Expression and clinical implication of p27 and p57 in cutaneous squamous cell carcinoma and Bowen's disease

Objective： To investigate the expression and clinical significance of cyclin dependent kinase inhibitors p27 and p57 in cutaneous squamous cell carcinoma and Bowen＇s disease. Methods： The expression of p27 and p57 were evaluated in 10 normal skin tissues, 25 Bowen＇s disease （BD） and 30 cutaneous squamous cell carcinoma （SCC） with immunohistochemistrical staining. Results： The levels of p27 protein expression in SCC were dramatically lower than those in normal skin and BD （P 〈 0.057. The levels of p57 protein expression in SCC were dramatically lower than those in normal skin and BD （P 〈 0.057. There was a posilk, e correlation between p27 and p57 （r = 0.469, P 〈 0.057. Conclusion： The decrease of p27 and skp2 may be used for considering the biological behavior of human cutaneous squamous cell carcinoma and Bowen＇s disease.

Cutaneous markers of coronary artery disease

Coronary artery disease (CAD) is rapidly increasing in prevalence across the world and particularly in south Asians at a relatively younger age. As atherosclerosis starts in early childhood, the process of risk evaluation must start quite early. The present review addresses the issue of cutaneous markers associated with atherosclerosis, and the strengths and weaknesses of the markers in identifying early coronary atherosclerosis. A diligent search for such clinical markers, namely xanthelasma, xanthoma, arcus juvenilis, acanthosis nigricans, skin tags, ear lobe crease, nicotine stains, premature graying in smokers, hyperpigmented hands in betel quid sellers, central obesity, and signs of peripheral vascular disease may prove to be a rewarding exercise in identifying asymptomatic CAD in high risk individuals.

Cutaneous Abnormalities in Chronic Kidney Disease Patients with and without Dialysis

Background: Chronic kidney disease (CKD) is increasingly prevalent worldwide. CKD may present with different cutaneous manifestations. Objectives: To evaluate the dermatological manifestations and compare these manifestations between patients with maintenance hemodialysis (MHD) and non-dialysis groups. Methods: It was a cross sectional study conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2013 to March 2014. A total of 150 hospital admitted CKD patients were evaluated for dermatological manifestations. Age, gender, haemoglobin level, 24-hours urinary total protein (UTP), serum creatinine, serum fasting lipid profile, estimated glomerular filtration rate (e-GFR) and dermatological manifestations of the study subjects were recorded accordingly. Inter-group comparisons were made between patients with and those without cutaneous abnormality. Results: Out of 150 study subjects, 99 (66%) were male and 51 (34%) were female, 69 (46%) patients were on MHD and 81 (54%) patients were without dialysis, their mean (±SD) age was 44.6 ± 12.3 year. A Total of 126 (84%) patients had cutaneous abnormalities;among them 69 (54.76%) were pre-dialytic and 57 (45.24%) were on MHD group. The mean (±SD) serum creatinine was relatively higher but haemoglobin level was significantly lower (p = 0.021), while UTP was significantly higher (p = 0.038) among patients with cutaneous abnormality. There was no relationship between lipid profile with cutaneous abnormality. Among 126 (84%) patients with cutaneous abnormality;pallor was the most common cutaneous abnormality (72%) followed by xerosis (68.66%), pruritus (65.33%), half and half nails (38.66%), pigmentation (33.33%), purpura/ecchymosis (16.66%), fungal infection (16%), ulcerative stomatitis (10.66%) and bacterial infection (10%). Pigmentation (52.6%), purpura (35.1%), ulcerative stomatitis (21.1%) and bacterial infection (19.3%) were significantly higher in MHD group. Among 69 (54.76%) predialytic patients;11 (15.94%), 20 (28.98%) and 38 (55.07%) of them were on CKD stage-III, IV and V respectively. Conclusions: The dermatological disorders are frequent among CKD patients. Pallor, pruritus, xerosis, pigmentation and purpura are predominant changes. Pigmentation, purpura, ulcerative stomatitis and bacterial infection are significantly higher in MHD patients. Cutaneous abnormalities are more frequent in advance stages of CKD.

Risk of infectious diseases and cutaneous tumours in solid organ recipients: A meta-analysis of literature

AIM: To compare the risk of cutaneous infections and tumours in kidney transplant recipients with data recently published about this topic.METHODS: In the present work, we evaluated the incidence of bacterial, fungal and viral cutaneous infectious diseases and the development of skin cancers in a cohort of 436 patients who underwent a renal transplantation. The median age at transplantation of our patients was 50 years and the median duration of the immunosuppression was of 7.2 years. Data obtainedfrom our cohort were compared with those obtained by a systematic review of the literature of the last 20 years about the same topic.RESULTS: Infectious diseases were the most frequent dermatological disorders that were diagnosed after transplantation, affecting about the 16.5% of patients. Herpes virus reactivation occurs in about the 35% of patients and is more common within 6 mo from transplantation, whereas when the immunosuppression is reduced, skin infections are mainly represented by Human Papilloma Virus infections and localized mycosis, such as pityriasis versicolor and superficial candidiasis. Bacterial infections were relatively rare and occur mainly in the first months after transplantation. The cumulative risk to develop skin cancer enhance significantly over the time, as consequence of longterm immunosuppressive regiments. Endogenous and exogenous risk factors, as well as the schedule of immunosuppression can play a role and justify the different incidence of skin cancer in the various series. CONCLUSION: Skin infections and cancer, commonly diagnosed in transplanted patients, impact on survival and life-quality, justifying the realization of follow-up programs for the early diagnosis and treatment.

Cutaneous Crohn’s Disease and Anogenital Granulomatosis with Crohn’s Disease: Many Names for the Same Clinical Entity

Anogenital granulomatosis (AGG) is a rare chronic idiopathic disorder presenting as a painless swelling of the vulva, labia, penis, and/or anogenital area. Some AGG cases have been diagnosed along with Crohn’s disease (CD). We report a case of AGG that led to diagnosis of underlying CD, namely Cutaneous Crohn’s disease (CCD). We guess that CCD appeared in the anogenital region is equal to AGG with CD.

A Case Report on Cutaneous Larva Migrans (CLM)

Cutaneous larva migrans (CLM) is a zoonotic hookworm infection of dogs and cats commonly found in low-income countries in the tropical and subtropical regions and travellers to these regions. It is caused by invasion of the skin by the parasitic larvae of hookworms which, after entry, move under the skin causing an inflammatory reaction resulting in a single or multiple tracks. Patients commonly present with a progressive, itchy, erythematous serpiginous skin rash, affecting the feet, although it can affect any other parts of the body. The diagnosis is mainly clinical, based on history and physical examination. Treatment of this condition can effectively be achieved with either albendazole or ivermectin. We present a case of a 7-year-old boy who was diagnosed with CLM after presenting to the hospital with a history of a progressive itchy rash with tracks on the left foot. Although CLM is a self-limiting disease, it causes a lot of suffering and, therefore, it is of public concern. There is a need to increase awareness of this disease among health workers, and to implement and promote preventive measures against the disease since the cause is known.

Therapeutic response and safety of different treatments for cutaneous leishmaniasis in patients: A retrospective cross-sectional study

Objective:To analyze the therapeutic response and safety of different treatments for cutaneous leishmaniasis,received by patients in the Program for the Study and Control of Tropical Diseases-PECET-Medellín-Colombia.Methods:This is a retrospective cross-sectional study of patients attended at PECET Research Center during 2016-2021.Relevant information regarding sociodemographic characteristics,history of leishmaniasis,characterization of current infection,treatment received,follow-up of therapeutic response and safety was collected from the medical records.Data were analyzed with Pearson's Chi-square association tests and Mann-Whitney U test using statistical software.Results:A total of 486 clinical records of patients were analyzed,and 356 received treatment.Eight different therapeutic alternatives(systemic,local and in combination)were analyzed.The therapeutic response of the different alternatives used(except thermotherapy)was higher than 50%.Most frequent adverse events were myalgias,arthralgias and headache,and vesicles for systemic and local treatment,respectively.Conclusions:Safety profile and performance of local therapeutic alternatives and combined schemes for the treatment of uncomplicated cutaneous leishmaniasis are an interesting option for the management of the disease.

Establishment of an early warning system for cutaneous leishmaniasis in Fars province, Iran

Objective:To establish an early warning system for cutaneous leishmaniasis in Fars province,Iran in 2016.Methods:Time-series data were recorded from 29 201 cutaneous leishmaniasis cases in 25 cities of Fars province from 2010 to 2015 and were used to fit and predict the cases using time-series models.Different models were compared via Akaike information criterion/Bayesian information criterion statistics,residual analysis,autocorrelation function,and partial autocorrelation function sample/model.To decide on an outbreak,four endemic scores were evaluated including mean,median,mean+ 2 standard deviations,and median+ interquartile range of the past five years.Patients whose symptoms of cutaneous leishmaniasis began from 1 January 2010 to 31 December 2015 were included,and there were no exclusion criteria.Results:Regarding four statistically significant endemic values,four different cutaneous leishmaniasis space-time outbreaks were detected in 2016.The accuracy of all four endemic values was statistically significant(P<0.05).Conclusions:This study presents a protocol to set early warning systems regarding time and space features of cutaneous leishmaniasis in four steps:(i)to define endemic values based on which we could verify if there is an outbreak,(ii)to set different time-series models to forecast cutaneous leishmaniasis in future,(iii)to compare the forecasts with endemic values and decide on space-time outbreaks,and(iv)to set an alarm to health managers.

A case report of cutaneous larva migrans in Argentina

Cutaneous larva migrans(CLM) represents the most common tropically acquired dermatosis.CLM is caused by infection with hookworm larvae in tropical and sub-tropical areas,and people who have a history of foreign travel and of walking barefoot on sandy soil or beaches are at a high risk of getting infected with it.The diagnosis is usually made on the basis of the typical appearance of the lesion,intense itching and history of foreign travel.CLM is a common parasitic skin disease that can be easily prevented by wearing 'protective' footwear.A case of CLM is described in this article.

Atypical Cutaneous Leishmaniasis by Leishmania Mexicana: A Case Report with Dermoscopic, Histopathological and Molecular Study

Cutaneous leishmaniasis is a neglected tropical skin endemic disease, with worldwide distribution. By 2020 in the Americas, Mexico was in 12th place with 11 states reporting new cases. Molecular biology with different targets for diagnosis and species identification has been used for decades, also dermoscopy, a non-invasive diagnostic tool has shown its usefulness. We present the first case of cutaneous leishmaniasis in non-endemic place (Guerrero, Mexico) identifying Leishmania mexicana with molecular biology, and treated with itraconazole.

Cutaneous leishmaniasis in Louisiana-one-year follow-up:A case report

Reports of leishmaniasis are scarce in North America.It is considered to be one of the neglected tropical diseases.It is seen in immigrants from endemic areas to United States.Treatments are not readily available in the United States.Untreated or inadequately treated cutaneous leishmaniasis not only causes localized disfigurement but can advance to more permanent and devastating mucosal disfigurement and perforation,if caused by a species that can also cause mucocutaneous leishmaniasis.CASE SUMMARY A 42-year-old human immunodeficiency virus negative male immigrant from Honduras presented to the emergency department of our facility in Louisiana with a 2-mo history of a left lower extremity ulcer.It started as a painless blister that progressed in size and developed into other smaller lesions tracking up the thigh and became tender and erythematous.Clinically looked nontoxic and healthy.He was afebrile.Blood tests,except inflammatory markers,were within normal limits.The cellulitis of the leg was treated with 6 d of vancomycin that also relieved the pain.Skin biopsy was obtained,and histopathology was suspicious for leishmania.Polymerase chain reaction/deoxyribonucleic acid sequencing done by centers for disease control and prevention confirmed the diagnosis as Leishmania panamensis.There was no involvement of nasooropharyngeal mucosa,confirmed by otolaryngology.The patient was treated with miltefosine for 28 d.Clinic follow-up after approximately 11 mo revealed a healed skin ulcer.CONCLUSION Cutaneous leishmaniasis should be in the differential diagnosis of skin ulcers of travelers from endemic areas.Awareness regarding diagnosis and treatment of leishmaniasis needs to be enhanced.

Behçet Disease with Generalized Polymorphous Cutaneous Lesions:A Case Report

Introduction:Behçet disease is a chronic multisystem vasculitis disease,however generalized polymorphous cutaneous lesions are uncommon.Here,we reported a case of Behçet disease with multiple parts of the body and complex lesions,which may lead to misjudging in clinical diagnosis.Case report:A 69-year-old man presented with a seven-year history of recurrent generalized polymorphous mucocutaneous lesions(erythematous papules,nodules,ulcers,and necrosis)over his entire body,and the lesions had been painful for the past three years.Based on the past medical history,clinical presentation,histological examination excluded other diseases,and the 2014-amended International Criteria for Behget disease,the patient had a score of 6 points and was diagnosed as Behçet disease.Discussion:The common clinical feature in patients with Behçet syndrome is the presence of recurrent and usually painful mucocutaneous ulcers.Other clinical manifestations of this disorder are more variable among different patients.A diagnosis of generalized polymorphous cutaneous lesions should remain on the list of differential diagnosis of Behçet disease after excluding other diseases.Conclusion:The mucocutaneous lesions of Behçet disease are often preceded by other manifestations,and timely diagnosis may benefit early treatment and prognosis.

Cutaneaous Myiasis: A Rare Tropical Disease in an 11-Year-Old Girl

Myiasis is the infestation of live human and vertebrate animals with maggots that feed on the host’s dead or living tissue, depending on the life cycle of the fly. It is a rare condition and often misdiagnosed. Tropical and subtropical regions of the world are commonly affected. The aim of this case report is to share this uncommon cutaneous condition with health workers and also remind them of its common symptoms and signs such that its diagnosis is not missed. An 11-year-old girl presented with a nine-day history of itchy rash involving mainly the trunk and upper arms which were found to be cutaneous Myiasis. Cutaneous Myiasis can cause miserly to the affected individual due to its symptoms, yet it can be prevented with good environmental and personal hygiene. Diagnosis and treatment are cheap and effective.

Observation on the Effect of Cutaneous Acupuncture for Erysipelas with Hard Swollen Skin

Objective： To observe the clinical efficacy of cutaneous acupuncture in treating erysipelas with hard swollen skin. Methods： A total of 150 erysipelas patients with hard swollen skin were allocated into two groups, an acupuncture group and a control group. The 110 cases in the acupuncture group were treated with skin needle tapping plus external application of Jin Huang San. The 40 cases in the control group were treated with external application of Jin Huang San alone. Comparison was then made between the two groups in the effective rate. Results： The total effective rate for the acupuncture group was 97.3% and the control group 75.0%. The difference in total effective rate was statistically significant between the two groups （P 〈 0.01）. Conclusion： In the treatment of hard swollen skin erysipelas, skin needle tapping combined with external application of Jin Huang San is superior to external application of Jin Huang San alone.

High-risk spatiotemporal patterns of cutaneous leishmaniasis:a nationwide study in Iran from 2011 to 2020

Background Cutaneous leishmaniasis(CL)is a wide-reaching infection of major public health concern.Iran is one of the six most endemic countries in the world.This study aims to provide a spatiotemporal visualization of CL cases in Iran at the county level from 2011 to 2020,detecting high-risk zones,while also noting the movement of high-risk clusters.Methods On the basis of clinical observations and parasitological tests,data of 154,378 diagnosed patients were obtained from the Iran Ministry of Health and Medical Education.Utilizing spatial scan statistics,we investigated the disease’s purely temporal,purely spatial,spatial variation in temporal trends and spatiotemporal patterns.At P=0.05 level,the null hypothesis was rejected in every instance.Results In general,the number of new CL cases decreased over the course of the 9-year research period.From 2011 to 2020,a regular seasonal pattern,with peaks in the fall and troughs in the spring,was found.The period of September–February of 2014–2015 was found to hold the highest risk in terms of CL incidence rate in the whole country[relative risk(RR)=2.24,P<0.001)].In terms of location,six signifcant high-risk CL clusters covering 40.6%of the total area of the country were observed,with the RR ranging from 1.87 to 9.69.In addition,spatial variation in the temporal trend analysis found 11 clusters as potential high-risk areas that highlighted certain regions with an increasing tendency.Finally,fve space-time clusters were found.The geographical displacement and spread of the disease followed a moving pattern over the 9-year study period afecting many regions of the country.Conclusions Our study has revealed signifcant regional,temporal,and spatiotemporal patterns of CL distribution in Iran.Over the years,there have been multiple shifts in spatiotemporal clusters,encompassing many diferent parts of the country from 2011 to 2020.The results reveal the formation of clusters across counties that cover certain parts of provinces,indicating the importance of conducting spatiotemporal analyses at the county level for studies that encompass entire countries.Such analyses,at a fner geographical scale,such as county level,might provide more precise results than analyses at the scale of the province.

Kawasaki Disease in a Togolese Child

Introduction: Kawasaki disease (KD) is a severe febrile vasculitis that affects children under 5 years of age. The severity of KD is related to coronary involvement. Few cases have been reported in sub-Saharan Africa. Objective: We present a clinical observation of a Togolese infant to illustrate the typical clinical picture that every pediatrician should know. Observation: The patient was a 20-month-old infant from Togo who presented with conjunctivitis, cheilitis, stomatitis, and pharyngitis in a febrile setting. There was a satellite sub-maxillary adenopathy. There was a persistent biological inflammatory syndrome with thrombocytosis and a doppler ultrasound confirmed the diagnosis of a coronary aneurysm. Treatment was based on corticosteroid therapy and acetylsalicylic acid with success. Conclusion: KD involves cardiac complications that require rigorous and sometimes long-term monitoring to prevent death.

膀胱癌输尿管皮肤造口患者夫妻疾病沟通体验的质性研究

目的深入探索膀胱癌输尿管皮肤造口患者夫妻疾病沟通中的真实感受和心理体验,为进一步促进夫妻间有效沟通,增强应对疾病的能力提供依据。方法采用目的抽样法,选取2021年5—11月在郑州大学第一附属医院泌尿外科住院治疗的12例膀胱癌输尿管皮肤造口患者,运用现象学研究方法,对其进行半结构式访谈,并运用Colaizzi 7步分析法进行分析。结果膀胱癌输尿管皮肤造口患者夫妻疾病沟通体验共提炼4个主题及10个亚主题:夫妻疾病沟通过程中回避敏感话题(回避个人情感及内心感受的沟通、回避生死或生命时限有关的敏感话题)、回避型沟通对患者产生不良影响(负性情绪得不到有效宣泄、产生疏离感、自信心下降、患者疾病的应对能力下降)、患者创伤后成长且获得积极沟通体验(康复期沟通主动性增强、沟通默契增强且亲密关系改善)、期待专业指导(疾病知识指导、沟通技能培训)。多维度展现了患者夫妻疾病沟通体验。结论患者在夫妻疾病沟通过程中存在不同阶段的沟通困境及指导需求,医务人员应通过疾病专业知识指导及心理干预以帮助其更好地应对压力。

丘疹结节型皮肤Rosai-Dorfman病一例

本文报道一例丘疹结节型皮肤Rosai-Dorfman病。患者左下腹、左乳房下方散在大小不等的暗红色斑片,其上散在分布绿豆至黄豆大暗红色丘疹、结节,部分融合成片。经病理学和免疫组化检查诊断为皮肤Rosai-Dorfman病。

可溶性共刺激分子在自身免疫性皮肤病中的研究进展

可溶性共刺激分子(soluble costimulatory molecules)是共刺激分子的可溶性形式,参与共刺激信号的传递并发挥重要的自我调控作用,其异常表达会影响机体免疫应答和免疫耐受的建立,与自身免疫性皮肤病的免疫调控和发生发展密切相关。本文就可溶性共刺激分子在自身免疫性皮肤病中的研究进展进行综述,旨在为临床医师和科研工作者明确该病的发病机制及有效治疗方案提供参考。

甲下鲍恩病

报告1例甲下鲍恩病。患者男,28岁。1年前右手拇指甲远端出现纵向褐色条纹。皮肤科检查:右手拇指甲远端一纵向褐色条纹,约5 mm×1 mm,远端逐渐变细,至距甲游离缘约2 mm处消失;甲板表面光滑,无触压痛,甲周皮肤正常。皮肤镜检查:右手拇指甲甲板见纵向褐色条纹,远端甲下见黄白色角质性赘生物,局部甲床受压后呈凹陷状。皮损组织病理检查:表皮棘层肥厚,细胞全层排列紊乱,有异形,可见核分裂象和角化不良细胞;真皮浅层可见炎性细胞浸润。诊断:甲下鲍恩病。