Lorenzo Gualandri

Clinical features of 36 cases of amelanotic melanomas and considerations about the relationship between histologic subtypes and diagnostic delay

Background  Amelanotic melanomas (AM) are a difficult diagnostic challenge for clinicians.

Comma Hairs in Tinea Capitis: A Useful Dermatoscopic Sign for Diagnosis of Tinea Capitis

Abstract:  Diagnosis of tinea capitis (TC) can be challenging for dermatologists, especially in noninflammatory TC caused by anthropophilic dermatophytes and in black patients, in whom erythema of the scalp is difficult to appreciate. The finding of a typical TC dermoscopic pattern may lead more quickly to a correct diagnosis.

Multiple familial smooth muscle hamartomas.

Abstract: Smooth muscle hamartoma is a cutaneous abnormality characterized by a disorganized proliferation of normal muscle fibers of arrector pili. Usually a single congenital hypertrichotic plaque involves the trunk and the extremities. Multiple lesions have rarely been reported in the literature. We describe three members of the same family with multiple skin‐colored patches on the back and legs, histologically confirmed as smooth muscle hamartomas. To our knowledge this is the first report of multiple smooth muscle hamartomas in different members of the same family and quite interestingly involving the same skin site.

Association of psoriasis-like eruption and Kawasaki disease.

We report a case of a 3‐month‐old female baby showing clinical and hematological signs compatible with Kawasaki disease. A few days after the beginning of the specific therapy, the young patient developed asymptomatic erythematous plaques appearing on the trunk. The histology disclosed a psoriasic pattern. To the best of our knowledge, we describe the youngest baby in the published work developing a psoriasis during the course of Kawasaki disease.

Atopic dermatitis: recent insight on pathogenesis and novel therapeutic target.

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. It affects infancy, but it is also highly prevalent in adults and it is one of the disease burdens for the patients and their families. Nowadays, AD is recognized as a heterogenous disease with different subtypes with variable clinical manifestations which is affected by the impairments of the skin barrier. The severity of AD dictates the level of treatment. Current AD treatment focuses on restoration of the barrier function, mainly through the use of moisturizers and corticosteroids to control the inflammation, topical calcineurin inhibitors, and immunosuppresive drugs in the most severe cases. However, targeted disease-modifying therapies are under investigation. The most recent findings on the skin microbial dysbiosis is a promising future direction for the development of new treatments. We need to improve the understanding of the complex microbiome-host interactions, the role of autoimmunity, the comparative effectiveness of therapies and the ways to appropriately implement the educational strategies.

Acquired self‐healing Blaschko dermatitis in an adult

A 24‐year‐old woman with a 3 year history of Blasehkitis is presented. The dermatosis consisted of erythematous vesicular papules following Blasehkos lines on her left trunk. A moderate itching was described by the patient initially. Resolution occurred spontaneously after 3 months with hypopigmentation. Histological examination demonstrated a perivascular inflammatory infiltrate in the subpapillary dermis with lymphocytic exocytosis.

Basal Cell Carcinomas of the Auricular Region: A Study of 23 Cases

Basal cell carcinomas (BCCs) of the auricular region are not frequently reported, especially in the Japanese literature. Predisposing conditions such as sun exposure or frostbite are possibly involved in their development.

Regional Eruptive Neurofibromas

A 71‐year‐old woman presented with multiple, flesh‐colored, papular lesions on the left dorsal side of the hand which had erupted 5 years earlier. No café‐au‐lait spots, freckles, or Lisch nodules were detected. Family history did not disclose neurofibromas or abnormal pigmentation. Two biopsy specimens of the lesions showed circumscribed, non‐encapsulated neurofibromas. Segmental neurofibromatosis is characterized by the unilateral, segmental appearance of neurofibromas and/or café‐au‐lait spots in the absence of genetic transmission. The authors discuss the significance of localized multiple cutaneous neurofibromas in the absence of family history and suggest the possibility of a cutaneous hamartoma.

Youngest case of idiopathic calcinosis cutis not associated with Down syndrome

Teris Minsue Chen, MD Rungsima Wanitphakdeedecha, MD, MA, MSc Tri H. Nguyen, MD Donald H. Parks, MD, FRCS(C), FACS From the Department of Dermatology, University of Texas – MD Anderson Cancer Center, Houston, TX, USA; Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; and Devision of Plastic and Reconstructive Surgery, Department of Surgery, University of Texas – MD Anderson Cancer Center, Houston, TX, USA

Nodular melanomas: Analysis of the casistic and relationship with thick melanomas and diagnostic delay

The present study aimed to: (i) define thick melanomas related to nodular melanomas and other melanoma subgroups; and (ii) establish diagnostic delay in relation to the biological behavior of these melanomas and prevention programs. Cutaneous primary melanomas were studied. Nodular melanoma (NM), lentigo maligna melanoma (LMM) and superficial spreading melanoma (SSM) were selected. A further category named vertical growth melanoma (VGM) was also utilized. Analysis for sex, age, different values of thickness (1–2 mm, >2 mm; 1–3 mm, >3 mm; >4 mm), delay to diagnosis and patterns of detection were performed in all of the different subtypes. Eighty‐seven patients with melanomas more than 1 mm of Breslows thickness out of 506 melanoma were collected. Twenty‐six were nodular cases, 39 SSM, five LMM and 17 VGM. Of those patients with NM, 42% had a thickness of more than 1–2 mm, 34% of 2–4 mm, 23% of more than 4 mm; and 54% with 1–3, 46% with more than 3 mm; and 58% with more than 2 mm. Even considering different values of thickness of more than 1 mm, a delay to diagnosis was significantly lower in NM (4.79 months) than in other subgroups. The value of more than 1 mm of Breslows thickness may be sufficient to consider a melanoma to be thick. The lower diagnostic delay of NM suggests that they represent faster growing lesions probably with a different biological behavior than other melanoma subtypes. VGM should not be confused with NM, having a longer delay and different clinical features compared with the latter. They represent an area of diagnostic carelessness than potentially be improved.