Benign Skin Diseases Research Articles

Considerations for Exploring Nanosecond Pulsed Electric Fields (nsPEFs) for Treatments of Cancer, Benign Skin Diseases, Atrial Fibrillation, and for New Mechanistic Understandings

Pulsed power includes acquiring electrical energy, compressing it, and releasing it in instantaneous bursts that are low in energy but very high in power. When the pulse duration is near the plasma membrane charging time constant, which is the time during which the cell interior is exposed to the applied pulsed electric field, it affects intracellular structures and functions. The technology is called nanosecond Pulsed Electric Fields (nsPEFs), nanosecond electric pulses (nsEP), or Nanopulse Stimulation (NPSTM) according to Pulse Biosciences, Inc., a company taking the technology to the market. Initial studies showed the elimination of tumor cells in vitro by apoptosis, and other regulated cell death mechanisms, elimination of rodent and canine osteosarcoma, and a basal cell carcinoma clinical trial. In the rat liver and mouse breast cancers, tumor-free animals were in situ vaccinated (ISV), preventing the recurrence of the treated cancers. The technology has also focused on treating benign skin diseases, with some advantages over cryoablation. More recently, the same technology called nanosecond pulsed-field ablation (nsPFA) has been used to treat cardiac arrhythmias like Atrial Fabulation (AFib) with catheters in humans. In pre-clinical studies and now in humans, this technology is showing advantages over radiofrequency ablation and cryoablation. On a new mechanistic landscape, nonlethal nsPEFs modulation of electron transport in the plasma membrane and the mitochondria show potential for controlling redox homeostasis and metabolism. Furthermore, different nsPEF waveforms have different effects on cells; waveforms can differ by pulse duration, rise time, electric field, and/or post-pulse features. So, for nsPEFs, there is a lethal side used for ablation as with NPS and nsPFA and a more recently recognized nonlethal side indicating new possibilities to differentially modify cell physiology depending on the different nsPEF waveforms.

Mastocytoma and juvenile xanthogranuloma in children

The growing number of children with rare diseases such as cutaneous mastocytoma and juvenile xanthogranuloma turning to dermatologists, as well as their clinical similarity, dictate the need for specialists to pay careful attention to these diseases. cutaneous mastocytoma is a clinical form of cutaneous mastocytosis. According to the WHO classification (2022), isolated (one focus) and multiple cutaneous mastocytoma (no more than three foci) are distinguished. juvenile xanthogranuloma belongs to the group of non-Langerhans cell histiocytosis, a broad group of related diseases characterized by the proliferation of histiocytes other than Langerhans cells. We describe a case of an unusual clinical course of solitary juvenile xanthogranuloma in a 3-year-old boy referred to Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology with suspected cutaneous mastocytoma. The size, unusual shape, localization of the lesion and elevated levels of serum tryptase exceeding the age norm (<5 μg/l) determined the atypicality of this case. Dermoscopic examination revealed a central deep yellow coloration of the lesion in the center (the setting sun symptom), a vascular pattern and a clouds symptom. Pathological examination confirmed the diagnosis of juvenile xanthogranuloma. The article also reflects the results of a dynamic observation of a child with an isolated large-sized cutaneous mastocytoma. During the examination, an increase in tryptase levels (>20 μg/l), and AST values, as well as ultrasound signs of hepatomegaly were revealed. Features of the dermoscopic and pathomorphological picture demonstrated patterns characteristic of infiltration and increased activity of mast cells. Cutaneous mastocytoma and juvenile xanthogranuloma are rare and benign skin diseases that usually begin in childhood. Diagnosis of rare diseases often requires complex differential diagnosis. Features of the modern course of cutaneous mastocytoma and juvenile xanthogranuloma are an atypical clinical picture and a high risk of developing extracutaneous symptoms. The presented clinical cases demonstrate the need for interdisciplinary monitoring of patients with these diseases and change the stereotypes of treating them as independent and regressive processes without a trace.

The treatment of infantile giant café au lait spot using golden parameter therapy with a high fluence 1064-nm Q-switched Nd: YAG laser

Background Infantile café au lait spot is a brown macule with various sizes (diameter: 0.5 cm–30 cm). Infantile giant café au lait spot (IGCALS) is a huge (diameter >20cm) irregular-shaped benign hyperpigmented skin disorder that arises in infants. There has been no clearly established laser treatment consensus for the treatment of IGCALS because infants are too fragile to receive laser treatment with long hours and broad areas along with the possibility of undesirable cosmetic results. Objectives This study investigated the safety and efficacy of Golden Parameter Therapy (GPT) using a high fluence 1064-nm Q-switched Nd:YAG laser (QSNL) for IGCALS treatment. Methods This study included 24 Korean patients with IGCALS. Twenty-one patients who were treated with a 1064-nm QSNL weekly for 30–50 treatment sessions with GPT. The parameters included a spot size of 7 mm, a fluence of 2.2 J/cm2 and a pulse rate of 10 Hz with one pass using a sliding-stacking technique over the IGCALS. In control group, three patients were treated with a 532-nm picosecond laser monthly for three treatment sessions with a spot size of 3 mm, a fluence of 1 J/cm2 and a pulse rate of 2 Hz. Results After the last treatment, 21 patients with IGCALS reached the complete removal of pigmented lesions, which can be considered optimal cosmetic results without any side effects such as purpura, crust, post-inflammatory hyperpigmentation, iatrogenic punctate leukoderma, and scarring. There are no recurrences in any patients after 6–21 months’ follow-up, but treatment failure occurred in three patients who were treated with 532 nm picosecond laser. Conclusions Convincingly, we argue that early intervention before 12 months of age with GPT using a high fluence 1064 nm QSNL is a safe, applicable and effective treatment for IGCALS, minimizing side effects without any recurrences.

Development of Cutaneous Pseudolymphoma following Bee Sting: A Case Report

Cutaneous pseudolymphoma (CPL) is a benign skin disorder characterized by the presence of a lymphocyte-rich infiltrate resembling malignant lymphoma. As there are significant differences in management and clinical outcomes, differentiating CPL from true lymphomas is crucial. The diagnostic process involves a comprehensive approach, incorporating clinical examination, histopathological analysis, and when necessary, immunohistochemical staining to distinguish CPL from true lymphomas. Biopsy plays a key role in assessing characteristics of infiltrating lymphocytes and architectural arrangements of cells within dermal layers. Here, we present an unusual case of CPL triggered by a bee sting, outlining its clinical and pathological features.

Stage-related increase in PIM2 expression in mycosisfungoides.

The oncogene PIM2 is upregulated in several malignancies but has never been investigated in mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma (CTCL). PIM2 is a well-known oncogene and is regulated by cell signaling pathways like the JAK/STAT- and NF-kB-pathway, key regulators in the pathogenesis of CTCL. The aim of this study was to examine the role of PIM2 in MF. PIM2 gene expression was measured in 81 formalin-fixed paraffin-embedded skin biopsies from patients with MF and 46 control biopsies from healthy skin (HS) and benign inflammatory skin disease (BID). Validation of PIM2 protein expression was performed on selected biopsies with immunohistochemical staining. We found a significant difference in gene expression levels between both early stage MF and HS (p < 0.0001), and BID (p < 0.0001). In addition, the PIM2 gene expression was higher in advanced-stage MF compared to early stage disease (p = 0.0001). No significant difference in gene expression levels was found between patients with and without disease progression. In conclusion, we found PIM2 expression is significantly increased in MF compared to controls, and in advanced-stage MF compared to early stage MF. These findings could potentially have diagnostic value in discriminating early stage MF from BID.

When mycosis fungoides seems not to be within the spectrum of clinical and histopathological differential diagnoses.

The most prevalent primary cutaneous T-cell lymphoma, mycosis fungoides (MF), is characterized by the development of plaques and nodules after an erythematous patchy phase that is non-specific. An infiltrate of atypical small- to medium-sized cerebriform lymphocytes in the superficial dermis, with variable epidermotropism, is the histopathological hallmark of the disease. In more advanced stages of the illness, large-cell transformation may be seen. Early diagnosis of MF can be very challenging based only on histopathologic or clinical findings, so it is critical to have a clinical-pathological correlation. Many atypical variants of MF that deviate from the classic Alibert-Bazin presentation of the disease have been described over the past 30 years, sometimes with different prognostic and therapeutic implications. Clinically or histopathologically, they can mimic a wide range of benign inflammatory skin disorders. To make a conclusive diagnosis in these cases, it is recommended to take multiple biopsies from various lesions and to carefully correlate the clinical and pathological findings. We have outlined the various facets of the illness in this review, positioning MF as a "great imitator", with an emphasis on the more recently identified variations, differential diagnosis, and its benign mimics.

The Past, Present, Future: Pathophysiology, Diagnosis, and Treatment of Human Skin Diseases

When thinking of skin disease, cancer comes up almost immediately as an example. While the American Cancer Society lists 6 major cancer types, the National Institute of Arthritis and Musculoskeletal and Skin Diseases identifies 13 significant benign skin disorders, reflecting the diversity of skin conditions in dermatology. This topical review aims to provide an overview of the pathophysiology of these major skin cancers and disorders and to summarize conventional diagnostic methods and current treatment approaches.

Application of Blood Lymphocyte Immunophenotype and TCR Gene Rearrangement in the Diagnosis of CTCL.

The immunophenotype of peripheral blood lymphocytes and T-cell receptor (TCR) gene rearrangement of cutaneous T cell lymphoma (CTCL) patients were retrospectively analyzed to explore their value in the diagnosis of CTCL. A total of fifty patients' results were enrolled from 2013 to 2021, including 29 malignant skin disorders and 21 benign skin disorders. The immunophenotype of peripheral blood lymphocytes were analyzed by flow cytometry and TCR gene rearrangement was detected by capillary electrophoresis. Lymphocyte subsets, CD4/CD8 ratio, the percentage of CD3+CD4+CD7- cells and CD45RA/CD45RO ratio was calculated between malignant and benign skin disorders. Peripheral blood lymphocyte immunophenotype and TCR gene rearrangement was compared with skin biopsy to evaluate their sensitivity and specificity. Lymphocyte subsets between malignant and benign groups have no significant difference in percentage of T cell (p > 0.05). The CD4/CD8 ratio is higher in patients with malignant lymphoma than the healthy range. The percentage of CD3+CD4+CD7- cells in malignant groups is higher than that in benign groups and CD45RA/ CD45RO ratio has significant difference between malignant and benign groups (p < 0.05). The sensitivity and specificity of TCR rearrangement for CTCL were 51.7% and 42.9%. The sensitivity and specificity of peripheral blood lymphocyte immunophenotype for CTCL were 44.8% and 33.3%. Combining the two methods, the sensitivity and specificity reached 69.0% and 38.1%, respectively. CD4/CD8 ratio of lymphocyte subsets, the proportion of CD4+CD7-T cells and CD45RA/CD45RO ratio can effectively distinguish benign and malignant dermatosis. TCR rearrangement method combined with lymphocyte immunophenotype can improve the sensitivity and specificity of CTCL diagnosis.

Inflamatorni karcinom dojke kod muškaraca - analiza

Abstract: Inflammatory breast cancer in males is an uncommon but extremely aggressive form of the disease. It is often misdiagnosed as a benign skin disease since it manifests as erythema along the chest wall. The management guidelines are not specific, and treatment is based on the experiences of female cancer patients. Since there is limited information available about this illness, this review aims to fill that gap by conducting a thorough analysis of case reports published in peer-reviewed journals since 2000.

121 A B cell-rich tumor microenvironment delineates cutaneous T cell lymphoma from benign inflammatory skin diseases

121 A B cell-rich tumor microenvironment delineates cutaneous T cell lymphoma from benign inflammatory skin diseases

Clinicopathologic evaluation of granuloma annulare: Study of 136 Iranian cases, south of Iran.

Granuloma annulare (GA) is a benign skin disorder with various histopathologic features that are rarely investigated in Iranian population. We performed this study to find out the clinical and histopathologic features of GA in our referral centre. One hundred-thirty-six patients with biopsy-proven GA were reviewed. Clinical data and pathological features were recorded. One hundred-eight female patients and 28 male patients (Female/male ratio: 3.85) with mean age of 42.54±21.2years (range: 2-83years) were recruited. Eighty-eight (64.7%) patients had interstitial infiltrative pattern and 48 (35.3%) patients had complete palisading granulomas. The infiltrate occupied both upper and lower dermis in most of the cases (67.7%). Significant mucin was detected more commonly in complete GA compared to interstitial GA (p=0.019), but inflammation degree, eosinophils, plasma cells, and giant cells were not different between two subtypes of GA (p>0.05). The significant inflammation contained more significant plasma cells (p=0.006). The significantly more giant cells were detected in patients between 20 and 60years of age (p=0.015); but other factors were not different between age groups. In our study, the prevalence of GA in women was significantly higher than in men. Interstitial GA was the more common histological subtype and the inflammation was less severe and the infiltrate was mostly pandermal in our cases. More severe inflammation contained more plasma cells, and more dense giant cells were seen in middle aged patients.

Syphilis, blanchiment and French colonial medicine in sub-Saharan Africa during the interwar period.

During the interwar period, France put unprecedented efforts into public health measures targeting the colonised populations of sub-Saharan Africa. This investment in health was seen as crucial to ensuring the renewal of the African labour force needed for the economic development of the colonies. Syphilis, although less deadly than other endemic or epidemic diseases such as yellow fever, sleeping sickness and bubonic plague, was one of the most widespread infections in France's sub-Saharan colonies. This article demonstrates the contradictory nature of the colonial medicine approach to this disease during the interwar years. The negative impact of syphilis on population growth in Africa made it a major threat to the colonial project, and France put significant, costly investment into tackling the disease, focusing its efforts on maternal and child health. However, a closer look at syphilis control in sub-Saharan Africa reveals that the disease was also minimised as a public health issue, under-resourced and downplayed by colonial doctors and administrators. This neglect was embodied in the invention of a new colonial disease, 'exotic syphilis', which was presented as being a relatively benign skin disease among the African populations. It was also reflected in care practices, via a form of mass medicine based on the use of blanchiment, which consisted of knowingly limiting treatment to a superficial effect.

Linear Sebaceous Gland Hyperplasia behind the Right Ear Clinically Simulating Verrucous Nevus

Sebaceous Glandhy Perplasia (SGH) is a common benign proliferative skin disorder, which most commonly involves the faces and usually appears as yellow, soft, umbilicated papules. But the clinical manifestations of SGH vary greatly. We presented a 40-year-old man with the flesh-colored to light brown linear plaque behind the right ear mimicking verrucous nevus clinically.

Ellagic acid inhibits the formation of hypertrophic scars by suppressing TGF-β/Smad signaling pathway activity.

Hypertrophic scar (HS) is a benign fibroproliferative skin disease, which lacks the ideal treatment and drugs. Ellagic acid (EA) is a natural polyphenol that prevents fibroblasts from proliferating and migrating. This study aimed to determine the role of EA in HS formation and its possible mechanism by in vitro experiments. HS fibroblasts (HSFs) and normal fibroblasts (NFs) were separated from HS tissue and normal skin tissue, respectively. HSFs were treated with 10 and 50 μM EA to assess their effect on HS formation. In particular, 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) and scratch assay were used to detect the viability and migration ability of HSFs. Quantitative reverse transcriptase real-time polymerase chain reaction was used to measure the mRNA expression level of basic fibroblast growth factor (bFGF), extracellular matrix (ECM)-related gene collagen-I (COL-I), and fibronectin 1 (FN1) in HSFs. Finally, Western blot was utilized to measure the expression level of TGF-β/Smad signaling pathway-related proteins in HSFs. The viability of HSFs was significantly increased compared with NFs. 10 and 50 μM EA treatment markedly inhibition the cell viability and migration of HSFs. EA treatment upregulated the bFGF expression level and downregulated the COL-I and FN1 expression level in HSFs. In addition, p-Smad2, p-Smad3, and transforming growth factor (TGF)-β1 expression levels as well as p-Smad2/Smad2 and p-Smad3/Smad3 ratios remarkably decreased in HSFs after EA treatment. EA inhibited the formation of HSs by suppressing the viability and migration of HSFs and ECM deposition as well as by preventing the activation of TGF-β/Smad signaling.

Three cases of subcorneal pustular dermatosis with immunohistochemical examinations.

Subcorneal pustular dermatosis, a rare, benign skin disease, is a type of neutrophilic dermatosis. The authors reported three cases of subcorneal pustular dermatosis. In case 1, a 9-year-old girl developed a skin rash with blisters following a mycoplasma infection and had a flare-up due to a common cold. She was successfully treated with a topical corticosteroid. In case 2, a 70-year-old woman who had been treated for rheumatoid arthritis with adalimumab, salazosulfapyridine, and leflunomide developed 3- to 5-mm pustules on her trunk and thighs 4 days after flu vaccination. The rash disappeared with drug withdrawal and treatment with diaminodiphenyl sulfone. In case 3, an 81-year-old man, who was diagnosed with pyoderma gangrenosum at 61 years old, developed multiple small flaccid pustules on his trunk and extremities due to an infection in the arteriovenous shunt area on the forearm. The pustule disappeared with intravenous antibiotic therapy; however, the pustules subsequently flared up along with ulcers typical of pyoderma gangrenosum. He was given oral prednisolone therapy, which was effective for the small pustules and some ulcers. Immunohistochemical examination of the three cases revealed neutrophilic infiltration in the subcorneal layer of the epidermis. The pustules contained neutrophils as well as some CD68+ and a few CD1a+ cells. The epidermis and dermis were more predominantly infiltrated by CD4+ cells than by CD8+ cells. Positive stainings for interleukin 8, interleukin 36γ, and phospho-extracellular signal-regulated kinases 1 and 2 were observed in the upper layers of the epidermis below the pustules. Although the pathogenesis of subcorneal pustular dermatosis has not been clarified, the current results suggest that a variety of inflammatory cells, including those responsible for both innate and acquired immunity, are involved in the accumulation of neutrophils in subcorneal pustular dermatosis.

Pityriasis Lichenoides et Varioliformis Acuta pada Wanita Dewasa dengan Bakteriuria Asimptomatik: Sebuah Pemicu Lain?

Introduction: Pityriasis Lichenoides et Varioliformis Acute (PLEVA) is a rare and benign inflammatory skin disease. This acute form is distinguished from the milder chronic condition, Pityriasis Lichenoides Chronica (PLC). The etiology of PLEVA itself remains unclear, although it has been associated with infection as a trigger.Case: Here, we present the case of a 34-year-old woman who presented with abrupt, generalized, pruritic skin eruptions for two months.Case Discussion: The eruptions started as red scaly papules and vesicles and resolved as hyperpigmentations. She denied having any previous dermatological diseases, routine medications, or vaccinations. On examination, she showed generalized multiple hyperpigmented macules, scaly papules, and vesicles over the trunk, extremities, and face, with erosions and crusts in several areas. Eosinophilia and asymptomatic bacteria were found in her urinalysis. A skin biopsy showed diffuse lymphocytic infiltration in the dermal/epidermal junction and perivascular region, with parakeratosis and lymphocyte exocytosis. While the pathogenesis of PLEVA itself remains unclear, a triggering factor of inflammatory reaction, such as infection, may contribute to the development of the disease.Conclusion: Asymptomatic bacteriuria is associated with inflammatory responses, and thus, it can be one of many possibilities. More studies are needed to confirm this association with PLEVA. Due to the lack of a clear pathogenesis and the benign nature of the disease, this rare entity may present difficulties in diagnosis and therapy

Analysis of clinical features in primary cutaneous T cell lymphoma

Background: Primary cutaneous T cell lymphoma is a diverse and rare group of diseases with clinical manifestations that, if not biopsied, are easily confused with benign skin diseases. Objective: To determine some clinical features of primary cutaneous T cell lymphomas and classify them according to the 2018 update of World Health Organization and European Organisation for Research and Treatment of Cancer classification. Methods: a case series study with 39 cases of primary cutaneous T cell lymphomas diagnosed at Pathology Department of University Medical Center at Ho Chi Minh city from 01/2018 to 02/2022. Results: Median age at diagnosis is 59 years old. Male:Female ratio is 1:2.3. In order of frequency, diagnoses were: subcutaneous panniculitis-like T cell lymphoma (35.8%), mycosis fungoides (28.2%), primary cutaneous anaplastic large cell lymphoma (15.4%), peripheral T cell lymphoma not otherwise specified (7.7%), extranodal NK/T cell lymphoma, nasal type (7.7%), primary cutaneous CD4+ small/medium T cell lymphoproliferative disorder (2.6%) and primary cutaneous CD8+ aggressive epidermotropic T- cell lymphoma (2.6%). Subcutaneous panniculitis-like T cell lymphoma always presents as subcutaneous nodule-tumor (100%); the most common site is lower extremities (71.4%). Mycosis fungoides has various appearance of skin lesions (36.4%) including patch-plaque (100%), and usually involves in trunk (90.9%). Extranodal NK/T cell lymphoma, nasal type always has skin ulcer (100%). Conclusion: The study documented the frequence and clinical characteristics of each subtype of primary cutaneous T cell lymphoma. The most common were subcutaneous panniculitis-like T cell lymphoma and mycosis fungoides. Although the morphology and location of skin lesions in the subtypes overlap, they still aid in the diagnosis of skin lymphoma. Key words: T-cell lymphoma, primary, cutaneous.

Granuloma Faciale from Dermatoscopic Perspective

Granuloma faciale (GF) is a rare and benign skin disease of unknown etiology, characterized by chronic leukocytoclastic vasculitis. It is usually diagnosed on the basis of clinical features and histopathology. Dermoscopy is a noninvasive method for the diagnosis of various skin conditions in clinical practice. GF needs to be differentiated from various dermatoses involving the face particularly presenting with the papular morphology. Here, we present the case of a 61-year-old male patient with facial lesions, diagnosed with GF on a dermoscopic and histopathologic basis.

Dermatological Disorder Classification

Abstract: Contrary to inspection with the untrained eye, Dermatoscopy is a frequently used diagnostic procedure that enhances the identification of benign and malignant pigmented skin diseases. To train artificial neural networks to automatically identify pigmented skin lesions, dermatoscopic images are also a good source. An artificial neural network was previously trained to successfully distinguish melanocytic nevi from melanomas, the deadliest kind of skin cancer. This was done using dermatoscopic pictures. Although the results were encouraging, the study suffered from a limited sample size and a lack of dermatoscopic pictures besides melanoma or nevi, like most prior investigations. Recent improvements in graphics card power and machine learning methods have boosted hopes for the availability of automated diagnostic systems that can quickly identify all types of pigmented skin lesions without the assistance of a human specialist. A lot of annotated pictures are needed for the training of neural network-based diagnosis algorithms, however the quantity of high-quality dermatoscopic images with accurate diagnoses is small or restricted to a small number of disease classes.

A scientific approach to skin radiotherapy nursing Article 2 - The anatomy, physiology, pathology and radiobiology of skin and its diseases

Nurses play an important role in the care of patients treated with radiotherapy (RT) for skin conditions such as skin cancers. A series of four articles will aim to supplement general oncology nurse training by providing a scientific basis to better understand the skin and its diseases, the use of RT in skin, and the management of necessary acute skin RT reactions to achieve best patient outcomes. The first article focused on the role of the nurse within the radiation oncology department and the initial patient assessment. This second article describes the anatomy, physiology, pathology and radiobiology of skin and its diseases. These concepts are fundamental to the understanding of how acute effects develop during treatment and how to best care for them. The transition time of normal keratinocytes in the epidermis from creation to demise (10-14 days) is discussed as essential to understanding the timing of acute RT effects. The effect of RT on DNA, and the different effects of RT on normal cells versus tumour cells, which underscore fractionation and normal tissue conservation, are also discussed. Finally, this article addresses the late effects of RT in normal skin, accelerated repopulation, types of skin cancers and their relative radiosensitivities, and the effects of RT on benign skin diseases. The third article will describe the skin RT prescription and plan, especially in relation to volume and dose; and the fourth will show how the nurse, by applying the knowledge from the previous articles, can predict, explain and care for the acute side effects that may arise during a course of skin radiotherapy.