Claudia Cotellessa

Indeterminate Cell Histiocytosis: A Rare Histiocytic Disorder

A 64-year-old woman, otherwise healthy, presented with multiple reddish-brown, slightly yellowish papules on the face and neck, which had developed 3 years earlier. The lesions were painless and nonpruritic and varied in diameter from 1 to 5 mm. Histological and immunohistochemical examination of cutaneous biopsies revealed a diffuse dermal infiltrate composed mainly of histiocytes which expressed both Langerhans cell as well as monocytic/macrophages cell marker characteristics. Electron microscopic studies revealed no Birbeck granules within the cytoplasm of the neoplastic cells, leading to a diagnosis of indeterminate cell histiocytosis. Indeterminate cell histiocytosis is a very rare disease characterized by the proliferation of indeterminate histiocytes which morphologically and immunophenotypically resemble Langerhans cells but lack Birbeck granules.

The use of pyruvic acid in the treatment of acne.

Background  Acne is one of the most common dermatological diseases, affecting about 50% of adolescents. Different chemical peelings are used in local treatment, either alone or in association with other therapies.

Topical tazarotene 0.05% versus glycolic acid 70% treatment in X-linked ichthyosis due to extensive deletion of the STS gene

Sir, X-linked ichthyosis (XLI) appears in the immediate neonatal period as a generalized large, slightly adherent, lightly coloured desquamation commonly affecting the scalp, preauricular area and posterior neck (1). In time, large, often dark scales, preferentially located on the trunk and extensor aspect of the extremities, become prominent. The palms, soles and face are generally spared (1). Cutaneous histopathological findings of XLI are not diagnostic, being characterized by orthokeratotic hyperkeratosis and a normal or slightly thickened granular layer. In the dermis, oedema and a slight perivascular inflammatory infiltrate can be observed (1). The most common associated extracutaneous findings include corneal opacities, cryptorchidism, epilepsy and electro-encephalographic changes (1). XLI is caused by deficient activity of the steroid sulphatase (STS) enzyme due, in most patients, to complete or partial deletions of the STS gene mapped on Xp22.3 (2–5). Therapeutic approaches for the treatment of mild to moderate cutaneous manifestations of XLI include keratolytic agents, moisturizers and topical retinoids, while systemic retinoids have been successfully employed in severe forms (6, 7). We describe a 22-year-old man with XLI associated with epilepsy. A within-patient study comparing topical tazarotene 0.05% and glycolic acid 70% resulted in almost complete remission of cutaneous lesions, although a longer response durability was achieved with tazarotene.

Use of recombinant interferon alpha-2a in the treatment of squamous cell carcinoma

In recent years, systemic and intralesional interferons (IFNs) have been used successfully to treat a variety of skin tumours including T-cell lymphoma, malignant melanoma, Kaposis sarcoma and basal cell carcinoma. However, only a few studies have been reported on the use of IFN for the treatment of squamous cell carcinoma (SCC). The aim of this study was to evaluate the efficacy of intra and perilesionally administered IFN α-2a on SCC. A group of 36 patients with SCC ranging in size from 1.5 to 4 cm were treated with intra- and perilesional recombinant IFN α-2a. The doses varied from 1.5 to 3 £ 106 IU, three times a week for periods of 4–8 weeks. Complete response (CR) was achieved in 25 of 36 patients (69.5%) partial response in 7 patients (19.5%) and no response in 4 patients (11%). Side-effects including fever, headache and mild fatigue were observed during the first injection in 9 patients (25%). However, they were completely reversible with the use of paracetamol. After follow-up periods of 12–48 m...