William Eng

The Presence of Alpha‐Synuclein in Skin from Melanoma and Patients with Parkinson's Disease

The misfolding and prion‐like propagation of the protein α‐synuclein (α‐syn) is the leading molecular signature in Parkinsons disease (PD). There is a significant coincidence of PD and melanoma that may suggest a shared pathophysiology. This study compared the presence of α‐syn in neural crest‐derived tissues, such as nevi, melanoma, skin tags, and skin biopsies from patients with PD and healthy controls.

Tau Protein in Oral Mucosa and Cognitive State: A Cross-sectional Study

Neurodegenerative diseases are characterized by the presence of abnormal aggregates of proteins in brain tissue. Among them, the presence of aggregates of phosphorylated Tau protein (p-Tau) is the hallmark of Alzheimer’s disease (AD) and other major neurodegenerative disorders such as corticobasal degeneration and frontotemporal dementia among others. Although Tau protein has previously been assumed to be exclusive to the central nervous system, it is also found in peripheral tissues. The purpose of this study was to determine whether there is a differential Tau expression in oral mucosa cells according to cognitive impairment. Eighty-one subjects were enrolled in the study and classified per Mini-Mental State Examination test score into control, mild cognitive impairment (MCI), and severe cognitive impairment (SCI) groups. Immunocytochemistry and immunofluorescence revealed the presence of Tau and four p-Tau forms in the cytoplasm and nucleus of oral mucosa cells. More positivity was present in subjects with cognitive impairment than in control subjects, both in the nucleus and cytoplasm, in a speckle pattern. The mRNA expression of Tau by quantitative real-time polymerase chain reaction was higher in SCI as compared with the control group (P < 0.01). A significantly higher percentage of immunopositive cells in the SCI group was found via flow cytometry in comparison to controls and the MCI group (P < 0.01). These findings demonstrate the higher presence of p-Tau and Tau transcript in the oral mucosa of cognitively impaired subjects when compared with healthy subjects. The feasibility of p-Tau quantification by flow cytometry supports the prospective analysis of oral mucosa as a support tool for screening of proteinopathies in cognitively impaired patients.

6 Year Old White Boy with a Rash on Buttock

The patient is a 6 year old that had been taken to the emergency room and to a pediatrician for a rash and pruritus on the buttocks and was given hydrocortisone cream with no help.

57 Year Old Male with Multiple Widespread Excoriations

An 57-year-old male presented with a rash on his left proximal upper arm and upper chest. Around seven discrete lesions are found on the upper left back and about four are found on the right upper back which worsen at night. Also lesions were found on the proximal thigh. The patient also exhibited pruritus His medical history consisted of a fracture of the radial bone, diverticulitis, depression, hypertension, viral hepatitis, dementia, dysphagia, anemia, encephalopathy, subdural hemorrhage, muscle weakness, chronic respiratory failure, and seborrheic dermatitis on the scalp. There was a previous treatment for scabies with elimite and stromectol.

53 Year Old Female with Multiple Areas of Erythema on Scalp

An 53-year-old female presented with an erythematous area on her scalp. The patient also presented with chronic pruritus on her right lower extremity. She was a new patient that was living in a local assisted living facility.

48 Year Old Hiv + Male with Multiple Papules and Nodules on Arms

A HIV positive 48 year old male presented with multiple papules and nodules on his arms. He reported having chest pain and a non-productive cough. He reported recently having explored several caves with his friends in eastern Tennessee.

95 Year Old White Female with a Reddish, Nodule on Temple

A 95 year old white female nursing home patient presented with three lesions on her face, one of which was rapidly growing. She has a history of skin cancers, primarily squamous cell carcinomas and pre-cancers (actinic keratosis). In her youth, she spent considerable time outdoors and had multiple episodes of sun burns.

9 Year Old Black Female with Multiple, Small Round, Firm Papules

A 9-year-old female presented with a recent growth on her chin, left knee and left posterior upper arm. She also had a history of mild acne on her face and lower abdomen. The patient was not on any current medications and had no known history of allergies to medications.

78 Year Old Brazilian Male with Multiple Skin and Nasal Mucosal Ulcerations

A 78 year old male from Brazil presented with a complaint of multiple ulcerations involving the skin and nasal mucosa.

76 Year Old Female with Enlarging Painless Nodule on the Arm

A 76 year old female presented with an enlarging, painless nodule on her arm. The lesion was slowly enlarging with discharge of putrid pus. She works on her garden in her spare time.