Reticular erythematous mucinosis: Relationship between its dermoscopic and histopathological findings.

Key Clinical Message: In reticular erythematous mucinosis, (1) the presence of dotted vessels and (2) uniform, structureless, yellowish-white spots, and patches on dermoscopy correspond to histopathological findings of (1) vessels at the tips of the dermal papillae and (2) thickening and rupture of the collagen and fiber bundles with mucin deposition, respectively. Abstract: Reticular erythematous mucinosis is a rare form of skin mucinosis that primarily affects middle-aged women, typically appearing as papules and plaques in the upper chest or midline of the back. Here, we report the case of a 75-year-old woman with skin papules and plaques left untreated for 8 years. A gross skin examination was followed by histopathological and dermoscopic examinations. The main dermoscopic findings were (1) dotted vessels and (2) uniform structureless yellowish-white spots and patches. The corresponding histopathological findings were (1) vessels at the tips of the dermal papillae and (2) thickening and rupturing of the collagen and fiber bundles with mucin deposition, respectively. Laboratory investigations revealed normal results, ruling out various autoimmune disorders. REM was diagnosed based on these findings. The study presents relevant evidence-based findings in dermatology and cutaneous pathology as it is the first description of REM using dermoscopy. Dermoscopic diagnosis without other unnecessary tests would benefit both the clinician and the patient.

Warty dyskeratoma: The relationship between its dermoscopic and histopathological findings.

Key Clinical Message: On dermoscopy, the central area was greenish-yellow with a coarse cobblestone-like structureless material-filled pattern, along with a bull's-horn-like tip and white globules. The marginal area was skin-colored with a dark red background and a dome-shaped pattern. A collarette with white ring and radial streaks, and whitish globules was noted. Abstract: In recent years, the dermoscopic findings of Warty dyskeratoma have only been reported in a few cases. A 71-year-old man presented with a brownish papular lesion, with a central umbilical fossa, posterior to the right auricle. Histopathologically, a keratocystic tumor with a dome-like morphology and an epidermal invagination in its limbic part was noted. The central part surrounding the fissure was filled with horn-like cells with cornification tendency. Corps ronds were mostly distributed in the stratum corneum and granulosa, and grains were observed in the stratum corneum as acantholytic cells within the epidermal voids (lacunae). On dermoscopy, the central area was greenish-yellow with a coarse cobblestone-like structureless material-filled pattern, along with a bull's-horn-like tip and white globules. The marginal area was skin-colored with a dark red background and a dome-shaped pattern. A collarette with white ring and radial streaks, and whitish globules was noted. No prominent vascular pattern was observed.

Diagnostic Histopathological Findings on a Tick-Bite Lesion without the Presence of an Insect Body.

Tick bite is detected when the insect's body remains, and portions, such as the mouthparts, may be used to confirm the species and the potential for microbial infection. Moreover, a histopathological diagnostic standard for tick-borne illnesses has not yet been established. Thus, this study aimed to perform a histopathological examination of the lesion in a patient in whom a tick was not identified along with its bite. The patient was a 47-year-old man who presented with a lesion caused by a tick bite; the lesion was resected en bloc from the subcutaneous fat on the left side of the neck. Histopathological findings showed necrosis and thickening of the epidermis, ulceration, a strong periodic acid-Schiff stain-positive substance over the epidermis, extravascular exposure of erythrocytes in the dermis, thrombi, sclerosis of collagenous fibers, pseudolymphoma with a predominance of T cells, and marked infiltration of basophils extending from the epidermis to the subdermal sebaceous layer. Tick-bite lesions may be detected histopathologically, even if the presence of the insect body is not confirmed, as in this case, if the injection of tick saliva and local reaction of the salivary component are histologically evaluated.

Diagnostic features of a non-pigmented eccrine poroma with a collarette: Histopathological and dermoscopic correlation.

This is a case that emphasized the need for detailed observation of the entire lesion in dermoscopic examination. Novel dermoscopic findings within a collarette.

Activation of the Hedgehog and Wnt/ß-Catenin Signaling Pathways in Basal Cell Carcinoma.

In basal cell carcinoma (BCC) tumorigenesis, interaction between Hedgehog (Hh) and Wnt/ß-catenin (Wnt) signaling pathways has been investigated, but not completely elucidated. Here, a case of sporadic BCC in an 80-year-old man is presented, and the effectiveness of SMO inhibitors in case of relapse is predicted. The aim of this study was to determine whether the SMO inhibitors can be effective in treating this individual should the tumor recur in the future. Immunohistochemistry (IHC) was performed in a tumor and the adjacent skin tissue from the patient. IHC within the same BCC tissue specimen revealed that Glioma-associated oncogene 1 (GLI1) and Smoothened (SMO) in the Hh signaling pathway and insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) in the Wnt signaling pathway were overexpressed. Hh and Wnt signaling pathways were activated. These findings suggest that the patient might be resistant to treatment with SMO inhibitors because of the interaction between Hh and Wnt signaling pathways. Overexpression of GLI1 leads to transcriptional activation, making it an attractive molecular target for anticancer therapy owing to the downstream effectors of the cascade.

Impact of the Electron Acceptor Nature on the Durability and Nanomorphological Stability of Bulk Heterojunction Active Layers for Organic Solar Cells.

A systematic study is conducted to compare the performances and stability of active layers employing a high performance electron donor (PBDB-T) combined with state-of-the-art fullerene (PC71 BM), nonfullerene (ITIC), and polymer (N2200) electron acceptors. The impact of the chemical nature of the acceptor on the durability of organic solar cells (OSCs) is elucidated by monitoring their photovoltaic performances under light exposure or dark conditions in the presence of oxygen. PC71 BM molecules exhibit a higher resistance toward oxidation compared to nonfullerene acceptors. Unencapsulated PBDB-T:PC71 BM OSCs display relatively stable performances at room temperature when stored in air for 3 months. However, when exposed to temperatures above 80 °C, their active materials demix causing notable reductions in the short-circuit densities. Such detrimental demixing can also be seen for PBDB-T:ITIC active layers above 120 °C. Although N2200 chains irreversibly degrade when exposed to air, thermally induced demixing does not occur in PBDB-T:N2200 active layers annealed up to 200 °C. In summary, fullerene OSCs may be the best currently available choice for unencapsulated room temperature applications but if oxidation of the polymer acceptors can be avoided, all polymer active layers should enable the fabrication of highly durable OSCs with lifetimes matching the requirements for OSC commercialization.

Overlapping tumor-specific expression of p53, p16INK4a, and sirtuin 1 in Bowen's disease: A case report.

Understanding the impact of inactivating mutations in SIRT1 on the p53 and p16 tumor suppressor genes may yield new insight into the oncogenic mechanisms underlying Bowen's disease.

Melanoma-targeted chemo-thermo-immuno (CTI)-therapy using N-propionyl-4-S-cysteaminylphenol-magnetite nanoparticles elicits CTL response via heat shock protein-peptide complex release.

Melanogenesis substrate, N-propionyl-4-S-cysteaminylphenol (NPrCAP) is specifically taken up by melanoma cells and inhibits their growth by producing cytotxic free radicals. By taking advantage of this unique chemical agent, we have established melanoma-targeting intracellular hyperthermia by conjugating NPrCAP with magnetite nanoparticles (NPrCAP/M) upon exposure to an alternating magnetic field (AMF). This treatment causes cytotoxic reaction as well as heat shock responses, leading to elicitation of antitumor immune response, which was proved by tumor rechallenge test and CTL induction. We found the level of heat shock protein 72 (Hsp72) to be increased in the cell lysate and culture supernatant after intracellular hyperthermia. Melanoma-specific CD8(+) T-cell response to dendritic cells loaded with hyperthermia-treated tumor lysate was enhanced when compared with non-treated tumor lysate. When heat shock protein, particularly Hsp72, was immuno-depleted from hyperthermia-treated tumor cell lysate, specific CD8(+) T-cell response was abolished. Thus, it is suggested that antitumor immune response induced by hyperthermia using NPrCAP/M is derived from the release of HSP-peptide complex from degraded tumor cells. Therefore, this chemo-thermo-immuno (CTI)-therapy might be effective not only for primary melanoma but also for distant metastasis because of induction of systemic antimelanoma immune responses.

Growth inhibition of re-challenge B16 melanoma transplant by conjugates of melanogenesis substrate and magnetite nanoparticles as the basis for developing melanoma-targeted chemo-thermo-immunotherapy.

Melanogenesis substrate, N-propionyl-cysteaminylphenol (NPrCAP), is selectively incorporated into melanoma cells and inhibits their growth by producing cytotoxic free radicals. Magnetite nanoparticles also disintegrate cancer cells and generate heat shock protein (HSP) upon exposure to an alternating magnetic field (AMF). This study tested if a chemo-thermo-immunotherapy (CTI therapy) strategy can be developed for better management of melanoma by conjugating NPrCAP on the surface of magnetite nanoparticles (NPrCAP/M). We examined the feasibility of this approach in B16 mouse melanoma and evaluated the impact of exposure temperature, frequency, and interval on the inhibition of re-challenged melanoma growth. The therapeutic protocol against the primary transplanted tumor with or without AMF exposure once a day every other day for a total of three treatments not only inhibited the growth of the primary transplant but also prevented the growth of the secondary, re-challenge transplant. The heat-generated therapeutic effect was more significant at a temperature of 43 degrees C than either 41 degrees C or 46 degrees C. NPrCAP/M with AMF exposure, instead of control magnetite alone or without AMF exposure, resulted in the most significant growth inhibition of the re-challenge tumor and increased the life span of the mice. HSP70 production was greatest at 43 degrees C compared to that with 41 degrees C or 46 degrees C. CD8(+)T cells were infiltrated at the site of the re-challenge melanoma transplant.

N-propionyl-cysteaminylphenol-magnetite conjugate (NPrCAP/M) is a nanoparticle for the targeted growth suppression of melanoma cells.

A magnetite nanoparticle, NPrCAP/M, was produced for intracellular hyperthermia treatment of melanoma by conjugating N-propionyl-cysteaminylphenol (NPrCAP) with magnetite and used for the study of selective targeting and degradation of melanoma cells. NPrCAP/M, like NPrCAP, was integrated as a substrate in the oxidative reaction by mushroom tyrosinase. Melanoma, but not non-melanoma, cells incorporated larger amounts of iron than magnetite from NPrCAP/M. When mice bearing a B16F1 melanoma and a lymphoma on opposite flanks were given NPrCAP/M, iron was observed only in B16F1 melanoma cells and iron particles (NPrCAP/M) were identified within late-stage melanosomes by electron microscopy. When cells were treated with NPrCAP/M or magnetite and heated to 43 degrees C by an external alternating magnetic field (AMF), melanoma cells were degraded 1.7- to 5.4-fold more significantly by NPrCAP/M than by magnetite. Growth of transplanted B16 melanoma was suppressed effectively by NPrCAP/M-mediated hyperthermia, suggesting a clinical application of NPrCAP/M to lesional therapy for melanoma. Finally, melanoma cells treated with NPrCAP/M plus AMF showed little sub-G1 fraction and no caspase 3 activation, suggesting that the NPrCAP/M-mediated hyperthermia induced non-apoptotic cell death. These results suggest that NPrCAP/M may be useful in targeted therapy for melanoma by inducing non-apoptotic cell death after appropriate heating by the AMF.

Papulonecrotic tuberculid-like eruptions after Bacille Calmette-Guerin vaccination.

One of the specific skin lesions occurring after Bacille Calmette-Guerin (BCG) vaccination is generalized tuberculid-like eruptions, which occur rarely, but have a tendency to heal spontaneously. Their pathogenesis and relationship to "true" tuberculids are poorly understood. This report presents a case of a 6-month-old girl who developed generalized papulonecrotic tuberculid-like eruptions after BCG vaccination. The skin lesions healed spontaneously in 3 months. Culture of blood, gastric juice and reverse transcription polymerase chain reaction (RT-PCR) of papulonecrotic skin biopsies were all negative for Mycobacterium tuberculosis. Histopathology of papulonecrotic eruptions revealed marked epidermal necrosis, perivascular lymphocytic infiltrates and epidermotropic infiltration of lymphocytes showing markers of CD3(+) lymphocytes (90-95% of all infiltrating cells), CD4(+) (40-50%), CD8(+) (40-50%), and CD45RO(+) (70%). In contrast, the BCG vaccination site revealed intradermal granuloma with epithelioid cells, occasional giant cells and infiltration of lymphocytes consisting of CD3(+) (60-70%), CD4(+) (40-50%), CD8(+) (30-40%), CD45RO(+) (40%), CD79a(+) (30-40%), and CD20(+) (20-30%). Our patient did not reveal any signs indicative of tuberculosis. Papulonecrotic lesions were therefore called papulonecrotic tuberculid-like eruptions, rather than tuberculids, that occurred after BCG vaccination and appeared to derive from a hypersensitive reaction mediated by immune lymphocytic infiltration.

Reconstruction method with a newly-designed bilobed flap after excision of tumours of the skin.

We have devised a bilobed skin flap for reconstruction after excision of small skin tumours. The sutured part serves as a zig-zag that leads to only slight postoperative contracture of the scar. The rotation centre of the flap is nearer to the affected area than other conventional bilobed flaps, resulting in less dog-ear deformity and distortion of tissue.