An unusual presentation of primary cutaneous follicle center lymphoma

Primary cutaneous follicle center lymphoma (PCFCL) is a rare low-grade cutaneous B-cell lymphoma. Clinically, PCFCL is usually an erythematous subcutaneous nodule or an infiltrated plaque. The dermoscopy is non-specific and it is characterized by polymorphous vascular pattern, arborizing vessels over a salmon-colored background and white areas. We reported a case of a 36-year-old woman presented with a rapidly growing, flashed-color, exophytic, soft consistency nodule on her scalp. Dermoscopy showed a diffuse structureless, skin-color area associated with a rare arborizing vascular pattern and brown circles. We reported a peculiar clinical and dermoscopic variant. This clinical presentation of PCFCL is unusual and represents a pitfall in the early clinical diagnosis. Histopathology is mandatory for a correct diagnosis

Palliative management of a recurrent destructive cutaneous squamous cell carcinoma of the scalp with brain exposure

INTRODUCTION: Squamous cell carcinoma (SCC) is the second most prevalent malignant skin carcinoma. Bone infiltration is uncommon, and invasion of the dura mater and brain parenchyma is rare and possible only in the advanced stages of the disease. Treatment of advanced SCC is challenging and often requires the collaboration of a multidisciplinary team to provide local and systemic treatment. Management of advanced SCC of the scalp involving bones and meninges with brain exposure was described herein. CASE REPORT: An 85-year-old male presented with advanced SCC of the scalp. A vegetative and infiltrating neoplastic ulcer of the frontal and parietal regions with exposure of the brain and extensive meningeal and bone destruction was observed. Because of comorbidities and decisions made by the patient and his family, he did not undergo immunotherapy, radiotherapy, or other invasive treatments. The neoplastic tissue was covered by blood, fibrin, and bacterial colonization. The patient received palliative care in a wound healing clinic twice monthly for 1 year, and daily dressing changes were performed at home. Binding bacteria dressings, silver dressings, and absorbent dressings were used to control exudate and infection. Alginate was used to manage bleeding, and charcoal dressings were used to manage odor. The dressings were covered with gauze and bandage. Additionally, swabs were performed when signs of infection were present and targeted systemic antibiotic treatment administered. CONCLUSIONS: Squamous cell carcinoma rarely presents with a devastating and rapid evolution. In this case, the local approach was based on the TIME (tissue, inflammation/infection, moisture imbalance, epithelial edge advancement) concept, with special attention paid to the most significant features of neoplastic wounds (eg, pain, exudate, bleeding, odor). Despite the patient's serious conditions, he survived for a relatively long time

Psoriasis caused by pembrolizumab treatment in advanced melanoma: A positive prognostic side effect?

n

The Role of Autoflorescence Imaging Device in the Evaluation of Bacteria Burden Control

MolecuLight i:X is a autofluorescence, portable device that allows an assessment of wound area, perimeter, width and length and an evaluation in real time of wound surface bacteria (>104 CFU/g). Primary objective of our study was to evaluate the reduction of bacterial load associated to 3 different therapeutic approaches: dressings and multicomponent bandages (Group1), sharp debridement, dressings and multicomponent bandages (Group 2), and 10 patients treated with zinc oxide bandage (Group 3). Secondary objective was NRS pain scale, Wound Bed Score (WBS) and Quality of Life (QoL) assessment. Despite the improvement of bacterial load, WBS, Qol and NRS was evident in all 3 groups, the analysis of our results demonstrates that the application of zinc oxide bandage, directly in contact with the wound bed and/or the perilesional skin, resulted in a higher improvement and a significant reduction of WBS and bacterial load. Fluorescence imaging can help the specialist in a more targeted assessment and management of infection. Sharp debridement and antiseptic dressings are classically used to reduced bacteria burden. Zinc oxide directly on the wound is an interesting cost-effective option to control different types of bacteria

The Genetic Basis of Dormancy and Awakening in Cutaneous Metastatic Melanoma

Immune dysregulation, in combination with genetic and epigenetic alterations, induces an excessive proliferation of uncontrolled melanoma cells followed by dissemination of the tumor cells to distant sites, invading organs and creating metastasis. Although immunotherapy, checkpoint inhibitors and molecular targeted therapies have been developed as treatment options for advanced melanoma, there are specific mechanisms by which cancer cells can escape treatment. One of the main factors associated with reduced response to therapy is the ability of residual tumor cells to persist in a dormant state, without proliferation. This comprehensive review aimed at understanding the genetic basis of dormancy/awakening phenomenon in metastatic melanoma will help identify the possible therapeutical strategies that might eliminate melanoma circulating tumor cells (CTCs) or keep them in the dormant state forever, thereby repressing tumor relapse and metastatic spread

Ultra-high-frequency ultrasound monitoring of melanomas arising in congenital melanocytic nevi: a case series

The aims of our study were to evaluate with ultra-high-frequency ultrasound (UHFUS) the ultrasound features of congenital melanocytic nevi (CMNs) and malignant melanomas (MMs) arising in CMNs and the correlation between ultrasonographic thickness and histological thickness in MMs. We evaluated 10 patients with small-medium CMNs and 10 patients with MMs arising in small-medium CMNs. We collected patient's data, clinical and dermoscopic features. The UHFUS was performed using a 70 MHz frequency probe to study the ecostructure, shape and vascularization. Breslow thickness was compared with ultrasonographic thickness. In the MMs group the following dermoscopic features were described: hyperpigmentation (n = 9), regression area (n = 6), whitish-blue veil (n = 5), thickened network (n = 5), irregular globules (n = 3), inverse network (n = 2) and striae (n = 1). Hyperpigmentation (n = n = 9), thickened network (n = 7), irregular globules (n = 5), regression area (n = 5), striae (n = 1) and whitish-blue veil (n = 1) were found in the CMNs group. The multicomponent pattern was present in both MMs (n = 4) and in CMNs (n = 5). Moreover, the parameters indicative of suspected malignancy were variously combined in the two groups, without showing significant differences in the statistical analysis; with the exception of the blue veil that correlated with the diagnosis of MM. Ultrasonoghaphic vascularization was an ever-present parameter in MMs (100%), with high intensity of intratumoral signal, as opposed to CMNs. We also found a statistically significant correlation between ultrasound thickness and Breslow thickness. In the future, this technique could implement the diagnostic preoperative phase of MMs arising in CMNs in combination with standard clinical-dermatoscopic evaluation