Francesca Cottoni

Circulating spindle cells : correlation with human herpesvirus-8 (HHV-8) infection and Kaposi's sarcoma

Vol 349 • January 25, 1997 255 cultures with the endothelial cell marker VE-cadherin and the tissue-macrophage marker PAM-1 (40–60% in KS patients and 0·5–6% in controls) (table). 4 weeks later, culture were examined for HHV-8 DNA sequences by nested PCR. None of the control cultures was positive, whereas HHV-8 was detected in all T-KS and AIDS-KS cases and in 11/14 cultures derived from patients with C-KS (table). HHV-8 was also detected in the patient with C-KS after bleomycin therapy. Our results indicate that an expansion of circulating KS-like cells or their progenitors is present in all forms of KS; KS-derived cultures are infected by HHV-8; and the presence of HHV-8 in these cells correlates with KS. Since these cells are capable of chemotaxis and can induce KS-like lesion formation in nude mice, our data suggest that they may localise into tissues, transmit HHV-8 infection to neighbour cells, and participate in the formation of KS lesions.

Classical Kaposi's sarcoma in north-east Sardinia: An overview from 1977 to 1991

The incidence of classical Kaposis sarcoma in 1977-91 was studied in north-east Sardinia. In this period, 160 new cases were observed in a defined area, of which 124 were in males. This represented a standardised incidence of the disease of 1.58/100,000 inhabitants per year (2.43 for males and 0.77 for females). This is the highest incidence of classical Kaposis sarcoma so far recorded. The incidence increased with age, particularly after the age of 70 in males.

Unusual aspects of juvenile xanthogranuloma

We describe three unusual features of juvenile xanthogranuloma that were observed in three different children. We also describe the mixed and clustered forms of juvenile xanthogranuloma and a giant juvenile xanthogranuloma of the nose.

HLA antigen distribution in different clinical subgroups demonstrates genetic heterogeneity in lichen planus.

Summary HLA‐A, B, Cw, DR and DQ antigens were serologically determined in 105 patients suffering from lichen planus (LP). Of these patients, 87 had idiopathic LP and 18 had secondary LP. In the first group, 43 had cutaneous LP without mucosal lesions, 17 had cutaneous LP with mucosal lesions and 27 had purely mucosal LP. No HLA antigen was found to be significantly associated with secondary LP or with mucosal idiopathic LP. In cutaneous idiopathic LP with or without mucosal lesions, the HLA‐DR1 and DQ1 antigen frequency was significantly increased, and that of HLA‐DQ3 significantly decreased. Among the HLA‐DR1 cutaneous idiopathic LP patients, 78.5% carried the DRB1*0101 allele, and 214% the DRBI*0102 allele, compared with 35.7 and 67.8%, respectively, of the HLA‐DR1 controls. Our data demonstrate that idiopathic LP is influenced by HLA‐associated genetic susceptibility and resistance factors not involved in secondary LP, and that cutaneous idiopathic LP is a genetically and therefore pathogenetically different condition from purely mucosal idiopathic LP.

Follicular spicules and multiple ulcers: cutaneous manifestations of multiple myeloma

We describe 2 patients with multiple myeloma who had horn-like filiform spicules in the follicular orifices of the face, particularly on the nowe, and multiple small ulcerations on the trunk. In the first patient, histopathologic study of a specimen from the nose showed follicular plugs of compact homogeneous eosinophilic material filling the intercellular spaces surrounding the keratinocytes. The same eosinophilic deposits were seen in the ulcer. In the second patient, biochemical investigation revealed that skin matter from spicules and ulcers were made up of monoclonal dysprotein with electrophoretic characteristics identical to those found in patient serum.

Lichen planus in children: a case report.

Abstract: Lichen planus (LP) Is rare in children. A review of the literature reveals that it has some peculiarities with respect to sex, localization, clinical aspect, race, and family history. We present an Indian child with the documented peculiarities of infantile LP. A comparison of LP and graft‐versus‐host disease points to the Importance of thymic Involution in the pathogenesis of the former, which could explain the rarity of this disorder In infants.

In situ study of chemokine and chemokine-receptor expression in Kaposi sarcoma.

Tissue expression of CC and CXC chemokines and chemokine receptors was investigated in 6 cases of classic non-AIDS Kaposi sarcoma (KS) using immunohistochemistry and RNase protection assay (RPA). Immunostaining of frozen sections of KS skin biopsies revealed that KS spindle cells express several chemokine receptors. In KS nodules, almost all KS spindle cells were intensely stained for CXCR4 and CCR5. Other chemokine receptors as CCR1, CXCR3, and CCR2 were also detected in the large majority of KS spindle cells. A minority of KS spindle cells also expressed the fractalkine receptor (FK-R) CX3CR1.The immunohistochemical findings were confirmed at RNA level. In fact, the RNase protection assay (RPA) revealed in 6 of 6 cases the presence of consistent amounts of mRNAs for CXCR4 and CCR1 and in 5 of 6 cases also for CCR5 and CXCR3.Expression of chemokine receptors by KS cells was associated with chemokine production within the lesions. In the same cases, RPA demonstrated the presence of mRNAs for MCP-1, RANTES, IP-10, MIP-1&agr;, and MIP-1&bgr;. Chemokine-producing cells, as detected by immunohistochemistry, were mainly spindle-shaped cells resembling tissue macrophages outside KS lesions and some scattered cells (<5%) present within KS nodules.The demonstration of chemokine receptors in KS cells raises the possibility that recruitment of KS cells in response to locally produced chemotactic stimuli may be one of the events involved in the pathogenesis of Kaposi sarcoma.

The role of occupation and a past history of malaria in the etiology of classic Kaposi's sarcoma: a case-control study in north-east Sardinia

A case-control study was performed to determine the role of rural factors including occupation and previous malaria exposure in the development of classic Kaposis sarcoma (CKS) in a high incidence area of Europe. The occurrence of CKS association with other malignancies was also examined. The results showed that the risk of having CKS was significantly increased in subjects farming cereals, while a previous history of malaria did not influence the risk of developing CKS. A near-significant increase in associated tumours was found.

Dermoscopic rainbow pattern in Kaposi's sarcoma lesions: our experience.

Accepted for Publication: April 6, 2012. Author Affiliations: Prevention Research Center/ Department of Biobehavioral Health (Drs Turrisi and Mallett and Ms Hultgren), Department of Dermatology, Milton S. Hershey Medical Center (Drs Gunn and Warner), The Pennsylvania State University, State College. Correspondence: Dr Turrisi, Prevention Research Center, The Pennsylvania State University, 204 E Calder Way, Ste 208, State College, PA 16801 (rturrisi@psu.edu). Author Contributions: Dr Turrisi had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Turrisi, Gunn, Warner, and Mallett. Acquisition of data: Gunn, Warner, and Mallett. Analysis and interpretation of data: Turrisi, Gunn, Hultgren, Warner, and Mallett. Drafting of the manuscript: Turrisi, Gunn, Hultgren, and Warner. Critical revision of the manuscript for important intellectual content: Turrisi, Gunn, and Hultgren. Statistical analysis: Turrisi. Obtained funding: Turrisi and Gunn. Administrative, technical, and material support: Turrisi, Gunn, and Warner. Study supervision: Gunn. Financial Disclosure: None reported. Funding/Support: Funding was provided by the Pennsylvania State University Children, Youth, and Family Consortium.

Environmental Factors Influence the Rate of Human Herpesvirus Type 8 Infection in a Population with High Incidence of Classic Kaposi Sarcoma

High prevalence of human herpesvirus type 8 (HHV-8) infection has been reported on the island of Sardinia. Among emigrants from Sardinia, rates of HHV-8 infection are lower than they are in Sardinia and are similar to those observed in the local population. Thus, environmental factors seem to play a relevant role in affecting the prevalence of HHV-8 infection.