Generalized eruptive keratoacanthoma of the Grzybowski type: some considerations on treatment and pathogenesis.

A 64‐year‐old male patient presented with a 2‐month history of a generalized mucocutaneous eruption characterized by suspected keratoacanthomas (KAs), umbilicated papules, and small follicular papules, which mainly involved the face, upper limbs, and trunk; the oral mucosa was affected as well. The presence of HPV‐16 DNA harbored in GEKA lesions does not allow any conclusive consideration on the etiological role of HPV infection and the role of HPV in keratoacanthomas remains thus elusive. However, its potential involvement in the pathogenesis of this disorder supports the retinoids as the first therapeutic option. Retinoids could be effective in GEKA treatment not only because of their antitumor properties but also by altering keratinization and inhibiting HPV replication and assembly. In keeping with this, an inverse relation has been observed between concentration of retinoids and HPV DNA within infected epithelial cells.15 We recommend the evaluation of the role of HPV infection in GEKA as meritorious of further investigation

Sometimes even Dr Google is wrong: An unusual contact dermatitis caused by benzoyl peroxide

The use of the internet to obtain medical information is becoming increasingly common among patients as a substitute for consulting a healthcare provider. The present case is a typical example of sequelae of self-diagnosis and self-therapy in a patient who preferred to look for a “do-it-yourself” solution online

Individuazione e valutazione dei contaminanti ambientali provenienti da impianti di discarica per rifiuti solidi urbani e assimilabili e per rifiuti pericolosi

Consiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7 , Rome / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

One-Stage Implant-Based Breast Reconstruction With Polyurethane-Coated Device: Standardized Assessment of Outcomes

Background: Nipple-sparing mastectomies (NSM) and implant-based breast reconstructions (IBR) have evolved from two-stage reconstructions with tissue expansion (TE) and implant exchange, to direct-to-implant (DTI). In this study, we tested safety and efficacy of Polyurethane based implants according to standard assessment tools. Objectives: This study aims to test safety and feasibility of polyurethane coated implants using standardized assessment with internationally acknowledge evaluation criteria. Methods: Cases of nipple sparing mastectomies followed by breast reconstruction in one stage with immediate pre-pectoral polyurethane coated implants placement were retrospectively reviewed. Pre-operative characteristics of the population Adherence to quality assurance criteria or ABS-BAPRAS was verified. Complications were assessed using the Clavied-Dindo classifications modified for breast. Rippling, implant rotation and malposition were also evaluated. Results: Sixty-three consecutive patients underwent 74 nipple-sparing mastectomies (NSM) and immediate breast reconstruction with micro-polyurethane foam-coated anatomic implants. In five cases we had an unplanned re-admission with return to theatre under general anaesthesia (6.7%) and implant loss within 3 months from breast reconstruction (5 implants 6.7%). Post-operative complications according to Clavien Dindo were grade 1 in 6 cases (8.1%), grade 2 in 3 (4%) and 3b in 5 cases (6.7%). Conclusions: Polyurethane coated implants may prevent rotation and malposition and capsular contracture in the short term. Unplanned re-admission rates and implant loss rates in the short term may be slightly higher

Nonpalpable Breast Carcinomas: Long-Term Evaluation of 1,258 Cases

A steady improvement in imaging diagnostics has been observed together with a rising adherence to regular clinical breast examinations. As a result, the detection of small clinically occult (nonpalpable) lesions has progressively increased. Nonpalpable carcinomas show very favorable prognostic features and high survival rates, showing the important role of modern imaging techniques

Contemporary antithrombotic strategies in patients with acute coronary syndromes managed without revascularization: Insights fromthe EYESHOT study

Aims Patients with acute coronary syndromes (ACSs) whoare managed without coronary revascularization represent a mixed and understudied population that seems to receive suboptimal pharmacological treatment. Methods and results We assessed patterns of antithrombotic therapies employed during the hospitalization and in-hospital clinical events of medically managed patients withACS enrolled in the prospective, multicentre, nationwideEYESHOT(EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in Italian cardiac care units) registry.Among the 2585 consecutive ACS patients enrolled in EYESHOT, 783 (30.3%) did not receive any revascularization during hospital admission. Of these, 478 (61.0%) underwent coronary angiography (CA), whereas 305 (39.0%) did not. The median GRACE and CRUSADE risk scores were significantly higher among patients who did not undergo CA compared with those who did (180 vs. 145, P, 0.0001 and 50 vs. 33, P, 0.0001, respectively). Antithrombotic therapies employed during hospitalization significantly differ between patients who received CA and those who did not with unfractioned heparin and novel P2Y12 inhibitors more frequently used in the first group, and low-molecular-weight heparins and clopidogrel in the latter group. During the index hospitalization, patients who did not receive CA presented a higher incidence of ischaemic cerebrovascular events and of mortality compared with those who underwent CA (1.6 vs. 0.2%, P = 0.04 and 7.9 vs. 2.7%, P = 0.0009, respectively). Conclusion Almost one-third of ACS patients are managed without revascularization during the index hospitalization. In this population, a lower use of recommended antiplatelet therapy and worse clinical outcome were observed in those who did not undergo CA when compared with those who did