Pigmented squamous cell carcinoma presenting as longitudinal melanonychia in a transplant recipient.

We report the case of a 62-year-old black man who was on a maintenance immunosuppressive regimen that included mycophenolate mofetil and cyclosporine following renal transplantation 9 years prior. He presented to the dermatology department for evaluation of a pigmented longitudinal streak on the left third finger adjacent to the lateral nail fold that had been present for several months. He noted that the streak was increasing in size, and his fingertip had recently become tender. The pigmented band was biopsied, and histopathology showed atypia of the epidermis consistent with pigmented squamous cell carcinoma (pSCC). Although subungual melanoma is the most concerning cause for longitudinal melanonychia, there are a number of other potential causes, including fungal infection, trauma, benign melanocytic lesions, or other cutaneous malignancies. Pigmented squamous cell carcinoma is another potential cause of longitudinal melanonychia and should be included in the differential diagnosis, particularly in individuals with skin of color or those who are immunosuppressed. This article highlights features of the clinical presentation of pSCC presenting as longitudinal melanonychia that mimicked the clinical appearance of subungual malignant melanoma in a renal transplant recipient. A review of pSCC and its associated risk factors also is provided.

Physiological concentrations of genistein and 17ß-estradiol inhibit MDA-MB-231 breast cancer cell growth by increasing BAX/BCL-2 and reducing pERK1/2.

AIM: The aim of the present study was to identify the mechanism by which genistein and 17ß-estradiol inhibit proliferation of MDA-MB-231 breast cancer cells. MATERIALS AND METHODS: The expression of cell signaling proteins involved in cell apoptosis, proliferation, and survival (BCL-2 associated X protein, BAX; B-cell lymphoma 2, BCL-2; extracellular signal regulated kinase, pERK1/2; and protein kinase B, pAKT) were examined by western blotting, and tested whether these effects correlated with cell proliferation and apoptosis. RESULTS: Compared to the control, 1 µM genistein plus 1 nM 17ß-estradiol significantly increased apoptosis, and the BAX/BCL-2 ratio, with a concomitant decrease in ERK1/2 phosphorylation. High concentrations of genistein (100 µM) both in the presence and absence of 17ß-estradiol also increased apoptosis; however, these changes were not correlated with the BAX/BCL-2 ratio or with phosphorylation of ERK1/2. CONCLUSION: These results suggest that different concentrations of genistein elicit cell responses through different signaling mechanisms. These results are especially relevant in premenopausal women with breast cancer who are on a soy diet.