537 research outputs found
efficacy of biofeedback and cognitive behavioural therapy in psoriatic patientsa single blind randomized and controlled study with added narrow band ultraviolet b therapy
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Rejection-mediated Regression of Melanocytic Naevi in an Immunosuppressed Organ Transplant Recipient
© 2014 The Authors. doi: 10.2340/00015555-1789 Journal Compilation © 2014 Acta Dermato-Venereologica. ISSN 0001-5555 Eruptive melanocytic naevi and/or excess of melanocytic naevi have been reported in several groups of immunosuppressed patients. The eruption of melanocytic naevi after immunosuppression is a peculiar phenomenon indicating that the immune system may play a major role in limitating proliferation of melanocytes (1). In this article we describe a patient with excess of post-transplant melanocytic naevi that spontaneously disappeared after graft rejection
The transition from mild to moderate-to-severe chronic plaque psoriasis
Dear Editor, The clinical course of psoriasis is unpredictable, and the proportion of patients with mild psoriasis at onset who progress to moderate-to-severe disease is unclear.1 The objective of this study was to investigate the transition from mild to moderate-to-severe psoriasis and to identify risk factor
A Misdiagnosed Desmoplastic Neurotropic Melanoma of the Scalp: A Challenging Case for the Pathologist and Surgeon
Desmoplastic neurotropic melanoma (DNM) is a rare melanoma
subtype that shows tropism for the nerves, perineural invasion correlates to
higher rate of local recurrence, poorer prognosis and worse morbidity. Given
the paucity of typical melanoma features, both clinical and pathological, this
confusing skin cancer may act as a pretender, thus leading clinician to misdiagnosis
and subsequent inappropriate conservative treatment. Sarcomatoid-
like cells rearrangement and absence of pigmentation can lead towards
sarcoma diagnosis, so specific skills are required to pathologist to properly recognize
this melanoma subtype. In this case report, we present an example of
how challenging can be the diagnosis, and how it can affect clinical outcom
primary cutaneous cd30 anaplastic large cell lymphoma in a heart transplant patient case report and literature review
Solid organ transplant recipients are at risk of develop ing a wide range of viral-associated malignancies, in cluding skin tumours and lymphoproliferative disorders. The risk of a post-transplant lymphoproliferative disorder is 28–49 times the risk of a lymphoproliferative disorder in the normal population. Most cases are of B-cell phenotype and are associated with Epstein-Barr virus infection. Post-transplant lymphoproliferative disorders presenting clinically in the skin are rare and usually of B-cell phenotype. Only rare cases of cutaneous T-cell post-transplant lymphoproliferative disorder have been reported previously, mostly mycosis fungoides type. We describe here a rare primary cutaneous T-cell lymphoma CD30+ arising in a heart transplant patient who had a nodule on the right leg, several years after heart transplantation. The morphology and immunohistochemical findings were consistent with a CD30+ anaplastic large cell lymphoma with a T-cell phenotype. Excisional biopsy and radiotherapy of the affected area were performed. In this patient, the presence of a solitary lesion and th
Long-term prognostic value of coronary flow reserve in psoriasis patients
BACKGROUND AND AIMS
Psoriasis affects more than 3% of the general population and is associated with an increased risk of premature cardiovascular events and death. We assessed the prognostic role of coronary flow reserve (CFR) as a marker of coronary microvascular function in psoriasis patients asymptomatic for cardiovascular disease.
METHODS
We retrospectively analyzed 153 prospectively collected patients affected by psoriasis (123 male; age 36 ± 8 years) without cardiovascular disease. CFR in the left anterior descending coronary artery was detected by transthoracic Doppler echocardiography, at rest, and during adenosine infusion. CFR was the ratio of hyperemic to resting diastolic flow velocity. CFR ≤2.5 was the cut off to define the presence of coronary microvascular dysfunction (CMD).
RESULTS
CMD was present in 23 patients (15%). Multivariable logistic regression analysis showed that CMD was associated with severe psoriasis (OR 3.1, p = 0.03), psoriatic arthritis (OR 2.9, p = 0.03), hypertension (OR 4.1, p = 0.009), and time elapsing since psoriasis diagnosis >6 years (OR 1.9, p = 0.03). Patients with CFR ≤2.5 had a lower survival free from events (p < 0.0001).
CONCLUSIONS
In psoriasis patients, CFR may be a reliable prognostic marker for cardiovascular event-free survival and may help identify patients at higher risk of developing cardiovascular complications. Whether novel biologic therapies able to reduce skin disease will improve CMD and prognosis in these patients needs to be further studied, prospectively
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