Paola Monari

Borrelia burgdorferi-Associated Primary Cutaneous Marginal-Zone B-Cell Lymphoma: A Case Report

An association between Borrelia burgdorferi with primary cutaneous B-cell lymphoma (PCBCL) has long been suspected but just recently, thanks to a polymerase chain reaction technique, it had been possible to demonstrate B. burgdorferi-specific DNA in skin lesions of patients with different PCBCL subtypes. Locating cases of PCBCL that are related to B. burgdorferi infection could be really important for therapeutic implications; in fact, there are several reports of PCBCL responding to antibiotic therapy against B. burgdorferi. We report a case of B. burgdorferi-associated primary cutaneous marginal-zone B-cell lymphoma that, after specific antimicrobial therapy, did not show any clinical regression. We can conclude that additional studies are necessary in order to establish the use of antimicrobial therapy in B. burgdorferi-associated PCBCL.

Cutaneous lesions as initial signs of interferon α-induced sarcoidosis: report of three new cases and review of the literature

Sarcoid reactions are well‐recognized adverse events during interferon (IFN) therapy. They are frequently underdiagnosed because misinterpreted as IFN‐induced side effects. Sarcoid cutaneous lesions may therefore represent useful hints to an early diagnosis, but their incidence is unknown. We report three new cases of mono‐localized, purely cutaneous IFNα‐induced sarcoidosis. In addition, an extensive review of the literature, with special attention to skin involvement, was performed through a PubMed search. The analysis of the retrieved articles showed that cutaneous lesions are frequent signs of IFN‐induced sarcoidosis. Skin involvement is documented in 56% of the reports and it appears among the presenting and diagnostic signs of a sarcoid reaction in 51%. Special attention to dermatologic signs is imperative in the course of IFN therapy because even minimal skin involvement may offer a clue to an early diagnosis of IFN‐induced sarcoidosis.

Successful treatment of systemic cold contact urticaria with etanercept in a patient with psoriasis.

mastocytoma: an uncommon variant mimicking juvenile xanthogranuloma and Langerhans cell histiocytosis. J Cutan Pathol 2009; 36:1215–20. 9 Sotlar K, Cerny-Reiterer S, Petat-Dutter K et al. Aberrant expression of CD30 in neoplastic mast cells in high-grade mastocytosis. Mod Pathol 2011; 24:585–95. 10 Valent P, Sotlar K, Horny HP. Aberrant expression of CD30 in aggressive systemic mastocytosis and mast cell leukemia: a differential diagnosis to consider in aggressive hematopoietic CD30positive neoplasms. Leuk Lymphoma 2011; 52:740–4.

Merkel cell carcinoma arising in immunosuppressed patients treated with high-dose ultraviolet A1 (320–400 nm) phototherapy: a report of two cases

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumour of the skin. Though immunodeficiency is the most relevant risk factor, ultraviolet (UV) radiation is also involved, but as of yet we do not know the action spectrum, pattern or dose which would produce a dangerous exposure. A retrospective study of two immunosuppressed patients who developed MCC during, or soon after a treatment cycle with high dose UVA1 exposures was conducted, in order to understand wether repeated exposures to suberythemogenic UVA1 radiation may have a cancerogenic activity provoking MCC in immunosuppressed patients.

Electrochemotherapy-induced virus disappearance in HHV-8-positive skin nodules of Kaposi sarcoma: first histological and immunohistochemical demonstration of efficacy

and rapid resolution of GA following discontinuation of topiramate. Although the temporal relationship between drug discontinuation and skin resolution is evident, further studies and epidemiological data are necessary to support our clinical observation. Based on the T-cell subpopulations identified in GA lesions, we hypothesize that a delayed-type hypersensitivity reaction to topiramate was the involved pathogenetic factor.

Matter of margins

Basal cell carcinoma (BCC) is the most common cancer, it represents a significant economic burden to health services because of a large volume of affected patients. Surgical excision with histological assessment of the surgical margins is widely considered as the mainstay of BCC treatment. Incomplete removal, in fact, should be considered a poor prognostic indicator, as incomplete removal of lesions is at risk of local recurrence. Actually, dermatological surgeries are carried out by a variety of different types of practitioners, such as plastic surgeons, maxillofacial surgeons, otorhinolaryngologists, ophthalmologists and finally dermatologists. Incomplete removal of the tumour ranges from 6.3% to 25%, depending on the improper intra‐operative evaluation of the extent of the tumour. It depends on the clinical knowledge derived from both training and daily experience. In this sense, the majority of the largest studies derive from plastic surgeons, while dermatologists have small case series, albeit with a higher therapeutic efficacy in terms of complete surgical excision.

Sentinel lymph node biopsy in clear cell sarcoma.

© 2007 The Authors 1271 JEADV 2007, 21, 1253–1302 Journal compilation

Eruptive squamous cell carcinomas with keratoacanthoma‐like features in a patient treated with ruxolitinib

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Multiple eruptive clear cell acanthoma.

BACKGROUND Clear cell acanthoma is a rare solitary benign epidermal tumor of unknown etiology. The disease arises in the middle-age, with no sex predominance. It appears as a single reddish papule or papule-nodule and a peripheral scaling collarette is characteristic. Although solitary lesions are the rule, less than 30 cases of multiple Clear cell acanthoma have been described in the literature to date. MAIN OBSERVATIONS We report an unusual case of a healthy 74-year-old male with multiple clear cell acanthoma on the lower extremities treated successfully with cryotherapy. CONCLUSIONS Despite significant progress in treatment of clear cell acanthoma, cryotherapy, based on liquid nitrogen, remains an important alternative in treating multiple clear cell acanthomas.

Nested graft in chronic wounds: a new solution for an old problem.

It is well shown that chronic wounds are populated by cells unable to respond to re‐epithelising stimulus. Large ulcers that remain unhealed for several months are more difficult to treat probably because of the depletion of active factors. Yet in 1869 Reverdin realised that the partial coverage of an ulcer with small fragments of healthy skin was able to lead to wound healing; unfortunately, its employment was limited to granulating wounds. Recently, the importance of factors such as cytokines, chemokines and adhesion molecules in wound healing, and the involvement of all cellular types resident or transiting in the skin has been partially elucidated. In this study, we proposed to simultaneously provide a new cellular and molecular reservoir with the efficient stimulus to trigger it. We created receiving site inside the ulcer, able to contain a full‐thickness graft taken from a donor site. Our aim was not to cover the entire defect, but to use the minigraft as ‘fount’ of functional cells and to give an acute stress through the chambers created inside the ulcer. A complete wound healing was obtained in all patients treated in a short period of time. This technique does not require special equipment and assistance in maintaining costs at very low levels.