flow diverter. This study examines its use in cases of incidental aneurysms and its application in the acute treatment of ruptured aneurysms. Additionally, it covers potential complications that may arise and methods for prevention. METHODS: We conducted a retrospective analysis of 25 patients who underwent treatment with the Contour device at 3 hospital centers. We collected data related to age, gender, baseline modified Rankin Scale, personal habits, medical history, procedure details, and angiographic results according to the Woven endobridge occlusion scale. RESULTS: A total of 15 patients (65.5%) achieved a satisfactory angiographic result (grade 0-0') 1 year after embolization. Contrast stagnation was observed in 14 patients (58.3%). Intraprocedural complications, such as device displacement, were documented in 3 patients (12%), while 2 patients (8%) had aggregates attached to the device. Regarding late complications, 5 patients (20%) experienced device displacement and 1 patient had a minor stroke (4%). Retreatment was necessary for 3 patients (12%), involving a flow diverter, stenting, and coiling. CONCLUSIONS: In summary, the Contour device offers a viable option for treating complex aneurysms. While initial results are promising, it is crucial to acknowledge a learning curve to minimize complications and achieve satisfactory angiographic results without the need for additional treatments.

Rescue stenting after artery occlusion as a complication of an intrasaccular device-assisted coiling embolization: illustrative case.

BACKGROUND: Endovascular embolization of wide-necked aneurysms can be challenging. The development of intrasaccular devices like the Contour has enabled us to approach these aneurysms effectively by reducing recanalization rates and eliminating the need for dual antiplatelet therapy, which is particularly beneficial in the case of ruptured aneurysms. Although complications from using these devices are rare, it is crucial to address them properly. In this case, the authors highlight how to manage artery thrombosis caused by device protrusion during aneurysm embolization. OBSERVATIONS: This report describes a complication in a male patient with a ruptured anterior communicating artery wide-necked aneurysm. Following Contour-assisted coiling of the aneurysm, a realignment of the detachable apex of the device occluded the A2 segment of the right anterior cerebral artery. After the failure of intra-arterial and intravenous tirofiban infusion as well as mechanical thrombectomy, a self-expanding open-cell stent was deployed in the involved vessel, achieving successful reperfusion. LESSONS: The Contour device has a detachable zone that can cause occlusion of the parent vessel after deployment. The use of a stent as a rescue maneuver may be useful if reperfusion of the vessel cannot be achieved through other methods such as aspiration or full-dose antiplatelet therapy.

Single vs. Multiphase Computed Tomography angiography in acute internal carotid artery occlusion: An accuracy and interobserver agreement study.

OBJECTIVE: Accurate differentiation between the intracranial and extracranial location of the acute internal carotid artery (ICA) occlusion is essential for guiding treatment decisions and mechanical thrombectomy planning. Multiphase Computed Tomography angiography (mCTA) appears to be superior to Single-phase Computed Tomography angiography (sCTA) in the evaluation of acute ICA occlusions. The main objective of our research is to study the accuracy of mCTA compared to sCTA in distinguishing isolated acute intracranial ICA occlusion from extracranial or tandem occlusion. METHODS: Two observers independently analyzed sCTA and mCTA of patients with acute ICA occlusion at two different time points. The location of the occlusion was categorized as intracranial or extracranial for both imaging techniques and then compared with digital subtraction angiography (gold standard). Sensitivity and specificity rates for isolated intracranial ICA occlusion on sCTA and mCTA were calculated. Kappa statistics were used to assess interobserver agreement. RESULTS: The sensitivity of sCTA and mCTA was 48.28% (28.36%-68.19%) and 79.31% (62.84%-95.78%) respectively for the diagnosis of isolated intracranial ICA occlusion, with an almost perfect interobserver agreement between both observers (p < 0.001). CONCLUSIONS: Our research suggests that mCTA is more accurate than sCTA in distinguishing isolated intracranial occlusions from extracranial or tandem occlusions.

Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography.

Extracranial carotid mural lesions (CML), caused by atherosclerosis or dissection, are frequently observed in acute internal carotid artery (ICA) occlusion, often requiring angioplasty or stenting. This study aimed to assess the diagnostic accuracy of computed tomography angiography (CTA) in differentiating extracranial CML from thromboembolic etiology in acute ICA occlusion in patients eligible for endovascular treatment. Two neuroradiologists retrospectively studied patients with apparent extracranial ICA occlusion on CTA. Patients were divided into two groups: thromboembolism and CML, based on findings from CTA and digital subtraction angiography (DSA). CTA sensitivity and specificity were calculated using DSA as the gold standard. Occlusive patterns and cervical segment widening were evaluated for atherosclerosis, dissection, and thromboembolism etiologies. CTA had a sensitivity of 84.91% (74.32-95.49%) and a specificity of 95.12% (87.31-100%) in detecting extracranial CML. Atherosclerosis was the most common cause, distinguishable with high accuracy using CTA (p < 0.001). No significant differences were found in occlusive patterns between dissection and thromboembolism (p = 0.568). Cervical segment widening was only observed in dissection cases due to mural hematoma. Conclusions: CTA accurately differentiates extracranial CML from thromboembolic etiology in acute ICA occlusion. The pattern of the occlusion and the artery widening help to establish the location and the etiology of the occlusion.

Acute intracranial internal carotid artery occlusion: Extension and location of the thrombus as an influencing factor in Computed Tomography angiography findings.

Purpose: Acute intracranial internal carotid artery (ICA) occlusion can mimic an extracranial affectation on Computed Tomography angiography (CTA). This fact could be explained by the extension of the thrombus in the ICA concerning its arterial branches. This study aims to determine how this factor may influence imaging findings. Methods: A retrospective study was conducted from a single-center database of patients undergoing mechanical thrombectomy due to ICA occlusion between October 2017 and March 2022 (n = 77). Patients with acute intracranial ICA occlusion were included (n = 29) and divided into two groups, according to ICA opacification on CTA: the discernible extracranial ICA or group D, and the pseudo-occlusion or group P. Patency of posterior communicating, anterior choroidal, and ophthalmic arteries on digital subtraction angiography were collected to determine thrombus extension. Sensitivity and specificity were calculated for CTA. Results: Significant differences were found in DSA between group P (n = 17) and group D (n = 12) in the frequency of patency of major artery branches: the presence of posterior communicating (PCOM) and anterior choroidal arteries (AChA) was observed in 2 patients in group P vs. 10 in group D (p < 0.001); whereas the patency of the ophthalmic artery (OA) was visualized in 10 patients in group P vs. 12 in group D, p = 0.023). For the diagnosis of isolated intracranial ICA occlusion, CTA had a sensitivity of 43.5% and a specificity of 97.2%. Conclusions: The location and extent of the thrombus in the intracranial ICA concerning major artery branches may influence CTA findings.

Exploring biocontamination in associated macrofaunal assemblages in marinas: Soft bottoms vs artificial hard substrate. Where and what to look for?

Marinas are hot spots of non-indigenous marine species (NIS). Introductions of NIS, regardless of their actual or potential impacts, can be considered as a biocontamination of the ecosystem. To characterize the biocontamination status of a marina it is important to know which habitats and major taxa can provide the most useful information. To address this issue, we analyze the associated macrofaunal community associated to soft substrate (sediment; SS) and artificial hard substrate (lateral surface of pontoons; AHS) of six marinas from Southern Spain. 9 NIS were found, including 8 crustaceans (7 peracarids) and 1 polychaete; 8 NIS were found on AHS and 4 in sediments. Indeed, site-specific BioContamination Index (SBCI) showed higher values in AHS than SS. Our results indicate peracarids in AHS should be the primary target for assessing the level of biocontamination in marinas. This may help scientists and environmental managers to stablish strategies for monitoring marine bioinvasions.

New transcriptome and clinical findings of platelet-activating factor in chronic spontaneous urticaria: Pathogenic and treatment relevance.

The objective of the study was to assess the pathogenic and treatment relevance of Platelet Activating factor (PAF) in chronic spontaneous urticaria (CSU). The expression and cellular location of PAF receptor (PAFR) and serum levels of PAF and PAF acetylhydrolase (PAF-AH) in patients with moderate/severe CSU (n = 45) and healthy controls (HCs, n = 17) were studied. Skin samples from the active wheal (LS-CSU, 13 samples for qPCR and 33 for immunohistochemistry) and non-lesional skin (NLS-CSU, 13 samples) of CSU patients and HCs (13 samples and 5 for immunohistochemistry) were analyzed. Serum PAF and PAF-AH levels were measured by ELISA and compared between HC (10 samples) and CSU patients (25 samples) and, among them, between those refractory and non-refractory to second-generation H1 -antihistamines (sgAH). PAFR mRNA expression was significantly higher in LS-CSU versus HCs (p = 0.014). PAFR positive staining in immunohistochemistry was mainly found in the epidermal basal layer in HCs, whereas it was broadly present along the epidermis in LS-CSU samples. Endothelial cells showed PAFR expression exclusively in LS-CSU and NLS-CSU samples. PAFR expression was observed in the nerves of HC, LS-CSU, and NLS-CSU samples. Double PAFR/CD43 expression showed that T-lymphocytes were the main cell type from the wheal inflammatory infiltrate expressing PAFR. A significantly lower PAF-AH/PAF ratio was observed in sgAH non-responders versus responders (6.1 vs. 12.6; p = 0.049). Our study confirms that PAF is a mediator of wheal pathogenesis in CSU. The significantly lower PAF-AH/PAF ratio in sgAH non-responders vs responders suggests that PAF could be a potential biomarker of sgAH refractoriness.

Clinical and pathological features of Merkel cell carcinoma: A 4-year follow-up observational retrospective study in Spain.

BACKGROUND: Merkel cell carcinoma (MCC) is a malignant skin cancer with a 5-year survival rate of approximately 50%. Knowledge of MCC has increased in recent years mostly due to improved diagnosis techniques. In Spain there is lack of information regarding the incidence and tumour characteristics, and the treatment approaches are not standardised. The objective of this study was to provide information of the clinical and epidemiological characteristics of MCC patients in Spain. METHODS: Retrospective, observational study involving 192 patients from 25 Spanish hospitals. Evaluated variables included overall survival and incidence rate of Merkel cell polyomavirus, in patients diagnosed from 2012 to 2016. RESULTS: The Spanish incidence rate was estimated 0.32/100,000 inhabitants/year, with variations according to geographical regions, being slightly higher in areas with greater sunlight exposure. In total, 61.5% of tumours showed expansive growth (progressive growth of the tumour), 78.6% showed localisation in UV-exposed skin. 97.4% of patients were diagnosed by excisional biopsy. Surgery was the first line treatment in 96.6% of patients, radiotherapy in 24.6%, and chemotherapy in 6.3%. These treatments were not mutually exclusive. Median overall survival was 38.3 months (78.4% at 12 months and 60% at 24 months). MCPyV was present in 33.8% of patients. CONCLUSION: The incidence of MCC in Spain is one of the highest in Europe, with a slight predominance in men. The sample has shown that a biopsy is available for diagnosis in most cases. Moreover, the treatment is surgical when the tumour is localized and is associated with lymphadenectomy, and/or it is radiotherapy if widespread.

Diagnostic usefulness of immunohistochemical evaluation of CD1a antigen and polyclonal anti-leishmania antibodies in cutaneous leishmaniasis.

BACKGROUND: Different immunohistochemical markers to detect amastigotes in cutaneous leishmaniasis have been proposed with variable diagnostic usefulness. OBJECTIVES: To evaluate the diagnostic usefulness of immunohistochemical amastigotes identification by specific polyclonal anti-Leishmania antibodies and CD1a expression (clone EP3622) in a series of PCR confirmed cutaneous leishmaniasis. MATERIALS AND METHODS: Thirty-three skin samples corresponding to PCR confirmed cutaneous leishmaniasis were included in the study. All samples were stained with Hematoxylin-eosin and Giemsa. Moreover, immunohistochemical studies with anti-CD1a and anti-Leishmania antibodies were performed. The patients clinical features and the observed histopathological features were also recorded. RESULTS: From the selected 33 biopsies, Leishmania spp. amastigotes were detected in 48.4% of cases with conventional Hematoxylin-eosin stain and in 57.5% of cases by Giemsa staining. In 31/33 cases, anti-CD1a allowed us to identify parasitic structures, and in 33/33 cases amastigotes were detected with anti-Leishmania antibodies. Concordance between both techniques, anti-CD1a and anti-Leishmania, was 94% [CI 95%: (79,8%-99,3%)] ; p value <0.05. The sensitivity of anti-CD1a in comparison with the PCR was 94%, with a positive predictive value of 100%. Two cases of low parasitic index were negative for CD1a immunostaining. In cases with high parasitic index, anti-CD1a stained amastigotes in superficial and deep dermis. Only a few cases were originally diagnosed with the available histological techniques, needing PCR for Leishmania spp. CONCLUSIONS: Anti-CD1a antibody seems to be a useful technique to identify amastigotes when PCR and anti-Leishmania antibodies are not available. The sensitivity to detect amastigotes is increased when the CD1a immunostaining is added to the classical Haematoxylin - eosin and Giemsa staining.

Ecological quality assessement of marinas: An integrative approach combining biological and environmental data.

The importance of marinas as infrastructures for recreational boating is increasing substantially. However, information on their soft-bottom benthic communities, a key tool for managing programmes, is still scarce. We combined environment features with macro- and meiofaunal soft-bottom community information for assessing the ecological status of marinas with an integrative approach. To address this issue, we focused on eight marinas of the Southern Iberian Peninsula. Macro- and meiofauna data revealed high benthic heterogeneity at a spatial scale. The environmental variables which correlated best with macrofauna were mainly phosphorus, granulometry, and total organic carbon, and secondarily important variables were faecal coliforms, the biocide Irgarol, and heavy metals; total hydrocarbon concentration was also significant for meiofauna. Annelida was the dominant phylum in terms of number of species (37%) and abundance (66%) and were better descriptors of the environmental conditions than Arthropoda and Mollusca. Although identification to the species level is desirable and mandatory for assessing biological pollution, significant differences among marinas and correlations between fauna and abiotic variables were already detected at the level of family and order. This implies that biota assessment at higher levels may still be useful in monitoring programmes limited by time and budget constraints. The major novelty of this study lies in the development of an integrative assessment method based on the following selected ecological indicators: Marinas Environmental Pollution Index (MEPI), Biocontamination Index (BCI), macrofaunal biotic indices (AMBI, M-AMBI, BENTIX, MEDOCC and BENFES), macrofaunal taxa richness and Shannon-Wiener's diversity, and nematode:copepod index. This approach was able to discriminate marinas of the Southern Iberian Peninsula based on their ecological status, which ranged from poor to good. The method can be useful to design standards for assigning "sustainable quality seals" to those marinas with better values of ecological indicators.

Assessing environmental pollution levels in marinas.

Despite the growing interest in recreational boating and the increasing number of marinas along the world's coastlines, environmental knowledge of these ecosystems is still very scarce. Detailed data of pollutants in marinas are necessary to provide a global approach of environmental risks in the context of international management strategies. In the present study, a set of 64 variables (30 in seawater and 34 in sediments) were measured to compare marinas from the Southern Iberian Peninsula (SIP). Uni and multivariate analyses showed significant differences among marinas, evidencing the importance of management on a local scale. The most relevant variables determining these differences were turbidity and the biocide Irgarol 1051 in seawater, and granulometry, hydrocarbons and faecal coliforms in sediment. The use of normalization techniques with Al or Fe, and the suitability of different methodologies to measure Total Organic Matter in marinas were also discussed. Additionally, we perform a comprehensive literature review of worldwide marina stressors and develop a simple and straightforward method for assessing environmental quality. The method was tested using SIP marinas and was based on the comparison of 15 selected sediment stressors with background values, concentrations of worldwide sediment quality guidelines (SQGs), and reference conditions/security thresholds established by the programme of coastal waters in port areas (ROM 5.1). A global score was assigned using a new proposed index, Marinas Environmental Pollution Index (MEPI), ranging from 0 to 150 points according to the environmental quality (<90: bad, 90-120: moderate, >120: good). MEPI of marinas from SIP ranged from 60 to 110 points indicating bad or moderate levels of pollution. Environmental quality is one of the decisive factors for awarding eco-labels or eco-certifications, such as Blue Flags in marinas. Therefore, pollution baseline information and environmental tools are mandatory for correct assignation of these awards and necessary for assessing the efficiency of management actions.

Diagnostic accuracy of pigmented labial macules by in vivo reflectance confocal microscopy and correlation among techniques.

BACKGROUND: Pigmented labial macules (PLMs) are clinical, dermoscopic, and histopathologic challenges. OBJECTIVE: To describe and evaluate the utility of reflectance confocal microscopy (RCM) in PLMs and to establish a correlation between dermoscopy, RCM, histopathology, and immunohistochemistry. METHODS: Prospective study of PLMs from 4 tertiary referral dermatology centers. The study included 51 biopsy specimen-proven PLMs. Dermoscopic, RCM images, and histopathologic preparations were evaluated for malignant criteria. Diagnostic accuracy of RCM for melanoma diagnosis, RCM Lip Score previously reported, and κ values between techniques were calculated. RESULTS: Included were 5 melanomas and 46 benign PLMs. Dermoscopically, melanomas exhibited more frequently ≥3 colors and ≥3 structures. With RCM, pagetoid spreading, epithelial disarray, continuous proliferation of atypical cells around papillae, nonhomogeneously distributed papillae, marked cellular atypia, and a higher number of dendritic cells per papillae were more frequent in melanomas. The RCM Lip Score was significantly higher in malignant lesions. Good κ values were observed in most of the evaluated features. A perfect sensitivity and specificity was obtained combining dermoscopy and RCM. LIMITATIONS: A low number of melanomas were obtained. CONCLUSIONS: RCM improves lip melanoma diagnosis, and the RCM Lip Score represents a useful tool for the evaluation of a PLM.

Diffuse dermal mucinosis secondary to colony-stimulating factor 1 receptor monoclonal antibody treatment: A novel and peculiar drug-induced diffuse cutaneous mucinosis.

Colony-stimulating factor 1 receptor (CSF1R) inhibitors represent a new class of immune-modulatory drugs, mostly investigated in clinical trials in different malignant neoplasms. Four patients, diagnosed with recurrent or advanced malignant neoplasm and treated with a combination of anti-programmed death ligand 1 and anti-CSF1R monoclonal antibodies, developed an asymptomatic cutaneous eruption characterized by an ill-defined pseudoedematous to waxy diffuse infiltration with a reticular cobblestone-like pattern. Histopathological examination revealed diffuse mucin deposition involving the superficial and mid-dermis with fragmented and scattered elastic fibers. The exact pathogenic mechanisms implicated in the development of mucin deposits in patients treated with CSF1R inhibitors remain to be elucidated. A reduced degradation and clearance of components of the extracellular matrix by macrophages secondary to CSF1 pathway inhibition may be hypothesized. Shredding and fragmentation of elastic fibers may be a result of the increased accumulation of mucopolysaccharides. This observation illustrates the new spectrum of skin-related toxicities secondary to new targeting therapies. This may contribute to a better understanding of the underlying pathogenic mechanisms in skin diseases characterized by a persistent dermal glycosaminoglycan deposition.

Development and use of a Cytoscape app for GRNCOP2.

BACKGROUND AND OBJECTIVE: Gene regulatory networks (GRNs) are essential for understanding most molecular processes. In this context, the so-called model-free approaches have an advantage modeling the complex topologies behind these dynamic molecular networks, since most GRNs are difficult to map correctly by any other mathematical model. Abstract model-free approaches, also known as rule-based extraction methods, offer valuable benefits when performing data-driven analysis; such as requiring the least amount of data and simplifying the inference of large models at a faster analysis speed. In particular, GRNCOP2 is a combinatorial optimization method with an adaptive criterion for the discretization of gene expression data and high performance, in contrast to other rule-based extraction methods for discovering GRNs. However, the analysis of the large relational structures of the networks inferred by GRNCOP2 requires the support of effective tools for interactive network visualization and topological analysis of the extracted associations. This need motivated the possibility of integrating GRNCOP2 in the Cytoscape ecosystem in order to benefit from Cytoscapes core functionality, as well as all the other apps in its ecosystem. METHODS: In this paper, we introduce the implementation of a GRNCOP2 Cytoscape app. This incorporation to Cytoscape platform includes new functionality for GRN visualizations, dynamic user-interaction and integration with other apps for topological analysis of the networks. RESULTS: In order to demonstrate the usefulness of integrating GRNCOP2 in Cytoscape, the new app was used to tackle a novel use case for GRNCOP2: the analysis of crosstalk between pathways. In this regard, datasets associated with Alzheimer's disease (AD) were analyzed using GRNCOP2 app and other apps of the Cytoscape ecosystem by performing a topological analysis of the AD progression and its synchronization with the Ubiquitin Mediated Proteolysis pathway. Finally, the biological relevance of the findings achieved by this new app were evaluated by searching for evidence in the literature. CONCLUSIONS: The proposed crosstalk analysis with the new GRNCOP2 app focused on assessing the phase of the Alzheimer's disease progression where the coordination with the Ubiquitin Mediated Proteolysis pathway increase, and identifying the genes that explain the signalling between these cellular processes. Both questions were explored by topological contrastive analysis of the GRNs generated for the GRNCOP2 app, where several facilities of Cytoscape were exploited. The topological patterns inferred by this new App have been consistent with biological evidence reported in the scientic literature, illustrating the effectiveness of using this new GRNCOP2 App in pathway analysis. AVAILABILITY: The GRNCOP2 App is freely available at the official Cytoscape app store: http://apps.cytoscape.org/apps/grncop2.

Self-healing Cutaneous Mucinosis in Adulthood: The Adult Counterpart of the Juvenile Variant of the Disease?

Self-healing cutaneous mucinosis (SHCM) is an idiopathic localized cutaneous mucinosis mainly described in children and characterized clinically by an acute onset of papules and nodules that exhibit a spontaneous resolution in a period ranging from weeks to few months. Histologically, a diffuse mucin deposition in the dermis and/or hypodermis associated with a proliferation of spindle-shaped cells and some large epithelioid gangliocyte-like mononuclear cells is usually observed. An uncommon adult variant of SHCM has also been reported; however, the clinicopathological features described in these patients are extremely heterogeneous and differ significantly from the juvenile variant of the disease, often showing exclusively dermal involvement. We report a case of a 37-year-old female patient with multiple asymptomatic nodules located on the legs and arms that resolved spontaneously in a period of 2 years, showing the typical subcutaneous features of the juvenile variant of SHCM at the histological examination (ie, mucinous areas associated with dense bands of fibrosis containing arborizing thin-walled vessels, spindle-shaped fibroblasts, and some gangliocyte-like cells). To the best of our knowledge, this is the first report of SHCM showing the classic pattern of deep-seated subcutaneous involvement of the disease in an adult patient. We also review the cases of adult-onset SHCM reported in the literature.

The natural history of cutaneous sarcoidosis. Clinical spectrum and histological analysis of 40 cases.

BACKGROUND: Cutaneous lesions of sarcoidosis can allow physicians to establish the diagnosis of a systemic disease, but the need of monitoring patients presenting skin limited sarcoidosis in order to detect further extracutaneous involvement has rarely been evaluated. OBJECTIVES: To review clinical and histological features of patients with cutaneous sarcoidosis and the risk of progression to systemic disease. To characterize the phenotype of patients with isolated cutaneous sarcoidosis and to assess the temporal relationship between cutaneous and systemic disease. METHODS: Retrospective review of a series of patients with cutaneous sarcoidosis. Clinical, histopathological, and evolutive features were reviewed. RESULTS: Forty patients were included in the study. Systemic disease was present in 82.5% of patients. Previous or concurrent cutaneous involvement occurred in 81.8% of them. Seven out of 14 patients with cutaneous lesions evolved to a systemic sarcoidosis in a mean time of 6 years, with a range between 4 and 9 years. No clinical or histological differences were found between patients with systemic sarcoidosis and those who showed persistent isolated cutaneous lesions. CONCLUSIONS: Sarcoidosis may be manifested as an isolated cutaneous disorder. No clinical or histopathological features seem to be helpful to discriminate cases of a persistent isolated cutaneous disease from those that will develop systemic involvement. Since the development of systemic involvement in cases of isolated cutaneous sarcoidosis can occur many years afterward, careful monitoring seems advisable, and a long follow-up is recommended.

Impoverished mobile epifaunal assemblages associated with the invasive macroalga Asparagopsis taxiformis in the Mediterranean Sea.

There is an increasing concern about the ecosystem consequences of altering macroalgal assemblages. Many macrophytes are foundation species in coastal habitats, supporting much of the biodiversity of these ecosystems by providing essential resources such as food and habitat. The addition of invasive species strongly contributes to habitat modification, but the bottom-up impacts of non-native macroalgae on higher trophic levels remains difficult to predict. The main aim of this study was to evaluate the effects of the invasive macroalga Asparagopsis taxiformis on biodiversity by comparing the mobile macrofauna inhabiting this species to the dominant native species Halopteris scoparia. This is the first comprehensive study of the possible effects of this widespread invasive species on higher trophic levels. A hierarchical sampling design with two different spatial scales was conducted to explore the consistency of the patterns observed. Fifty-nine species belonging to superorder Peracarida were found, accounting 90% of all organisms. A. taxiformis hosted an impoverished epifaunal assemblage in comparison to that associated with the native seaweed, showing significantly lower values of diversity, abundance and number of epifaunal species across study locations. The structure of the associated macrofauna (both in terms of species composition, variability among samples and relative abundance of the species) was also different. Our results highlighted the strong influence of A. taxiformis in the resident community, with differences among the two macroalgae in all the parameters considered. Finally, our results also reflect a biotic homogenization of the epifaunal assemblages associated to A. taxiformis, a scarcely explored consequence of invasive processes in marine environments. Future studies exploring the cascading effects of the observed changes in the epifaunal assemblages would be necessary in order to estimate system responses to macroalgal invasions.

Fish mitigate trophic depletion in marine cave ecosystems.

Dark marine habitats are often characterized by a food-limited condition. Peculiar dark habitats include marine caves, characterized by the absence of light and limited water flow, which lead to reduced fluxes of organic matter for cave-dwelling organisms. We investigated whether the most abundant and common cave-dwelling fish Apogon imberbis has the potential to play the role of trophic vector in Mediterranean marine caves. We first analysed stomach contents to check whether repletion changes according to a nycthemeral cycle. We then identified the prey items, to see whether they belong to species associated with cave habitats or not. Finally, we assessed whether A. imberbis moves outside marine caves at night to feed, by collecting visual census data on A. imberbis density both inside and outside caves, by day and by night. The stomach repletion of individuals sampled early in the morning was significantly higher than later in the day. Most prey were typical of habitats other than caves. A. imberbis was on average more abundant within caves during the day and outside during the night. Our study supports the hypothesis regarding the crucial trophic role of A. imberbis in connecting Mediterranean marine caves with external habitats.

Disseminated Granulomatous Perifollicular Dermatosis With Comedones: A Follicular Variant of Lichen Nitidus or a New Entity?

The presence of acquired generalized keratotic follicular papules and comedones developing in adulthood constitute an uncommon clinical situation. Although this clinical presentation has been described in several noninflammatory, inflammatory, and neoplastic skin disorders, its association with an exclusive perifollicular epitheliod or granulomatous inflammatory reaction represents an exceedingly rare phenomenon. We report a case of a 57-year-old male patient presenting clinically numerous acquired disseminated follicular papules and comedones, showing isolated perifollicular sarcoid-like granulomatous inflammatory infiltrates at the histological examination. These lesions experienced a complete spontaneous resolution after several months. The possibility that this disseminated, epithelioid, granulomatous, perifollicular dermatosis may represent an isolated follicular variant of lichen nitidus or a previously nonreported skin disorder is discussed.