Mariana Costache

MicroRNA Expression Profiles in Kaposi’s Sarcoma

Kaposi’s sarcoma (KS) is a mesenchymal tumor, caused by Human herpesvirus 8 (HHV8) with molecular and cytogenetic changes poorly understood. To gain further insight on the underlying molecular changes in KS, we performed microRNA (miRNA) microarray analysis of 17 Kaposi’s sarcoma specimens. Three normal skin specimens were used as controls. The most significant differentially expressed miRNA were confirmed by quantitative reverse transcriptase polymerase chain reaction (RT-PCR). We detected in KS versus normal skin 185 differentially expressed miRNAs, 76 were upregulated and 109 were downregulated. The most significantly downregulated miRNAs were miR-99a, miR-200 family, miR-199b-5p, miR-100 and miR-335, whereas kshv-miR-K12-4-3p, kshv-miR-K12-1, kshv-miR-K12-2, kshv-miR-K12-4-5p and kshv-miR-K12-8 were significantly upregulated. High expression levels of kshv-miR-K12-1 (p = 0.004) and kshv-miR-K12-4-3p (p = 0.001) was confirmed by RT-PCR. The predicted target genes for differentially expressed miRNAs included genes which are involved in a variety of cellular processes such as angiogenesis (i.e. THBS1) and apoptosis (i.e. CASP3, MCL1), suggesting a role for these miRNAs in Kaposi’s sarcoma pathogenesis.

Oral lichen planus: A retrospective study of 633 patients from Bucharest, Romania

Objective: In this retrospective study, patients’ medical records were reviewed to investigate the profiles of 633 OLP cases in a group of Romania. Material and Methods: In this retrospective study, the following clinical data were obtained from the medical charts of patients: gender, age, clinical presentation of OLP, site affected, presence of symptoms, extraoral manifestations of lichen planus, presence of systemic diseases, and history of medications. Results: Most (78.67%) OLP patients were female and the mean age at presentation was 52 years. The white type of the disease (reticular/papular/plaque lesions) was the main form encountered in this sample (48.97%). Among patients with available hepatitis C virus test results, 9.6% were serum-positive. OLP was associated with gallbladder disease (i.e. cholecystitis, cholelithiasis) in 19% of patients. Six patients (0.95%) developed squamous cell carcinoma at a site with confirmed OLP lesions. Conclusions: To the best of our knowledge, no similar study has been conducted in a Romanian population. The present investigation revealed the predominance of OLP among middle-aged white women and the prevalence of bilateral involvement of the buccal mucosa with reticular white lesions. Anti-HCV circulating antibodies were more common in patients with OLP than in the general population and, notably, OLP was associated with gallbladder disease (cholecystitis, cholelithiasis) in 19% of patients. Key words:Oral lichen planus, oral mucosal diseases, retrospective study.

Dermatoscopy of an invasive melanoma on the upper lip shows possible association with Laugier-Hunziker syndrome.

We report mucosal melanoma of the upper lip in a patient affected by the Laugier-Hunziker disease. Using dermatoscopy, two distinct parts were identified in the same mucosal area: nodular (malignant) and macular (benign). A complete surgical excision was performed and the patient has been free of disease for 16 months.

Cutaneous melanoma: digital dermoscopy -essential tool for positive diagnosis

Cutaneous melanoma is a “perfid”, aggressive and hard to be treated malignant tumor in case of delayed diagnosis. However, patients still have a chance to escape progressive disease if the lesion is recognized early, when the surgical approach is curative. Dermoscopy has the important advantage of rapidity and non‐invasivity in a field with (still) contradictory algorithms of diagnosis and treatment. The recognition of the elementary dermoscopic lesions enables accurate diagnosis for cutaneous melanoma. In our opinion, dermoscopy appears compulsory in the routine derma‐tologic examination. In vivo microscopy (dermoscopy) together with histopathology (plus or minus immunohisto‐chemistry) seem, at present, to provide the most reliable diagnosis of melanoma.

Apoptosis in seborrheic keratoses: an open door to a new dermoscopic score

The aetiology of seborrheic keratoses (SK), the most common benign epithelial tumours, and any relationship with malignancy are not yet known. As a protective anti‐cancer mechanism, apoptosis reflects cellular loss as a reaction to proliferative activity. The objective of this study was to quantify apoptosis in different SK types (acanthotic, hyperkeratotic, reticulated, irritated and clonal) and correlate the dermoscopic picture with apoptosis rate. After a qualitative and quantitative analysis of dermoscopic images, we defined a new quantitative dermoscopic score (C3V2F, crypts, millia cysts, colours, hairpin vessels, irregular vessels, fissures) from 0 to 22, which enabled us to establish cut‐offs correlating with apoptosis rates. All five SK forms were associated with lower apoptosis rates compared with normal skin. A C3V2F score >10 and greater number of crypts and colours reflected a higher apoptosis rate, which implies a benign character of evolution. In contrast, the presence of irregular vessels on more than 50% of the lesion surface implied a lower rate of apoptosis and probably associated with a risk of malignant transformation. On the basis of dermoscopic information, we used multiple regression to establish a model for estimating the rate of apoptosis with a 0.7 prediction interval (approximately 1S.D.). The new C3V2F score could be valuable for the clinical evaluation of possible SK prognosis and decisions regarding excision.

Learning from mistakes: errors in approaches to melanoma and the urgent need for updated national guidelines.

The tracking and identification of errors in the detection and follow‐up of melanoma are important because there is huge potential to increase awareness about the most vulnerable aspects of diagnosis and treatment, and to improve both from the perspective of healthcare economics. The present study was designed to identify where errors occur and to propose a minimum set of rules for the routine guidance of any specialist in melanoma management.

The iris signal: blue periphery, tan collaret and freckles pattern – strong indicators for epidermal skin cancer in South‐Eastern Europe

Eye and skin share the embryological origin. Both are established risk factors in epidermal skin cancer. There are few reports using iris colour classification scales, most of them analyse colour in general or are too complex to use in daily practice.

Local enhancement of multiphoton images of skin cancer tissues using polarimetry

Skin cancers can be classified in three major classes: squamous cell carcinoma (SCC), basal cell carcinoma and melanoma. While the first two are effectively treatable even when discovered in more advanced stages, the 5-year survival rate drops dramatically with melanoma progression as this variant can rapidly spread to other sites of the body (the lungs or the brain via the circulatory system). Regardless of their type, the early detection and accurate analysis of skin cancers is of utmost importance in clinical practice, having deep implications over the efficiency of administered therapies, survival probability, sustainability of healthcare systems and emotional comfort of the patients and their relatives. Since skin cancer development modifies tissue morphology and alters its biochemical characteristics, a variety of optical and chemical imaging techniques have been proposed so far as suitable tools to investigate genesis and progression aspects. Among these, multiphoton microscopy (MPM) has emerged as a powerful clinical tool which can non-invasively image and obtain complementary information from human skin [1]. In this work we propose to extend a previously reported polarimetric method [2] to MPM imaging, in order to improve the quality of images collected on human epithelial tissues.

A Novel Iris Colour Classification Scale

Background :Eye colour can be a predictive factor for skin cancer. Several iris colour classification scales have been described, but are not widely accepted. Further investigation of the relationship between the iris and skin cancer requires a valid and reliable inst rument for iris colour classification. Objective:Development and validation ofan easy and clinically reliable scale for iris colour classification. Design:This is a descriptive case series study. Participants:We analysed 211 irises digital photograph s of patients with primary skin

A short-term retrospective analysis of the clinical, histopathological and immunohistochemical aspects in endometrial malignancy

Endometrial carcinoma is the most frequent malignancy of the female reproductive system and the 7th cause of death by cancer in women from Western Europe. This study aims to evaluate the clinical, histopathological and immunohistochemical aspects as well as the short-term evolution in a series of 52 cases of endometrial carcinoma investigated, diagnosed and treated at the University Emergency Hospital in Bucharest, Romania over a period of one year. Demographic analysis revealed that in our country the majority of women presenting with endometrial carcinoma and, in particular, early stages of disease, usually come from urban regions and from areas with higher socioeconomic status. This raises the problem of disproportionate cultural levels and social inequity regarding access to healthcare services. All patients were postmenopausal and the mean age at presentation was 60.83, ranging from 43 to 81 years. Almost one-quarter (24%) of the women who have undergone radical hysterectomy as treatment for endometrial carcinoma presented endometrial intraepithelial neoplasia (EIN) on a previous biopsy. Immunohistochemical comparison between EIN and EIN with concurrent endometrial carcinoma revealed that expression of PTEN was slightly higher in the first study group. Moreover, we were surprised to find that one of the 2 serous carcinomas presented diffuse estrogen receptor (ER) positivity within the papilary structure of the tumor, whereas the solid areas completely lost positivity for estrogen receptor (ER). Precise evaluation of the tumor type in endometrial cancers is one of the most frequent issues encountered in endometrial biopsies. Accurate diagnosis and distinction between type I and type II endometrial carcinoma is of critical importance for proper surgical planning and further clinical management.