Standard e procedure aperte per l'interoperabilità degli strumenti BIM: una applicazione per il complesso demaniale in piazza VIII agosto a Bologna, sede del Provveditorato Interregionale per le Opere Pubbliche Lombardia – Emilia-Romagna

L’interoperabilità tra le differenti piattaforme BIM-oriented è un concetto fondamentale per la collaborazione tra le diverse figure coinvolte nelle fasi di progettazione e gestione di una costruzione; inoltre, a seguito del Decreto Ministeriale n. 560 del 2017 (conosciuto come “decreto BIM”), l’obbligatorietà di eseguire progetti con metodi e strumenti informatici per la gestione delle informazioni è già una realtà. La tesi propone un approccio metodologico volto alla valutazione comparativa tra i differenti metodi di condivisione delle informazioni nel processo edilizio, investigandone i termini operativi esprimibili tra diverse piattaforme di modellazione BIM, tramite il formato di scambio IFC. Questo lavoro di tesi presenta le analisi relative ai criteri, potenzialità e limiti nello scambio informativo tramite modelli digitali espressi nel formato IFC e creati da software di BIM authoring diversi. In particolare, si è studiato come vengono tradotte le informazioni attribuite agli elementi costruttivi, come si configurano le complesse geometrie modellate, quanti e quali elementi vengono correttamente visualizzati graficamente, per consentire uno scambio adeguato e coerente dei dati nel tempo. Per validare il percorso di studio intrapreso, volto a dimostrare come l’interoperabilità degli strumenti sia fondamentale per alimentare un corretto flusso di progetto BIM, si è trattato il caso studio del complesso demaniale in piazza VIII agosto a Bologna, sede del Provveditorato Interregionale per le Opere Pubbliche Lombardia – Emilia-Romagna. In parallelo alla gestione dei dati raccolti per l’edificio nel modello federato multidisciplinare, si è cercato di coniugare l’approccio alla digitalizzazione a tale edificio esistente, affrontando un contesto operativo attuale. In conclusione, si sono evidenziati i grandi vantaggi derivanti dall’adozione di processi di gestione informativa BIM, circostanziandone le attuali criticità ed ipotizzandone gli avanzamenti futuri

Clinical, dermoscopical and histological evaluation of non-responder actinic keratosis.

Le cheratosi attiniche (CA), conosciute anche come cheratosi solari o neoplasie intraepidermiche cheratinocitarie, sono le neoplasie ad origine dai cheratinociti più comuni. Sebbene le CA siano state storicamente definite "precancerose" o "premaligne", studi istopatologici e molecolari più recenti supportano la loro attuale classificazione come prima fase del carcinoma a cellule squamose (SCC) in situ. Una volta sviluppate, le CA possono seguire uno dei tre diversi percorsi: regressione, persistenza o progressione verso SCC in situ o invasivo sebbene il rischio reale di una singola CA di progredire verso SCC non sia chiaro, le stime variano da un minimo di 0,1% ad un massimo del 20%. Vari studi in letteratura hanno considerato l'aspetto clinico e istologico CA in particolare delle cheratosi attiniche associate a carcinoma a cellule squamose, ma nessun autore ha mai studiato le caratteristiche cliniche, dermoscopiche e istologiche delle CA non responsive a trattamenti specifici (CA-non responder). L’obiettivo primario nel nostro studio è valutare le caratteristiche istologiche di CA (singole o su un campo di cancerizzazione) che nel periodo tra il 01/11/2016 e il 31/10/2018 siano state diagnosticate come CA “non responder” in quanto non responsive ad almeno due trattamenti specifici quali crioterapia, Ingenolo Mebutato, imiquimod, PDT, diclofenac 3%, 5 fluoruracile. Gli obiettivi secondari sono evidenziare le caratteristiche cliniche ed evidenziare l'aspetto della videodermatoscopia delle CA non-responder a due o più terapie. Verranno inoltre valutati i dati clinico-demografici dei pazienti affetti da CA non responder a partire dalle cartelle cliniche dei pazienti (sesso del paziente, età alla diagnosi, fototipo, familiarità per neoplasie dermatologiche, eventuali malattie concomitanti, terapie concomitanti); la sede e le dimensioni dei CA alla diagnosi, il tipo terapia eseguita per la CA.Actinic keratoses (AKs), also known as solar keratosis or keratinocytic intraepidermal neoplasia, are the most common neoplasms within the continuum of keratinocyte skin cancer. Although AKs have been historically defined as “precancerous” or “premalignant,” more recent histopathologic and molecular studies support their current classification as earliest stage of squamous cell carcinoma (SCC) in situ. Prevalence estimates of AK range between 1% and 44% in the adult population. Skin type and cumulative sunlight exposure are major risk factors for both AK and SCC. Once developed, AK may follow one of three different pathways: regression, persistence, or progression to in situ or invasive SCC. Although the actual risk of an individual AK progressing to invasive SCC is unclear, estimations vary from as low as 0.1% to as high as 20%. Various study in literature have considered the clinical and histological aspect of AK but in particular no author has ever classified clinical, dermoscopical and histological peculiar features of non-responder AK. Our project want to follow up the non-responder AK to understand if there are some characteristics than can predict this comportment and the potential evolution versus SCC. The main objective is evaluated the histological feature of AK (single or on field cancerization) that not responder at least two specific treatment including cryosurgery, Ingenol Mebutate, imiquimod, PDT, diclofenac 3% and 5% fluorouracile. In addition to the primary objective, we will consider the following items: clinical feature of non-responder AK; videodermatoscopy aspect of non-responder AK and we evaluate, if possible, the risk of an individual non responder AK progressing to invasive SCC

Angiokeratoma Circumscriptum Naeviforme Presenting as a Dark Warty Plaque on the Leg

45-year-old man presented with a large, dark, keratotic, warty, and friable plaque on the distal posterior aspect of the left leg (Figure 1, a). The patient reported that the lesion was not present at birth but had appeared approximately at the age of three as an erythematous patch that progressively grew over the time. During adolescence, the surface of the lesion became rough and warty and was easily traumatized due to its location, resulting in recurrent bleeding episodes over a period of years. For this reason, the patient requested lesion removal

An Atypical Presentation of Extragenital Lichen Sclerosus et Atrophicus

open6noLichen Sclerosus et Atrophicus is a chronic inflammatory,invalidating disorder mainly involving the anogenital skin. Extragenital lesions are uncommon, occurring asmultiple, oval, porcelain-white macules, or papules. Whenpresent, they are mostly observed on the superior trunk, axillae, buttocks, and extremities, following Blaschko lines.openSabina Vaccari, Alessia Barisani, Francesca Pepe, Carlotta Baraldi, Bianca Maria Piraccini, Valeria GaspariSabina Vaccari, Alessia Barisani, Francesca Pepe, Carlotta Baraldi, Bianca Maria Piraccini, Valeria Gaspar

Frequency of malignant neoplasms in 257 chronic leg ulcers

none7noBACKGROUND: Chronic leg ulcers are one of the most common medical conditions and are a substantial source of morbidity. OBJECTIVES: To investigate the prevalence of skin cancer mimicking leg ulcers. PATIENTS AND METHODS: This observational study included all patients with a clinical diagnosis of chronic leg ulcers (CLU) admitted to the Wound Care Unit, Division of Dermatology, University of Bologna, between March 2008 and February 2011. Patients' general health was assessed, and skin biopsy and vascular Doppler of the lower limbs were performed. RESULTS: Two hundred fifty-seven patients ages 45 to 98 with CLU were included. Skin biopsies were performed in all patients. Pathologic results showed that 10 patients had ulcerative lesions of neoplastic origin. Surgical excision was performed in all patients with neoplasms. After at least 1 year of follow-up, no recurrences were observed. DISCUSSION AND CONCLUSION: Our findings highlight the important role of systematic biopsies in diagnosing ulcerated tumors of the lower legs and indicate a high prevalence of large ulcerated basal cell carcinomas.Background Chronic leg ulcers are one of the most common medical conditions and are a substantial source of morbidity. Objectives To investigate the prevalence of skin cancer mimicking leg ulcers. Patients and Methods This observational study included all patients with a clinical diagnosis of chronic leg ulcers (CLU) admitted to the Wound Care Unit, Division of Dermatology, University of Bologna, between March 2008 and February 2011. Patients' general health was assessed, and skin biopsy and vascular Doppler of the lower limbs were performed. Results Two hundred fifty-seven patients ages 45 to 98 with CLU were included. Skin biopsies were performed in all patients. Pathologic results showed that 10 patients had ulcerative lesions of neoplastic origin. Surgical excision was performed in all patients with neoplasms. After at least 1 year of follow-up, no recurrences were observed. Discussion and Conclusion Our findings highlight the important role of systematic biopsies in diagnosing ulcerated tumors of the lower legs and indicate a high prevalence of large ulcerated basal cell carcinomas. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.openMisciali C;Dika E;Fanti PA;Vaccari S;Baraldi C;Sgubbi P;Patrizi AMisciali C;Dika E;Fanti PA;Vaccari S;Baraldi C;Sgubbi P;Patrizi

Localized cold urticaria after vaccination in a child: A case and literature review

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An Ulcerated Reddish Nodule of the Chest: When You See, Think …

A 97-year-old man with a previous personal history of multiple nonmelanoma skin cancers presented with a fast-growing, ulcerated reddish nodule on his chest. The nodule was surgically removed, and hematoxylin and eosin stains of the specimen showed an asymmetrical, nonpigmented lesion with architectural and structural impairment, round cells with clear, whitish, foamy cytoplasm, multiple dermal mitoses and nuclear pleomorphism. Our first hypothesis was sebaceous carcinoma, a rare malignant neoplasm derived from epithelial cells showing sebaceous differentiation. A further histopathologic examination showed the presence of pigment in a few areas of the neoplasm. On immunohistochemical study, neoplastic cells were negative for wide-spectrum cytokeratin and diffusely positive for S-100, MART-1, and HMB-45 proteins. Our final diagnosis was nodular malignant melanoma (MM) with balloon epithelioid cells, a “bizarre” presentation of MM in vertical growth phase, mimicking metastatic and primary neoplasms of different lineage derivations

Neoplastic Leg Ulcers

Skin biopsy is an important procedure for a correct diagnosis of varying skin conditions, from inflammatory to neoplastic diseases. Nevertheless, some authors still consider this procedure a high risk in patients affected by leg ulcers (LUs) and prefer reserving it for selected cases

The Histopathologic Evaluation of Diagnostic Procedures in Nail Melanoma

Introduction: The diagnostic delay in nail melanoma (NM) has been repeatedly emphasized. It may be related to both clinical misinterpretations and to errors in the bioptic procedure. Objectives: To assess the efficacy of histopathologic examination in different diagnostic biopsies in NM. Methods: We retrospectively investigated the diagnostic procedures and histopathologic specimens referred to the Laboratory of Dermatopathology for the clinical suspicion of NM from 2006 to January 2016. Results: Eighty-six nail histopathologic specimens were analysed consisting in 60 longitudinal, 23 punch and 3 tangential biopsies. A diagnosis of NM was performed in 20 cases, benign melanocytic activation in 51 cases and melanocytic nevi in 15 patients. Longitudinal and tangential biopsy were diagnostic in all cases, regardless of the clinical suspicion. Nail matrix punch biopsy instead was not diagnostic in most of the cases (13/23 specimens). Conclusions:  In the presence of an NM clinical suspicion, longitudinal biopsy is recommended (lateral or median) because it provides exhaustive information on the characteristics of melanocytes’ morphology and distribution in all the components of the nail unit. Tangential biopsy, recently encouraged by expert authors due to the optimal surgical outcome, in our experience gives incomplete information on tumor extension. Punch matrix biopsy gives limited evidence in the diagnosis of NM