Abstract Human sweat glands disorders are common and can have a significant impact on the quality of life and on professional, social, and emotional burdens. It is of paramount importance to diagnose ...and treat them properly to ensure optimal patient care. Hyperhidrosis is characterized by increased sweat secretion, which can be idiopathic or secondary to other systemic conditions. Numerous therapeutic options have been introduced with variable success. Novel methods with microwave-based and ultrasound devices have been developed and are currently tested in comparison to the conventional approaches. All treatment options for hyperhidrosis require frequent monitoring by a dermatologist for evaluation of the therapeutic progress. Bromhidrosis and chromhidrosis are rare disorders but are still equally disabling as hyperhidrosis. Bromhidrosis occurs secondary to excessive secretion from either apocrine or eccrine glands that become malodorous on bacterial breakdown. The condition is further aggravated by poor hygiene or underlying disorders promoting bacterial overgrowth, including diabetes, intertrigo, erythrasma, and obesity. Chromhidrosis is a rare dermatologic disorder characterized by secretion of colored sweat with a predilection for the axillary area and the face. Treatment is challenging in that the condition usually recurs after discontinuation of therapy and persists until the age-related regression of the sweat glands.
Background Although recent advances in genetics have revealed distinct mutational profiles and molecular signaling pathways associated with Spitzoid malignant melanoma (SMM), less is known about the ...clinicopathologic characteristics and behavior of SMM compared with conventional melanoma. Objective We sought to determine the clinicopathologic characteristics and mortality risk associated with SMM and conventional malignant melanoma. Methods We conducted a retrospective study of 30 patients with SMM and 30 patients with conventional melanoma. The two groups were matched by age, gender, and depth of tumor invasion. Additional patient- and tumor-level characteristics were compared between groups and regression modeling was used to assess relative mortality risk. Results Unadjusted analyses of SMM and conventional malignant melanoma revealed no significant differences in clinical impression, anatomic location, mitotic rate, and presence of ulceration. Sentinel lymph node biopsy, completion lymphadenectomy, and visceral metastases did not differ between groups. Cox proportional hazards regression showed no differences in mortality between Spitzoid and conventional melanoma. Limitations Small sample size, short follow-up duration, and residual confounding may limit the accuracy and generalizability of our results. Conclusions SMM and conventional malignant melanoma differ in some clinicopathologic features. We did not find a statistically significant difference in mortality between the two.
Abstract Normal pregnancy is characterized by a natural homeostasis between the mother and the fetus with the development of a tolerance for genetically and immunologically different tissues ...engrafted in the maternal organism. Upset of the fine mechanisms of the balance of this homeostasis leads to the development of different diseases. Pemphigoid gestationis is a self-limiting, autoimmune subepidermal bullous dermatosis of pregnancy that results from the recognition of placental proteins as foreign and the subsequent production of anti-placental antibodies that cross-react with the same proteins in skin. The main antigen of PG was found to be collagen XVII, present in both skin and placenta, that is exposed to the maternal immune system through an abnormal expression of MHC class II molecules in the placenta. The genetic predisposition determined by a specific HLA genotype combined with the aberrant presentation of collagen XVII triggers an inflammatory response resulting in the typical clinical phenotype. Immunofluorescence shows a linear deposition of C3 with or without concomitant IgG deposition, along the basement membrane zone (BMZ). The disease usually resolves within weeks to months after delivery and tends to recur with subsequent pregnancies. Treatment is challenging in that the disease is extremely rare to allow for controlled studies and most of the treatment options are based on case reports and clinical experience. Oral corticosteroids are the therapeutic mainstay both in pregnancy and postpartum, but several other modalities may be tried in recalcitrant disease. Further research is needed to clarify the exact pathogenic cascade and the interaction of its different components. The elucidation of the target antigens, the targeting antibodies and the mechanism of action of the inflammatory infiltrate may help for the development of new focused therapeutic agents. This review presents an overview of the current understanding of Pemphigoid gestationis and the latest scientific and clinical data in relation to the pathogenesis and treatment modalities.
Glanzmann thrombasthenia is a rare clotting disorder caused by impaired platelet function that can present with unexplained bruising. We present the case of a 4-month-old girl and outline the ...assessment and management of this condition, as well as an algorithm for the evaluation of abnormal bleeding and bruising.
Pigmented lesions: when should I worry? Baron, Susannah; Semkova, Kristina
Paediatrics and child health,
February 2019, 2019-02-00, Letnik:
29, Številka:
2
Journal Article
Recenzirano
Pigmented lesions in children are very common. The majority are benign melanocytic naevi that develop during childhood but, rarely, sinister lesions such as melanoma and atypical Spitz naevi can also ...occur. The group of benign pigmented lesions includes benign acquired and congenital melanocytic naevi, blue naevi, halo naevi and Spitz naevi. This article will enable clinicians to be aware of the concerning features, use the ABCDE criteria appropriately, understand how to use the available diagnostic tools and when to refer to a Paediatric Dermatology department for further opinion and management.
Primary cutaneous acral CD8(+) lymphoma (AL) has been accepted as primary cutaneous acral CD8-positive T-cell lymphoproliferative disorder in the revised WHO and updated WHO-EORTC lymphoma ...classifications. Commonly arising on the ears and comprising a clonal cytotoxic CD8 + T-cell infiltrate, almost all cases follow an indolent clinical course. A single aggressive case reported in the literature had a deletion at the CDKN2 locus at 9p21. We report an atypical CD8 + T-cell proliferation arising on the chest of an elderly man who had some similarities to AL but with a very high proliferation rate, absent p16 protein expression, and homozygous loss of the CDKN2 locus using FISH analysis. A diagnosis of peripheral T-cell lymphoma not otherwise specified (PTCL NOS) was preferred. Analyses of 4 cases of AL demonstrated often low p16 protein expression but intact CDKN2 loci. This case raises the problems of the boundaries between AL and PTCL NOS, and a possible role in the loss of p16 function in pathogenesis.
Blistering rash in a child Mounsey, Stephen J; Oluwole, Ebunoluwa; Semkova, Kristina ...
Clinical and experimental dermatology,
07/2023, Letnik:
48, Številka:
7
Journal Article
Recenzirano
A 5-year-old child was brought to the dermatology department with a blistering rash on the lower limbs. Indirect and direct immunofluorescence, in conjunction with haematoxylin and eosin showed a ...rare blistering disorder.
A case of epidermolysis bullosa aquisita following immunotherapy for melanoma. This adds to the repertoire of subepidermal blistering disorders documented following immune checkpoint therapy.
