Primary cutaneous plasmacytoma after rejection of a transplanted kidney: case report and review of the literature.

Immunosuppressed organ allograft recipients are at risk of developing lymphomas and lymphoproliferative disorders as a consequence of immunosuppressive therapy and long-term antigenic stimulation from both the graft and possible viral infections. No more than 4% of the malignant tumors detected in organ recipients are plasmacytomas. Primary cutaneous plasmacytoma is a rare type of cutaneous B-cell lymphoma arising primarily in the skin. It is derived from clonally expanded plasma cells with various degrees of maturation and atypia. We report the occurrence of a solitary cutaneous plasmacytoma in a 56-year-old male patient undergoing hemodialysis after rejection of a grafted kidney. The diagnosis was made a few months after the kidney had been surgically removed. A thorough examination showed no evidence of systemic disease. Skin lesions were successfully treated with local radiotherapy. After 2 years of follow-up there were no local or systemic recurrences

Chronic pruritus in the absence of specific skin disease: an update on physiopathology, diagnosis and therapy

Chronic pruritus is a major and distressing symptom of many cutaneous and systemic diseases and can significantly impair the patient's quality of life. Pruritus perception is the final result of a complex network involving dedicated nerve pathways and brain areas, and an increasing number of peripheral and central mediators are thought to be involved. Itch is associated with most cutaneous disorders and, in these circumstances, its management overlaps with that of the skin disease. Itch can also occur without associated skin diseases or primary skin lesions, but only with nonspecific lesions secondary to rubbing or scratching. Chronic itch with no or minimal skin changes can be secondary to important diseases, such as neurologic disorders, chronic renal failure, cholestasis, systemic infections, malignancies, and endocrine disorders, and may also result from exposure to some drugs. The search for the cause of pruritus usually requires a meticulous step-by-step assessment involving careful history taking as well as clinical examination and laboratory investigations

Excessive number of skin cancers in an Italian renal transplant recipient.

the present a case of a trannsplanted patients with more thant 20 non melanoma skin cancer

Of cytochrome P450 isoenzymes in drug metabolism. Clinical aspects

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The facial grid analysis for filler injection: a cohort study on 300 patients

BACKGROUND: Filler injection is widely used for facial rejuvenation. Global skin rejuvenation requires the precise sequential injections ofdifferent areas, but a standardized and reproducible method is lacking. The purpose of the study was to develop a new method for a precisemeasurement of the degree of facial defect before and after full-face rejuvenation with injectable fillers, so called facial filler (FAFI) grid.METHODS: Three hundreds patients were included. There were 76 males and 224 females with a median age of 30.5 years. A grid of horizontal and vertical lines was drawn on the patients\u2019 face with a rigid meter and a surgical pen to identify some precise areas for sequential filler injections.The grid was also used to measure the defects and the corrections obtained. Three different formulations of hyaluronic acid were used fortreating specific facial areas.RESULT S: Correction was judged adequate in 77% and 90% of cases by the physician and patients, respectively. Prevalence of adverse events was 8.8%, with mostly mild, with resolution in few weeks.CONCLUSIONS: FAFI grid proved to be helpful in guiding sequential injections for total facial rejuvenation

Non-Bullous Pemphigoid: A Single-Center Retrospective Study

Introduction: Bullous pemphigoid (BP) is an autoimmune disease that typically presents with blisters, but sometimes early lesions may be eczematous, maculopapular, or urticarial. The aim of the present study was to highlight possible differences between typical bullous and non-bullous pemphigoid (NBP) and compare results with the literature. Material & methods: Patients receiving a diagnosis of BP between January 2000 and December 2019 were analyzed. Patients who developed a blister after 3 months from the onset of pruritus were considered as NBP. Demographic features, clinical findings at diagnosis and at 2-year follow-up, histological features, auto-antibodies titers, comorbidities and their treatment were retrieved. Categorical variables were evaluated for normal distribution using a histogram and a Q-Q plot. The chi(2) and Fisher's exact tests were used to compare categorical variables between the groups. Continuous variables were compared between the groups using analysis of variance and the independent-samples t test. For multivariate analysis, logistic regression was performed. Results: A total of 532 patients received a diagnosis of BP. A total of 122 patients were enrolled in the study; 63 were females, and the mean age at the diagnosis was 77.2 years (+/- 11.9 SD). 98 were affected by BP and 24 were categorized as NBP. Mean time to diagnosis was 2.9 months (+/- 5.8 SD) for BP and 30.4 months (+/- 59.8 SD) for NBP (p = 0.0001). Skin manifestations in NBP patients were, in order of frequency: urticarial, papular or nodular, eczematous, and excoriations. Pruritus intensity was high but similar in the two groups (Numerical Rating Scale - NRS, 9.3 vs. 8.9). Seven out of 24 NBP patients (29%) never developed blisters; the other patients developed blisters after a mean follow-up time of 24.9 months (+/- 54.9 SD). NBP patients had a more frequent history of myocardial infarction than BP patients (37.5 vs. 10.2%; p < 0.003). More NBP patients were taking diuretics than BP patients (66.7 vs. 49%; p = 0.03). NBP patients had a worse response to pruritus compared to BP patients at 2 years (NRS 3.7 vs. 11; p 0.001). Conclusions: NBP patients have a delayed diagnosis and may be at an increased risk of cardiovascular disease, especially myocardial infarction. Severely and persistently itchy skin disorders in aged patients should be investigated for BP diagnosis

Reply to: Non-Bullous Pemphigoid: A Yet-to-Be Defined Disease Entity

Reply to: Non-Bullous Pemphigoid: A Yet-to-Be Defined Disease Entit

Incidence and ten-year follow-up of primary cutaneous lymphomas: a single-centre cohort study

Primary cutaneous lymphomas (PCLs) are a rare group of extranodal non-Hodgkin lymphomas, and epidemiological data in Mediterranean countries are scarce

Allergic contact dermatitis in children with and without atopic dermatitis.

BACKGROUND:Prevalence and causes of allergic contact dermatitis (ACD) in children vary with time and geographical area.OBJECTIVE:This study aimed to determine the relevant allergens causing ACD in children and the relation between ACD and atopic dermatitis (AD).METHODS:A cohort study on 349 children (0-15 years old) patch tested over a 7-year period was conducted.RESULTS:Patch test results were positive for at least 1 allergen in 69.3% of patients and were relevant in 69.8%. The highest sensitization rate (76.7%) was observed in children who are 0 to 5 years old (n = 86, 64% females), followed by the group of 6- to 10-year olds (70%, n = 157, 47.8% females), whereas 62.3% of 11- to 15-year-old children (n = 106, 59.4%) were sensitized. The most frequent allergens were nickel (16.3%), cobalt (6.9%), Kathon CG (5.4%), potassium dichromate (5.1%), fragrance mix (4.3%), and neomycin (4.3%). Body areas mostly affected were upper limbs and hands (31%). Approximately one third of children also had AD. Allergic contact dermatitis was more widespread in children with AD. Patch tests resulted positive in 55.3% (50% relevant) of AD compared with 76.9% (77.5% relevant) of the children without AD. Sensitizers were similar to children without AD.CONCLUSIONS:Very young children showed a high rate of relevant positive patch test reactions to common haptens. Allergic contact dermatitis may easily coexist with A

Mechanisms of immune-mediated skin diseases: an overview.

The skin is a frequent site of pathological immune responses that can take place in the dermal and/or the epidermal compartments. These immunopathological reactions often occur towards innocuous antigens and may be the result of T cell-dependent and/or autoantibody- dependent mechanisms. Defective immune regulation is increasingly recognized as very relevant in many skin and systemic immune-mediated disorders. In some instances (e.g., psoriasis and atopic dermatitis) genetic predisposition can affect also the capacity of keratinocytes to initiate or perpetuate inflammatory responses. A more precise understanding of the molecular and cellular mechanisms underlying each disorder may allow the identification of novel targets for more effective therapeutic strategies