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1.
J Med Case Rep ; 17(1): 1, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36597169

RESUMO

BACKGROUND: Necrobiosis lipoidica located to the breast; without evidence of glucose intolerance, is extremely rare, and its association to Crohn's disease is not usual. CASE PRESENTATION: We report an interesting case of an association of necrobiosis lipoidica of the breast and Crohn's disease in a 54-year-old Moroccan woman. Skin necrobiotic changes are a characteristic feature in necrobiosis lipoidica, but they are exceptional in metastatic Crohn's disease, since there are only three published cases of necrobiotic skin lesions on the lower leg resembling erythema nodosum in metastatic Crohn's disease. CONCLUSIONS: On the basis of this rare observation, necrobiosis lipoidica without evidence of glucose intolerance should be recognized as a possible cutaneous manifestation or association of Crohn's disease.


Assuntos
Doença de Crohn , Intolerância à Glucose , Necrobiose Lipoídica , Dermatopatias , Feminino , Humanos , Pessoa de Meia-Idade , Necrobiose Lipoídica/complicações , Necrobiose Lipoídica/diagnóstico , Necrobiose Lipoídica/patologia , Doença de Crohn/complicações , Doença de Crohn/patologia , Intolerância à Glucose/complicações , Intolerância à Glucose/patologia , Pele/patologia , Dermatopatias/patologia
3.
Am J Dermatopathol ; 45(2): 81-85, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36669069

RESUMO

ABSTRACT: An 84-year-old woman presented with a 3-month history of a papular rash on the trunk, abdomen, and back. Histopathological examination revealed atypical lymphoid deep and band-like dermal infiltrates with marked epidermotropism. Neoplastic cells expressed B-cell markers (CD20), and clonal immunoglobulin gene rearrangement was observed. A complete peripheral blood study revealed aberrant circulating villous lymphocytes with the expression of B-cell markers (CD20, CD22, and CD79a) and aberrant expression of CD5. A staging workup revealed discrete splenic enlargement and bone marrow and gastrointestinal tract involvement. Skin lesions regressed spontaneously several weeks after diagnosis. Throughout evolution, the patient developed scattered cutaneous nodules and generalized papulo-nodules showing either epidermotropic or nonepidermotropic atypical dermal lymphoid infiltrates. This case illustrates the observation of autoinvolutive and recurrent epidermotropic B-cell atypical cutaneous infiltrates as a characteristic feature of secondary cutaneous involvement in splenic marginal B-cell lymphoma. Previously reported cases of epidermotropic B-cell lymphoma have been reviewed. Concurrent and simultaneous observation of epidermotropic and nonepidermotropic lesions seems to indicate that epidermotropism is an important but nonconstant diagnostic feature of splenic marginal B-cell lymphoma.


Assuntos
Leucemia Linfocítica Crônica de Células B , Linfoma de Zona Marginal Tipo Células B , Dermatopatias , Neoplasias Cutâneas , Feminino , Humanos , Idoso de 80 Anos ou mais , Linfoma de Zona Marginal Tipo Células B/patologia , Pele/patologia , Neoplasias Cutâneas/patologia , Leucemia Linfocítica Crônica de Células B/patologia , Dermatopatias/patologia
4.
Am J Dermatopathol ; 45(2): 90-92, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36669071

RESUMO

ABSTRACT: Some have proposed that melanomas in situ may be associated with fields of melanocytic dysplasia, particularly on sun-damaged skin, whereas others maintain that the atypical junctional melanocytic hyperplasia (MH) at the periphery of melanomas is simply background junctional MH of sun-damaged skin. The biological potential of atypical junctional MH at the periphery of melanomas is uncertain. We examined whether atypical junctional MH was intrinsic to the melanoma itself (ie, melanoma-associated field of melanocytic dysplasia) or was simply the predictable junctional MH associated with long-standing sun exposure. We retrospectively compared 106 cutaneous melanoma excisions without residual tumor with 105 nonmelanoma cutaneous tumor excisions (ie, basal cell or squamous cell carcinomas) without residual tumor. MH with atypia occurred significantly more frequently in melanoma than in nonmelanoma cutaneous tumor excisions (55.7% vs. 24.8%, P < 0.001). Solar elastosis occurred significantly less frequently in melanoma than in nonmelanoma cutaneous tumor excisions; 33.0% of melanoma excisions and 8.6% of nonmelanoma excision samples exhibited no solar elastosis, respectively (P < 0.001). After controlling for solar elastosis using multivariable linear regression, the association between MH with atypia and melanoma excisions remained significant (P < 0.001). Our results, therefore, demonstrate that melanomas were associated with atypical junctional MH that could not solely be accounted for by the extent of sun damage as measured by solar elastosis.


Assuntos
Melanoma , Dermatopatias , Neoplasias Cutâneas , Humanos , Melanoma/patologia , Neoplasias Cutâneas/patologia , Hiperplasia , Neoplasia Residual/complicações , Estudos Retrospectivos , Luz Solar , Dermatopatias/patologia
5.
J Postgrad Med ; 69(1): 50-52, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36537394

RESUMO

Pancreatic panniculitis is a rare disease characterized by subcutaneous fat necrosis. It could be the result of an associated pancreatic tumor. Herein, we reported a 63-year-old man who presented with progressive bilateral lower limb edema accompanied with nodule-like lesions for 1 month. His serum lipase was 3,927 U/L (normal, 0-160 U/L). Histopathology of the skin specimen revealed lobular panniculitis, favoring a diagnosis of pancreatic panniculitis. Abdominal computed tomography (CT) scan with contrast showed a huge mass in his left upper quadrant. Endoscopic ultrasound showed a mixed echoic tumor, measuring 11.9 × 7.8 cm in dimensions, originating from the pancreatic tail. Biopsy performed via an endoscopic ultrasound showed a poorly differentiated acinar cell carcinoma. Because of the unresectable status of the tumor, the patient underwent chemotherapy with paclitaxel and gemcitabine. After chemotherapy, his skin lesions improved progressively. It is important to treat pancreatic panniculitis with its underlying pancreatic disease.


Assuntos
Neoplasias Pancreáticas , Paniculite , Dermatopatias , Masculino , Humanos , Pessoa de Meia-Idade , Paniculite/complicações , Paniculite/patologia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/tratamento farmacológico , Dermatopatias/patologia , Biópsia/efeitos adversos , Necrose
6.
Nat Commun ; 13(1): 7729, 2022 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-36513651

RESUMO

Abundant heterogeneous immune cells infiltrate lesions in chronic inflammatory diseases and characterization of these cells is needed to distinguish disease-promoting from bystander immune cells. Here, we investigate the landscape of non-communicable inflammatory skin diseases (ncISD) by spatial transcriptomics resulting in a large repository of 62,000 spatially defined human cutaneous transcriptomes from 31 patients. Despite the expected immune cell infiltration, we observe rather low numbers of pathogenic disease promoting cytokine transcripts (IFNG, IL13 and IL17A), i.e. >125 times less compared to the mean expression of all other genes over lesional skin sections. Nevertheless, cytokine expression is limited to lesional skin and presented in a disease-specific pattern. Leveraging a density-based spatial clustering method, we identify specific responder gene signatures in direct proximity of cytokines, and confirm that detected cytokine transcripts initiate amplification cascades of up to thousands of specific responder transcripts forming localized epidermal clusters. Thus, within the abundant and heterogeneous infiltrates of ncISD, only a low number of cytokine transcripts and their translated proteins promote disease by initiating an inflammatory amplification cascade in their local microenvironment.


Assuntos
Dermatopatias , Transcriptoma , Humanos , Transcriptoma/genética , Pele/patologia , Citocinas/metabolismo , Perfilação da Expressão Gênica , Dermatopatias/patologia
7.
Acta Dermatovenerol Alp Pannonica Adriat ; 31(4): 151-155, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36541398

RESUMO

Microcystic adnexal carcinoma (MAC) is a rare adnexal tumor with eccrine and pillar differentiations with a localized and aggressive nature, often misdiagnosed as other dermatoses. The most common clinical manifestations of MAC are yellowish or skin-colored papules, nodules, and plaques. However, in some rare cases an atypical manifestation such as ulceration that resembles malignancies such as basal cell carcinoma (BCC) can also occur. Diagnosis of MAC mainly relies on the aid of histopathology. Due to potential infiltration to other structures such as in perineural invasion, wide surgical excision or Mohs micrographic surgery is the preferred surgical option. We report the case of a 75-year-old male patient with ulcerative lesion on the forehead that clinically resembled BCC in addition to typical dermoscopic findings of BCC. However, histopathology confirmed a diagnosis of MAC, prompting physicians to be more aware of this condition when encountering chronic ulcerative lesions. After wide excision and a 1-year follow-up, the patient exhibited no signs of recurrences and will continue long-term follow-up.


Assuntos
Carcinoma Basocelular , Neoplasias de Anexos e de Apêndices Cutâneos , Dermatopatias , Neoplasias Cutâneas , Masculino , Humanos , Idoso , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias de Anexos e de Apêndices Cutâneos/diagnóstico , Neoplasias de Anexos e de Apêndices Cutâneos/cirurgia , Dermatopatias/patologia , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/cirurgia
8.
Zhonghua Shao Shang Za Zhi ; 38(11): 1057-1065, 2022 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-36418263

RESUMO

Objective: To explore the effect of deep dermal tissue dislocation injury on skin fibrosis in pig, in order to provide some theoretical basis for burn scar treatment. Methods: The experimental research method was applied. Six 2-month-old female Duroc pigs were taken. Fifteen operative areas on the right dorsum of pigs on which medium-thick skin grafts and deep dermal tissue slices were cut and re-implanted were included into dermal in situ reimplantation group, and fifteen operative areas on the left dorsum of pigs on which medium-thick skin grafts and deep dermal tissue slices were cut and the deep dermal tissue slice was placed under the fat layer were included into the dermal dislocation group. The hair growth in the operative areas on post-injury day (PID) 7, 14, and 21 and the cross-sectional structure on PID 14 were observed in the two groups. On PID 7, 14, and 21, the skin thickness (the distance from the epidermis to the upper edge of the fat), the dermal thickness (the distance from the lower edge of the epidermis to the upper edge of the fat, excluding the fibrotic tissue thickness between the dermis and the fat), and the fibrosis tissue thickness of the dermis-fat interface (from the lower edge of the deep dermis to the upper edge of the fat in dermal in situ reimplantation group and from the lower edge of the superficial dermis to the upper edge of the fat in dermal dislocation group) in the operative areas were measured and compared between the two groups; the fibrotic tissue thickness at the dermal cutting interface (from the lower edge of the superficial dermis to the upper edge of the deep dermis) in the operative areas in dermal in situ reimplantation group was measured and compared with the fibrotic tissue thickness at the dermal-fat interface. Sirius red staining was performed to observe and compare the type Ⅰ and Ⅲ collagen content in the dermal-fat interface in the operative areas between the 2 groups and between the dermal cutting interface and dermal-fat interface in the operative areas in dermal in situ reimplantation group. Immunohistochemical staining was performed to observe the positive expressions of proliferating cell nuclear antigen (PCNA), transforming growth factor ß1 (TGF-ß1), fibroblast growth factor 2 (FGF-2), and hepatocyte growth factor (HGF) in the operative areas in the two groups. The sample number was 6. Data were statistically analyzed with independent sample t test. Results: On PID 7, 14, and 21, the hairs in the operative areas in dermal in situ reimplantation group were denser than those in dermal dislocation group. On PID 14, the skin cross section in the operative areas in dermal dislocation group showed a "sandwich"-like structure, while the skin cross section in the operative areas in dermal in situ reimplantation group had normal structure. On PID 7, 14, and 21, the skin thickness in the operative areas in dermal dislocation group was (4 234±186), (4 688±360), and (4 548±360) µm, respectively, which was close to (4 425±156), (4 714±141), and (4 310±473) µm in dermal in situ reimplantation group (P>0.05); the dermal thickness in the operative areas in dermal dislocation group was significantly thinner than that in dermal in situ reimplantation group (with t values of -9.73, -15.85, and -15.41, respectively, P<0.01); the fibrotic tissue thickness at the dermal-fat interface in the operative areas in dermal dislocation group was significantly thicker than that in dermal in situ reimplantation group (with t values of 14.48, 20.58, and 15.67, respectively, P<0.01); there was no statistically significant difference between the fibrotic tissue thickness at the dermal-fat interface and the dermal cutting interface in the operative areas in dermal in situ reimplantation group (P>0.05). On PID 7, 14, 21, the type Ⅲ collagen content in the dermal-fat interface in the operative areas in dermal dislocation group was increased significantly compared with that in dermal in situ replantation group (with t values of 2.65, 0.61, and 7.39, respectively, P<0.05 or P<0.01), whereas there were no statistically significant differences in the type Ⅰ collagen content at the dermal-fat interface in the operative areas between the 2 groups (P>0.05) and the type Ⅰ and Ⅲ collagen content between the dermal-fat interface and the dermal cutting interface in the operative areas in dermal in situ reimplantation group (P>0.05). On PID 7, 14, and 21, PCNA, TGF-ß1, FGF-2, and HGF were positively expressed in the superficial dermis and adipose tissue in the operative areas in dermal dislocation group, while PCNA, TGF-ß1, FGF-2, and HGF were positively expressed in the superficial dermis, deep dermis, and adipose tissue in the operative areas in dermal in situ reimplantation group. Conclusions: Inadequate intrinsic thickness of dermal tissue is the key factor causing fibrosis, and the biological purpose of fibrosis is to "compensate" the intrinsic thickness of the skin. Besides, adipose tissue may also be an important component of fibrotic skin repair.


Assuntos
Derme , Dermatopatias , Suínos , Feminino , Animais , Derme/patologia , Antígeno Nuclear de Célula em Proliferação/metabolismo , Fator 2 de Crescimento de Fibroblastos , Estudos Transversais , Fibrose , Dermatopatias/metabolismo , Dermatopatias/patologia , Colágeno/metabolismo
9.
Dis Aquat Organ ; 152: 9-16, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36394136

RESUMO

Although skin disease is a common cause of morbidity and mortality in amphibians, published reports of integumentary conditions affecting skin-brooding anurans are extremely limited. This case series describes the clinical, macroscopic, and histopathologic features of nodular skin lesions in an aquarium-managed population of Sabana Surinam toads Pipa parva, a fully aquatic, skin-brooding species native to South America. The skin lesions represented an ongoing clinical concern in this group, affecting approximately 10-20% of animals throughout the study period, and were observed exclusively in females, suggesting an association with the females' specialized cutaneous reproductive anatomy. Multiple animals died or were euthanized due to skin lesions, which were histologically complex and encompassed a range of hyperplastic, cystic, and neoplastic changes (with internal metastases in one animal). Cultures and special stains showed evidence of mixed polymicrobial infection, including occasional fungal hyphae and acid-fast organisms, but were predominated by Gram-negative bacteria. Lack of a significant response to various environmental modulations and therapeutic interventions indicates that the pathogenesis of the skin lesions is multifactorial. Additional research into the reproductive physiology and ideal environmental conditions (both social and physical) for this species will likely help identify new strategies for prevention and treatment of skin disease.


Assuntos
Dermatopatias , Feminino , Animais , Suriname , Dermatopatias/patologia , Dermatopatias/veterinária , Bufonidae , Pele , América do Sul
10.
Sensors (Basel) ; 22(21)2022 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-36366009

RESUMO

Skin cancer classification is a complex and time-consuming task. Existing approaches use segmentation to improve accuracy and efficiency, but due to different sizes and shapes of lesions, segmentation is not a suitable approach. In this research study, we proposed an improved automated system based on hybrid and optimal feature selections. Firstly, we balanced our dataset by applying three different transformation techniques, which include brightness, sharpening, and contrast enhancement. Secondly, we retrained two CNNs, Darknet53 and Inception V3, using transfer learning. Thirdly, the retrained models were used to extract deep features from the dataset. Lastly, optimal features were selected using moth flame optimization (MFO) to overcome the curse of dimensionality. This helped us in improving accuracy and efficiency of our model. We achieved 95.9%, 95.0%, and 95.8% on cubic SVM, quadratic SVM, and ensemble subspace discriminants, respectively. We compared our technique with state-of-the-art approach.


Assuntos
Dermatopatias , Neoplasias Cutâneas , Humanos , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Pele/patologia , Dermatopatias/patologia
11.
J Med Case Rep ; 16(1): 444, 2022 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-36435796

RESUMO

BACKGROUND: Umbilical discharge in an adult is rare and generates broad diagnostic considerations. Umbilical anatomy is variable owing to congenital abnormalities and acquired pathology such as umbilical hernias. The umbilicus can be a site of primary or metastatic malignancy or endometriosis. CASE PRESENTATION: A 40-year-old white American woman came to the clinic with a 2-day history of spontaneous umbilical bleeding. She reported periumbilical pain associated with nausea and emesis. There were no visible skin abnormalities, but deep palpation of the abdomen produced a thin, watery, serosanguineous fluid from the umbilicus. She experienced a similar episode of umbilical bleeding 5 years prior without clear cause. Laboratory workup was notable for mildly elevated C-reactive protein . Computed tomography imaging revealed a fat-containing umbilical hernia with fat necrosis, necessitating complete surgical resection of the umbilicus. CONCLUSIONS: Umbilical hernia with fat necrosis is a rare condition that should be considered in adults with umbilical discharge. Additional diagnostic considerations in adults with spontaneous umbilical bleeding/discharge include embryonal remnants, omphalitis, and metastasis. If the cause is not readily apparent on physical exam, imaging with computed tomography should be considered to assess for hernia and embryonal anomalies.


Assuntos
Endometriose , Necrose Gordurosa , Hérnia Umbilical , Neoplasias , Dermatopatias , Adulto , Feminino , Humanos , Umbigo/patologia , Umbigo/cirurgia , Hérnia Umbilical/complicações , Hérnia Umbilical/diagnóstico por imagem , Hérnia Umbilical/cirurgia , Necrose Gordurosa/complicações , Necrose Gordurosa/patologia , Hemorragia Gastrointestinal/patologia , Endometriose/patologia , Dermatopatias/patologia
12.
Cells ; 11(22)2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36429125

RESUMO

Lymphomatoid papulosis (LyP) is a very rare disease that belongs to the group of CD30+ lymphoproliferative skin diseases. LyP is localized or generalized and usually presents as isolated or clustered red/brown-red lesions in the form of nodules and/or papules. The course of the disease is in most cases mild; however, depending on concomitant risk factors and history, it may progress to lymphoma, significantly reducing the survival rate and prognosis. Importantly, the clinical picture of the disease remains somewhat ambiguous, leading to a large number of misdiagnoses that result in inappropriate treatment, which is usually insufficient to alleviate symptoms. In addition to clinical manifestations, the histological characteristics vary widely and usually overlap with other conditions, especially those belonging to the group of lymphoproliferative disorders. Although diagnosis remains a challenge, several recommendations and guidelines have been introduced to standardize and facilitate the diagnostic process. This article reviews the available literature on the most important aspects of etiopathogenesis, clinical and histopathological features, diagnostic criteria, and possible treatment strategies for LyP, with particular emphasis on the role of the immune system.


Assuntos
Papulose Linfomatoide , Dermatopatias , Humanos , Papulose Linfomatoide/diagnóstico , Papulose Linfomatoide/terapia , Sistema Imunitário/patologia , Dermatopatias/patologia , Hiperplasia/complicações , Hiperplasia/patologia , Erros de Diagnóstico
13.
Medicina (Kaunas) ; 58(11)2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36363575

RESUMO

Primary cutaneous lymphomas are a heterogeneous group of T-cell (CTCL) and B-cell lymphomas (CBCL) developing in the skin and without signs of extracutaneous disease at the time of diagnosis. The term "primary small/medium CD4+ T-cell lymphoma" was changed to "primary small/medium cutaneous CD4+ lymphoproliferative disorder" due to its indolent clinical behavior and uncertain malignant potential. This paper presents a rare case of primary cutaneous lymphoma with small to medium CD4+ T-cells. A 37-year-old patient presented with a tumor in the frontal region that had occurred approximately 8-9 months earlier. The tumor had a diameter of about 8-9 mm, well demarcated macroscopically, it was round in shape, about 6-7 mm high, pink in color, firm in consistency and painless during palpation. Surgical excision of the tumor was performed with a margin of safety of 8 mm and deep to the level of the frontal muscle fascia. The histopathological examination supported the diagnosis of cutaneous lymphoproliferation with a nodular disposition in the reticular dermis and extension around the follicular epithelia and sweat glands, composed mainly of dispersed medium-large lymphocytes. Additional immunohistochemical examination was requested. Immunohistochemical examination confirmed the diagnosis of "primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder." Patient monitoring was carried out through clinical dermatological controls at 3, 6, and 12 months. After one year, a cranio-cerebral MRI was performed. For the following 5 years, an annual dermatological examination accompanied by cranio-cerebral MRI, blood count, and pulmonary X-ray were recommended. Similarly to all solitary skin lesions, the prognosis is excellent in this case, the only treatment being surgical excision.


Assuntos
Linfoma Cutâneo de Células T , Transtornos Linfoproliferativos , Dermatopatias , Neoplasias Cutâneas , Humanos , Adulto , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/cirurgia , Linfócitos T CD4-Positivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/cirurgia , Pele/patologia , Dermatopatias/patologia
14.
Am J Dermatopathol ; 44(11): 789-798, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36240498

RESUMO

ABSTRACT: Acquired dermal melanocytosis (ADM) is a pigmented lesion caused by melanocytes in the dermis, and it is most often observed on the face of young and middle-aged Asian women. ADM development may be associated with melanin synthesis alterations, but little evidence of its molecular and histological alteration has yet been reported. This study aimed to evaluate ADM in different body locations using different immunohistochemical and chemical staining techniques. This retrospective case series includes consecutive patients confirmed as ADM by biopsy between 2001 and 2018. Patient data and archival images were used to determine the pattern and duration of skin lesions, as confirmed by data analysis of immunohistopathological staining of skin biopsy specimens. A total of 22 ADM patients were included with mean age at diagnosis of 47 years, and 63.6% were female. The most common site was limbs (36.4%), followed by face (27.3%), trunk (22.7%), and scalp (13.6%). Melanin levels were highest in the face and upper extremities and lowest in the trunk. All participants had perivascular distribution of dermal melanocytes, particularly on the face and limbs. The perineural distribution of dermal melanocytes was observed in the lower limbs, with prominent inflammation and fibrosis on the scalp. Dermal melanocytes expressed most markers recognizing melanocytes except for CD117. Analysis of this ADM case series has confirmed that melanin is activated by dermal melanocytes that may aggregate along blood vessels. CD117 may be a useful biomarker by which to identify the migration of epidermal melanocytes.


Assuntos
Melaninas , Dermatopatias , Biomarcadores , Feminino , Humanos , Masculino , Melanócitos/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Dermatopatias/patologia
16.
Stem Cell Res Ther ; 13(1): 499, 2022 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-36210466

RESUMO

BACKGROUND: Localized scleroderma causes cosmetic disfigurement, joint contractures, and other functional impairment, but no currently available medications can reverse the resulting skin lesions. Fat grafting is beneficial for reversing skin fibrosis; however, the mechanism by which adipose tissue transplantation contributes to lesion improvement has not been fully clarified. The purpose of our study was to verify the therapeutic effect of fat grafts in reversing skin fibrosis. METHODS: Inguinal fat pads from AdipoqCreER+;mT/mG mice, which were treated with tamoxifen, were transplanted to the skin lesion in bleomycin-treated wild-type C57 mice. Tdtomato transgenic mice-derived adipocytes, adipose-derived stem cells (ASCs), dedifferentiated adipocytes (DAs) were embedded in matrigel and transplanted beneath the skin lesion of bleomycin-treated wild-type C57 mice. A transwell co-culture system was used to verify the effect of ASCs, adipocytes or DAs on scleroderma fibroblasts or monocytes. RESULTS: Adipocytes from the fat grafts could undergo dedifferentiation and redifferentiation for dermal adipose tissue re-accumulation within the skin lesion. Moreover, compared with ASCs and adipocytes, DAs show greater potency of inducing adipogenesis. ASCs and DAs showed comparable effect on inducing angiogenesis and suppressing macrophage infiltration in fibrotic skin. Co-culture assay showed that DAs and ASCs were able to reduce fibrosis-related genes in human scleroderma fibroblasts and drive M2 macrophage polarization. CONCLUSION: Our results indicated that adipocytes would transform into a more functional and dedifferentiated state and reverse dermal fibrosis, by promoting dermal adipose tissue regeneration, improving angiogenesis, suppressing macrophage-mediated inflammation and myofibroblast accumulation.


Assuntos
Adipócitos , Dermatopatias , Tecido Adiposo , Animais , Bleomicina , Fibrose , Humanos , Camundongos , Camundongos Transgênicos , Dermatopatias/patologia , Tamoxifeno
17.
Indian J Pathol Microbiol ; 65(4): 895-897, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36308201

RESUMO

Acquired reactive perforating collagenosis (ARPC), rare disorder characterized by transepidermal elimination (TEE) of collagen fibers, is seen in adult diabetics. Genetic predisposition, familial aggregation, trauma, bites and scratching are implicated. Diabetics develop microvascular diseases leading to intense pruritus causing repeated micro trauma leading to necrosis of connective tissue of dermis, causing TEE. Isolated papules, plaques and nodules with central keratotic plugs, are mostly seen on extensor surfaces of limbs but trunk and face may be involved. Histopathology shows extrusion of abnormal collagen fibers through epidermis. Multiple treatment modalities show variable response. A 52 year old diabetic female had multiple, itchy, well defined, erythematous papules and plaques with central adherent crusting on lower back since 1 month. Histopathology showed cup shaped epidermal depression filled with plug of altered collagen, acanthotic epidermis with hyperkeratosis and parakeratosis. Underlying epidermis was thin with fine slits through which vertically oriented basophilic collagen fibers were extruded.


Assuntos
Doenças do Colágeno , Diabetes Mellitus , Dermatopatias , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Doenças do Colágeno/diagnóstico , Doenças do Colágeno/patologia , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/patologia , Epiderme/patologia , Colágeno
18.
Dermatol Ther ; 35(11): e15812, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36088631

RESUMO

Cutaneous pseudolymphomas (CPL) is a group of benign, reactive, and polyclonal lymphoproliferative dermatoses that simulate cutaneous lymphomas (CL) clinically and histologically. Based on the predominating component of lymphocytic infiltrate, CPL can be divided into cutaneous B-cell pseudolymphomas (CBPL), cutaneous T-cell pseudolymphomas (CTPL), mixed (T-/B-cell) pseudolymphomas, CD30-positive pseudolymphomas, and non-classifiable pseudolymphomas. Most patients with localized nodular CBPL present with a solitary nodule. However, few patients develop multiple skin lesions, rarely in generalized forms. Here we describe a rare case of multiple nodular CBPL on both sides of the patient's neck, which was treated successfully with intramuscular injection of compound betamethasone, oral methotrexate, and hydroxychloroquine for 4 months. No recurrence was observed in the patient at the one-year follow-up. This combined treatment may be a promising treatment choice for multiple nodular CBPL.


Assuntos
Pseudolinfoma , Dermatopatias , Neoplasias Cutâneas , Humanos , Pseudolinfoma/diagnóstico , Pseudolinfoma/tratamento farmacológico , Pseudolinfoma/patologia , Metotrexato/uso terapêutico , Hidroxicloroquina/uso terapêutico , Glucocorticoides/uso terapêutico , Diagnóstico Diferencial , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Dermatopatias/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia
19.
An Bras Dermatol ; 97(6): 778-782, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36153176

RESUMO

Congenital and self-healing Hashimoto-Pritzker reticulohistiocytosis is the benign variant of the Langerhans cell histiocytosis (LCH) group. It is characterized by multiple skin lesions (congenital or appearing during the first days after birth), without systemic manifestations and spontaneous resolution in days to months. The authors report the case of a boy with a single congenital leg skin lesion, a rare disease variant. Through histopathology, a dense skin infiltration of S100 protein-, CD1a-, CD207-immunomarked cells was found. KI67 index was high (62%). A complete spontaneous resolution occurred 07 days after the biopsy (25 days after birth). Monolesional disease, distal limb lesion, absence of lesions in the mucous membrane or seborrheic area, and less than 25 percent of LCs with Birbeck granules were said to be possible clues for a favorable prognosis in LCs histiocytosis. But, as a precautionary measure, the child will be followed up until at least 2 years of age.


Assuntos
Histiocitose de Células de Langerhans , Dermatopatias , Criança , Histiocitose de Células de Langerhans/patologia , Humanos , Antígeno Ki-67 , Masculino , Proteínas S100 , Pele/patologia , Dermatopatias/patologia
20.
Clin Exp Dermatol ; 47(12): 2123-2129, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36103137

RESUMO

Oestrogen plays a vital role in maintaining a normal vulvovaginal epithelium, vaginal lubrication, as well as a healthy microbiome to ensure an acidic pH. The decrease in oestrogen levels in women going through menopause results in both physiological and physical changes of the genitourinary system, and more specifically the vulva. We conducted a literature review on the effects of low oestrogen levels on the physiology and function of the vulva and the vulvovaginal epithelium. 'Genitourinary syndrome of menopause' (GSM) is the term used to describe the signs and symptoms of a low oestrogen state. The symptoms and signs of GSM can overlap or coexist with other vulval dermatoses. Expert opinion is needed to diagnose and manage vulval dermatoses in menopause. This article will discuss the signs and symptoms of GSM, as well as the different management options available. Other vulval dermatoses that can be affected by hypo-oestrogenism are also reviewed.


Assuntos
Dermatopatias , Vagina , Feminino , Humanos , Vagina/patologia , Atrofia/patologia , Síndrome , Menopausa , Estrogênios/uso terapêutico , Dermatopatias/patologia
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