Skin Biopsy Research Articles

Psoriasis in pediatric dermatological clinical practice: diagnosis and management

The relevance of this topic is confirmed by the widespread psoriasis prevalence. Psoriasis in children has severe forms growth and diagnostic difficulties. It is crucially important to examine histologically the skin especially in pediatric dermatological clinical practice. According to our observations Pityriasis Rubra Pilaris has become one of the most frequent dermatoses with which differential diagnosis of psoriasis has to be carried out. A clinical dermatosis observation in a 13-year-old girl is described. The disease was similar to the manifestations of Pityriasis Rubra Pilaris. The results of the affected skin biopsy study did not exclude this diagnosis. The clinical and morphological manifestations of the dermatosis could be effected by steroid therapy. Subsequent dynamic observation and histological examination allowed us to diagnose psoriasis. Current data is collected and presented. The choice of external therapy in pediatric practice is a controversial topic. Clinical results of the Activated Zinc Pyrithion external forms use in the psoriasis treatment are presented.

Clinical, histologic, and immunologic signatures of Small Fiber Neuropathy in Systemic Lupus Erythematosus.

Systemic Lupus Erythematosus (SLE) often causes damage to small nerve fibers, leading to distressing painful and autonomic symptoms. Despite this, Small Fiber Neuropathy (SFN) remains an underrecognized complication for SLE patients. In this cross-sectional study, we aimed to assess SFN in patients with SLE and to explore its correlations with immunologic disease features and clinical manifestations. We recruited 50 SLE patients (1 male to 12.5 females, aged 20-80 years) reporting painful disturbances. We conducted a comprehensive clinical and neurophysiological evaluation, using Nerve Conduction Studies and Quantitative Sensory Testing. Additionally, we carried out an extensive laboratory assessment of disease-related serological parameters. We also performed a thorough skin biopsy analysis, investigating somatic and autonomic innervation while detecting complement and inflammatory cell infiltrates within the skin. Out of 50 patients, 19 were diagnosed with SFN, primarily characterized by a non-length-dependent distribution; 7 had a mixed neuropathy, with both large and small fiber involvement. Patients with SFN were younger than patients with a mixed neuropathy (p = .0143); furthermore, they were more likely to have a history of hypocomplementemia (p = .0058) and to be treated with cyclosporine A (p = .0053) compared to patients without neuropathy. However, there were no significant differences in painful and autonomic symptoms between patients with and without SFN. This study highlights the relevant frequency of SFN with a non-length-dependent distribution among SLE patients experiencing painful symptoms. Indeed, SFN emerges as an early manifestation of SLE-related neuropathy and is closely associated with hypocomplementemia, suggesting a potential pathogenic role of the complement system. Moreover, SFN may be influenced by disease-modifying therapies. However, the precise role of SFN in shaping painful and autonomic symptoms in patients with SLE remains to be fully elucidated.

Diagnostic Utility of Multiplex Polymerase Chain Reaction in Patients of Clinically Suspected Pure Neuritic Leprosy by Identifying Mycobacterium leprae in Skin Biopsy Samples and Nasal Swabs.

Pure neuritic leprosy (PNL) often remains underdiagnosed due to the lack of simple, reliable diagnostic tools to detect Mycobacterium leprae. This study aimed to investigate the utility of multiplex polymerase chain reaction (MPCR) in easily accessible and less invasive biopsy sites, including skin biopsy samples and nasal swabs (NSs), to detect M. leprae. A total of 30 (N = 30) clinically suspected and untreated patients with PNL were recruited. Nasal swabs and skin biopsy samples from the innervation territory of an "enlarged nerve" were collected. DNA was extracted and subjected to MPCR (targeting leprae-specific repetitive element [RLEP], 16S rRNA, and SodA genes) and RLEP-PCR (individual gene PCR). The PCR products were analyzed by 3% agarose gel electrophoresis. In 30 patients with clinically suspected PNL, 60% (N = 18) of skin biopsy samples and 53% (N = 16) of NSs were found positive for M. leprae DNA by MPCR, whereas only 23.3% (N = 7) of skin biopsy samples and 10% (N = 3) of NSs were found positive by RLEP-PCR. MPCR demonstrated a greater positivity rate than did RLEP-PCR for detection of M. leprae. Serologic positivity for anti-natural disaccharide-octyl conjugated with bovine serum albumin (ND-O-BSA) antibodies was 80% (16/20), including 35% (7/20) of PNL patients for which the skin MPCR was negative. Both serologic positivity and skin MPCR positivity were observed in 65% of patients (N = 20). Multiplex polymerase chain reaction is a useful tool for detection for M. leprae in skin biopsy samples and NSs in clinically suspected cases of PNL, with the added advantages of being less invasive and technically easier than nerve biopsy.

Case Report: Activated B-cell-diffuse large B-cell lymphoma

Lymphomas of the oral and oropharyngeal regions are rather uncommon, and diagnosis can be challenging and confusing due to the multiple histological subgroups. Lymphomas are the third most common type of tumor in the head and neck region and are brought on by the lymphoreticular system. The two forms of lymphoma are Hodgkin’s lymphoma and non-Hodgkin’s lymphoma (NHL). Herein, we present a case report of oropharyngeal lymphoma. The female patient reported with a complaint of swelling over the palatal region for two to three months. An ulceroproliferative lesion was evident over the posterior palatal region. We diagnosed reactive lymphadenitis based on an incisional biopsy. To confirm the diagnosis and rule out other conditions, a punch biopsy followed by immunohistochemical studies were done. Features suggestive of activated B-cell-diffuse large B-cell lymphoma were confirmed. Among malignant lymphomas, diffuse large B-cell lymphoma is the most prevalent variety. Much progress has been made in recent years in understanding the molecular pathophysiology of this disease. In this case report, we aim to correlate the clinical presentation, histology features and immunohistochemical significance in order to promote early discovery, diagnosis, and treatment for a better prognosis of the patient.

Linear immunoglobulin A/immunoglobulin G bullous dermatosis with celiac disease in a 26-year-old Filipino male

Linear immunoglobulin A/immunoglobulin G bullous dermatosis (LAGBD) is a rare form of autoimmune blistering disease characterized by circulating anti-keratinocyte cell surface antibodies from both the immunoglobulin A and immunoglobulin G. It presents as blisters, erosions, and pustules with erythematous lesions, primarily on the trunk and extremities. A 26-year-old Filipino male presented with a 4-year history of multiple pruritic vesicles on an erythematous base on the mentum spreading on the face, scalp, neck, upper trunk, and upper extremities. Skin biopsy and direct immunofluorescence suggest a diagnosis of LAGBD. The patient underwent esophagogastroduodenoscopy, which revealed duodenal villous atrophy. A small bowel biopsy revealed duodenal villous atrophy with a predominance of lymphocytes. He was treated with dapsone for two years with remarkable improvement. He was also advised to do a strict, lifelong gluten-free diet. After a 5-year follow-up, he only experienced occasional very mild flares treated with topical clobetasol 5% cream. We present a rare case of a patient with LAGBD with celiac disease. Systemic involvement, particularly gastroenteropathy, should also be investigated. Dapsone and a gluten-free diet have been the primary treatment modalities for this case.

Clinicopathological concordance of mucocutaneous manifestations in people living with HIV: A cross-sectional study.

To describe the frequency and clinicopathological concordance of mucocutaneous manifestations in people living with HIV (PLWH) and its correlation with CD4+ T lymphocyte count and HIV viral load. Cross-sectional study of patients diagnosed with HIV infection who underwent skin biopsy for histopathological study from 1992 to 2022. Skin diseases were categorized as opportunistic and sexually transmitted infections, inflammatory dermatoses, benign cutaneous neoplasms, and premalignant and malignant cutaneous neoplasms. Clinicopathological concordance was classified as complete, partial or discordant. Frequency of skin diseases are presented by category and according to lymphocyte CD4+ count and HIV viral load. A total of 659 patients were included of whom 88.5% (n = 583) were male. The most frequent diagnostic category was opportunistic or sexually transmitted infections in 34% (n = 224) and the most frequently found condition was Kaposi sarcoma in 17% (n = 112). Clinicopathological concordance was complete in 53.7% (n = 354) of cases, partial in 26.7% (n = 176) and discordant in 19.6% (n = 129). Among the 282 patients with available serological data, 58.9% (n = 166), 23.8% (n = 67) and 17.4% (n = 49) had CD4+ counts below 200, between 200 and 499, and above 500 cells/μl, respectively. Although there is a high variability in skin conditions which people with HIV may present, there was a high rate of clinicopathological concordance (80.4%). We emphasize the importance of diagnostic skin biopsies due to their diverse morphological presentation. The frequency of skin diseases in PLWH depending on different clinical settings should aid the clinician in reaching an adequate diagnosis in this population.

Clinical management and case review of a presumptive novel clinical presentation of protothecosis in donkeys causing ulcerated nodular lesions in the ear pinnae of 18 animals

AbstractThis is a retrospective case series that describes a novel syndrome seen in 18 donkeys in Morocco that presented to this author,'s clinic with ulcerated nodular lesions of the ear pinnae. In the majority of cases, the lesions are confined to the ears, they are always bilateral and can occasionally progress to other areas of the body. Macroscopically, the lesions in all 18 donkeys are very uniform in presentation, even if the size of the nodules varies. This case series reviews the presentation, investigation, treatment and outcome for 18 cases presented to these authors’ clinics from 2011 to 2021. Skin biopsies from a subset of eight cases showed similar changes in chronic pyogranulomatous, dermatitis with myriad intra‐ and extra‐histiocytic organisms, the morphology of which is most consistent with that of Prototheca spp. infection. This is a novel presentation that represents a significant welfare issue for donkeys, as well as having important economic consequences for owners in the developing world.

ELFN1 is a new extracellular matrix (ECM)-associated protein

AimsThe ELFN1, discovered in 2007, is a single-pass transmembrane protein. Studies conducted thus far to elucidate the function of the Elfn1 have been limited only to animal studies. These studies have reported that ELFN1 is a universal binding partner of metabotropic glutamate receptors (mGluRs) in the central nervous system and its functional deficiency has been associated with the pathogenesis of neurological and neuropsychiatric diseases. In 2021, we described the first disease-associated human ELFN1 pathogenic gene mutation. Severe joint laxity, which was the most striking finding of this new disease and was clearly seen in the patients since early infancy, showed that the ELFN1 may have a possible function in the connective tissue besides the nervous system. Here, we present the first experimental evidence of the extracellular matrix (ECM)-related function of the ELFN1. Materials and methodsPrimary skin fibroblasts were isolated from the skin biopsies of ELFN1 mutated patients and healthy foreskin donors. For the clinical trial in a dish, in vitro ECM and DEM (decellularized ECM) models were created from skin fibroblasts. All the in vitro models were comparatively characterized and analyzed. Key findingsThe mutation in the ELFN1 signal peptide region of patients resulted in a severe lack of ELFN1 expression and dramatically altered the characteristic morphology and behavior (growth, proliferation, and motility) of fibroblasts. SignificanceWe propose that ELFN1 is involved in the cell-ECM attachment, and its deficiency is critical enough to cause a loss of cell motility and soft ECM stiffness.

Naltrexone accelerated oral traumatic ulcer healing and downregulated TLR-4/NF-kB pathway in Wistar rats

ObjectiveTo assess the effect of naltrexone on oral mucosal healing using a traumatic ulcer model DesignWistar rats (n = 112) received distilled water (control) or naltrexone (0.5, 10, or 50 mg/kg/day). Ulcers were induced on the buccal mucosa using a round skin biopsy punch (diameter 6 mm). Euthanasia was performed on days 1, 3, 7, and 14. Healing was assessed by ulcer area, histological scores, histomorphometric analysis (number of polymorphonuclears, mononuclears, and fibroblasts), and collagen percentage. Immunohistochemistry for TLR-2, TLR-4, NF-kB, and CD31 was evaluated. Nociceptive threshold was measured daily. ResultsThe 50 mg/kg group showed reduced ulcer area on days 1 (p < 0.001), 3 (p < 0.05), and 14 (p < 0.01). In this group, there was, on day 14, an increase in the percentage of reepithelization (p = 0.043) and collagen (p < 0.05), an increase in connective tissue maturation (p = 0.016), and on day 7 an increase in fibroblasts (p < 0.001). The 10 mg/kg dose reduced the ulcer area on day 1 (p < 0.001). The 50 mg/kg group showed lower expression of TLR-4 (p < 0.001) on day 1, NF-kB on days 1 (p < 0.05) and 14 (p < 0.05), and CD31 on day 14 (p < 0.05). The 0.5 and 10 mg/kg doses reduced TLR-4 expression on day 1 (p < 0.05; p < 0.01, respectively). Nociceptive threshold increased in the 50 mg/kg group (p < 0.01). ConclusionNaltrexone enhanced traumatic oral ulcer healing by reducing TLR-4/NF-kB signaling and promoting fibroblast proliferation and collagen deposition. Additionally, naltrexone reduced pain in rats.

Determination of percentage elongation at break and histopathology of skin from yankasa sheep experimentally infested with Amblyomma variegatum

Bites of haematophagous ectoparasites cause mechanical injuries and histopathological changes in their hosts’ hides and skins whose resultant leathers become unsuitable for certain leather products. The effects of tick bites on the wellbeing of their hosts are known, however, knowledge of their effects on the quality of leathers is scarce. This work investigated the effects of tick bites on the histopathology of skin and the percentage elongation at break (PEB) of shoe upper leathers produced from the skins of Amblyomma variegatum infested Yankasa sheep. A total of nine apparently healthy Yankasa sheep were selectively purchased from the open market and acclimatized for four weeks in the laboratory. Three animals in each of group 1 and 2 were infested with 40 nymphs and 20 adults of Am. variegatum respectively. Group three animals served as uninfested control. All animals were euthanized after the ticks were fully engorged and detached. Skin biopsies at tick attachment points and the uninfested control were taken from flayed skins and processed for histopathological examination. All skins were processed into finished leathers and their PEB determined. Histopathological studies revealed keratinization in all Am. variegatum infested sheep skins, while the un-infested control skins were normal. Mean PEB (%) of leathers were 21.41±3.33SE (nymphs), 36.73±4.44SE (adults) and 47.83±2.78SE (control). Bites of Am. variegatum cause histopathological changes in Yankasa sheep skins that significantly (p = 0.006) reduce the PEB of resultant leathers to less than the acceptable minimum standard of 40 % whose leathers are classified as rejects. In this study, skin of Yankasa sheep infested by nymphs and adults of Am. variegatum ticks resulted in low quality leathers that are unsuitable for standard leather products production and are also of low market value due to keratinization. Sustained efforts need to be undertaken to increase the awareness on the negative impact of tick bites on leather products by encouraging livestock farmers to engage in early treatment of animals infested with ticks.

Proteome profiling of cutaneous leishmaniasis lesions due to dermotropic Leishmania donovani in Sri Lanka

BackgroundCharacterization of the host response in cutaneous leishmaniasis (CL) through proteome profiling has gained limited insights into leishmaniasis research compared to that of the parasite. The primary objective of this study was to comprehensively analyze the proteomic profile of the skin lesions tissues in patients with CL, by mass spectrometry, and subsequent validation of these findings through immunohistochemical methods.MethodsEight lesion specimens from leishmaniasis-confirmed patients and eight control skin biopsies were processed for proteomic profiling by mass spectrometry. Formalin-fixed paraffin-embedded lesion specimens from thirty patients and six control skin specimens were used for Immunohistochemistry (IHC) staining. Statistical analyses were carried out using SPSS software. The chi-square test was used to assess the association between the degree of staining for each marker and the clinical and pathological features.ResultsSixty-seven proteins exhibited significant differential expression between tissues of CL lesions and healthy controls (p < 0.01), representing numerous enriched biological processes within the lesion tissue, as evident by both the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Reactome databases. Among these, the integrated endoplasmic reticulum stress response (IERSR) emerges as a pathway characterized by the up-regulated proteins in CL tissues compared to healthy skin. Expression of endoplasmic reticulum (ER) stress sensors, inositol-requiring enzyme-1 (IRE1), protein kinase RNA-like ER kinase (PERK) and activating transcription factor 6 (ATF6) in lesion tissue was validated by immunohistochemistry.ConclusionsIn conclusion, proteomic profiling of skin lesions carried out as a discovery phase study revealed a multitude of probable immunological and pathological mechanisms operating in patients with CL in Sri Lanka, which needs to be further elaborated using more in-depth and targeted investigations. Further research exploring the intricate interplay between ER stress and CL pathophysiology may offer promising avenues for the development of novel diagnostic tools and therapeutic strategies in combating this disease.

Elevated cutaneous expression of stem cell factor in chronic spontaneous urticaria: a prospective cohort study.

Tissue expression of endothelial cell (EC) markers of microcirculatory changes in CSU is poorly investigated. to explore the expression of specific EC markers (stem cell factor (SCF), vascular endothelial growth factor (VEGF) and membrane attack complex (MAC)) in CSU-L and CSU-NL skin through immunohistochemistry (IHC) and in serum. Lesional (L) and non-lesional (NL) skin biopsies from CSU patients and HCs were studied for the IHC expression of SCF, VEGF and MAC in CSU patients (n = 23) and healthy controls (HCs, n = 9). In this population, we also investigated blood levels of VEGF and SCF. Patients were also assessed for clinical characteristics, disease activity, and markers of autoimmune CSU (aiCSU). Epidermal SCF reactivity was significantly higher in CSU-L skin compared to HC skin (p=0.026). In the dermis, SCF immunoreactivity was seen particularly on endothelial, perivascular and epithelial cells. In CSU-L skin, mean perivascular SCF stainings were significantly more intense compared to HCs (p<0.001). Furthermore, CSU-NL skin also showed significantly higher SCF stainings on dermal perivascular cells compared to HCs (p<0.001). CSU patients had the highest SCF immunoreactivity scores in the epidermis and/or on dermal ECs. These patients did not have significantly higher SCF serum levels. This is the first study to show elevated cutaneous expression of SCF in chronic spontaneous urticaria. These findings underline the potential therapeutic possibilities of anti-KIT antibodies in CSU treatment.

Rare Presentation, Critical Diagnosis: Primary Actinomycosis of the Foot

Actinomycosis, an uncommon granulomatous infection caused by the Actinomyces species, rarely targets as primary involvement the limb and is often linked to traumatic incidents. In this report, we present the case of a 44-year-old female who developed multiple small nodules on her left foot over approximately 12 months. Some nodules exhibited firmness and a violet hue, while others discharged a yellowish fluid. The patient had no significant comorbidities. Despite thorough blood paraclinical assessments, including complete blood count, serological HIV testing, and QuantiFERON-TB Gold testing, no abnormalities were detected. Bacteriological examinations and cultures of the discharge yielded negative results. Dermatoscopic examination revealed ovoid yellowish structures, with confocal microscopy highlighting granulomas. A subsequent skin biopsy confirmed characteristic changes indicative of actinomycosis. Although systemic antibiotic therapy with penicillin derivatives was initially considered, the patient’s documented allergic history to this medication class, verified through allergological testing, prompted the initiation of doxycycline treatment. Notably, significant improvement was observed at the 3-month follow-up. This case underscores the importance of reporting rare instances of actinomycosis due to its diagnostic complexity and management challenges.

A skin-specific α-Synuclein seeding amplification assay for diagnosing Parkinson’s disease

The seeding amplification assay (SAA) has recently emerged as a valuable tool for detecting α-synuclein (αSyn) aggregates in various clinically accessible biospecimens. Despite its efficiency and specificity, optimal tissue-specific conditions for distinguishing Parkinson’s disease (PD) from non-PD outside the brain remain underexplored. This study systematically evaluated 150 reaction conditions to identify the one with the highest discriminatory potential between PD and non-synucleinopathy controls using skin samples, resulting in a modified SAA. The streamlined SAA achieved an overall sensitivity of 92.46% and specificity of 93.33% on biopsy skin samples from 332 PD patients and 285 controls within 24 h. Inter-laboratory reproducibility demonstrated a Cohen’s kappa value of 0.87 (95% CI 0.69–1.00), indicating nearly perfect agreement. Additionally, αSyn seeds in the skin were stable at −80 °C but were vulnerable to short-term exposure to non-ultra-low temperatures and grinding. This study thoroughly investigated procedures for sample preprocessing, seed amplification, and storage, introducing a well-structured experimental framework for PD diagnosis using skin samples.

Helicobacter Pylori: Beyond The Gut - Insights Into Its Association With Dermatological Conditions

Introduction: Helicobacter pylori (H. pylori) is a Gram-negative bacterium associated with gastrointestinal diseases and extra-gastrointestinal manifestations, including dermatological conditions. Understanding the precise mechanisms and clinical implications of the H. pylori skin disorder association is essential. Materials and methods: A cross-sectional observational study was conducted at a private dermatology center in Ahmedabad, Gujarat, from January 2021 to August 2023. Patients coming with various dermatological conditions and with suspected H. pylori infection underwent clinical examination, laboratory tests, and skin biopsy to confirm the diagnosis of disease. The statistical analysis assessed associations between demographics, dermatological conditions, and H. pylori antibody test results. Laboratory Investigation: H. pylori antibody levels were measured using serology by doing H.pylori IgG antibody level testing and cut-off values of &gt;0.90 were considered positive. Statistical Analysis: Data entry and analysis involved Microsoft Excel 360, calculating proportions, and percentages, and drawing appropriate inferences. Results: Of 1131 enrolled patients (male-female ratio 1:1.43), 22% tested positive for H. pylori, with higher positivity rates in patients aged &gt;60 years and 40-60 years. Analysis revealed varying proportions of H. pylori positivity across dermatological conditions, with alopecia areata and chronic urticaria showing the highest rates. Conclusions: While studies suggest H. pylori’s involvement in dermatological diseases, further research is needed to understand this relationship fully. Systematic investigations into the impact of eradication therapy are essential to inform clinical management strategies and guide future research directions.

P-665 High FSH level impairs VEGF secretion by thawed human ovarian tissue

Abstract Study question How does a high FSH level as related to POI (premature ovarian insufficiency) affect VEGF secretion by thawed human ovarian tissue? Summary answer After thawing, the high FSH concentration of 175mIU/mL (10ng/mL) significantly decreased VEGF secretion by human ovarian tissue by 25.6%. 17.5mIU/mL did not change VEGF secretion. What is known already Cryopreservation of ovarian cortical tissue has become an important method in fertility preservation. However, 70% of the follicles do not survive the reimplantation process due to an insufficient blood supply and oxidative stress. Human ovarian tissue secretes angiogenic factors, including VEGF, spontaneously. Its regulation by FSH is not known although 50% of the reimplantation patients show increased FSH levels (&amp;gt;25mIU/mL) due to POI. Study design, size, duration Provided a signed consent, biopsy punches of ovarian cortical tissue from 8 patients undergoing fertility preservation were studied. Slow freezing and thawing was applied as in the intern routine instructions. Participants/materials, setting, methods Human ovarian cortical tissue was cultured in full medium at 37 °C for 48h after thawing in presence or absence of 17.5mIU/mL (1ng/mL) or 175mIU/mL (10ng/mL) recombinant human FSH. VEGF-A secretion was measured by ELISA. The expression of VEGF-A, HIF-1α and FSHR was assessed by immunohistofluorescence per follicle. The effect of FSH was assessed by one-way-ANOVA with Tukey’s post test. The effect of culture or follicular maturation stage was analyzed by t test. Main results and the role of chance After thawing, VEGF secretion recovers and rises over time. The addition of 175mIU/mL FSH significantly impaired VEGF-A expression compared to untreated ovarian tissue (p = 0.016). The analysis of 481 follicles showed similar results of FSH affecting VEGF-A expression by immunostaining. In particular, primordial follicles expressed significantly less VEGF-A compared to growing follicles (primary+secondary; p &amp;lt; 0.0001). 48h tissue culture significantly increased VEGF-A expression in primordial follicles (p = 0.0041). The addition of the high FSH level significantly decreased VEGF-A expression in growing follicles (p = 0.0005). Limitations, reasons for caution Although VEGF-A is a key factor in angiogenesis, more factors are known to affect angiogenesis. The direct effect on angiogenesis should be evaluated. Moreover, the conditions in tissue culture may not represent those after reimplantation. Wider implications of the findings High FSH levels, as seen in patients with POI, might impair ovarian VEGF expression and angiogenesis. Hormone replacement therapy (HRT) might be endorsed before and during ovarian tissue reimplantation. More clinical and biological data are required to understand the regulators of angiogenesis after ovarian tissue reimplantation adequately. Trial registration number not applicable

Dietary plasticity and broad North Atlantic origins inferred from bulk and amino acid-specific δ15N and δ13C favour killer whale range expansions into Arctic waters.

Killer whales (Orcinus orca) occur seasonally in the eastern Canadian Arctic (ECA), where their range expansion associated with declining sea ice have raised questions about the impacts of increasing killer whale predation pressure on Arctic-endemic prey. We assessed diet and distribution of ECA killer whales using bulk and compound-specific stable isotope analysis (CSIA) of amino acids (AA) of 54 skin biopsies collected from 2009 to 2020 around Baffin Island, Canada. Bulk ECA killer whale skin δ15N and δ13C values did not overlap with potential Arctic prey after adjustment for trophic discrimination, and instead reflected foraging history in the North Atlantic prior to their arrival in the ECA. Adjusted killer whale stable isotope (SI) values primarily overlapped with several species of North Atlantic baleen whales or tuna. Amino acid (AA)-specific δ15N values indicated the ECA killer whales fed primarily on marine mammals, having similar glutamic acid δ15N-phenylalanine δ15N (δ15NGlx-Phe) and threonine δ15N (δ15NThr) as mammal-eating killer whales from the eastern North Pacific (ENP) that served as a comparative framework. However, one ECA whale grouped with the fish-eating ENP ecotype based δ15NThr. Distinctive essential AA δ13C of ECA killer whale groups, along with bulk SI similarity to killer whales from different regions of the North Atlantic, indicates different populations converge in Arctic waters from a broad source area. Generalist diet and long-distance dispersal capacity favour range expansions, and integration of these insights will be critical for assessing ecological impacts of increasing killer whale predation pressure on Arctic-endemic species.

Vascular Leiomyoma of oral cavity: A case report in young male patient

Abstract Vascular Leiomyoma of the oral cavity is an uncommon benign soft tissue neoplasia arising from the tunica media of the smooth muscle cells. We reported a rare case of Vascular Leiomyoma involving the retromolar trigone area of a young man. A 24-year-old male presented with a slowly growing mass in the retromolar area, which was associated with pain and difficulty in opening of mouth and eating and drinking. A punch biopsy was taken and sent for histopathological examination which revealed a benign angiomatous lesion. The mass was excised, and the adjoining area was curetted. Histopathological examination confirmed the diagnosis of Vascular Leiomyoma. The immunohistochemistry of cells shows: alpha-smooth muscle (+); vimentin (+), Desmin, actin (+), and S100 (−). Angioleiomyomas are benign lesions, but malignant transformation is a possibility so careful histologic inspection is necessary to distinguish these lesions from their malignant counterpart.

Topical nanoencapsulated cannabidiol cream as an innovative strategy combating UV-A–induced nuclear and mitochondrial DNA injury: A pilot randomized clinical study

BackgroundUltraviolet-A radiation (UVA) contributes to photoaging/photocarcinogenesis by generating inflammation and oxidative damage. Current photoprotective strategies are limited by availability/utilization of UVA filters, highlighting an unmet need. Cannabidiol (CBD), having anti-inflammatory/antioxidant properties via regulation of NFR-2, HMOX1, and PPAR-y, could potentially mitigate damage from UVA exposure. Objective/MethodsProspective, single-center, pilot clinical trial (NCT05279495). Nineteen participants applied nano-CBD (nCBD) or vehicle (VC) cream to randomized, blinded buttock sites twice-daily for 14-days, then treated sites were irradiated with ≤3x UVA minimal erythema dose. After 24-hours, punch biopsies were obtained for histology, immunohistochemistry, real-time PCR. ResultsAt 24-hours, 21% of participants had less observed erythema on CBD-treated skin than VC skin. Histologically, nCBD-treated skin had reduced UVA-induced epidermal hyperplasia than VC (p=0.01). Immunohistochemistry detected reduced cytoplasmic/nuclear 8-oxo-guanine glycosylase 1 staining in nCBD-treated skin compared to VC (p<0.01). Quantitative mtDNA PCR demonstrated UVA-induced deletion of ND4 (proxy:4977bp deletion; p=0.003) and ND1 (proxy:3895bp deletion; p=0.002) were significantly reduced by in vivo nCBD treatment compared to VC. LimitationsSample size. ConclusionTopically applied nCBD cream reduced UVA-induced formation of a frequent mutagenic nuclear DNA base lesion and protected against mtDNA mutations associated with UVA-induced skin aging. This trial is the first to identify UV-protective capacity of CBD-containing topicals in humans.

Mucocutaneous Manifestations among Patients with Malignancies at a Tertiary Care Center in Maharashtra: A Cross-Sectional Study

Abstract Background: Malignant disorders are a leading cause of mortality and morbidity. Cutaneous manifestations may be presenting features of internal malignancies, leading to diagnosis of occult tumors, while others may occur as adverse reactions to therapeutic modalities. Aims and Objectives: To classify cutaneous manifestations among patients with malignant disorders, document their clinical profile, and analyze them with respect to age, gender, type of malignancy, and treatment. Materials and Methods: One hundred twenty patients with proven malignancy presenting with mucocutaneous lesions were enrolled in the cross-sectional study. On the basis of history, clinical examination, investigations and skin biopsy, the lesions were classified as (1) Primary cutaneous malignancy, (2) Cutaneous metastasis, (3) Paraneoplastic syndromes, (4) Mucocutaneous manifestations not related to malignancies, (5) Adverse effects secondary to treatment modalities. Results: One hundred twenty patients comprised 70 females (58.3%) and 50 males (41.7%). They were categorized as primary cutaneous malignancy (20.2%), hematological malignancies (15%), solid organ malignancy (50.9%), and gastrointestinal malignancies (5%). HIV seropositivity was seen in two patients (1.6%). Maximum belonged to Category 5 (60, 50%), of which 52 (86.7%) were adverse effects of chemotherapy with single patient showing radiation dermatitis and one patient in Category 3 (0.8%). Eleven patients showed cutaneous metastasis (9.1%), predominantly carcinoma breast. Clinically, primary cutaneous malignancies often presented as ulceronodular growths with squamous cell carcinoma being the most common histopathological type (30%). Anagen effluvium was the most common (35%) manifestation overall and in solid organ malignancies followed by melanonychia (16, 13.33%), cutaneous xerosis (9, 7.5%), and mucocutaneous hyperpigmentation (23, 19.16%). Conclusions: Mucocutaneous manifestations need prompt attention to facilitate timely diagnosis and improved outcomes.