1,721,026 research outputs found
Cytokeratin profile as a clue to origin and differentiation in cutaneous squamous cell carcinoma.
No full textAim. Several types of squamous cell carcinoma (SCC) of the skin are recognized, even if SCCs in situ such as bowenoid actinic keratosis and Bowen's disease are histopathologically almost indistinguishable and the existance of entities such as trichilemmal carcinoma is still discussed. The aim of this study was to verify if the determination of the cytokeratin (CK) profile could be useful to better characterize some cutaneous SCCs. Methods. We studied CK1, 5, 6, 7, 8, 10, 14, 15, 16, 17, 18 and 19 expression in normal epithelial structures of the skin and in bowenoid actinic keratosis, Bowen's disease, Bowen's carcinoma, trichilemmal carcinoma, keratoacanthomatous SCC, acantholytic SCC, conventional cutaneous SCC and malignant proliferating onycholemmal cyst. Results. The most significant findings were: (a) CK17 positivity in lower follicle; (b) focal positivity for CK19 in the basal layer of the outer root sheath near the bulge; (c) CK7 positivity with CK19 negativity in the sebaceous lobules; (d) CK19 positivity in the secretory portion of both apocrine and eccrine sweat glands; (e) CK10 negativity with CK17 positivity in the nail matrix and nail bed; (f) focal expression for CK19 in several cases of Bowen's disease in contrast with its constant negativity in bowenoid actinic keratosis; (g) the almost superimposable pattern of CK expression in Bowen's disease, Bowen's carcinoma and trichilemmal carcinoma; (h) the CK10 and CK17 positivity in keratoacanthomatous SCC; (i) the lack of CK10 expression in acantholytic SCC, cutaneous conventional SCC and malignant proliferating onycholemmal cyst. Conclusion. The study was in favour of a common origin of Bowen's disease, Bowen's carcinoma and trichilemmal carcinoma from pluripotential cells of the acrothrichium and of keratoacanthomatous SCC from the lower follicle. It also showed that a strong and diffuse positivity for CK17 may be useful to differentiate keratoacanthomatous SCC from trichilemmal carcinoma in doubtful cases and that the search for CK10 expression may be useful to distinguish between well differentiated and poorly differentiated SCCs of the skin. This last statement is not true for onycholemmal carcinomas because CK10 is negative in the normal nail matrix and nail bed
Rash caused by Oryctes nasicornis
No full textWe report a case of rash caused by crushing of a male of Oryctes nasicornis (Linnaeus 1758) (Coleoptera, "http:// it. wikipedia. org/ wiki/ Scarabaeidae" \o "Scarabaeidae" Scarabaeidae), popularly known as "European rhinoceros beetle", on the skin of an Italian tourist who developed the reaction during a trip to Turkey. The rash appeared one hour after the crushing of the insect on the skin. The patient was observed one day later, when she returned to Italy. To our knowledge, no similar cases have been reported in the literature
Treatment of refractory pemphigus with the anti-CD20 monoclonal antibody (Rituximab)
No full textPemphigus is a severe blistering disorder caused by autoantibodies to desmogleins 1 and 3. Because some patients with pemphigus never enter into remission, new immunosuppressants are warranted. Rituximab is a chimeric monoclonal antibody binding to the CD20 antigen on B cells, which proved to be effective in recalcitrant pemphigus. OBJECTIVES: To evaluate the efficacy and safety of rituximab in refractory pemphigus and to investigate its effects on the autoantibody profile. PATIENTS AND METHODS: Six patients with recalcitrant pemphigus were treated. Rituximab was administered intravenously at a dosage of 375 mg/m2 body surface once weekly for 4 weeks. RESULTS: Three pemphigus foliaceus patients and 1 with mucocutaneous pemphigus vulgaris (PV) showed complete response over a follow-up period of up to 18 months. In one oral PV, control of the disease was achieved using pulse therapy with cyclophosphamide following rituximab withdrawal. In one PV with vegetating features, good improvement was obtained after 6 rituximab infusions. All patients tolerated the treatment well. Anti-desmoglein autoantibodies significantly decreased only in pemphigus foliaceus. CONCLUSIONS: This study highlights that rituximab is a valuable drug for refractory pemphigus, although the response of mucous membranes and cutaneous folds may be delaye
Cytokeratin profile in basal cell carcinoma
No full textOrigin of basal cell carcinoma (BCC) is still unclear. We studied the cytokeratin (CK) profile in BCC using monoclonal antibodies against 12 CKs to further investigate the suggested origin of the tumor from follicular matrix cells or from follicular outer root sheath cells and to determine if BCC subtypes can be identified on the basis of their CK profiles. Cases of pilomatricoma and samples of fetal skin served as controls to establish the CK profile in matrical cells and developing follicles during intrauterine life, that of the epidermis and cutaneous adnexa in adult life having been determined in a previous study. The most significant findings were as follows: (a) CK 5 and CK 17 positivity in all the BCCs studied; (b) CK 7, CK 8, CK 18, and CK 19 positivity in 30/52, 33/52, 42/52, and 14/52 BCCs, respectively; (c) CK 14 negativity in almost all the BCCs studied; and (d) lack of CK 1 expression only in 2/2 morpheiform BCCs and 4/10 nodular BCCs. The study suggests a tumorous differentiation toward follicular outer root sheath cells and, in most cases, also toward the glandular components of the pilosebaceous-apocrine unit. No significant difference in the CK profile among the BCC subtypes studied was foun
Primary cutaneous T-cell lymphoma expressing FOXP3: a case report supporting the existence of malignancies of regulatory T cells
No full textRegulatory T (Treg) cells, which represent 5% to 10% of peripheral T cells, regulate the activities of T-cell subsets by performing immunosuppressive functions and thus preventing the development of autoimmune responses. The majority of Treg cells are CD4+, CD25+, and FOXP3+. Recently, it has been demonstrated that the tumor cells in adult T-cell leukemia lymphomas can function as Treg, raising the question of whether any variant of primary cutaneous T-cell lymphoma may also express a regulatory phenotype. We describe an extraordinary case of primary cutaneous T-cell lymphoma clinically characterized by protean cutaneous manifestations and histologically showing a pattern consistent with epidermotropic pleomorphic medium-/large-cell primary cutaneous T-cell lymphoma. The majority of neoplastic cells were CD4+ CD25+ T cells and strongly expressed FOXP3. With this background, the current case, characterized by an aggressive course requiring polychemotherapy, may support the existence of lymphoproliferative malignancies of Treg cells
Activation of coagulation in bullous pemphigoid and other eosinophil-related inflammatory skin diseases
No full textBullous pemphigoid (BP) is a skin disease caused by autoantibodies to hemidesmosomal proteins BP180 and BP230, with eosinophils participating in blister formation. Tissue factor (TF), the initiator of coagulation, is embodied within the eosinophil granules and exposed upon activation. We evaluated the coagulation activation in patients with BP (63), chronic urticaria (CU; 20), atopic dermatitis (AD; 14), cutaneous drug reactions (CDRs; six), psoriasis (20), dermatitis herpetiformis (DH; four) and primary cutaneous T cell lymphoma (CTCL; five), and in 40 healthy controls. Prothrombin fragment F1+2 and d-dimer (coagulation markers) were measured by enzyme-linked immunosorbent assay (ELISA) in all plasma samples and BP blister fluid. Skin TF expression was evaluated immunohistochemically in the patients and 20 controls. F1+2 and d-dimer levels were higher in BP plasma than in control plasma (P = 0·0001 for both), and dramatically high in blister fluid; both correlated positively with disease severity, esinophil counts and anti-BP180 antibodies (P = 0·006-0·0001). Plasma F1+2 and d-dimer levels were higher in the CU, AD and CDR patients than in controls (P = 0·0001 for all), but normal in the psoriasis, DH and CTCL patients. Skin TF was expressed in the BP (P = 0·0001), CU (P = 0·0001), AD (P = 0·001) and CDR patients (P = 0·01), but not in the psoriasis, DH or CTCL patients. Co-localization confocal microscopy studies confirmed eosinophils as the source of TF in 10 BP patients. The coagulation cascade is activated in BP and other eosinophil-mediated skin disorders, but not in non-eosinophil driven conditions. This hypercoagulability may contribute to inflammation, tissue damage and, possibly, thrombotic ris
New monoclonal antibodies against B-cell antigens: possible new strategies for diagnosis of primary cutaneous B-cell lymphomas
No full textReactivities of the monoclonal antibodies (mAbs) of the 9th Human Leukocyte Differentiation Antigen Workshop, in order to define specific antigenic expression of the primary cutaneous B-cell lymphomas (PC-BCL), were analyzed by immunohistology on human tonsil and on PC-BCL, such as follicular centre B-cell lymphomas (FCL), marginal zone lymphomas (MZL) and diffuse large B-cells lymphomas leg-type (DLBL-LT). We identified some subgroups of mAbs that were exclusively or preferentially positive in one lymphoma cell type: the PC-FCL subgroup of mAbs includes PD1/CD279, GCET-1, hFCRL1/CD307a, FCRL2/CD307b, CXCR5/CD185, B7-DC/CD273, MRC/CD200, CD130, CXCR4/CD184, Siglec-5/14, CD150, on the other hand subgroup of mAbs in PC-MZL includes BTLA/CD272, BLIMP-1, hCD38. No specific subgroup of mAbs was found to label PC-DLBCL. This study may be useful to better define specific antigen profile of different PC-BCL entities leading to a correct diagnosis
New monoclonal antibodies (mAbs) against B-cells antigens: immunohistochemical analysis of cryostat sections of primary cutaneous B lymphomas (PC-BL)
Full text linkTo define specific reactivities of PC-BL (WHO/EORTC 2008 classification), we
analyzed, by using an immunohistochemical method, the mAbs of the FACS panel
of the 9th HLDA Workshop on tissue sections of the different cutaneous lymphomas
entities: follicular centre B-cell lymphomas (FCL), marginal zone lymphomas (MZL)
and diffuse large B-cells lymphomas (DLBL) leg-type. Cryostat sections of frozen
tissues were dried for 12 hours, fixed 10" in aceton and stained by an avidin-biotin
immunoalkaline phosphatase method (DAKO). Tissue reactivities of lymphocytes and/or other resident cells were detected by using all mAbs, except for n° 49-51-81-90-91-109. Specific lymphoma reactivities were detected on PC-BL: Group 1 mAbs stained all PC-BL: n° 88 (CD48). Group 2 mAbs stained PC-FCL: n°20(hFCRL1); 34(CD152); 35 (CD80), 36(CD126); 37(PD1-CD279); 38(B7-DC-CD273); 40 (CD200); 41(CD130); 46 (CD184-CXCR4); 47 (BTLA-CD272); 50(CD185-CXCR5); 56(CMKLR1); 57 (DR5); 77(Siglec-5/14); 83 (CRTAM); 86(CD229); 89 (CD84); 93(NTBA); 94(HVEM); 96(TWEAK); 97(TCL1); 100(LT-betaR); 106(CD150). Group 3
mAbs stained PC-MZL: n° 36(CD126); 47(BTLA); 50(CXCR5); 55(DR4); 77(Siglec-5/14); 83(CRTAM); 84(DCIR/CLEC4A); 86(CD229); 87(CD319); 93(NTBA). Group 4 mAbs stained PC-DLBL: n° 35(CD80); 36(CD126); 39(CD124); 50(CD185); 55(DR4); 56(CMKLR1); 57(DR5); 75(Dectin-1); 76-101(TREM-1); 82(Integrin
alfaVbeta5); 83(CRTAM); 85-99(GITR); 86(CD229); 87(CD319); 89(CD84); 92(Dr3-
TRAMP); 93(NTBA); 94(HVEM-CD258); 97(TCL-1); 100(Lymphotoxin betaR).
Furthermore, variable mixed reactivities with infiltrating or neoplastic cells were
observed by using several mAbs and other Mabs showed many tissue cross
reactivities and were not easy to evaluate by IHC (further investigations may be done
on "pure" infiltrates, cell suspensions of neoplastic cells or by using double labeling
techniques-confocal laser microscopy). Finally, mAbs n° 21-22-23-30-31-32-33-42-44-45-48-49-51-52-53-54-58-74-78-79-80-81-82-84-90-91-98-109 were negative in all lymphoma cases. This study may be useful to better define specific profile of different PC-BL entities
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