Red Nodules Research Articles

Non-Invasive Diagnosis of Polypoidal Choroidal Vasculopathy as a Variant of the Course of Age-Related Macular Degeneration

Purpose: to study noninvasive diagnostic options for polypoidal choroidal vasculopathy (PCV) — a subtype of neovascular agerelated macular degeneration — by monitoring clinical progression, defining optical coherence tomography (OCT) findings specific for PCV and evaluating diagnostic utility of OCT angiography.Patients and methods. The study included 254 patients (292 eyes) with neovascular age-related macular degeneration. All patients underwent complex eye examination: visual acuity test, slit lamp biomicroscopy, ophthalmoscopy with 60 and 78D fundus lenses, fundoscopy with color filters, spectral-domain OCT, OCT angiography and biometry. Fluorescein angiography was performed in 66 cases. Indocyanine green angiography was employed in 16 patients with PCV. All statistical analyses were performed with IBM SPSS Statistics 19 software package.Results. In 14 of 16 patients (87.5%) indocyanine green angiography revealed round hyperfluorescent lesions which corresponded to ophthalmoscopy findings — subretinal reddish orange nodules localized primarily in the parafovea. In 11 cases (68.8%) the nodules were associated with hemorrhage and in 14 cases (87.5%) — with hard yellowish exudates. Comparative analysis of retinal anatomy allowed for defining typical OCT signs of PCV that distinguish the clinical entity from type 1 and 2 choroidal neovascular membranes: neurosensory retinal detachment in the parafovea (80.0%, p < 0.001) and hard exudates (71.9%, p < 0.001). OCT findings characteristic of PCV are dome-shaped pigment epithelium detachment (100%), bubble sign (94.74%), notch sign (68.4%) and double layer sign (92.9%).Conclusion. Noninvasive diagnosis of polypoidal choroidal vasculopathy should encompass clinical signs, fundoscopy findings, OCT-based morphometry and OCT angiography criteria. OCT angiography has high diagnostic value and enables detection of branching vascular network and polypoidal formations.

Indeterminate Cell Histiocytosis – Case Report and Review of Literature

Abstract Introduction. Indeterminate cell histiocytosis is a rare proliferative disorder of indeterminate dendritic cells, reported in only 50 case reports so far. It is clinically presented as yellow, red or brown papules and nodules that appear in otherwise healthy adult individuals. Indeterminate cells are distinct dendritic cells of the skin that have ultrastructural similarities to the epidermal Langerhans cells but do not contain the characteristic Birbeck’s granules and they are also langerin-negative, unlike LCH. Indeterminate cell histiocytosis is an exceptional entity with variable clinical, histopathologic or immunohistochemical findings, sharing morphologic and immunophenotypic features with both Langerhans- and non-Langerhans cell histiocytoses. Case Report. We present a case of indeterminate histiocytosis in a 77-year-old man with 3-year history of asymptomatic, multiple reddish and brown papules and nodules over the entire body, including the oral mucosa. Skin biopsy was done, and histopathological analysis with immunohistochemistry was performed. The positive ICH staining of cells for CD68, CD1a, and S-100 enabled us to diagnose ICH in our patient. Also, BRAF V600E mutation was detected in tumor tissue. The treatment was started with methotrexate that was effective for 6 months, but due to the disease recurrence, further therapy with thalidomide was advised, without effect. Conclusion. Indeterminate histiocytosis is a rare disease, therefore no standardized treatment has been established and the treatment options are limited.

A red nodule of the scalp.

Citation: Lambertini M, Dika E, Patrizi A, Fanti PA, Baraldi C, Di Altobrando A. A red nodule of the scalp. Dermatol Pract Concept. 2018;8(1):48-50. DOI: https://doi.org/10.5826/dpc.0801a10

Effect of deferoxamine on osteoblast differentiation under iron overload environment

Objective To study the influence of eferoxamine (DFO) intervention on osteoblast defferentiation under iron overload environment [using ferric ammonium citrate (FAC) to offer iron overload environment]. Methods The FAC and DFO intervention dosage was determined by method of cell counting kit-8 (CCK-8). Experiment was divided into three groups: control group, 50 μmol/L FAC intervention group, and FAC + DFO group (50 μmol/L FAC intervention + 20 μmol/L DFO). After intervention, alkaline phosphatase staining and quantitation, alizarin red staining and calcium nodule count were carried out. Real-time quantitative polymerase chain reaction detecting system (QPCR) was used to detect the osteogenesis related gene [runt related transcription factor 2 (Runx2), special protein 7 (Sp7), bone gamma-carboxyglutamic acid-containing protein (Bglap), osteoprotegerin (OPG)] mRNA expression level. Results CCK-8 showed 50 μmol/L FAC [(95.6±0.7)%], or 20 μmol/L DFO [(97.6±0.5)%] did not influence the cell viability, with the difference being not statistical differences among groups (P=0.427). As compared with control group, the expression of osteogenesis related genes (Runx2, Sp7, Bglap and OPG) was significantly decreased in the FAC group. As compared with the FAC group, the expression of osteogenesis related genes was significantly increased in the FAC + DFO group (P=0.026). As compared with the control group, the activity of alkaline phosphatase (ALP) staining and quantitation, alizarin red staining and nodule count were decreased in the FAC group. As compared with the FAC group (36±3), the nodule count in the FAC + DFO group (120±6) was increased significantly (P=0.017). Conclusion Osteoblast differentiation is restrained under the iron overload environment. DFO intervention can restore osteoblast differentiation to a certain extent under the iron overload environment. Key words: Deferoxamine; Osteoblast; Iron overload environment; Osteoporosis

Rare Case Report of Angiolymphoid Hyperplasia with Eosinophilia

Aims and objective: The aim of this study was to assess the clinical and demographic features of a rare cutaneous condition, angiolymphoid hyperplasia with eosinophilia (ALHE), and compare them with those previously reported. ALHE is a benign vascular proliferation of unknown etiology and its treatment is unclear. Methods: A 29 year old woman visited the Hospital of Skin and Venereal diseases for pruritic lesion in the ear. She presented with a reddish papulonodular rash. Laboratory tests showed no abnormalities. She was diagnosed with ALHE based on clinical, histological, and immunological features. Treatment with injectable prolonged systemic glucocorticoid and topical prednisolone was initiated. The rash and pruritic sensation improved within one week in the hospital, and the reddish infiltration and nodules had dramatically decreased at the 6 month follow-up. Continuous topical application resulted in no recurrence at the 6 month follow-up. Results and conclusion: Management of ALHE is still poorly standardized and poorly understood due to uncertainties concerning its pathophysiology and development and the small number of available studies. Establishing the final clinical diagnosis is difficult owing to the absence of subjective sensations. ALHE can persist for years but serious complications like cancer transformation do not occur.

Early Stage of Pilomatricoma with an Empty Cyst Cavity and Unusual Clinical Appearance

We present an unusual case of cystic pilomatricoma. A 13-year-old Japanese boy was referred to our department for evaluation of a 10-day history of a small reddish nodule on his right cheek. Histopathological examination showed a well-circumscribed cystic structure showing a central empty cavity in the dermis. The wall of the cyst was composed of basophilic cells. Inner layers of the wall were covered with flattened epithelial cells having trichohyalin granules. Based on these findings, a diagnosis of cystic pilomatricoma was made. To our knowledge, there has been no report of cystic pilomatricoma with an empty cavity. Dermatologists should be aware of pilomatricoma in the early stage showing a central empty cavity.

Nodular hepatocellular carcinoma in a Labrador dog with metastases

A 10 year old male Labrador retriever was presented for necropsy with the clinical history of vomition and pain on palpation of abdomen. Ultrasound examination revealed enlarged and abnormal liver borders. Haemato-biochemical studies revealed anaemia, leukocytosis and elevated liver specific enzymes. Necropsy examination of the carcass revealed mottled liver with multiple variably sized round, discrete to coalescing grey white to brown soft friable nodules on all the lobes. A few nodules were cystic with accumulation of viscid fluid. Similarly, multifocal variable sized dark red nodules were also found randomly scattered on both the lungs. Pancreas and kidneys also revealed metastasis. Histologically, the liver nodules appeared as nodular hepatocellular carcinoma with adenoid pattern. Metastatic foci were observed in the lungs, pancreas and kidneys. Immunohistochemical detection of tumour markers such as alpha fetoprotein, proliferating cell nuclear antigen, pancytokeratin, vimentin, chorioembryonic antigen were carried out for differential diagnosis.

Electrochemotherapy treatment of oral extramedullary plasmacytoma of the tongue: a retrospective study of three dogs

ABSTRACT: Extramedullary plasmacytomas (EPs) are responsible for 2.5% of neoplasms in dogs. They are solitary, smooth, elevated, pink or red nodules, of 1 to 2cm in diameter. Cutaneous and oral extramedullary plasmacytomas in dogs are usually benign tumors, treated with local therapies. Prognosis is generally good. Recurrence and metastatic rates are low. Electrochemotherapy is a local treatment that combines chemotherapy and electroporation and shows objective responses of 70% to 94% with few local and systemic side effects. This scientific communication has the objective to report treatment of three canine patients with oral extramedullary plasmacytoma. Nodules were located on the tongue and patients were submitted to one or two electrochemotherapy sessions, which preserved the tongue without mutilation and cured the patients.

Pruritic and Painful Red Nodules and Papules

Pruritic and Painful Red Nodules and Papules

Pruritic and Painful Red Nodules and Papules

Pruritic and Painful Red Nodules and Papules

Angiolymphoid hyperplasia with eosinophilia: report of nine cases.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign vascular proliferation characterized by dermal or subcutaneous red or brown papules or nodules, most commonly on the head and neck. The aim of this study was to review the epidemiological and clinical characteristics of ALHE, focusing particularly on the histological and therapeutic features. We performed a retrospective study of all cases of ALHE diagnosed in our dermatology and pathology departments between 2004 and 2015. Over 12 years, we collected nine cases of ALHE (0.75 case/year). There were four men and five women. The mean age was 43 years. Lesions presented as erythematous or violaceous papules or nodules in all cases, multiple in five cases, and localized on the head in eight cases or other sites in four cases. The diagnosis of ALHE was clinically suspected in only two cases. The histopathological findings showed an ill-circumscribed, intradermal slightly lobular proliferation of capillary-sized vessels around several central vessels. In all cases, the blood vessels were lined by large endothelial cells. An inflammatory infiltrate around the vessels was formed mainly of lymphocytes and eosinophils with isolated plasma cells and histiocytes. Surgery was the most common treatment in our series. Other local or general treatment has also been used with varying responses. Angiolymphoid hyperplasia with eosinophilia is a rare epithelioid vascular tumor with a challenging clinical and histological diagnosis. Despite its benign nature, ALHE causes a therapeutic dilemma.

Merkel cell carcinoma: literature review

Merkel cell carcinoma (MCC) was given a such name after the German histopathologist Friedrich Merkel, who first in 1875, described the Merkel cells, as small round or oval basophilic cells located at the end of nerve axons and within the basal layer of the epidermis. The current agreement about the function of Merkel cells they are associated with the nerve terminals acting as mechanoreceptors. MCC is a clinically aggressive uncommon, cutaneous neuroendocrine neoplastic tumour with a high mortality rate. Clinically may be presented as a painless, rapidly growing, dome-shaped red or purplish nodule. Usually in a sun-exposed area of the head and neck or upper limbs. Tremendous effort has been done in the last few years for a better understanding of the pathogenesis behind the MCC and the discovery of the Merkel cell polyomavirus suggests another clue to its pathogenesis. The expression of both epithelial and neuroendocrine immunohistochemical markers in the malignant cells, gives the tumour a unique feature that helps differentiate this neoplasm from other entities.

The megalithic necropolis of Panoria, Granada, Spain: Geoarchaeological characterization and provenance studies

AbstractThe characterization of materials used in the construction of megalithic monuments can be considered a key aspect for a better understanding of the social behavior of past societies. The excavation of four dolmens and one small cist in 2015 at the megalithic necropolis of Panoria (Granada, Spain) offered an excellent opportunity to explore the geological properties and potential source area(s) of the uprights used in their construction. All the stone slabs came from the same raw material: fine‐grained, beige to pink limestones that occasionally show red and black chert nodules, with wavy stratifications and a packstone texture. Comparison with the geological properties of the surrounding outcrops matches a lithostratigraphy known as the Ammonitico Rosso Formation. Thus, it seems safe to say that the quarry area was located next to the necropolis. Explanations other than the traditional practical reasons have been put forward to understand why the stone slabs were quarried from the same mountain in which the tombs were located.

Merkel Cell Carcinoma of Cheek: 2 Case Reports

Merkel cell carcinoma (MCC) is a rare aggressive skin cancer with the mortality rate of 33%. MCC was first described by Toker in 1972 as a trabecular cell carcinoma and is classified as a neuroendocrine tumor similar to small cell lung carcinoma and melanoma. The pathogenesis of MCC remains largely unknown. However, ultraviolet radiation and immunosuppression are likely to play a significant pathogenic role. The primary skin lesion is usually asymptomatic and it typically presents as a red or purple dome-shaped nodule. The management of MCC is controversial, however, local wide excision followed by radiotherapy is accepted as the primary treatment modality. The regional draining nodal basin is the most common site for recurrence. Therefore, sentinel lymph node biopsy is recommended in all cases, except for the clinically node-negative cases. We herein report two cases of MCC on the left cheek with different clinical manifestations. Key words: Cheek ㆍ Merkel cell carcinoma ㆍ Neoplasms

Experimental study of transforming growth factor-β3 combined with dental pulp stem cells in promoting the implant's osseointegration

Objective: To investigate the effect of transforming growth factor-β3 (TGF-β3) and dental pulp stem cells (DPSC) in promoting the implant's osteointegration. Methods: Thirty-three New Zealand white rabbits were randomly divided into phosphate buffer saline (PBS) group, DPSC group and TGF-β3 + DPSC group (12 rabbits/group). Two teeth from the rabbits's mandibular incisors or molars were pulled out randomly, then implant were placed in the tooth extraction site immediately. In PBS group, the implant area was filled with Bio-Oss powder 0.30 g mixed by PBS 20 μl only; while the implant area was filled with Bio-oss powder 0.30 g and 1×10(8)/L DPSC 20 μl in DPSC group; in the the TGF-β3+DPSC group the implant area was filled with Bio-Oss powder 0.30 g mixed with 1×10(8)/L DPSC 20 μl and 80 μg/L TGF-β3 20 μl. Eighteen New Zealand rabbits were executed in the 4 weeks and 8 weeks respectively. The treated alveolar bone tissue and implant were collected for plastic section. Alizarin red staining (ARS), immunohistochemical detection (IHC) of bone sialoprotein (BSP), osteocalcin (OC) and type Ⅰ collagen (COL-Ⅰ) were performed after 4 weeks and 8 weeks. Combined bone lamelta width (CBLW) and implant bone contact rate (IBCR), trabecular width (TW) and trabecular area percentage (TA) were observed by histomorphometric measurement. Results: ARS staining: 4 weeks after the operation, the TGF-β3+ DPSC group showed more red calcified nodules than the other two groups; 8 weeks after operation, the red calcified nodule was further increased. 4 weeks after the operation, the expression of BSP, OC and COL-Ⅰ was (0.35± 0.04), (0.36 ± 0.03) and (0.39 ± 0.01) respectively in TGF-β3+ DPSC group, (0.27 ± 0.02), (0.24 ± 0.01) and (0.28±0.03) respectively in DPSC group, and (0.13±0.03), (0.15±0.02) and (0.16±0.02) respectively in PBS group. Eight weeks after operation, the expression of BSP, OC and COL-Ⅰ was (0.51±0.02), (0.49±0.03) and (0.53±0.02) respectively in TGF-β3+DPSC group, (0.35±0.02), (0.37±0.01) and (0.38±0.01) respectively in DPSC group, and (0.21±0.03), (0.19±0.01) and (0.22±0.02) respectively in PBS group. After 4 weeks and 8 weeks, the expression of BSP, OC and COL-Ⅰ in TGF-β3+DPSC group were significantly higher than the other groups (P<0.05), there was no significant difference between DPSC group and PBS group (P>0.05). Eight weeks after operation, the CBLW, IBCR, TW and TA around implant in TGF-β3+ DPSC group were significantly higher than that in the other groups (P<0.05), there was no significant difference between DPSC group and PBS group (P>0.05). Conclusions: The DPSC has the potential osteogenic differentiation ability; TGF-β3 can accelerate the osteogenic differentiation of DPSC to some extent; TGF-β3 combined with DPSC can effectively promote the implant's osseointegration.

A case of lymphocutaneous sporotrichosis caused by Sporothrix schenckii sensu stricto finally diagnosed by molecular identification based on "ITS" and "CAL" coding regions in combination with phenotypic analysis

A 54-year-old female farmer presented with a pea-sized red nodule on the left upper limb near the wrist for 15 days, which occurred after trauma, gradually became swollen and ruptured, and developed into multiple nodules arranged in a chain in 30 days. Skin examination revealed multiple hard purple-red nodules arranged in a line on her left upper limb, some of which were ruptured with a small amount of purulent exudate. Histopathological examination further revealed that the focus of infection manifested as pyogenic granuloma-like inflammation mainly infiltrated with mixed inflammatory cells. Periodic acid Schiff (PAS) staining showed no fungal structures, including fungal spores, hyphae and asteroid body. The biopsy tissue culture yielded the fungus. According to the morphological analysis of the cultures and results of molecular identification based on internal transcribed spacer (ITS) and calmodulin (CAL) coding regions, this case was finally diagnosed as lymphocutaneous sporotrichosis caused by Sporothrix schenckii sensu stricto. The patient was treated with oral potassium iodide 10% solution in a dose of 10 ml thrice a day. After 2-month treatment, the patient felt that the lesions were obviously improved, but afterwards she was lost to follow-up. This research report suggests that phenotypic analysis combined with ITS/CAL-based molecular identification can accurately identify Sporothrix schenckii complex at the species level. Key words: Sporotrichosis; Sporothrix; Phenotype; Sequence alignment; Sporothrix schenckii sensu stricto

Individual Risk and Prevention of Complications: Doctors' Advice to Persons Wishing a New Tattoo.

Doctors who are consulted about health and tattoo risks have an important role in the prevention of an individual's tattoo complications. Tattooing is a tremendous exposure of the human body to needle operation, particles, and chemicals. The risk is related to a person's health condition, level of insight, decision-making, and to the operation of tattooing, tattoo inks and utensils, tattoo parlour, and the aftercare. Tattooing is painful minor surgery performed without anesthesia. It can be associated with syncope. It is major needle trauma with histamine release and wheal and flare in the operation field. The skin barrier is broken. Bacterial infections come early. Chronically intermittent and mild complaints affect 4/10 of all the tattooed, and 2/10 have sensitivity to sun. Chronic complications with allergy in red tattoos and nodules due to pigment agglomeration and foreign body formation in black tattoos are less common but certainly at the level of cumbersome skin disease. Reactions to black tattoos are strongly associated with sarcoidosis. There are many other distinct entities of tattoo complications. A campaign called 'Tattoo - know your risk' is presented with detailed fact sheets about tattoos, tattoo problems, how to reduce risk, and a checklist for the tattoo customer before decision-making. The sheets with keynote information are useful aids for doctors giving advice to persons curious about acquiring a tattoo.

Parasitosis en el proventrículo por Procyrnea sp. (Spiruroidea: Habronematidae), de un aguililla caminera (Rupornis magnirostris) del estado de Veracruz, México: reporte de un caso

The report presented herein describes the necropsy findings (red nodules over the linning of the proventriculus) in an adult female roadside hawk (Rupornis magnirostris) found in Veracruz State, Mexico. We further provide the description of a nematode from the genus Procyrnea found in the proventriculus wall including histopathological sections of tissue damage associated with the parasite.

Living carbonate habitats in temperate California (USA) waters: distribution, growth, and disturbance of Santa Catalina Island rhodoliths

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 560:135-145 (2016) - DOI: https://doi.org/10.3354/meps11919 Living carbonate habitats in temperate California (USA) waters: distribution, growth, and disturbance of Santa Catalina Island rhodoliths Paul A. Tompkins*, Diana L. Steller Moss Landing Marine Laboratories, 8272 Moss Landing Rd., Moss Landing, California 95039, USA *Corresponding author: ptompkins25@gmail.com ABSTRACT: Rhodoliths are globally widespread, free-living coralline red algal nodules (Rhodophyta). Living beds of rhodoliths create carbonate-based biogenic benthic habitats, which are sensitive to human disturbance and slow to recover. Despite their ecological importance, few quantitative assessments of the distribution and anthropogenic impacts on rhodoliths exist for the eastern Pacific Ocean. Following historical reports of beds in the Channel Islands off California, USA, we mapped bed distributions, examined rhodolith habitat sensitivity to human disturbance, and determined seasonal growth rates to assess rhodolith recovery potential at Santa Catalina Island. Rhodolith material from 7 beds covering 23000 m2 of live rhodoliths and 43000 m2 of dead rhodolith sediment were mapped. Beds were patchy, dominated by small Lithothamnion australe rhodoliths (mean ± SD: 10.6 ± 0.8 mm in diameter), and 6 beds were disturbed by mooring arrays. Surveys of mooring frequency and experimental manipulation of mooring chains showed that the cover of live rhodoliths, their physical structure, and the diversity and abundance of associated benthic species were negatively related to this prevalent anthropogenic disturbance. Axial growth rates of Santa Catalina Island rhodoliths were relatively slow, seasonally variable, and similar to those reported in other rhodolith studies (annual mean: 1.25 ± 0.62 mm yr-1). Due to their importance as biogenic habitat, sensitivity to disturbance, and slow recovery potential, California rhodolith beds should be considered a priority for monitoring efforts and restoration and should be included within marine protected area planning. KEY WORDS: Rhodophyta · Disturbance · Lithothamnion australe · Coralline algae · Maerl · Channel Islands Full text in pdf format PreviousNextCite this article as: Tompkins PA, Steller DL (2016) Living carbonate habitats in temperate California (USA) waters: distribution, growth, and disturbance of Santa Catalina Island rhodoliths. Mar Ecol Prog Ser 560:135-145. https://doi.org/10.3354/meps11919 Export citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 560. Online publication date: November 24, 2016 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2016 Inter-Research.

Pharmacologic treatments for rosacea

Rosacea represents a common and chronic inflammatory skin disorder. Clinical features include transient and permanent erythema, inflammatory papules and pustules, phymatous changes, and ocular signs and symptoms. Rosacea is generally classified into four subtypes and one variant. Subtype 1, erythematotelangiectatic rosacea, includes clinical features of flushing and persistent central facial erythema with or without telangiectasia. Subtype 2, papulopustular rosacea, is characterized by persistent central facial erythema with transient papules or pustules or both on the central face. Subtype 3, phymatous rosacea, includes thickening of the skin with irregular surface nodularities and enlargement. Subtype 4, ocular rosacea, includes inflammation of different parts of the eye and eyelid. A variant, granulomatous rosacea, is noninflammatory and is characterized by hard, brown, yellow, or red cutaneous papules or nodules of uniform size. Patients may present with more than one subtype, and each individual characteristic may fluctuate. There is debate whether rosacea progresses from one subtype over time or subtypes represent discreet entities. Defining clinical presentation and improved understanding of pathophysiology has resulted in identification of novel treatment approaches. This contribution outlines a rationale for treatment, highlights an evidence-based approach with approved treatments, and considers novel developments and off-license therapy available.