Rosanna Satta

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.

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.

Cutaneous sporotrichoid leishmaniasis resistant to pentavalent antimonial therapy: complete resolution with itraconazole

Sporotrichoid leishmaniasis is a sporadic form of cutaneous leishmaniasis, a protozoal infection, reported particularly in the Middle East. Clinically it occurs as nontender, subcutaneous, slightly erythematous nodules, often associated with lymphangitis, usually on exposed areas of the skin. Sometimes it occurs after treatment with a single dose of antimonials, and in older lesions, the biopsy can be negative for amastigotes. We report a case of cutaneous sporotrichoid leishmaniasis unresponsive to intralesional pentavalent antimonial therapy, which completely resolved after treatment with oral itraconazole. To our knowledge, this is only the third such case reported. We discuss the causes of dissemination of the nodular lesions and the negative results for amastigotes on re‐biopsed lesions.

Mandibular hypoplasia, deafness, progeroid features and lipodystrophy (MDPL) syndrome in the context of inherited lipodystrophies

BACKGROUND Lipodystrophies are a large heterogeneous group of genetic or acquired disorders characterized by generalized or partial fat loss, usually associated with metabolic complications such as diabetes mellitus, hypertriglyceridemia and hepatic steatosis. Many efforts have been made in the last years in identifying the genetic etiologies of several lipodystrophy forms, although some remain to be elucidated. METHODS We report here the clinical description of a woman with a rare severe lipodystrophic and progeroid syndrome associated with hypertriglyceridemia and diabetes whose genetic bases have been clarified through whole-exome sequencing (WES) analysis. RESULTS This article reports the 5th MDPL (Mandibular hypoplasia, deafness, progeroid features, and lipodystrophy syndrome) patient with the same de novo p.S605del mutation in POLD1. We provided further genetic evidence that this is a disease-causing mutation along with a plausible molecular mechanism responsible for this recurring event. Moreover we overviewed the current classification of the inherited forms of lipodystrophy, along with their underlying molecular basis. CONCLUSIONS Progress in the identification of lipodystrophy genes will help in better understanding the role of the pathways involved in the complex physiology of fat. This will lead to new targets towards develop innovative therapeutic strategies for treating the disorder and its metabolic complications, as well as more common forms of adipose tissue redistribution as observed in the metabolic syndrome and type 2 diabetes.

Cutaneous Mycobacterium chelonae infection in a presumably immunocompetent host.

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Idiopathic facial aseptic granuloma: case report and literature review

Idiopathic facial aseptic granuloma (IFAG) is a skin disease that has been described extensively in the French literature as a childhood-specific disorder. Originally, the disease was described as pyoderma froide, a designation that refers to modest clinical signs of inflammation, but the term was later replaced with the acronym IFAG. Clinically, IFAG presents with one or more papules or nodules located on the face, both monoand bilaterally, and lasts for at least 1 month. It is located within a triangle, the vertices of which are represented by the labial commissure, the earlobe, and the outer canthus. The lesions are asymptomatic, of hard and elastic consistency and vary in size, and in some cases tend toward colliquation. There are no accompanying blackheads, telangiectasia, or pilar keratoses. Histologically, the disease presents with diffuse inflammation of histiocytic granuloma in the midand deep dermis, numerous or scattered giant cells, and areas of abscess formation. Residues of follicles are observed occasionally within inflammatory infiltrate. Special and histochemical stains, such as periodic acid–Schiff (PAS), Grocott, Giemsa, and Ziehl–Neelsen stains, are negative. Culture tests in specific media (L€ owenstein–Jensen medium, Sabouraud agar) performed on purulent material or small-piece biopsies show no growth of bacteria, fungi, or mycobacteria. There are no common predisposing factors, family history, or associated clinical features, including satellite lymph nodes. Herein, we present a peculiar case of extensive IFAG.

Kaposi's sarcoma associated with treatment with adalimumab

A 61-year-old man, born and residing in Sardinia, came to our observation in March 2009 because of the appearance of purplish-red papulonodular lesions, located on his feet and hands. In addition, there was an isolated papule located on the distal portion of the lower right leg. The past medical history highlighted that the patient has been affected by rheumatoid arthritis since 2005, treated with leflunomide and methylprednisolone.

Amicrobial pustular dermatosis of the folds and Dapsone syndrome on treatment: a case report

Amicrobial pustolosis of the folds (APF) is a recently described, relapsing, primary aseptic pyoderma involving predominantly the cutaneous folds and the scalp and is often associated with autoimmune diseases or immunological abnormalities. We describe such a case in a lupus erythematous patient under corticosteroid therapy.