Recurrent erysipelas of the face with hyperimmune reaction to group C streptococcus

Abstract

We present the case of a 73-year-old-woman, admitted in 2014 for n erysipelas of the face (figure 1a) beginning 3 days before, with red oedematous papules of the left temple, hyperthermia and chills the day after. Clinical examination did not find lymphadenopathy or skin lesion especially at her left ear. Blood samples showed a raised C reactive protein (CRP) to 120 mg/L without leukocytosis. Antinuclear antibodies were negative. Viral serologies (HIV, hepatitis C and B, EBV, parvovirus B19, VZV, mumps), viral PCR assay (EBV, parvovirus B19, CMV, VZV) and bacterial blood cultures were all negative Histopathological findings revealed a reactive infiltrate without vasculitis and necrosis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2FsSzPB

Differential blood cellular profile in patients with moderate to severe psoriasis treated with classical systemic therapies: A step forward in personalised medicine

Abstract

patients with moderate to severe psoriasis are difficult to treat with topical therapy only and they usually require additional systemic therapy. Despite this, a significant percentage of patients on these therapies shows an inadequate response to these drugs. Treatment decisions are often difficult as they usually rely on subjective terms. Therefore, finding indicators that predict efectiveness or failure to classical systemic therapy is an urgent need. The objective of this study was to analyse whether the phenotype of peripheral blood mononuclear cells (PBMC) would be different in responder or non-responder patients to classical systemic therapy, and thus could be used as a efectiveness predictor of this therapy effectiveness. These predictor markers could help physicians to choose the best individualised treatment for psoriasis patients.

This article is protected by copyright. All rights reserved.

http://ift.tt/2tAxIEb

Cutaneous squamous cell carcinomas are associated with basal proliferating actinic keratoses

Abstract

Background

In addition to the extent of atypical keratinocytes throughout the epidermis, actinic keratoses (AKs) are histologically characterized by downward directed basal layer expansion. It is not known if this growth pattern correlates with the risk of developing invasive squamous cell carcinoma (iSCC).

Objective

To characterize the prevalence of downward directed basal layer expansion of AKs adjacent to iSCC.

Methods

The epidermis overlying and adjacent to iSCCs was assessed histologically. We determined the histological grade (AKI-III), basal growth pattern (PROI-III) and accompanying parameters such as adnexal involvement.

Results

Of 307 lesions, 52.4% of AKs were histologically classified as AKI, 38.1% as AKII, and 6.8% as AKIII (chi-squared; P<0.0001). 2.6% of adjacent epidermis did not show any atypical keratinocytes. The epidermis adjacent to iSCCs was classified as having a PROI basal growth pattern in 25.7%, PROII in 31.9%, and PROIII in 39.4% cases. 2.9% of AKs showed no basal growth (chi-squared; P<0.0001).118 (48.8%) AKs showed extension into adnexal structures. These AKs were graded as PROI in 18.6%, PROII in 30.5%, and PROIII in 50.8%. The epidermis above iSCCs could only be assessed for upwards directed growth and showed no significant differences in the three AK grades (P=0.4211).

Conclusions

Basal proliferative AKs as well as atypical keratinocytes restricted to the lower third of the epidermis are most commonly seen adjacent to iSCC with less evidence for full thickness epidermal dysplasia. Our study supports the important role of dysplastic keratinocytes in the epidermal basal layer and their potential association with iSCC.

This article is protected by copyright. All rights reserved.

http://ift.tt/2GjoXBq

Population-based prevalence of Eosinophilic (Shulman's) Fasciitis: a capture-recapture study

Abstract

Our knowledge of Eosinophilic fasciitis (EF), also known as Shulman's syndrome, is limited, and its prevalence has not been estimated so far. We conducted a regional survey which aimed at estimating the prevalence of EF in Alsace, a Region in the North-East of France. We retrospectively collected EF cases from the first of January 1983 to the 30^th of March 2015 among Alsace residents aged >18 years, then performed a capture-recapture analysis with the prevalent cases in 2015.

This article is protected by copyright. All rights reserved.

http://ift.tt/2tAxGw3

Differential expression of organic cation transporter 3 in oral submucous fibrosis-associated buccal squamous cell carcinoma.

Related Articles

Differential expression of organic cation transporter 3 in oral submucous fibrosis-associated buccal squamous cell carcinoma.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Mar 06;:

Authors: Hu Y, Qian Y, Lin L, Chen W, Yang L, Hu X, Tian K, Xia K, Su T

Abstract
OBJECTIVE: The aim of this study was to examine the expression of organic cation transporter 3 (OCT3) in patients with oral submucous fibrosis (OSF)-associated buccal squamous cell carcinoma (BSCC) and to explore its clinical significance.
STUDY DESIGN: A total of 56 tissue specimens were collected from patients, among which there were 13 specimens with normal buccal mucosa (NBM), 13 with oral submucous fibrosis (OSF), 10 with OSF-associated BSCC (BSCC-OSF), 10 with well-differentiated BSCC (BSCC-I), and 10 with poorly to moderately differentiated BSCC (BSCC-II+III), based on pathologic examination. The expression of OCT3 was detected by using immunohistochemistry and real-time quantitative reverse transcription polymerase chain reaction.
RESULTS: There was a significant difference in both the protein and mRNA expression levels of OCT3 among the NBM, OSF, BSCC-OSF, BSCC-I, and BSCC-II+III groups (protein: F = 82.45 [P < .0001]; mRNA: F = 50.69 [P < .0001]). The expression of OCT3 from NBM to OSF to BSCC-OSF was gradually upregulated. In addition, as BSCC became better differentiated, the expression of OCT3 increased.
CONCLUSIONS: The expression of OCT3 was associated with OSF progression and the differentiation of BSCC. OCT3 expression may serve as a molecular marker for the prevention and early diagnosis of OSF and BSCC.

PMID: 29523428 [PubMed - as supplied by publisher]

http://ift.tt/2FwgXfa

Physiologic distribution of PSMA-ligand in salivary glands and seromucous glands of the head and neck on PET/CT.

Related Articles

Physiologic distribution of PSMA-ligand in salivary glands and seromucous glands of the head and neck on PET/CT.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Jan 31;:

Authors: Klein Nulent TJW, Valstar MH, de Keizer B, Willems SM, Smit LA, Al-Mamgani A, Smeele LE, van Es RJJ, de Bree R, Vogel WV

Abstract
OBJECTIVES: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is used for detection and (re)staging of prostate cancer. However, healthy salivary, seromucous, and lacrimal glands also have high PSMA-ligand uptake. This study aimed to describe physiologic PSMA-ligand uptake distribution characteristics in the head and neck to aid in PSMA PET/CT interpretation and to identify possible new clinical applications for PSMA-ligand imaging.
STUDY DESIGN: Thirty consecutive patients who underwent PSMA PET/CT for prostate cancer were evaluated. Tracer maximum standardized uptake values (SUVmax) in the salivary, seromucous, and lacrimal glands were determined visually and quantitatively. Overall and intraindividual variations were reported.
RESULTS: All gland locations had increased tracer uptake. The mean SUVmax ± standard deviation varied: parotid 12.3 ± 3.9; submandibular 11.7 ± 3.5; sublingual 4.5 ± 1.9; soft palate 2.4 ± 0.5; pharyngeal wall 4.3 ± 1.3; nasal mucosa 3.4 ± 0.9; supraglottic larynx 2.7 ± 0.7; and lacrimal 6.2 ± 2.2. The parotid had the largest overall variation in SUVmax (5.2-22.9), and the sublingual glands had the largest mean intraindividual difference (18.1%).
CONCLUSIONS: Major and minor salivary and seromucous glands consistently have high PSMA-ligand uptake. Minor gland locations can be selectively visualized by this technique for the first time. This provides potential new applications such as quantification of present salivary gland tissues and individualization of radiotherapy for head and neck cancer or lutetium-177-PSMA radionuclide treatment.

PMID: 29523427 [PubMed - as supplied by publisher]

http://ift.tt/2FqjpHS

Laparoscopic Versus Open Transverse Colectomy: A Systematic Review and Meta-Analysis.

Related Articles

Laparoscopic Versus Open Transverse Colectomy: A Systematic Review and Meta-Analysis.

World J Surg. 2018 Mar 09;:

Authors: Gavriilidis P, Katsanos K

Abstract
OBJECTIVES: The survival benefits, oncological adequacy, effectiveness, and safety of laparoscopic transverse colectomy (LTC) were compared with that of open transverse colectomy (OTC) using a meta-analysis.
METHODS: EMBASE, Medline, Cochrane library, and Google scholar databases were searched for the last 20 years. Meta-analyses were performed using both fixed-effects and random-effects models. Five-year disease-free survival and overall survival were estimated using the inverse variance hazard ratio method.
RESULTS: No survival benefits were detected between the two LTC and OTC cohorts. OTC showed shorter operative time by 38 min compared to LTC [mean difference (MD) = 38(15.23-60.77), p = 0.001]. However, LTC was associated with earlier postoperative recovery. The time to flatus and time to oral intake for LTC were MD = -1.12(-1.68 to -0.55, p = 0.001) and MD = -1.57(-2.38 to -0.76, p = 0.001), respectively. In addition, LTC was associated with a shorter hospital stay by 4.5 days [MD = -4.64(-7.52 to -1.75), p = 0.002].
CONCLUSIONS: Compared to OTC, LTC provides similar survival benefits, earlier postoperative recovery, and shorter hospital stay by 4.5 days.

PMID: 29523909 [PubMed - as supplied by publisher]

http://ift.tt/2FAHaJv