Hidradenitis suppurativa (HS) is an inflammatory follicular skin disease. In women and men, the condition starts after puberty, has a peak in the third decade, and is rare after the menopause in ...women. This age distribution suggests a hormonal influence in the pathogenesis of the disease. We therefore hypothesized that apocrine glands in HS patients have a different expression of androgen receptor (AR) and estrogen receptor (ER) compared with healthy skin.
Axillary, inguinal, and perianal skin biopsies from female and male patients with HS were immunohistochemically stained for AR and ER activities. Expression of both receptors in apocrine glands of HS patients was compared with expression in apocrine glands in normal axillary or inguinal skin of a control group of women.
Twenty-two patients with HS were included (16 women), with 10 women in the control group. In the HS group, apocrine glands were present in 11 out of 22 skin biopsies and in the control group in 4 out of 10 biopsies. Expression of ER in the apocrine gland was weak and observed in 2 out of 4 patients in the control group and in none of the HS patients. Expression of the AR was strong and observed in all apocrine glands in both groups.
We could not demonstrate a significant difference in the expression of ER and AR in apocrine glands in skin biopsies of patients with HS, compared with healthy skin biopsies. The exact relation between sex hormones and occurrence of HS therefore remains unclear.
Background
Osmidrosis is a malodorous disease caused by the breakdown of sweat secreted from the apocrine glands by surface bacteria. The aim of this study was to evaluate the effect of ...Versajet-assisted hydraulic epilation for the treatment of axillary osmidrosis.
Methods
Thirty-two patients with axillary osmidrosis (64 axillae) underwent Versajet-assisted hydraulic epilation between January 2016 and January 2017. Subjective assessments were evaluated by a patient survey at least 3 months after the procedure.
Results
There were no complications other than one mild pigmentation in the axilla at 3 months after the procedure. Thirty-two patients evaluated malodor elimination as good. No patients evaluated it as fair or poor. There were no recurrences.
Conclusion
Versajet-assisted hydraulic epilation is an ideal surgical procedure for the treatment of axillary osmidrosis that decreases complications and recurrence.
No Level Assigned
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.
Most mammals rely upon scent for intraspecific communication. As most bear species have large home ranges and are non-territorial, scent deposit while walking could be an effective way to communicate ...with conspecifics. Here, we investigate the existence of pedal glands in brown bears and their role in chemical communication from a histological, biochemical and behavioural perspective. We found eccrine glands in footpads, and prominent apocrine and sebaceous glands in the interdigital, metacarpal and metatarsal skin sections. Pedal scent contained 26 compounds including carboxylic acids, important constituents of mammalian secretions. Six of these compounds were exclusive for males. Finally, we describe a specific marking gait recorded in the field, mostly performed by males. Our study supports the existence of chemical communication through pedal marking in brown bears and suggests sex-coding potential of pedal scent.
Key points
Xanthine oxidoreductase (XOR) modulates milk lipid secretion and lactation initiation.
XOR is required for butyrophilin1a1 clustering in the membrane during milk lipid secretion.
XOR ...mediates apical membrane reorganization during milk lipid secretion.
Loss of XOR delays milk fat globule secretion.
XOR loss alters the proteome of milk fat globules.
Apocrine secretion is utilized by epithelial cells of exocrine glands. These cells bud off membrane‐bound particles into the lumen of the gland, losing a portion of the cytoplasm in the secretion product. The lactating mammary gland secretes milk lipid by this mechanism, and xanthine oxidoreductase (XOR) has long been thought to be functionally important. We generated mammary‐specific XOR knockout (MGKO) mice, expecting lactation to fail. Histology of the knockout glands showed very large lipid droplets enclosed in the mammary alveolar cells, but milk analysis showed that these large globules were secreted. Butyrophilin, a membrane protein known to bind to XOR, was clustered at the point of contact of the cytoplasmic lipid droplet with the apical plasma membrane, in the wild‐type gland but not in the knockout, suggesting that XOR mediates ‘docking’ to this membrane. Secreted milk fat globules were isolated from mouse milk of wild‐type and XOR MGKO dams, and subjected to LC‐MS/MS for analysis of protein component. Proteomic results showed that loss of XOR leads to an increase in cytoplasmic, cytoskeletal, Golgi apparatus and lipid metabolism proteins associated with the secreted milk fat globule. Association of XOR with the lipid droplet results in membrane docking and more efficient retention of cytoplasmic components by the secretory cell. Loss of XOR then results in a reversion to a more rudimentary, less efficient, apocrine secretion mechanism, but does not prevent milk fat globule secretion.
Key points
Xanthine oxidoreductase (XOR) modulates milk lipid secretion and lactation initiation.
XOR is required for butyrophilin1a1 clustering in the membrane during milk lipid secretion.
XOR mediates apical membrane reorganization during milk lipid secretion.
Loss of XOR delays milk fat globule secretion.
XOR loss alters the proteome of milk fat globules.
Introduction
We report the clinical features and the management of two cases of orbital hidrocystoma in the setting of an enlarging orbital mass.
Cases description
A 48-year-old man presented with a ...mass in the right upper medial orbital quadrant, firmly attached to the supraorbital incisure. A 70-year-old man had a well demarcated lesion in the upper lateral orbital quadrant adherent to the lacrimal gland. There was no history of previous orbital trauma. In both cases histopathology confirmed a diagnosis of apocrine hidrocystoma. Following surgery, the first patient complained of mild hypoesthesia in the territory of the supraorbital nerve that resolved spontaneously within 3 weeks. Surgery was uneventful in the other patient. No recurrence was seen during the follow up.
Conclusions
Apocrine hidrocystomas have been rarely described in the orbit, but should be considered in the differential diagnosis of orbital cystic masses. Recurrence is rare following complete surgical excision.
To date, the apocrine variant of lobular carcinoma in situ (AP-LCIS) has been cursorily described as a subtype of lobular carcinoma in situ (LCIS). We retrospectively reviewed 34 cases of AP-LCIS ...(including 23 associated with invasive lobular carcinoma) to fully characterize it. AP-LCIS typically presented with screen-detected calcifications in older women (mean age: 65 y) and was characterized by distended terminal duct lobular units with relatively large "pleomorphic" cells, central necrosis, and calcifications. AP-LCIS cells exhibited abundant eosinophilic occasionally granular cytoplasm, hyperchromatic nuclei, and prominent nucleoli. Synchronous classic and/or florid LCIS was identified in 24/34 (70%) AP-LCIS, and in 9/11 (82%) pure AP-LCIS. Most (68%) cases of AP-LCIS were estrogen receptor-positive (50% strongly), 35% were progesterone receptor-positive, 26% were human epidermal growth factor 2-positive, 18% demonstrated high-proliferation rate (Ki67: >15%), and 90% were androgen receptor-positive. Aurora kinase A, immunoreactive in 38% of AP-LCIS cases, was not significantly associated with recurrence, development of invasion, or nodal positivity (P>0.05). Compared with conventional (nonapocrine) pleomorphic lobular carcinoma in situ (P-LCIS), aurora kinase A was expressed in a significantly greater proportion of P-LCIS (100%). AP-LCIS and P-LCIS did not otherwise differ in clinicopathologic features. Next-generation sequencing utilizing the Oncomine Comprehensive Panel v2, performed on 27 AP-LCIS cases, showed no specific molecular findings. In a mean follow-up of 57 months, 2 (of 11, 18%) pure AP-LCIS cases recurred (2 both in situ and invasive) and none metastasized or proved fatal. AP-LCIS should be regarded as another high-grade LCIS similar to P-LCIS in many respects, and pending additional studies should be managed similarly.
Invasive apocrine carcinoma of the breast is a rare entity with an incidence of 3 or 4 cases per million women. Although apocrine breast cancers may have an aggressive clinical presentation, the ...7-year cancer survival rate is the same as non-apocrine cancers. The prognosis of IAC is currently determined by conventional factors such as grade, tumor size, and nodal status. Targeted AR therapy is increasingly adopted with some positive results in clinical trials. This research may result in the development of a tailored treatment for these unusual and rare cancers.
We aimed at evaluating the effects of hydrosurgery and traditional surgical approach with two parallel incisions in the treatment of osmidrosis.
This prospective study enrolled patients with axillary ...osmidrosis between January 2015 and November 2016. For hydrosurgery, a 1-cm-long incision was made in the middle of the posterior long axis. The hand piece was turned upside down and processed in a 'W-O' way. For traditional method, two 3-cm-long parallel incisions were made transversely. Patient demographics, complications, duration of procedures and the outcomes were collected and compared. All patients had a follow-up period of 24-36 months.
A total of 93 patients were included: 41 patients in hydrosurgery group and 52 patients in traditional method group. No severe complications occurred in the hydrosurgery group, while necrosis occurred in six sides of axillae of traditional surgical group. No recurrence occurred in both groups. Both groups showed similar odor and hair growth reduction rate. Only one in 82 sides occurred slight scar formation, while in traditional group, 22 sides of axillae formed scars (p < .001).
The application of hydrosurgery in the treatment of osmidrosis is efficient and effective. Moreover, it has less postoperative complications, and high patient satisfaction rates.
Molecular apocrine (MA) tumors are estrogen receptor (ER) negative breast cancers characterized by androgen receptor (AR) expression. We analyzed a group of 58 transcriptionally defined MA tumors and ...proposed a new tool to identify these tumors.
We performed quantitative reverse transcription PCR (qRT-PCR) for ESR1, AR, FOXA1 and AR-related genes, and immunohistochemistry (IHC) for ER, PR, Human Epidermal Growth Factor Receptor 2 (HER2), CK5/6, CK17, EGFR, Ki67, AR, FOXA1 and GCDFP15 and we analyzed clinical features.
MA tumors were all characterized by ESR1(-) AR(+) FOXA1(+) and AR-related genes positive mRNA profile. IHC staining on these tumors showed 93% ER(-), only 58% AR(+) and 90% FOXA1(+). 67% and 57% MA tumors were HER2(3+) and GCDFP15(+), respectively. Almost all MA tumors (94%) had the IHC signature HER2(3+) or GCDFP15(+) but none of the 13 control basal-like (BL) tumors did. Clinically, MA tumors were rather aggressive, with poor prognostic factors.
MA tumors could be better defined by their qRT-PCR-AR profile than by AR IHC. In addition, we found that HER2 or GCDFP15 protein overexpression is a sensitive and specific tool to differentiate MA from BL in the context of ER negative tumors. A composite molecular and IHC signature could, therefore, help to identify MA tumors in daily practice.
Background
Axillary bromhidrosis is a condition presenting as malodor caused by an interaction between the discharge of apocrine glands and bacteria. Topical agents, liposuction, and elective surgery ...are currently the main therapeutic modalities. However, the efficiency of these treatments and incidences of side effects are various and frequent, and depend on patient characteristics, surgical technique, and other unknown factors.
Methods
We report a retrospective study of outcomes in 396 patients treated by mini‐incision with subdermal vascular preservation.
Results
At 2 years postoperatively, 87.1% of patients had achieved very satisfactory results. Short‐term side effects included hematomas, epidermal erosions, infections, necrosis, incision dehiscence, and skin ripples. Long‐term side effects comprised comedones, epidermoid cysts, relapsing cyst infections, skin gauffers, scars, keloids, and persistent malodor. Some patients reported unsatisfactory cosmetic results, including skin gauffers, scars, or epidermoid cyst formations.
Conclusions
Two discrete aspects of the procedure that must be considered are the extent of apocrine gland clearance, which must be thorough in order to achieve the resolution of malodor, and the maintenance of an intact subdermal vascular plexus to support the regrowth of skin flaps after surgery and to avoid the occurrence of severe side effects.
PDF
