The current consensus for the diagnostic and treatment of extramammary Paget’s disease

Extramammary Paget's disease is a slow-growing cutaneous intraepithelial adenocarcinoma of the apocrine glands in the anogenital and axillary regions. The disease is extremely rare, affects predominantly postmenopausal women, and has nonspecific clinical caracteristics, so that it can take 210 years from the first clinical signs to diagnosis. The vulva and the perianal region are the most affected zones. Extramammary Pagets disease is clinically manifested as well-defined erythematous plaques with secondary changes, such as scaling, ulceration and even bleeding. Differential diagnosis is made between primary and secondary forms of Extramammary Pagets disease, candidiasis, contact dermatitis, Crohn's disease, eczema, erosive lichen planus, hydradenitis suppurativa, Langerhans cell histiocytosis, sclerosing lichen, psoriasis, squamous cell carcinoma in situ, amelanotic melanoma and mycosis fungoide. Treatment mainly includes the surgical component, as well as the use of photodynamic therapy, cytostatic agents, and, depending on the stage, systemic chemotherapy

Gene expression changes of angiogenesis factors during basal skin cancer laser destruction

Background. Basal cell carcinoma is the most widespread malignant skin neoplasm. Angiogenesis is critical for the growth and metastasis of malignant tumors. Aims. To study the levels of representation of transcripts in the foci of basal cell skin cancer before and after the therapy of genes for angiogenesis proteins and their receptors: angiopoietin 2 ANGPT2, calcitonin-related polypeptide alpha CALCA, epidermal growth factor receptor EGRF, fibroblast growth factor FGF2, intracellular adhesion molecule ICAM1, vascular endothelial growth factor VEGFA and its type 2 receptor VEGFR2, matrix metalloproteinase MMP9, homologue protein of phosphatase and tensin PTEN, tachykinin receptor TAC1, and tumor necrosis factor protein genes TNF. Methods. The study included 31 patients with histologically confirmed basal cell skin cancer who received treatment at the consultative and diagnostic center of the State Research Center of Dermatovenereology and Cosmetology of Russian Ministry of Health, Moscow in the period from 2020 to 2021, using a pulsed dye laser (wavelength — 585 nm) and long-pulsed neodymium laser (wavelength — 1064 nm). The patients provided skin punch biopsies from BCC lesions and after therapy from the same localization. The gene expression was analyzed with real-time reverse transcription PCR using endogeneous control, and the gene expression ration changes during the therapy were calculated according to Livak’s double delta formulae. Results. An increased expression of the matrix metalloproteinase MMP9 and the tachykinin precursor TAC1 genes were revealed in skin biopsy samples of the superficial form of basal cell skin cancer during laser pulsed therapy. The expression of tumor necrosis factor TNF, epidermal growth factor receptor EGFR, fibroblast growth factor FGF2 genes increases to a lesser extent. The increasing expression of MMP9 and TAC1 genes also established in skin biopsy samples of the nodular form of basal cell skin cancer. It was shown that the expression of the calcitonin-related polypeptide alpha CALCA gene in the skin of patients is at basal level, which makes it possible to exclude the influence of the neuropeptide on the basal cell skin cancer pathogenesis. Despite the bidirectional changes in expression due to individuality of patients, the average values allow to conclude the expression of all the studied genes is increased after pulse laser destruction therapy. This means neoangiogenesis is continued at the skin even after the destruction of basal cell skin cancer lesions. This could be due to the presence of the basal cell carcinoma microenvironment, likely mast cells, at the affected skin area. Conclusions. Among the factors of neoangiogenesis potentially influencing the development of basal cell skin cancer, the leading role of expression of the MMP9 matrix metalloproteinase and TAC1 precursor protein of tachykinin has been shown. Simultaneous changes in the level of these proteins may be due to neuroimmune interactions in the epidermis, which is probably realized by mast cells as the microenvironment of the basal cell carcinoma. In the process of laser destruction, there is also a slightly pronounced increased expression of additional factors of neoangiogenesis

Synthesis of Star-Shaped Boron Carbide Micro-Crystallites under High Pressure and High Temperatures

We synthesized star-shaped pentagonal microcrystals of boron carbide with an extremely low carbon content (~5%), from m-carborane under high pressure (7 GPa) and high temperature (1370⁻1670 K). These crystals have five-fold symmetry and grow in the shape of stars. A 5-fold symmetry in large micron-sized crystals is extremely rare making this a striking observation

Electron Microscopic Characteristics of The Blood-Air Barrier Interstitium in Fibrous Cavernous Pulmonary Tuberculosis in Comparison with Chronic Nonspecifi c Lung Diseases

Aim. To describe the ultrastructural characteristics of the blood-air barrier (BAB) interstitium in fi brous cavernous pulmonary tuberculosis (FCT) in comparison with chronic nonspecifi c lung diseases (CNSLD).Materials and methods. The fragments of the pericavernal zone and lung tissue were taken for the study at the resection border from the dead or operated for CNSLD persons (n = 163), and the perifocal and boundary zone of lung tissue. 116 CNSLD patients were divided into 3 subgroups: 1) chronic lung abscess (n = 42); 2) bronchiectasis (n = 44); 3) lung cyst (n = 30). The lung fragments of 30 patients who died from pathology not associated with lung diseases (myocardial infarction, acute cerebrovascular accident) were used as a control group to compare the morphological parameters. The criteria for inclusion of patients in the study: age from 18 to 65 years, negative clinical and laboratory data on the presence of comorbid pathology (viral hepatitis B, C and HIV). For TEM, lung fragments 1×1×1 mm in size were cut out and fi xed in a 2.5% glutaraldehyde solution in phosphate buffer (pH = 7.2–7.4) and washed in 0.1 M phosphate buffer (pH = 7.4), followed by dehydration in alcohols of an ascending concentration and placing in a mixture of Epon and Araldite resins according to the scheme. Ultrathin sections were made with Reynolds staining. Viewing and photographing preparations was carried out on a PEM-100 transmission electron microscope (Ukraine) (magnifi cation range from ×1000 to ×30 000). Results. It was established that changes in BAB components in all groups had similar features in the form of severe interstitial fi brosis, the signs of endothelial cell degeneration and destruction of varying degrees of severity, as well as the heterogeneity of the endothelial and epithelial basement membranes.Conclusion. Ultrastructural changes in the BAB components of the removed lung part in patients with FCT and chronic nonspecifi c lung diseases are characterised by a polymorphism with prevailing dystrophic and destructive changes in the perifocal zone of infl ammation, and compensatory-adaptive processes on the peripheral, especially at the resection border