Neutrophil Gelatinase-Associated Lipocalin as Potential Predictive Biomarker of Melanoma and Non-Melanoma Skin Cancers in Psoriatic Patients: A Pilot Study.

Background: Studies have demonstrated a higher risk of nonmelanoma skin cancers (NMSC) and a modestly increased melanoma risk in patients with psoriasis. To date, no biomarkers predictive of evolution have been identified yet. Methods: The aim of this prospective case-control study was to investigate the potential role of neutrophil gelatinase-associated lipocalin (NGAL) as a predictive biomarker of skin cancers in psoriatic patients. Patients with a diagnosis of psoriasis were enrolled, as well as healthy subjects and patients with skin cancers as controls. Plasma protein expression of NGAL, metalloproteinases (MMP)-2, and MMP-9 was performed by an enzyme-linked immunosorbent assay (ELISA). In all the patients who developed skin cancer at follow-up, NGAL, MMP-2, and MMP-9 serum levels were dosed again. Results: Plasma NGAL levels were significantly higher in psoriatic patients with NMSC than without (182.3 ± 36.6 ng/mL vs. 139.9 ± 39.3 ng/mL) (p < 0.001). Plasma NGAL levels were significantly higher (p < 0.00001) in patients with psoriasis and NMSC than in patients with skin tumors without psoriasis (182.3 vs. 122.9). Patients with psoriasis who developed NMSC at follow-up showed increased plasma MMP-9 levels. Conclusion: NGAL seems to play a role in the pathogenesis of NMSC but not melanoma in patients with psoriasis.

Mycetomatoid infection of the penis by Candida albicans.

BACKGROUND: Mycetoma is generally understood to be a chronic suppurative infection involving the skin and the underlying tissue. Mycetomas may be classified as those produced by true fungi (eumycetoma) versus those due to aerobic bacteria Actinomycetales (actinomycetoma). METHODS: We report the atypical case of a mycetomatoid infection of the penile shaft and glans in a 36-year-old man, originally from Senegal, affected by Takayasu's arteritis. RESULTS: Extensive investigations excluded any other causative pathogen other than Candida albicans, and the ailment accordingly healed after fluconazole monotherapy. CONCLUSION: The authors discuss the unusual site of the disease and the singular clinical features related to the fungal etiology and put forward considerations on the pathogenic role of common microorganisms.