Zosteriform cutaneous metastases : an unusual presentation of metastatic lung carcinoma

Zosteriform cutaneous metastases are an unusual and rare morphological variant. We discuss the case of a 78‐year‐old gentleman with a background of end‐stage renal disease with metastatic adenocarcinoma of the lung which was diagnosed due to the development of zosteriform cutaneous metastases around his vascular catheter (vascath) site. The vascath may have acted as a traumatic nidus for lymphatic spread

Morphological and morphometric analysis of the distal branches of the rat brachial plexus

The rat brachial plexus has gained interest recently in neuro-regenerative research due to the advancement of neurosurgical equipment and techniques, but moreover in that it provides a model that can closely resemble the common peripheral nerve injuries seen in humans. The aim of this study was to provide a systematic baseline quantification for fibre type and morphology of the major terminal nerve branches of the rat brachial plexus (radial, ulnar and median) at four surgically accessible sites, through the forelimb. We applied a microstructural and immunohistological analysis of 12 rat brachial plexuses using three forms of micro-visualisation: electron microscopy; whole mount; and immunohistology. The three distal nerves studied showed a similar patterning in terms of the number and size of myelinated fibres, with all proportionally decreasing when moving distally. The fibre types of both the median and ulnar nerve appeared to be homogenously mixed throughout their trajectory, while the radial nerve had a more distinct patterning, especially distal to the elbow, with the entire nerve’s main branch appearing to consist of sensory fibres only. Our microstructural analysis of the rat brachial plexus provides important normative reference data for future peripheral nerve research using the forelimb of the rat

Review: the spectrum of antimicrobial resistance in bacteria isolated from wounds of patients with epidermolysis bullosa

Purpose: Cutaneous infection in epidermolysis bullosa (EB) can cause significant morbidity, mortality, and dangerous sequelae. This review article aims to delve into the known epidemiology of EB, highlight the disease’s primary causative agents and their antimicrobial resistance spectrum.Materials and methods: A thorough literature search was conducted using Medline, EMBASE, JBI and PubMed to gather data on the microbial landscape of EB wounds. The focus was on identifying the most common bacteria associated with EB infections and assessing their antimicrobial resistance profiles.Results: The analysis revealed that Staphylococcus aureus is the most frequently identified bacterium in EB wounds, with a notable prevalence of methicillin-resistant strains (MRSA). Specific studies on mupirocin resistance further indicated rising rates of mupirocin-resistant Staphylococcus aureus, with one study reporting rates as high as 16.07%. Additionally, high resistance to other antibiotics, such as levofloxacin and trimethoprim/sulfamethoxazole, was observed in MRSA isolates.Conclusions: The findings highlight the critical need for regular resistance surveillance and the prudent use of mupirocin to manage infections effectively in EB. The multi-drug resistant nature of pathogens in EB presents a significant challenge in treatment, highlighting the importance of antimicrobial stewardship. Ultimately, given the sparse literature and the rarity of large-scale studies, further longitudinal research on the antimicrobial resistance profile of bacteria isolated from EB wounds is essential

Morphological and morphometric analysis of the distal branches of the rat brachial plexus

The rat brachial plexus has gained interest recently in neuro-regenerative research due to the advancement of neurosurgical equipment and techniques, but moreover in that it provides a model that can closely resemble the common peripheral nerve injuries seen in humans. The aim of this study was to provide a systematic baseline quantification for fibre type and morphology of the major terminal nerve branches of the rat brachial plexus (radial, ulnar and median) at four surgically accessible sites, through the forelimb. We applied a microstructural and immunohistological analysis of 12 rat brachial plexuses using three forms of micro-visualisation: electron microscopy; whole mount; and immunohistology. The three distal nerves studied showed a similar patterning in terms of the number and size of myelinated fibres, with all proportionally decreasing when moving distally. The fibre types of both the median and ulnar nerve appeared to be homogenously mixed throughout their trajectory, while the radial nerve had a more distinct patterning, especially distal to the elbow, with the entire nerve’s main branch appearing to consist of sensory fibres only. Our microstructural analysis of the rat brachial plexus provides important normative reference data for future peripheral nerve research using the forelimb of the rat.Griffith Health, School of Nursing and MidwiferyFull Tex

Cutaneous malignancies in Indigenous peoples of urban Sydney

Introduction: Despite 3% of Australians identifying as Indigenous, cutaneous malignancies in these patients, including incidence, risk factors and outcomes have not been investigated. This is despite recognition that cancer outcomes in this population are significantly poorer. Methods: We undertook a retrospective case series of Indigenous Peoples who presented to two urban cancer therapy centres for the management of cutaneous malignancies from 2003 to 2017. Risk factors, tumour‐specific characteristics, treatments and outcomes were reviewed. Results: Twenty‐two patients identified as Aboriginal and/or Torres Strait Islander. The median age at presentation was 61 years and the majority were male (63.6%) and had skin phototype III (86.4%). Patients presented with basal cell carcinoma (50%), squamous cell carcinoma (31.8%), melanoma (9.1%) and cutaneous sarcomas (9.1%). The majority (68.2%) presented with stage II or higher disease, and there were high rates of immunosuppression (45.5%). At the time of reporting, 68.2% patients were alive, 18.2% had died from their skin cancers and 13.6% had died from unrelated causes. Conclusion: This cohort has demonstrated late‐stage presentation of skin cancers, with substantial morbidity and mortality from potentially treatable cutaneous malignancies. This parallels other health conditions in Indigenous Australians and has highlighted the need for improved data collection of Indigenous status to better quantify the epidemiology of skin cancer in this population. There is an imperative to improve skin cancer awareness in this population to allow earlier detection and management to ensure better outcomes

Morphological and morphometric analysis of the distal branches of the rat brachial plexus

The rat brachial plexus has gained interest recently in neuro-regenerative research due to the advancement of neurosurgical equipment and techniques, but moreover in that it provides a model that can closely resemble the common peripheral nerve injuries seen in humans. The aim of this study was to provide a systematic baseline quantification for fibre type and morphology of the major terminal nerve branches of the rat brachial plexus (radial, ulnar and median) at four surgically accessible sites, through the forelimb. We applied a microstructural and immunohistological analysis of 12 rat brachial plexuses using three forms of micro-visualisation: Electron microscopy; whole mount; and immunohistology. The three distal nerves studied showed a similar patterning in terms of the number and size of myelinated fibres, with all proportionally decreasing when moving distally. The fibre types of both the median and ulnar nerve appeared to be homogenously mixed throughout their trajectory, while the radial nerve had a more distinct patterning, especially distal to the elbow, with the entire nerve's main branch appearing to consist of sensory fibres only. Our microstructural analysis of the rat brachial plexus provides important normative reference data for future peripheral nerve research using the forelimb of the rat