Background: Merkel cell polyomavirus (MCPyV) is the likely causative agent of Merkel cell carcinoma (MCC). However, the prevalence of MCPyV in non‐MCC population and its possible role in the ...pathogenesis of other skin cancers are not known yet.
Methods: A molecular pathology study was performed in 33 MCC samples and 33 age‐ and sex‐matched samples of sun exposed non‐MCC tumors 12 seborrheic keratoses (SK), 11 basal cell carcinomas (BCC) and 10 lentigo maligna melanomas (LMM). All tumors were analyzed for presence of MCPyV‐DNA by polymerase chain reaction (PCR) and Southern‐Blot hybridization of PCR products.
Results: MCPyV sequences were detected in 21 MCC samples (64%) and in 2 non‐MCC tumors of sun exposed skin (6%; both SK‐patients). Neither the tissue samples from BCC nor LMM proved positive for MCPyV sequences.
Conclusion: We were able to confirm prior data on prevalence of MCPyV‐DNA in MCC. Furthermore, a female predominance of MCPyV‐positive MCC‐patients was detected. There was no relevant association of MCPyV with SK, BCC and LMM. Speculative, prevalence of MCPyV in an age‐ and sex‐matched non‐MCC population could average up to 6%.
Sarcomas are a heterogeneous group of mesenchymal tumors which can affect bone and soft tissue. Leiomyosarcoma (LMS) is a rare subtype localized to the skin or subcutaneous tissue. Due to the ...heterogeneity of sarcomas, reviews and guidelines with an in-depth focus specifically on primary LMS of the skin are sparse. This article is intended to provide an up to date and systematic overview on diagnosis, treatment, and surveillance of this rare entity to provide a framework for decision making and management for dermato-oncologists. We discuss novel treatment options for advanced disease such as targeted therapy with kinase inhibitors and immune checkpoint blockade which may improve the prognosis even in advanced stages of LMS.
S2k guideline: Rosacea Clanner‐Engelshofen, Benjamin M.; Bernhard, Dominik; Dargatz, Sonja ...
Journal der Deutschen Dermatologischen Gesellschaft,
August 2022, 2022-08-00, 20220801, Letnik:
20, Številka:
8
Journal Article
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Summary
This updated and upgraded S2k guideline deals with the diagnosis and treatment of rosacea, which is a common, chronic inflammatory skin disease mostly affecting the face. Initially, rosacea ...is characterized by recurrent erythema, telangiectasia and flushing. Later, the inflammatory component predominates, with persistent erythema with follicular papules, papulopustules and pustules. The development of phyma, which usually occurs on the acral localizations, is the most severe manifestation. For the treatment of rosacea, the interdisciplinary guideline committee, with representatives of the German Dermatological Society (DDG), the Professional Association of German Dermatologists (BVDD), the German Opthalmological Society (DOG), the Society for Dermopharmacy (GD), the Swiss Society for Dermatology and Venereology (SGDV) and the German Rosacea Aid e. V., recommends the avoidance of trigger factors and topical applications of metronidazole, azelaic acid or ivermectin. For symptomatic treatment of persistent centrofacial erythema, the topical vasoconstrictors brimonidine or oxymetazoline can also be used. Systemic therapy is recommended for therapy‐resistant and severe forms of rosacea papulopustulosa. The drug of choice is low‐dose doxycycline. Alternatively, low‐dose isotretinoin can be recommended. Ocular rosacea should be treated with lid margin hygiene. For topical treatment, ciclosporin eye drops, azithromycin, ivermectin or metronidazole are suggested.
Bullous pemphigoid (BP) and pemphigus vulgaris (PV) are two major autoimmune blistering skin diseases. Unlike PV, BP is accompanied by intense pruritus, suggesting possible involvement of the ...pruritogenic cytokine IL-31. However, the underlying mechanisms of the clinical difference between BP and PV in terms of pruritus are not fully understood. To compare the expression levels of IL-31 and its receptor IL-31RA in the lesional skin, including peripheral nerves in BP and PV patients, immunohistochemical staining for IL-31 and IL-31RA was performed in skin samples of BP and PV patients and healthy controls (HC). The IL-31RA-expressing area in epidermis and peripheral nerves was analysed using ImageJ and the percentage of positive cells for IL-31/IL-31RA in dermal infiltrating cells was manually quantified. Quantitative analyses revealed that IL-31/IL-31RA expressions in the epidermis and dermal infiltrate were significantly increased in BP compared to PV and HC. The difference between BP and PV became more obvious when advanced bullous lesions were compared. Peripheral nerves in BP lesions presented significantly higher IL-31RA expression compared to PV lesions. In conclusion, we found significantly augmented expressions of IL-31/IL-31RA in BP lesions, including peripheral nerves, in comparison to PV. These results suggest a possible contribution of IL-31/IL-31RA signalling to the difference between BP and PV in the facilitation of pruritus and local skin inflammation, raising the possibility of therapeutic targeting of the IL-31/IL-31RA pathway in BP patients.
Ex vivo confocal laser scanning microscopy (ex vivo CLSM) is a novel diagnostic tool for a quick bedside evaluation of freshly excised tissue, comparable to histology. We aimed to assess the ...sensitivity and specificity of ex vivo CLSM in detecting malignant features, to validate its reliability in identifying various skin tumours based on a combination of confocal features and to evaluate the digital staining mode (DS). One‐hundred twenty freshly excised skin samples from 91 patients were evaluated. Each lesion was screened for the presence of 23 predefined confocal criteria with ex vivo CLSM, followed by a histopathological examination. The diagnostic agreement between ex vivo CLSM and histology was 89.2%. The diagnostic accuracy of ex vivo CLSM in detecting malignancy reached a sensitivity of 98% and a specificity of 76%. Ex vivo CLSM enabled a rapid identification of the most common skin tumours, the tumour dignity and cytological features. The DS demonstrated a close resemblance to conventional histopathology.
The aim of this study was to prove the suitability of ex vivo confocal laser scanning microscopy for performing a fast and reliable microscopic examination of skin tumours in a real‐life setting. The results were verified by means of conventional histopathology. Furthermore, we examined the applicability of the newly added digital staining mode and could confirm its similarity to conventional histopathology.
S2k‐Leitlinie – Merkelzellkarzinom – Update 2022 Becker, Jürgen C.; Beer, Ambros J.; DeTemple, Viola K. ...
Journal der Deutschen Dermatologischen Gesellschaft,
March 2023, 2023-03-00, 20230301, Letnik:
21, Številka:
3
Journal Article
Recenzirano
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Zusammenfassung
Das Merkelzellkarzinom (MCC, ICD‐O M8247/3) ist ein seltener, maligner, primärer Hauttumor mit epithelialer und neuroendokriner Differenzierung. Die Tumorzellen teilen viele ...morphologische, immunhistochemische und ultrastrukturelle Eigenschaften mit den Merkel‐Zellen der Haut. Die Ursprungszelle (cell of origin) des MCC ist dennoch unklar. Das MCC imponiert klinisch als ein rötlich bis violett farbiger kugeliger Tumor mit glatter glänzender Oberfläche und weicher bis prall‐elastischer Konsistenz, der in der Regel ein schnelles Wachstum aufweist. Spontane, häufig auch komplette Regressionen des Tumors werden beobachtet. Diese wahrscheinlich immunologisch‐vermittelten Regressionen erklären die Fälle, bei denen zum Zeitpunkt der Erstdiagnose nur Lymphknoten‐ oder Fernmetastasen gefunden werden und warum der Tumor auch in weit fortgeschrittenen Stadien sehr gut auf immunmodulierende Therapien anspricht. Aufgrund seiner Aggressivität, der in der Regel gegebenen Indikation zur Schildwächterlymphknotenbiopsie, der zu evaluierenden Indikation adjuvanter Therapien, sowie der Komplexität der notwendigen Diagnostik sollte das Vorgehen bereits bei Erstdiagnose durch ein interdisziplinäres Tumorboard festgelegt werden.
Abstract Objectives No guidelines exist for the management of micropapillary bladder cancer (MPBC) and most reports of this variant of urothelial carcinoma are case series comprising small numbers of ...patients. We sought to determine current practice patterns for MPBC using a survey sent to the Society of Urologic Oncology (SUO) and to present those results in the setting of a comprehensive review of the existing literature. Materials and methods A survey developed by the Translational Science Working Group of the Bladder Cancer Advocacy Network–sponsored Think Tank meeting was distributed to members of the SUO. The results from 118 respondents were analyzed and presented with a literature review. Results Most survey respondents were urologists, with 80% considering bladder cancer their primary area of interest. Although 78% of the respondents reported a dedicated genitourinary pathologist at their institution, there were discrepant opinions on how a pathologic diagnosis of MPBC is determined as well as variability on the proportion of MPBC that is clinically significant. Among them, 78% treat MPBC differently than conventional urothelial carcinoma, with 81% reporting that they would treat cT1 MPBC with upfront radical cystectomy. However, the respondents had split opinions regarding the sensitivity of MPBC to cisplatin-based chemotherapy, which affected utilization of neoadjuvant chemotherapy in muscle-invasive disease. Conclusions The management of MPBC is diverse among members of the SUO. Although most favors early cystectomy for cT1 MPBC, there is no consensus on the use of neoadjuvant chemotherapy for muscle-invasive MPBC.
We previously reported that ethanol fixation and paraffin embedding of tissues produce excellent histomorphology and good preservation of macromolecules. Here, we present a detailed evaluation of ...ethanol‐fixed tissues for proteomic initiatives. When proteins were extracted from ethanol‐fixed, paraffin‐embedded prostate tissue, resolved by two‐dimensional gel electrophoresis (2‐DE), and stained by standard methods, several hundred protein molecules could be detected and successfully analyzed by mass spectrometry. Protein profiles obtained from ethanol‐fixed tissues were highly similar to those observed from frozen tissues, in contrast to the poor protein recovery from formalin‐fixed material. The protein content of specific cells that were microdissected from ethanol‐fixed tissue sections using laser capture microdissection could also be successfully analyzed by 2‐DE. We observed that eosin staining of tissue sections had a detrimental effect on protein separation, whereas hematoxylin staining had minimal consequence. In order to illustrate the applicability of ethanol‐fixed tissues for proteomic discovery studies, we compared the protein profiles of patient‐matched, normal prostatic epithelial cells and invasive adenocarcinoma cells obtained from ethanol‐fixed, paraffin‐embedded tissues. A number of differentially expressed proteins was discovered and identified by mass spectrometry. Immunohistochemical analyses performed on ethanol‐fixed tissue sections were in agreement with the proteomic discovery findings. In light of these results, we conclude that ethanol‐fixed tissues can be successfully utilized for proteomic analyses.
Epstein-Barr virus (EBV) infection may rarely be associated with genital ulcers (ulcus vulvae acutum), a very painful manifestation. The aetiopathogenesis of the disease is not fully understood. We ...describe here a case of an adolescent virgin with multiple, deep genital ulcers associated with acute infectious mononucleosis. The diagnosis was supported by the clinical symptoms, atypical lymphocytosis, elevated circulating levels of liver enzymes, positive EBV serology, and the detection of EBV in a swab sample and a biopsy specimen by PCR. The virus could not be detected by immunohistochemistry or in situ hybridization. After a short course of methylprednisolone as a supportive treatment, the ulcers healed within one month. No relapse occurred during the 2-year follow-up. Available data relating to the aetiopathogenesis of this condition are reviewed, and we speculate that it may have been caused by percutaneous autoinoculation through cervicovaginal fluid.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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