Autochthonous borderline tuberculoid leprosy in a man from Florida

Leprosy (Hansen's disease) is a chronic contagious granulomatous disease principally affecting the skin and peripheral nervous system, caused by Mycobacterium leprae. In this report, we present a case of autochthonous leprosy in a man from Florida as the first human case reported from this region. Authors believe dermatologists need to be aware of the possibility of autochthonous transmission of leprosy in the Eastern-Southern United States, and should consider leprosy in any patient with atypical skin lesions, even when a history of contact with armadillo is missing

effects of a new human recombinant mnsod in the treatment of photoaging and actinic keratosis

Physiological processes, as aerobic metabolism and inflammatory response, generate reactive oxygen species (ROS) that may induce cellular injury when their amount is increased and antioxidant defense mechanisms are overwhelmed. Also, ROS are generated following UV skin irradiation able to deplete the natural antioxidant defenses in the skin. The increase in exposure to UV may lead to photoaging and precancerous skin lesions (actinic keratosis). New antioxidant strategies in the prevention and therapy of skin lesions are urgently needed. In this study, we evaluated the antioxidant efficacy of a recombinant form of human manganese superoxide dismutase able to inhibit reactive oxygen species production in some patients affected by severe photoaging and actinic keratosis

Retrospective observational multicenter study on patients treated with a non-animal origin cross-linked hyaluronic acid with different molecular weights for nasolabial folds

Background: According to the American Academy of Aesthetic Plastic Surgeons, more than 11 million cosmetic surgical and nonsurgical procedures were performed by board-certified plastic surgeons, dermatologists and otolaryngologists in the United States, totaling more than 12 billion dollars. Of that total, more than 7 billion was spent on surgical procedures and more than 5 billion was spent on nonsurgical procedures. More than 1,872,172 people received Hyaluronic Acid (HA) injections in 2013. Moreover, filler treatments are the most popular procedures performed by dermatologists. Objective: Evaluate, with a new imaging system, durability, efficacy and safety of a nasolabial fold treatment with a cross-linked HA of non-animal origin with different molecular weights. Material and methods: A cross-linked HA (25 mg/ml, 1000-2000 kDa, 23 ± 3 Newton [N] extrusion force, 1,4-Butanediol Diglycidyl Ether (BDDE) content < 0.1 ppm) was used in order to perform the treatment. The product is commercially available with the trademark Aliaxin®GP (Global Performance) and distributed by IBSA Farmaceutici Italia Srl. 25 female subjects aged 40 and 60 years with a photoageing level III according Rubin or type III according Glogau were recruited for the treatment and 0.5 ml of the product were injected for single nasolabial fold. The aesthetic result and the duration of the aesthetic correction were evaluated by the analysis of the skin microreliefs through confocal microscopy and by Glogau's Scale. Additionally, pictures of each patient were collected by Canon PowerShot G10 Digital Camera (14.7 megapixels) before and after treatment. Below the description of the experimental schedule: T0: Baseline, evaluation and treatment; T1: second visit, 4 months after the treatment; T2: third visit, 6 months after the treatment. Results: From 25 patients, 150 silicone casts were obtained: 75 casts of the right nasolabial fold and 75 casts of the left nasolabial fold. Roughness arithmetical average (Ra) was assessed by profilometry. This parameter represents the arithmetic mean deviation of the profile points compared to the average value. The Ra of the right fold at T2 decreased by 50% versus T0 and by 40% compared to T1; Ra of the left fold at T2 decreased by the 45% versus T0 and by 35% compared to T1. No side effects were reported during the observation period beyond mild symptoms (pain, sensation of heat, reddening in the injection site) also described by the product technical sheet. Conclusion: The results proved the efficacy and safety of the nasolabial folds treatment with the tested product and the durability of the aesthetic correction

Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis

We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P &lt; 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD4OL (Spearman's rank correlation coefficient [r(s)], -0.33; P &lt; 0.001), sNox2-dp (r(s), -0.57; P &lt; 0.0001), and urinary excretion of isoprostanes (r(s), -0.48; P &lt; 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2 alpha-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation

Borreliae Part 2: Borrelia Relapsing Fever Group and Unclassified Borrelia

Borreliae of the relapsing fever group (RFG) are heterogenous and can be divided mainly into three groups according to vectors, namely the soft-tick-borne relapsing fever (STBRF) Borreliae, the hard-tick-borne relapsing fever (HTBRF) Borreliae, the louse-borne relapsing fever (LBRF) Borreliae, and the avian relapsing fever ones. With respect to the geographical distribution, the STBRF Borreliae are further subdivided into Old World and New World strains. Except for the Avian relapsing fever group Borreliae, which cause avian spirochetosis, all the others share infectivity in humans. They are indeed the etiological agent of both endemic and epidemic forms of relapsing fever, causing high spirochaetemia and fever. Vectors are primarily soft ticks of Ornithodoros spp. in the STBRF group; hard ticks, notably Ixodes sp., Amblyomma sp., Dermacentor sp., and Rhipicephalus sp., in the HTBRF group; and the louse pediculus humanus humanus in the TBRF one. A recent hypothesis was supported for a common ancestor of RFG Borreliae, transmitted at the beginning by hard-body ticks. Accordingly, STBRF Borreliae switched to use soft-bodied ticks as a vector, which was followed by the use of lice by Borrelia recurrentis. There are also new candidate species of Borreliae, at present unclassified, which are also described in this review

Effects of a New Human Recombinant MnSOD in the Treatment of Photoaging and Actinic Keratosis

Physiological processes, as aerobic metabolism and inflammatory response, generate reactive oxygen species (ROS) that may induce cellular injury when their amount is increased and antioxidant defense mechanisms are overwhelmed. Also, ROS are generated following UV skin irradiation able to deplete the natural antioxidant defenses in the skin. The increase in exposure to UV may lead to photoaging and precancerous skin lesions (actinic keratosis). New antioxidant strategies in the prevention and therapy of skin lesions are urgently needed. In this study, we evaluated the antioxidant efficacy of a recombinant form of human manganese superoxide dismutase able to inhibit reactive oxygen species production in some patients affected by severe photoaging and actinic keratosis

Effetti della rMnSOD nella terapia delle discheratosi attiniche

Gli UV sono in grado di indurre modificazioni sia quantitative che qualitative delle cellule immunocompetenti e possono alterare l’immuno-sorveglianza verso i tumori cutanei. L’irradiazione ultravioletta stimola i cheratinociti a secernere citochine e fattori di crescita che intervengono sulle cellule deputate alla risposta immunitaria (Santoianni, 2003 ). Dati sperimentali, epidemiologici e clinici negli ultimi anni hanno messo in evidenza l’importanza dell’ultravioletto lungo nella genesi di cheratosi attiniche (Nino 2006). Organismi esposti a radiazioni ionizzanti sono principalmente danneggiati dai radicali liberi, generati dalla radiolisi dell'acqua contenuta nelle cellule. Inoltre è stata dimostrata una significativa riduzione del danno tissutale da irradiazione utilizzando trattamenti con una manganese superossido dismutasi. Le superossido dismutasi (SOD) sono enzimi che hanno un ruolo chiave nella prevenzione di tutte le patologie determinate dal danno ossidativo (Borrelli et al., 2009). Le SOD sono implicate nella difesa antiossidante di quasi tutte le cellule, poiché catalizzano la dismutazione del radicale superossido a perossido d’idrogeno che, successivamente, è convertito in ossigeno e acqua dall’enzima catalasi. Questi enzimi hanno la capacità di prevenire il danno provocato dagli alti livelli di ROS prodotti, in particolare da radiazioni ionizzanti (Epperly et al., 2003). Nelle cellule sono presenti tre isoforme: la SOD 1 è localizzata nel citosol, la SOD 2 nella matrice mitocondriale, mentre la SOD 3 è secreta nello spazio extracellulare (Oberley, 2005). L’isoforma SOD 2, conosciuta anche come manganese superossido dismutasi (MnSOD), ricopre un ruolo di notevole importanza nella conversione del radicale superossido (O2.-) nei mitocondri e, dunque, rappresenta la prima linea di difesa contro questo radicale (Wang et al., 2001). Recentemente nel laboratorio di ricerca del dott. Aldo Mancini (Istituto Nazionale Tumori G.Pascale) è stata isolata un’isoforma di SOD da cellule di liposarcoma umano in coltura (LSA-Type MnSOD) che ha mostrato sia in vivo che in vitro una azione citotossica specifica e selettiva solo per le cellule esprimenti il recettore per gli estrogeni. Pur avendo la stessa attività enzimatica comune a tutte le SOD, la LSA-Type MnSOD si differenzia dalla sua corrispondente nativa per la presenza del peptide leader (da 24 amminoacidi), evidentemente non clivato, che le conferisce la peculiare capacità di penetrare in tutte le cellule. Tale proteina è stata riprodotta in forma ricombinante, rMnSOD, a partire da uno specifico clone di cDNA derivato da cellule di liposarcoma umano (Mancini et al., 2006). La rMnSOD è risultata, in vitro, essere radioprotettiva per le cellule normali e radiosensibilizzante per quelle tumorali. Inoltre, animali sani, esposti a dosi letali di radiazioni ionizzanti in presenza della rMnSOD (1,4 µM), mediante iniezioni s.c. sono sopravvissuti al danno radiante rimanendo vivi 30 giorni dopo l'irradiazione, tempo in cui è stato interrotta il controllo della loro sopravvivenza. Al contrario, animali irradiati con le stessse dosi letali, in assenza della rMnSOD, morivano dopo 7-8 giorni dall’irradiazione (Borrelli et al.2009). La notevole capacità enzimatica della rMnSOD, in formulazione topica, di neutralizzare i radicali liberi che incontra e che si accumulano nei tessuti danneggiati da qualsivoglia noxa patogena, è stata dimostrata, inoltre, con il suo utilizzo nella cura di una necrosi profonda ed estesa a testa, collo, e natatoie di un esemplare di tartaruga marina Caretta caretta. Il trattamento topico di tali esemplari con rMnSOD ha consentito una piena restitutio ad integrum anche nei siti delle necrosi che avevano provocato esposizione dell'osso (Occhiello A. et al 2009). Sulla base dei risultati precedentemente ottenuti è stato allestito uno studio su pazienti afferenti alla Dermatologia dell'Ospedale Ascalesi di Napoli, i quali si sono spontaneamente dichiarati disponibili al trattamento con la formulazione cosmetica contenente la rMnSOD, Sono stati arruolati per lo studio 30 pazienti di entrambi i sessi di eta’ compresa tra i 35 e i 70 anni con fotodanno medio severo con presenza di discheratosi attiniche. I pazienti hanno praticato terapia topica con una formulazione O/A a base di rMnSOD, mattina e sera per due mesi. Ogni settimana è stato effettuato un controllo e sono state fotografate le lesioni per monitorare l'effetto della terapia. Già nella prima settimana è stato osservata una diminuzione dello stato infiammatorio in tutti i pazienti trattati. A due mesi di trattamento è stato osservato miglioramento consistente del fotodanno, migliorata la compattezza e la luminosità della cute con riduzione della elastosi solare e scomparsa o regressione parziale delle discheratosi. La formulazione topica della rMnSOD merita di essere considerata come un promettente farmaco con potente azione antiinfiammatoria utilizzabile in dermatologia. • Borrelli A, Schiattarella A, Mancini R, Morrica B, Cerciello V, Mormile M, d'Alesio V, Bottalico L, Morelli F, D'Armiento M, D'Armiento FP, Mancini A. Free Radical Biology and Medicine. 2009 Jan 1;46(1):110-6. Epub 2008 . • Epperly M.W., Gretton J. E., Sikora C.A., Jefferson M., Bernarding M., Nie S. and Greenberger J.S. (2003). Radiation Research. 160 (5): 568-578. • Mancini A., Borrelli A., Schiattarella A., Fasano S., Occhiello A., Pica A., Sher P., Tommasino M., Nüesch J. P. F. and Rommelaere J. (2006). International Journal of Cancer. 119 (4): 932-943. • Oberley L.W. Biomedicine & Pharmacotherapy. 59 (4): 143-148. • Occhiello A., Bentivegna F., Borrelli A., Schiattarella A., Mancini A., Pica A. Comparative clinical Pathology. DOI 10.1007/s00580-009-0816-9 • Wang L.I., Miller D.P., Sai Y., Liu G., Su L., Wain J.C., Lynch T.J. and Christiani D.C. (2001). Journal of the National Cancer Institute. 93 (23): 1818-1821. • Santoianni P., Nino M. Giornale italiano di dermatologia e venereologia. 2003. 138(6):455-64 • Nino M., Santoianni P. . Giornale italiano di dermatologia e venereologia 2006. 141(5):471-