Environmental factors influence the rate of human herpesvirus type 8 infection in a population with high incidence of classic Kaposi sarcoma

High prevalence of human herpesvirus type 8 (HHV-8) infection has been reported on the island of Sardinia. Among emigrants from Sardinia, rates of HHV-8 infection are lower than they are in Sardinia and are similar to those observed in the local population. Thus, environmental factors seem to play a relevant role in affecting the prevalence of HHV-8 infection

Myrtle-Functionalized Nanofibers Modulate Vaginal Cell Population Behavior While Counteracting Microbial Proliferation

Vaginal infections affect millions of women annually worldwide. Therapeutic options are limited, moreover drug-resistance increases the need to find novel antimicrobials for health promotion. Recently phytochemicals were re-discovered for medical treatment. Myrtle (Myrtus communis L.) plant extracts showed in vitro antioxidant, antiseptic and anti-inflammatory properties thanks to their bioactive compounds. The aim of the present study was to create novel nanodevices to deliver three natural extracts from leaves, seeds and fruit of myrtle, in vaginal milieu. We explored their effect on human cells (HeLa, Human Foreskin Fibroblast-1 line, and stem cells isolated from skin), resident microflora (Lactobacillus acidophilus) and on several vaginal pathogens (Trichomonas vaginalis, Escherichia coli, Staphylococcus aureus, Candida albicans, Candida kefyr, Candida glabrata, Candida parapsilosis, Candida krusei). Polycaprolactone-Gelatin nanofibers encapsulated with leaves extract and soaked with seed extracts exhibited a different capability in regard to counteracting microbial proliferation. Moreover, these nanodevices do not affect human cells and resident microflora viability. Results reveal that some of the tested nanofibers are interesting candidates for future vaginal infection treatments

Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience

Cutaneous immune-related adverse events are frequently associated with immune checkpoint inhibitors (ICIs) administration in cancer patients. In fact, these monoclonal antibodies bind the cytotoxic T-lymphocyte antigen-4 and programmed cell death-1/ligand 1 leading to a non-specific activation of the immune system against both tumoral cells and self-antigens. The skin is the most frequently affected organ system appearing involved especially by inflammatory manifestations such as maculopapular, lichenoid, psoriatic, and eczematous eruptions. Although less common, ICI-induced autoimmune blistering diseases have also been reported, with an estimated overall incidence of less than 5%. Bullous pemphigoid-like eruption is the predominant phenotype, while lichen planus pemphigoides, pemphigus vulgaris, and mucous membrane pemphigoid have been described anecdotally. Overall, they have a wide range of clinical presentations and often overlap with each other leading to a delayed diagnosis. Achieving adequate control of skin toxicity in these cases often requires immunosuppressive systemic therapies and/or interruption of ICI treatment, presenting a therapeutic challenge in the context of cancer management. In this study, we present a case series from Italy based on a multicenter, retrospective, observational study, which included 45 patients treated with ICIs who developed ICI-induced bullous pemphigoid. In addition, we performed a comprehensive review to identify the cases reported in the literature on ICI-induced autoimmune bullous diseases. Several theories seeking their underlying pathogenesis have been reported and this work aims to better understand what is known so far on this issue

Amicrobial pustular dermatosis of the folds and Dapsone syndrome on treatment: a case report

Amicrobial pustolosis of the folds (APF) is a recently described, relapsing, primary aseptic pyoderma involving predominantly the cutaneous folds and the scalp and is often associated with autoimmune diseases or immunological abnormalities. We describe such a case in a lupus erythematous patient under corticosteroid therapy

Kaposi's sarcoma associated with treatment with adalimumab

A 61-year-old man, born and residing in Sardinia, came to our observation in March 2009 because of the appearance of purplish-red papulonodular lesions, located on his feet and hands. In addition, there was an isolated papule located on the distal portion of the lower right leg. The past medical history highlighted that the patient has been affected by rheumatoid arthritis since 2005, treated with leflunomide and methylprednisolone.</br

Follicular spicules and multiple ulcers: cutaneous manifestations of multiple myeloma

We describe 2 patients with multiple myeloma who had horn-like filiform spicules in the follicular orifices of the face, particularly on the nowe, and multiple small ulcerations on the trunk. In the first patient, histopathologic study of a specimen from the nose showed follicular plugs of compact homogeneous eosinophilic material filling the intercellular spaces surrounding the keratinocytes. The same eosinophilic deposits were seen in the ulcer. In the second patient, biochemical investigation revealed that skin matter from spicules and ulcers were made up of monoclonal dysprotein with electrophoretic characteristics identical to those found in patient serum

Cutaneous sporotrichoid leishmaniasis resistant to pentavalent antimonial therapy: complete resolution with itraconazole

Sporotrichoid leishmaniasis is a sporadic form of cutaneous leishmaniasis, a protozoal infection, reported particularly in the Middle East. Clinically it occurs as nontender, subcutaneous, slightly erythematous nodules, often associated with lymphangitis, usually on exposed areas of the skin. Sometimes it occurs after treatment with a single dose of antimonials, and in older lesions, the biopsy can be negative for amastigotes. We report a case of cutaneous sporotrichoid leishmaniasis unresponsive to intralesional pentavalent antimonial therapy, which completely resolved after treatment with oral itraconazole. To our knowledge, this is only the third such case reported. We discuss the causes of dissemination of the nodular lesions and the negative results for amastigotes on re-biopsed lesions

Rare diseases with skin involvement: a retrospective study (1996–2008)

The dermatologist’s role as a front-line medical practitioner in the field of rare diseases is a fundamental one. He actually comes up against rare diseases not only among dermatological disorders per se but also because skin lesions may sometimes reflect an underlying disorder and patients can often be referred from other medical departments. The present work comprises a retrospective data collection on patients with rare diseases in admission and outpatients seen in the Department of Dermatology operative unit (OU), University of Sassari, from January 1996 to December 2008. For this research, we used the rare diseases list under the Italian Health Ministry’s Ministerial Decree no. 279.2001, comprising 583 diseases

Classic Kaposi sarcoma in northern Sardinia: a prospective epidemiologic overview (1977-2003) correlated with malaria prevalence (1934)

Background Studies have demonstrated considerable variations in classic Kaposi sarcoma (CKS) incidence within Europe, with some of the highest incidences found in the Mediterranean area. As a Mediterranean area, northern Sardinia has a high CKS frequency. Objective In order to determine CKS incidence in people born in and residing in northern Sardinia, a clinical prospective epidemiologic study was carried out between 1977 and 2003 by the Department of Dermatology, University of Sassari. We also evaluated a correlation between malaria prevalence in 1934, estimated on the eight historical sub-areas of the Sassari province, and the standardized morbidity ratio from 1977 to 2003. Results A total of 332 patients with CKS were identified. Incidence among the northern Sardinian population ≥40 years of age was 4.06/100,000 persons/year and it was almost stable through the years. The male to female ratio showed a significant decline from 3.6 to 2.5 (P = .03). Females had a statistically decreased risk of developing CKS compared to males (adjusted incidence rate ratio = 0.27; 95% CI: 0.21-0.34), and the risk of developing CKS increased exponentially with age. The prevalence of malaria in each sub-area ranged from 9% to 91%. The standardized morbidity ratio for CKS in the years between 1977 and 2003 ranged from 0.27 to 1.76; the regression coefficient was −0.85 (95% CI: −2.94-1.24), yielding a nonsignificant relationship between the two diseases

Overexpression of the fibroblast growth factor receptor 2-IIIc in Kaposi's sarcoma

Kaposi's sarcoma (KS) is a neoplastic disorder characterized by a highly vascularized lesion with bundles of spindle-shaped cells, pathognomonic of the disease, infiltrated by mononuclear inflammatory and plasma cells. The KS lesion presents as a patch/plaque, which eventually develops into a nodular tumor. Thus far, the mechanisms involved in the etiopathogenesis of KS are not completely understood. Kaposi's Sarcoma-associated Herpesvirus (KSHV) infection is present in all KS cases. However, KSHV is not sufficient for the development of the disease and other factors are certainly involved. Alterations in the expression of cytokines, growth factors and relative receptors have been analyzed over the years. To evaluate the involvement of FGFR2 in the development and progression of KS, we assayed by immunohistochemistry and quantitative real-time PCR (Q-RT-PCR) the expression of FGFR2-IIIb and FGFR2-IIIc in biopsies of KS lesions compared to normal skin. Further studies are needed to analyze whether FGFR2-IIIc up-regulation varies in the history of the disease, and whether these variations might correlate with the clinical status of the disorder. In any case, our survey provides new elements to better understand the complex interplay between viral infection and host response in the development of KS