Dermoscopy of Mycobacterium marinum Skin infection: A Challenging Diagnosis

Mycobacterium (M.) marinum is a slow-growing atypical mycobacterium found mainly in saltwater environments. Infection occurs following inoculation of a skin lesion and manifests as a localized granulo-ma; in fact, the most common cause of infection with M. marinum is the exposure of traumatized skin to affected aqueous environments (1), and it most commonly involves individuals with occupational and recreational exposure to non-chlorinated water (2)

Dermoscopy of Mycobacterium marinum Skin infection: A Challenging Diagnosis

Dear Editor, Mycobacterium (M.) marinum is a slow-growing atypical mycobacterium found mainly in saltwater environments. Infection occurs following inoculation of a skin lesion and manifests as a localized granuloma; in fact, the most common cause of infection with M. marinum is the exposure of traumatized skin to affected aqueous environments (1), and it most commonly involves individuals with occupational and recreational exposure to non-chlorinated water (2). An erythematous or bluish 0.5 to 3.0 cm nodule usually develops at the inoculation site, while ulceration can occur later and subsequent lesions may be present along the lymphatic drainage. We present the first case in the literature describing the dermatoscopic characteristics of a microbiologically proven Mycobacterium marinum skin infection, although more cases are certainly needed to identify the main dermatoscopic features of this infection. In January 2019, a 66-year-old patient was referred to our Dermatological Clinic reporting the appearance of two purplish nodules about 2 months earlier, located on the back of the hand and on the left thumb (Figure 1) and of erythematous purplish appearance and quite painful to palpation. Based on the clinical presentation, infection with atypical mycobacteria, botryomycosis, fungal infection (Cryptococcus neoformans, Histoplasma capsulatum) and infection with Francisella tularensis were considered in the differential diagnosis. The patient was asked if he had an aquarium at home and he confirmed this by telling us of his passion for aquariums, which made the diagnosis easier. Dermatoscopic examination performed on the two lesions at the center of the first nodule located on the hand showed a whitish area surrounded by an erythematous background with fine scaling and dotted vessels and orange-whitish central areas with looped concentric monomorphic vessels (Figure 2, a). However, the thumb lesion had a purplish background with multiple structured rounded areas with orangish appearance surrounded by looped vessels arranged in a crown-like shape (Figure 2, b). It is interesting to note the dermoscopic-histological correlation in this disease: the orangish areas in fact correspond to a granulomatous dermatitis, characterized by inflammatory nodular infiltrate within the dermis (tuberculoid granulomas) (3). Clinically and dermoscopically, the nodules had two different sets of features because they were in different stages of development: the nodule of the thumb was older than the other one on the hand, which the patient reported was of recent onset, also confirmed by the presence of suppuration and ulceration. Both lesions had orange areas in the context of an erythematous background which led us to investigate a granulomatous disease. A deep culture examination and a skin biopsy were thus performed, showing Mycobacterium marinum infection. Oral therapy with clarithromycin 500 mg twice daily for 4 weeks was started and healing occurred in about 21 days. We present this case to emphasize the role of dermoscopy in differential diagnosis of granulomatous disease and to show dermoscopic clues that have not yet been described and that can be used in the future to establish very early diagnosis of this infection, reducing the diagnostic delay

Dermoscopy of Skin Adnexal Neoplasms: A Continuous Challenge

No abstract availabl

Performance and results of the high-resolution biogeochemical model PELAGOS025 v1.0 within NEMO v3.4

Abstract. The present work aims at evaluating the scalability performance of a high-resolution global ocean biogeochemistry model (PELAGOS025) on massive parallel architectures and the benefits in terms of the time-to-solution reduction. PELAGOS025 is an on-line coupling between the Nucleus for the European Modelling of the Ocean (NEMO) physical ocean model and the Biogeochemical Flux Model (BFM) biogeochemical model. Both the models use a parallel domain decomposition along the horizontal dimension. The parallelisation is based on the message passing paradigm. The performance analysis has been done on two parallel architectures, an IBM BlueGene/Q at ALCF (Argonne Leadership Computing Facilities) and an IBM iDataPlex with Sandy Bridge processors at the CMCC (Euro Mediterranean Center on Climate Change). The outcome of the analysis demonstrated that the lack of scalability is due to several factors such as the I/O operations, the memory contention, the load unbalancing due to the memory structure of the BFM component and, for the BlueGene/Q, the absence of a hybrid parallelisation approach

Monolateral Grover’s disease with blaschkoid distribution.

No abstract availabl

Monolateral Grover’s disease with blaschkoid distribution.

No abstract availabl

Benign dermatoses of the male genital areas: A review of the literature

The male genitalia are a common site of dermatoses. Patients with penile diseases often delay or avoid medical care due to anxiety and embarrassment. In this narrative review, we describe some of the main benign dermatoses localized to male genital, focusing on their epidemiology, clinical and dermoscopic features, as well as available therapies

Long-term efficacy of boosted and unboosted atazanavir-containing regimens: results from the SCOLTA project

In this study we evaluated the efficacy of boosted and unboosted ATV in different regimens in a cohort of HIV-1 infected patients

An explainable model of host genetic interactions linked to COVID-19 severity

We employed a multifaceted computational strategy to identify the genetic factors contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing (WES) dataset of a cohort of 2000 Italian patients. We coupled a stratified k-fold screening, to rank variants more associated with severity, with the training of multiple supervised classifiers, to predict severity based on screened features. Feature importance analysis from tree-based models allowed us to identify 16 variants with the highest support which, together with age and gender covariates, were found to be most predictive of COVID-19 severity. When tested on a follow-up cohort, our ensemble of models predicted severity with high accuracy (ACC = 81.88%; AUCROC = 96%; MCC = 61.55%). Our model recapitulated a vast literature of emerging molecular mechanisms and genetic factors linked to COVID-19 response and extends previous landmark Genome-Wide Association Studies (GWAS). It revealed a network of interplaying genetic signatures converging on established immune system and inflammatory processes linked to viral infection response. It also identified additional processes cross-talking with immune pathways, such as GPCR signaling, which might offer additional opportunities for therapeutic intervention and patient stratification. Publicly available PheWAS datasets revealed that several variants were significantly associated with phenotypic traits such as "Respiratory or thoracic disease", supporting their link with COVID-19 severity outcome.A multifaceted computational strategy identifies 16 genetic variants contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing dataset of a cohort of Italian patients