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Elber-Dorozko S, Berkun Y, Zlotogorski A, Maly A, Tenenbaum A. Bullous Hemorrhagic Target Lesions in IgA Leukocytoclastic Vasculitis. Isr Med Assoc J 2023; 25:233-234. [PMID: 36946671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Affiliation(s)
- Sergei Elber-Dorozko
- Department of Pediatrics, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yackov Berkun
- Department of Pediatrics, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Alexander Maly
- Pathology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Ariel Tenenbaum
- Department of Pediatrics, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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Fleissig Y, Dan-Gur M, Michael-Gayego A, Maly A, Tabib R, Jaffe CL, Korem M. A trespasser from a foreign land? A case report of primary mucosal leishmaniasis. BMC Infect Dis 2022; 22:212. [PMID: 35241005 PMCID: PMC8892399 DOI: 10.1186/s12879-022-07169-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We report a clinically challenging and unusual case of L. donovani oral mucosal leishmaniasis. CASE PRESENTATION Israeli resident with a former travel to central and North Africa, with no documented or prior cutaneous lesions presented with oral lesions of the maxillary gingiva and the upper lip. A delay in diagnosis and treatment have led to progression of the maxillary gingival lesions towards the hard palatal and the soft palate that could have potentially compromised the upper airway. CONCLUSIONS This case highlights the importance of early diagnosis of leishmaniasis in patients with oral lesions and the laboratory workup necessary to appropriately characterize and treat the disease.
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Affiliation(s)
- Yoram Fleissig
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem, 9112102, Israel. .,Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel.
| | - Mary Dan-Gur
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,National Center for Leishmaniasis, Kuvin Center for Study of Tropical and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
| | - Ayelet Michael-Gayego
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Pathology, Hadassah Medical Center, Jerusalem, Israel
| | - Rami Tabib
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem, 9112102, Israel.,Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Charles L Jaffe
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,National Center for Leishmaniasis, Kuvin Center for Study of Tropical and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
| | - Maya Korem
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
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Lyakhovitsky A, Segal O, Maly A, Zlotogorski A, Barzilai A. Permanent chemotherapy-induced alopecia after hematopoietic stem cell transplantation successfully treated with low-dose oral minoxidil. JAAD Case Rep 2022; 22:64-67. [PMID: 35321258 PMCID: PMC8935347 DOI: 10.1016/j.jdcr.2022.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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4
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Sarika GM, Shreberk-Hassidim R, Maly A, Molho-Pessach V. Acrofacial necrotic ulcers in an infant: An undiagnosed presentation. Front Pediatr 2022; 10:1069242. [PMID: 36619501 PMCID: PMC9815528 DOI: 10.3389/fped.2022.1069242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Acral necrotic ulcers in infancy are rare but have been described in type I interferonopathies. Herein, we present a case of an 8-year-old child who presented at the age of one month with severe ulceronecrotic lesions on the face and limbs with exacerbations following exposure to cold weather. Despite extensive investigation the case remains undiagnosed to this day. We hypothesize that this case represents a novel and yet unknown autoinflammatory disease.
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Affiliation(s)
| | | | - Alexander Maly
- Department of Pathology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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5
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Neuman T, Maly A, Alterman M, Popovtzer A, Weinberger JM, Hirshoren N. Salivary Gland Heterotopia, a Clinical and Pathological TNM Staging Challenge - Carcinoma ex Pleomorphic Adenoma Arising in a Parotid Lymph node. Cancer Treat Res Commun 2021; 28:100435. [PMID: 34280887 DOI: 10.1016/j.ctarc.2021.100435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Heterotopia is the presence of a particular tissue / tumor at a non-physiological / ectopic site. The study primary goals: To review the current data investigating heterotopic, normal appearing, and diseased salivary gland tumors, in lymph nodes. To describe the meticulous pathological investigation and multidisciplinary decision-making process of a heterotopic carcinoma ex pleomorphic adenoma arising in an intra-parotid lymph node. MATERIALS AND METHODS A literature search in the "PubMed" database using key words "carcinoma ex pleomorphic adenoma", "parotid lymph node", "salivary gland" and "heterotopia" was conducted. We describe the thorough pathological investigation and clinical decision-making process, focusing TNM staging system limitations. RESULTS A few case reports presented either normal appearing salivary tissue, benign tumors or low and high-grade salivary malignancies arising in lymph nodes. We present the investigation, controversies and treatment decision process of a 46-year-old man with CXPA in intra-parotid lymph node. CONCLUSIONS The staging scheme does not distinguish between nodal spread and primary tumor arising in a lymph node. Multidisciplinary input regarding prognosis and follow-up plans, may consider heterotopia differently from the usual pattern of nodal spread.
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Affiliation(s)
| | | | | | | | - Jeffrey M Weinberger
- Department of Otolaryngology / Head & Neck Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
| | - Nir Hirshoren
- Department of Otolaryngology / Head & Neck Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.
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6
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Pukhalskaya T, Smoller BR, Becker M, Maly A, Zadik Y, Elad S. Oral white lesion in patients post-hematopoietic stem cell transplantation: a case series demonstrating the diagnostic dilemma. Support Care Cancer 2021; 29:7999-8007. [PMID: 34218349 DOI: 10.1007/s00520-021-06392-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
The current National Institutes of Health (NIH) consensus paper excluded "white hyperkeratotic plaque" from the diagnostic criteria for oral chronic graft-versus-host disease (cGVHD) in order to ensure malignant transformation is not overlooked. Therefore, an isolated oral white plaque is recommended to be subjected to biopsy and pathologic examination. The cases described in this paper shed a new light on the clinical approach to oral white plaque post-hematopoietic stem cell transplantation. The objectives of this article are to demonstrate that a white plaque does not contradict a diagnosis of oral cGVHD, and to highlight the clinical considerations for taking a biopsy.
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Affiliation(s)
- Tatsiana Pukhalskaya
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Ave, Box 626, Rochester, NY, 14642, USA.
| | - Bruce R Smoller
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Ave, Box 626, Rochester, NY, 14642, USA
| | - Michael Becker
- Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Alexander Maly
- Department of Pathology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Yehuda Zadik
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sharon Elad
- Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
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Goldberger T, Levi SS, Armoni G, Ben-Shushan S, Maly A, Ramot Y. Granuloma Annulare Located on Striae Distensae. Dermatol Pract Concept 2021; 11:e2021018. [PMID: 33954012 DOI: 10.5826/dpc.1102a18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 10/31/2022] Open
Affiliation(s)
- Tal Goldberger
- Department of Dermatology, Hadassah Medical Center and the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - S Sheffer Levi
- Department of Dermatology, Hadassah Medical Center and the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gil Armoni
- Department of Dermatology, Hadassah Medical Center and the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Stephanie Ben-Shushan
- Department of Pathology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Yuval Ramot
- Department of Dermatology, Hadassah Medical Center and the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Goldberger T, Armoni G, Lavie D, Merims S, Maly A, Shreberk-Hassidim R. Pityriasis rubra pilaris induced by PD-1 inhibitor nivolumab. Int J Dermatol 2021; 60:1038-1039. [PMID: 33846975 DOI: 10.1111/ijd.15563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Tal Goldberger
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
| | - Gil Armoni
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
| | - David Lavie
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Hematology, Hadassah Medical Center, Jerusalem, Israel
| | - Sharon Merims
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Oncology, Hadassah Medical Center, Jerusalem, Israel
| | - Alexander Maly
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Pathology, Hadassah Medical Center, Jerusalem, Israel
| | - Rony Shreberk-Hassidim
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
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9
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Hirshoren N, Al-Kharouf I, Weinberger JM, Eliashar R, Popovtzer A, Knaanie A, Fellig Y, Neuman T, Meir K, Maly A, Vainer GW. Spatial Intratumoral Heterogeneity Expression of PD-L1 Antigen in Head and Neck Squamous Cell Carcinoma. Oncology 2021; 99:464-470. [PMID: 33789303 DOI: 10.1159/000515441] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Immune-checkpoint inhibitors have demonstrated a significant survival benefit in metastatic and non-resectable head and neck squamous cell carcinoma (HNSCC). Patients with a combined positivity score (CPS) of 20 and higher benefit the most from therapy. Inaccurate definition of the CPS category might lead to the incorrect stratification of patients to immunotherapy. This study's main aim was to investigate programmed death-ligand 1 (PD-L1) antigen expression in HNSCC in diverse clinical situations and histological settings. MATERIALS AND METHODS This is a prospective cohort study conducted in a tertiary referral medical center. Tissues were investigated for PD-L1 expression using the FDA-approved 22C3 immunohistochemistry assay (Dako). We analyzed potential associations between the CPS category and meaningful demographic, clinical, and outcome metrics. Furthermore, we investigated morphologically separate sites for CPS scores in whole surgical tissue specimens and matched preoperative biopsies. RESULTS We analyzed 36 patients, of whom 26 had oral cavity SCC and 10 had laryngeal SCC. The overall, disease-specific, and progression-free survival of the HNSCC group of patients were not associated with the CPS category (p = 0.45, p = 0.31, and p = 0.88, respectively). There was a significant (18%, 95% CI 0.65-0.9) inconsistency between the CPS category determined in biopsies versus whole carcinoma analyses. We also found an uneven distribution of whole-tumor CPS attributed to spatial carcinoma invasiveness, tumor differentiation, and inflammatory cell infiltration heterogeneity. DISCUSSION AND CONCLUSIONS Our data suggest that careful selection of tumor area for CPS analysis is important. PD-L1 antigen expression, clinically represented by CPS, may be up- or down-categorized in different clinical and pathological circumstances. The high whole-tissue CPS category scatter may clinically result in potential treatment modifications. We argue that CPS analysis requires not only adequacy (at least 100 viable tumor cells), but also correct representation of the tumor microenvironment.
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Affiliation(s)
- Nir Hirshoren
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Issa Al-Kharouf
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Jeffrey M Weinberger
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ron Eliashar
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Aron Popovtzer
- Sharett Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ariela Knaanie
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yakov Fellig
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Tzahi Neuman
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Karen Meir
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Gilad W Vainer
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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10
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Meirovitz A, Shouchane-Blum K, Maly A, Bersudski E, Hirshoren N, Abrams R, Popovtzer A, Orevi M, Weinberger J. The potential of somatostatin receptor 2 as a novel therapeutic target in salivary gland malignant tumors. J Cancer Res Clin Oncol 2021; 147:1335-1340. [PMID: 33598797 DOI: 10.1007/s00432-021-03538-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatment regimens for patients with metastatic or recurrent post-radiation, locoregional, unresectable salivary cancer are limited. An inverse correlation between somatostatin receptor 2 (SSTR2) and the proliferating marker Ki-67 in neuroendocrine tumors has enabled a treatment plan for metastatic disease, utilizing peptide receptor radionuclide therapy. Interestingly, healthy salivary glands express high levels of SSTR2. In this study, the presence of SSTR2, its correlation with Ki-67 in glandular salivary carcinomas and the clinical applicability thereof was determined. METHODS In the retrospective part of this study, 76 adequate tumor tissue specimens obtained from patients diagnosed with primary or metastatic salivary carcinomas between 1988 and 2016, were collected for tissue array and histologically classified. Immunohistochemistry was performed to determine the presence, relative expression and potential correlation of SSTR2 and Ki-67. The clinical significance of SSTR2 expression was determined by prospectively assessing 68Ga-DOTATATE uptake using PET-CT imaging, in patients diagnosed with metastatic salivary gland malignant tumors between 2015 and 2016. RESULTS Sixty-three primary cancer tumors and 14 metastatic tumors were tested. All tumor subtypes were found to express SSTR2 to some extent. The highest expression was seen in Mucoepidermoid carcinoma (MEC) tissues where the majority of specimens (86.4%) expressed SSTR2. A relatively strong immunohistochemical staining score for SSTR2 was observed in MEC, adenoid cystic carcinoma and polymorphous adenocarcinoma. Interestingly, an inverse correlation between SSTR2 and Ki-67 expressions was observed (44%) in MEC tissue. Uptake of 68Ga-DOTATATE was visualized using PET-CT imaging in 40% of patients, across metastatic MEC and ACC. All observations were found to be statistically significant. CONCLUSION This study confirms the expression of SSTR2 in glandular salivary carcinomas and an inverse correlation in expression levels between SSTR2 and Ki-67. This lays a foundation for novel treatment options in salivary metastatic cancers where SSTR2 may be a potential novel therapeutic target.
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Affiliation(s)
- Amichay Meirovitz
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel.
| | - Karny Shouchane-Blum
- Hebrew University Medical School, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Evgeniya Bersudski
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Nir Hirshoren
- Department of Otolaryngology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Ross Abrams
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Aron Popovtzer
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Marina Orevi
- Department of Nuclear Medicine, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Jeffrey Weinberger
- Department of Otolaryngology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
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Abu Assab D, Maly A, Zlotogorski A, Molho-Pessach V. Multiple Nasal Papules in a 12-year-old Boy: A Quiz. Acta Derm Venereol 2020; 100:adv00350. [PMID: 33283250 PMCID: PMC9309698 DOI: 10.2340/00015555-3716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Dania Abu Assab
- Department of Dermatology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, POB 12000, Jerusalem 9112001, Israel
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12
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Hartshtark S, Ramot Y, Maly A, Klapholz L. Multiple brown papules on the chest in a zosteriform distribution. Int J Dermatol 2020; 60:e181-e183. [PMID: 33107028 DOI: 10.1111/ijd.15276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Stav Hartshtark
- Departments of, Department of, Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Ramot
- Departments of, Department of, Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alexander Maly
- Departments of, Department of, Pathology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Laurent Klapholz
- Departments of, Department of, Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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Maoz K, Greenberger S, Maly A, Merims S, Tirosh I, Barzilai A, Molho-Pessach V. Subcutaneous granuloma annulare mimicking dermatomyositis. Pediatr Dermatol 2020; 37:687-689. [PMID: 32314413 DOI: 10.1111/pde.14167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/04/2020] [Accepted: 03/19/2020] [Indexed: 11/29/2022]
Abstract
We present three children who presented with papules and plaques over the knuckles, mimicking Gottron's papules of juvenile dermatomyositis, as well as subcutaneous nodules over the joints of the extremities that were initially thought to represent calcinosis cutis. However, thorough clinical and laboratory evaluation, as well as imaging, failed to support this diagnosis. Skin biopsies were consistent with a diagnosis of subcutaneous granuloma annulare. This unique phenotype of granuloma annulare should be recognized in order to prevent erroneous diagnosis and treatment.
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Affiliation(s)
- Karin Maoz
- Department of Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shoshana Greenberger
- Department of Dermatology, Tel Hashomer and Sackler Faculty of Medicine, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Alexander Maly
- Department of Pathology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sharon Merims
- Department of Oncology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Irit Tirosh
- Department of Pediatrics, Tel Hashomer and Sackler Faculty of Medicine, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Aviv Barzilai
- Department of Dermatology, Tel Hashomer and Sackler Faculty of Medicine, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Vered Molho-Pessach
- Department of Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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14
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Schnapp A, Abulhija H, Maly A, Armoni-Weiss G, Levin Y, Faitatziadou SM, Molho-Pessach V. Introductory histopathological findings may shed light on COVID-19 paediatric hyperinflammatory shock syndrome. J Eur Acad Dermatol Venereol 2020; 34:e665-e667. [PMID: 32535977 PMCID: PMC7323333 DOI: 10.1111/jdv.16749] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 05/31/2020] [Accepted: 06/03/2020] [Indexed: 01/18/2023]
Affiliation(s)
- A Schnapp
- Department of Pediatrics, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - H Abulhija
- Department of Pediatrics, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - A Maly
- Department of Pathology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - G Armoni-Weiss
- Department of Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Y Levin
- Department of Pediatrics, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - S M Faitatziadou
- Department of Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - V Molho-Pessach
- Department of Dermatology, The Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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15
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Shoukair FL, Maly A, Haran TK, Hirshoren N, Abu Tair J. Maxillofacial diagnostic features of the enigmatic metastasizing pleomorphic adenoma. Int J Oral Maxillofac Surg 2020; 49:841-847. [PMID: 32005572 DOI: 10.1016/j.ijom.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 12/26/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
Considering the confusion in the literature regarding local recurrence, spread, or metastases of pleomorphic adenoma (PA) in the head and neck region, the aim of this study was to enhance understanding of the characteristics of metastasizing pleomorphic adenoma (MPA) by reviewing the literature and presenting a case. English language articles with proof of metastases were included in the literature review. Of the 80 cases in the literature with MPA, 46 were female and 33 were male (sex missing for one case). Thirty-five percent of the neoplasms affected the bones; the maxilla was affected in five cases and the mandible in three. The parotid was the primary site in 72.5% of cases and the submandibular gland in 16.2% of cases. The local recurrence rate was 70%. The mean interval between primary PA and MPA was 15.52 years. The total mortality rate was 8.7%. A case of PA of the submandibular gland that recurred after surgical excision and metastasized (confirmed by the presence of intact cortical borders) to the ipsilateral mandibular body, upper lip, and neck is described. The high mortality rate in a histologically defined benign disease that metastasizes demands that management include careful primary excision and long-term clinical follow-up.
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Affiliation(s)
- F L Shoukair
- Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah, Jerusalem, Israel.
| | - A Maly
- Department of Pathology, Faculty of Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - T K Haran
- Department of Pathology, Faculty of Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - N Hirshoren
- Department of ENT, Faculty of Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - J Abu Tair
- Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah, Jerusalem, Israel; Arab American University-AAUP, Palestinian Authority
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Abdalla-Aslan R, Friedlander-Barenboim S, Aframian DJ, Maly A, Nadler C. Ameloblastoma incidentally detected in cone-beam computed tomography sialography: A case report and review of the literature. J Am Dent Assoc 2019; 149:1073-1080. [PMID: 30497576 DOI: 10.1016/j.adaj.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/26/2018] [Accepted: 09/05/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OVERVIEW Cone-beam computerized tomographic (CBCT) imaging is increasingly used in the maxillofacial region for various purposes. The volumetric dataset created by means of CBCT increases the possibility of detecting incidental findings. CASE DESCRIPTION In this case report, the authors describe an otherwise healthy 45-year-old man who was referred from the Sjogren's Syndrome Center in Jerusalem, Israel, for bilateral parotid CBCT sialographic imaging owing to xerostomia lasting for 4 months. CBCT sialographic imaging using iodine contrast material showed normal glandular structure and activity according to the postcannulation panoramic imaging. CBCT sialographic imaging routine volume interpretation revealed a lesion in the mandibular area causing destruction and perforation of the cortical plates, partial disappearance of adjacent lamina dura, and resorption of adjacent teeth, suggesting an aggressive benign tumor. Histopathologic examination confirmed mural cystic ameloblastoma, which was resected with preservation of the mental nerve and the lower mandibular border. The patient received bone graft and implants, with regular follow-ups and no recurrence after 4 years. CONCLUSIONS AND PRACTICAL IMPLICATIONS This case strengthens the need for thorough examination of the whole CBCT imaging volume within and outside the region of interest to detect incidental findings with clinical importance.
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Goldberger T, Maly A, Harel T, Molho-Pessach V. Ulcers and Scars on the Trunk of a 20-month-old Boy: A Quiz. Acta Derm Venereol 2019; 99:629-630. [PMID: 30809686 DOI: 10.2340/00015555-3153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Tal Goldberger
- Department of Dermatology, Hadassah Medical Center, IL-75015 Jericho, Israel
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Perlman A, Maly A, Ackerman Z. Skin Hypersensitivity to Oral Budesonide: Case Report and Review of the FDA Adverse Event Reporting System Database. Ann Pharmacother 2018; 52:1049-1050. [DOI: 10.1177/1060028018780394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Thomaidou E, Armoni G, Klapholz L, Hadayer N, Maly A, Ramot Y. Zosteriform cutaneous metastases. Clin Exp Dermatol 2018; 43:734-736. [PMID: 29736943 DOI: 10.1111/ced.13545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 11/29/2022]
Affiliation(s)
- E Thomaidou
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, 9112001, Israel
| | - G Armoni
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, 9112001, Israel
| | - L Klapholz
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, 9112001, Israel
| | - N Hadayer
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, 9112001, Israel
| | - A Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, 9112001, Israel
| | - Y Ramot
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, 9112001, Israel
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Ramot Y, Tetro T, Soteriou L, Doviner V, Maly A, Zlotogorski A. Solitary angiokeratoma of the vulva mimicking malignant melanoma. Cutis 2018; 101:E6-E7. [PMID: 29894537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Tamar Tetro
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Leonidas Soteriou
- Department of Plastic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Victoria Doviner
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Renert-Yuval Y, Merims S, Maly A, Ramot Y. A Rapidly Expanding Ulcer in the Armpit of a 48-year-old Man: A Quiz. Acta Derm Venereol 2018; 98:384-385. [PMID: 29199350 DOI: 10.2340/00015555-2858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yael Renert-Yuval
- Department of Dermatology, Hebrew University Medical Center, 9112001 Jerusalem, Israel.
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Shreberk-Hassidim R, Neumark M, Greenberger S, Goldstein G, Hassidim A, Dukler Y, Maly A, Stepensky P, Molho-Pessach V. Cutaneous Chronic Graft Versus Host Disease Following Allogeneic Haematopoietic Stem Cell Transplantation in Children: A Retrospective Study. Acta Derm Venereol 2018; 98:206-211. [PMID: 29057425 DOI: 10.2340/00015555-2824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic graft versus host disease (cGVHD) is a complication of allogeneic haematopoietic stem cell transplantation (HSCT). The aim of this study was to clinically characterize childhood cutaneous cGVHD. A retrospective study of children treated with HSCT at 2 tertiary medical centres in Israel between 2011 and 2014 was performed. A total of 112 children were included. Cutaneous cGVHD developed in 18% of subjects. Risk factors were older age, HSCT from peripheral blood and acute lymphoblastic leukaemia. The eruption was lichenoid in 90% of subjects, of whom one-third progressed to sclerosis. Topical treatments were usually sufficient in localized disease. Widespread eruption necessitated phototherapy, extracorporeal photopheresis and/or systemic immunosuppressants. Patients presenting with palmoplantar keratoderma, developed sclerosis. To the best of our knowledge, this is the first study describing childhood cutaneous cGVHD. Lichenoid eruption is the most common cutaneous pattern of cGVHD in children. Sclerotic changes may be associated with prior keratoderma. cGVHD poses a therapeutic challenge and better treatments should be sought.
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Affiliation(s)
- Rony Shreberk-Hassidim
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Kiryat Hadassah, POB 12000, Jerusalem, 9112001, Israel
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Laviv A, Maly A, Abu-Tair J. Large facial lymphatic malformation treatment using sclerosing agent followed by surgical resection: clinical and pathology report. Oral Maxillofac Surg 2017; 21:363-369. [PMID: 28735345 DOI: 10.1007/s10006-017-0640-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/11/2017] [Indexed: 11/29/2022]
Abstract
Lymphatic malformations are rare slow-flow vascular malformations, with high tendency to appear in the head and neck region. The treatment of these lesions ranges from follow-up to sclerosing agent injection to surgical excision. The authors present a case of a new born with large extensive lingual and submandibular lymphatic malformation, for which the patient underwent tracheostomy and gastrostomy insertion. He was then treated successfully with sclerosing agent injections followed by surgical excision, with 7 years follow-up. The second case presented is a two and a half baby with large lingual lymphatic malformation, treated successfully with doxycycline injections followed by intraoral excision of the lesion. Pathology of the excised lesion is then demonstrated, which shows for the first time the different layers affected by the sclerosing agent.
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Affiliation(s)
- Amir Laviv
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, PO Box 12272, 91120, Jerusalem, Israel.
| | - Alexander Maly
- Department of Pathology, Faculty of Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - Jawad Abu-Tair
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, PO Box 12272, 91120, Jerusalem, Israel
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Shreberk-Hassidim R, Hassidim A, Adler N, Horev L, Maly A, Zlotogorski A, Ramot Y. Squamous cell carcinoma in situ
in association with HPV 11 in Netherton's syndrome patient: a case report. J Eur Acad Dermatol Venereol 2016; 30:e232-e234. [DOI: 10.1111/jdv.13568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- R. Shreberk-Hassidim
- Department of Dermatology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - A. Hassidim
- Department of Plastic surgery; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - N. Adler
- Department of Plastic surgery; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - L. Horev
- Department of Dermatology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - A. Maly
- Department of Pathology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - A. Zlotogorski
- Department of Dermatology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - Y. Ramot
- Department of Dermatology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
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Marmary Y, Adar R, Gaska S, Wygoda A, Maly A, Cohen J, Eliashar R, Mizrachi L, Orfaig-Geva C, Baum BJ, Rose-John S, Galun E, Axelrod JH. Radiation-Induced Loss of Salivary Gland Function Is Driven by Cellular Senescence and Prevented by IL6 Modulation. Cancer Res 2016; 76:1170-80. [PMID: 26759233 DOI: 10.1158/0008-5472.can-15-1671] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/19/2015] [Indexed: 11/16/2022]
Abstract
Head and neck cancer patients treated by radiation commonly suffer from a devastating side effect known as dry-mouth syndrome, which results from the irreversible loss of salivary gland function via mechanisms that are not completely understood. In this study, we used a mouse model of radiation-induced salivary hypofunction to investigate the outcomes of DNA damage in the head and neck region. We demonstrate that the loss of salivary function was closely accompanied by cellular senescence, as evidenced by a persistent DNA damage response (γH2AX and 53BP1) and the expression of senescence-associated markers (SA-βgal, p19ARF, and DcR2) and secretory phenotype (SASP) factors (PAI-1 and IL6). Notably, profound apoptosis or necrosis was not observed in irradiated regions. Signs of cellular senescence were also apparent in irradiated salivary glands surgically resected from human patients who underwent radiotherapy. Importantly, using IL6 knockout mice, we found that sustained expression of IL6 in the salivary gland long after initiation of radiation-induced DNA damage was required for both senescence and hypofunction. Additionally, we demonstrate that IL6 pretreatment prevented both senescence and salivary gland hypofunction via a mechanism involving enhanced DNA damage repair. Collectively, these results indicate that cellular senescence is a fundamental mechanism driving radiation-induced damage in the salivary gland and suggest that IL6 pretreatment may represent a promising therapeutic strategy to preserve salivary gland function in head and neck cancer patients undergoing radiotherapy.
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Affiliation(s)
- Yitzhak Marmary
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Revital Adar
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Svetlana Gaska
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Annette Wygoda
- Department of Oncology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Jonathan Cohen
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Ron Eliashar
- Department of Otolaryngology/Head and Neck Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Lina Mizrachi
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Carmit Orfaig-Geva
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Bruce J Baum
- Molecular Physiology and Therapeutics Branch National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland
| | - Stefan Rose-John
- Institut für Biochemie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Eithan Galun
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Jonathan H Axelrod
- Goldyne-Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel.
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Ramot Y, Zamir M, Maly A, Zlotogorski A. Ausgedehnte Papeln und hyperkeratotische Knoten. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.100_12796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yuval Ramot
- Department of Dermatology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - Mariana Zamir
- Department of Dermatology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - Alexander Maly
- Department of Pathology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - Abraham Zlotogorski
- Department of Dermatology; Hadassah - Hebrew University Medical Center; Jerusalem Israel
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27
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Ramot Y, Zamir M, Maly A, Zlotogorski A. Widespread papules and hyperkeratotic nodules. J Dtsch Dermatol Ges 2015; 14:77-9. [PMID: 26636427 DOI: 10.1111/ddg.12796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Mariana Zamir
- Department of Dermatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
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Sheffer S, Shreberk-Hassidim R, Olshtain K, Maly A, Zlotogorski A, Ramot Y. Lymphocutaneous nocardiosis caused by Nocardia brasiliensis in an immunocompetent elderly woman. Int J Dermatol 2015; 55:e45-7. [PMID: 26475056 DOI: 10.1111/ijd.12988] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 01/19/2015] [Accepted: 01/20/2015] [Indexed: 12/30/2022]
Affiliation(s)
| | | | - Karen Olshtain
- Department of Microbiology and Infectious Diseases, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Yuval Ramot
- Department of Dermatology, Jerusalem, Israel.
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29
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Shreberk-Hassidim R, Zaguri R, Maly A, Zlotogorski A, Ramot Y. Skin manifestations of primary hyperoxaluria: a case report. Int J Dermatol 2015; 54:e478-9. [PMID: 26227278 DOI: 10.1111/ijd.13036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/28/2015] [Accepted: 03/12/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - Reut Zaguri
- Department of Nephrology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Yuval Ramot
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Czerninski R, Shavit I, Maly A. Lip Lesions: Lichen Planus vs. Solar Cheilitis. Int J Dermatol 2015; 54:e315-7. [DOI: 10.1111/ijd.12846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 08/18/2014] [Accepted: 08/25/2014] [Indexed: 01/16/2023]
Affiliation(s)
- Rakefet Czerninski
- Department of Oral Medicine; The Hebrew University- Hadassah School of Dental Medicine; Jerusalem Israel
| | - Idan Shavit
- Department of Oral Medicine; The Hebrew University- Hadassah School of Dental Medicine; Jerusalem Israel
| | - Alexander Maly
- Department of Pathology; Hadassah-Hebrew University Medical School; Jerusalem Israel
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Amit M, Ilana K, Avraham SP, Binenbaum Y, Bachar G, Billan S, Zaarura S, Czerninski R, Bar-Tov M, Maly A, Akrish S, Gil Z. Trends in human papillomavirus-related oropharyngeal cancer in Israel. Head Neck 2015; 38 Suppl 1:E274-8. [PMID: 25545260 DOI: 10.1002/hed.23985] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The role of human papillomavirus (HPV) infection in oropharyngeal cancer (SCC) is well established. The annual incidence of oropharyngeal SCC in Israel is considerably lower than that in the United States. The purpose of this study was to assess the rate of HPV-related oropharyngeal SCC in Israel. METHODS The cohort included patients with oropharyngeal SCC who were treated during 1999 to 2011 in Israel. HPV typing was carried out using reverse hybridization and immunohistochemistry. RESULTS Of the 74 patients analyzed, 25 (33.7%) had detectable HPV DNA. Patients in the HPV-positive group tended to be younger, with a higher rate of nodal metastases, and no history of smoking (p < .02). CONCLUSION This study demonstrated a rate of HPV-related oropharyngeal SCC in Israel as approximately 3-fold lower than in Western countries. Low exposure to HPV-16, a lower rate of transformation, to cancer or protective genetic factors may contribute to the lower rate of oropharyngeal SCC in Israel. © 2015 Wiley Periodicals, Inc. Head Neck 38: E274-E278, 2016.
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Affiliation(s)
- Moran Amit
- Department of Otolaryngology, Rambam Medical Center, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Kaplan Ilana
- Department of Pathology, Tel Aviv Medical Center, Tel Aviv, Israel
| | | | - Yoav Binenbaum
- Department of Otolaryngology, Rambam Medical Center, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Gideon Bachar
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Israel
| | - Salem Billan
- Oncological Institute, Rambam Medical Center, Haifa, Israel
| | | | - Rakefet Czerninski
- Department of Oral Medicine, The Hebrew University-Hadassah School of Dental Medicine, Israel
| | - Matan Bar-Tov
- Department of Oral Medicine, The Hebrew University-Hadassah School of Dental Medicine, Israel
| | - Alexander Maly
- Department of Oral Medicine, The Hebrew University-Hadassah School of Dental Medicine, Israel
| | - Sharon Akrish
- Department Pathology, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Ziv Gil
- Department of Otolaryngology, Rambam Medical Center, The Technion, Israel Institute of Technology, Haifa, Israel
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Mansura A, Maly A, Ramot Y, Zlotogorski A. Acantholytic dermatosis of the vulva. Dermatol Online J 2015; 21:13030/qt5ws3453j. [PMID: 26295855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 05/18/2015] [Indexed: 06/04/2023] Open
Abstract
Acantholytic dermatosis of the vulva is a rare condition, presenting with papular eruption in the genital area without history of Darier disease or Hailey-Hailey disease. We report a case with a papular pruritic eruption in the region of the vulva, coalescing into plaques. Biopsy specimen showed irregular acanthosis with an area of split-like bullous formation in the deeper part of the epidermis, as well as acantholytic cells, marked hypergranulosis and hyperkeratosis, compatible with the rare diagnosis of acantholytic dermatosis of the vulva. We review the clinical and histological characteristics of this uncommon disease.
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Czerninski R, Zeituni S, Maly A, Basile J. Clinical characteristics of lichen and dysplasia vs lichen planus cases and dysplasia cases. Oral Dis 2015; 21:478-82. [PMID: 25482285 DOI: 10.1111/odi.12306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/17/2014] [Accepted: 11/30/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the clinical characteristics of lichen planus with dysplasia (LD) cases with oral dysplasia (DYS), and LP/lichenoid reaction (LP/LR). METHODS Patients treated at the Department of Oral Medicine with a histological diagnosis were included. Patient information (age, gender, ethnicity, smoking habits, and medical status) and parameters of oral manifestation (lesions' distribution, site, and type) were compared. RESULTS Two hundred and thirty five patients were included. 54% were never smokers and 25% were current smokers. The LD group (n = 79) had more bilateral cases when compared to the DYS group (n = 30), 70% to 40.7%, respectively (P = 0.008), and a lower average age [56-62, respectively (P = 0.043)]. All other parameters were similar. When compared to LR patients, the LD group had a higher percentage of men [41.8-27.9%, respectively (P = 0.08)] while all other parameters were similar. CONCLUSIONS As clinical characteristics of LD are more similar to the LP and LR group than to dysplasia, these findings may indicate that LD should be considered as part of the lichen planus disorder spectrum rather than a separate entity, although further analysis of larger groups is warranted. These results support the need for clinical follow-up among patients diagnosed with lichenoid changes.
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Affiliation(s)
- R Czerninski
- Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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35
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Shreberk-Hassidim R, Ramot Y, Maly A, Horev L, Zlotogorski A. Kerion celsi of the vulva: an unusual location. J Mycol Med 2014; 24:359-60. [PMID: 25459677 DOI: 10.1016/j.mycmed.2014.06.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 06/06/2014] [Accepted: 06/16/2014] [Indexed: 11/20/2022]
Affiliation(s)
- R Shreberk-Hassidim
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - Y Ramot
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - A Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - L Horev
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - A Zlotogorski
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel.
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36
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Ramot Y, Renert-Yuval Y, Maly A, Zlotogorski A. Fleckförmiger Haarausfall am Hinterkopf. J Dtsch Dermatol Ges 2014. [DOI: 10.1111/ddg.12369_suppl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - Yael Renert-Yuval
- Department of Dermatology, Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - Alexander Maly
- Department of Pathology, Hadassah - Hebrew University Medical Center; Jerusalem Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah - Hebrew University Medical Center; Jerusalem Israel
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37
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Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
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Nadler C, Enk CD, Leon GT, Samuni Y, Maly A, Czerninski R. Diagnosis and Management of Oral Leishmaniasis—Case Series and Literature Review. J Oral Maxillofac Surg 2014; 72:927-34. [DOI: 10.1016/j.joms.2013.10.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 10/31/2013] [Accepted: 10/31/2013] [Indexed: 11/16/2022]
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Abstract
Pemphigus vulgaris is an autoimmune disease, which leads to flaccid bullae and erosions. Although the scalp is commonly involved, hair loss is rarely seen. We herein report a case of 32-year-old female patient with a 2-year history of pemphigus vulgaris, involving the skin and mucosa. Although clinical improvement was achieved with oral corticosteroids and mycophenolate mofetil, the patient developed tender plaques on her scalp, accompanied by hair loss. Histopathology and direct immunofluorescence were consistent with pemphigus vulgaris. Skin swab cultured Staphylococcus aureus. Treatment with oral and topical corticosteroids combined with mycophenolate mofetil resulted in clinical remission, with regrowth of scalp hair. Alopecia is an unusual clinical manifestation of pemphigus vulgaris. Our case supports the hypothesis that hair loss is induced by antibody-mediated outer root sheath keratinocyte acantholysis, in combination with skin infection, that together lead to the observed hair loss.
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Affiliation(s)
- Noa Hadayer
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Yuval Ramot
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem,, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Affiliation(s)
- Y Ramot
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Abstract
Trichotillomania (TTM) is a type of impulse control disorder, characterized by recurrent pulling of hair. The etiology of TTM is complex, but a genetic contribution to this condition was advocated based on a limited number of reports on familial TTM. We report a 13-year-old male with history of focal hair loss in the scalp. Examination showed a patchy area of hair loss, with several short broken hairs of varying lengths. Dermoscopy and pathology examinations were consistent with TTM. Upon further questioning, his father admitted repeated pulling of his beard. The paternal grandfather also suffers from severe hair pulling of his beard since puberty. To our knowledge, this is the first report of TTM in a 3 generation family. This report strengthens the possibility that TTM is a genetic disease, probably with a complex inheritance pattern. It also highlights the importance of appropriate family history taking when examining a TTM patient.
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Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Liran Horev
- Department of Dermatology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Lukach L, Maly A, Zini A, Aframian DJ. Morphometrical study of minor salivary gland in xerostomic patients with altered lipid metabolism. Oral Dis 2013; 20:714-9. [PMID: 24118379 DOI: 10.1111/odi.12195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 08/26/2013] [Accepted: 08/28/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the correlation between dyslipidemia in patients with oral dryness and the development of non-specific histopathological findings in their labial salivary gland biopsies. METHODS Thirty seven patients suffering from oral dryness (18 patients with dyslipidemia and 19 age-matched patients with normal lipid blood levels) underwent labial salivary gland biopsy. Total acinar area (TAA), acinar cell number, acinar lumen area (ALA), duct lumen area (DLA), area occupied by cells in acinus (AoCA), and area of one acinar cell (OAC) were calculated. RESULTS A significantly (P < 0.05) increased AoCA, OAC, and DLA in labial glands from patients with impaired lipid metabolism, compared to controls, were found. CONCLUSION A positive relationship between dyslipidemia and morphological changes in labial salivary glands was obtained.
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Affiliation(s)
- L Lukach
- Salivary Gland Clinic and Saliva Diagnostic Laboratory, Department of Oral Medicine, Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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Tokarsky-Amiel R, Azazmeh N, Helman A, Stein Y, Hassan A, Maly A, Ben-Porath I. Dynamics of senescent cell formation and retention revealed by p14ARF induction in the epidermis. Cancer Res 2013; 73:2829-39. [PMID: 23423975 DOI: 10.1158/0008-5472.can-12-3730] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cellular senescence, a state of cell-cycle arrest accompanied by dramatic morphologic and metabolic changes, is a central means by which cells respond to physiologic stress and oncogene activity. Senescence is thought to play important roles in aging and in tumor suppression, yet the dynamics by which senescent cells are formed, their effects on tissue function and their eventual fate are poorly understood. To study cellular senescence within an adult tissue, we developed transgenic mice inducibly expressing p14(ARF) (human ortholog of murine p19(ARF)), a central activator of senescence. Induction of p14(ARF) in the epidermis rapidly led to widespread apoptosis and cell-cycle arrest, a stage that was transient, and was followed by p53-dependent cellular senescence. The endogenous Cdkn2a products p19(ARF) and p16(Ink4a) were activated by the transgenic p14(ARF) through p53, revealing a senescence-promoting feed-forward loop. Commitment of cells to senescence required continued p14(ARF) expression, indicating that entry into this state depends on a persistent signal. However, once formed, senescent cells were retained in the epidermis, often for weeks after transgene silencing, indicating an absence of an efficient rapidly acting mechanism for their removal. Stem cells in the hair follicle bulge were largely protected from apoptosis upon p14(ARF) induction, but irreversibly lost their ability to proliferate and initiate follicle growth. Interestingly, induction of epidermal hyperplasia prevented the appearance of senescent cells upon p14(ARF) induction. Our findings provide basic insights into the dynamics of cellular senescence, a central tumor- suppressive mechanism, and reveal the potential for prolonged retention of senescent cells within tissues.
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Affiliation(s)
- Ronit Tokarsky-Amiel
- Department of Developmental Biology and Cancer Research, Institute for Medical Research-Israel-Canada, Hadassah School of Medicine, The Hebrew University of Jerusalem, Israel
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Ganzel C, Gatt ME, Maly A, Ben-Yehuda D, Goldschmidt N. High incidence of skin rash in patients with hairy cell leukemia treated with cladribine. Leuk Lymphoma 2011; 53:1169-73. [DOI: 10.3109/10428194.2011.635864] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Alexander Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center,
Jerusalem, Israel
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Mishalian I, Ordan M, Peled A, Maly A, Eichenbaum MB, Ravins M, Aychek T, Jung S, Hanski E. Recruited Macrophages Control Dissemination of Group A Streptococcus from Infected Soft Tissues. J I 2011; 187:6022-31. [DOI: 10.4049/jimmunol.1101385] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Horev L, Murad S, Maly A, Zlotogorski A. Aggressive cutaneous squamous cell carcinoma in a patient with KLICK. J Am Acad Dermatol 2011; 64:e128-30. [DOI: 10.1016/j.jaad.2010.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 12/24/2010] [Accepted: 12/28/2010] [Indexed: 10/18/2022]
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Zadik Y, Findler M, Maly A, Rushinek H, Czerninski R. A 78-year-old woman with bilateral tongue necrosis. ACTA ACUST UNITED AC 2011; 111:15-9. [PMID: 21176820 DOI: 10.1016/j.tripleo.2010.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 08/25/2010] [Accepted: 09/02/2010] [Indexed: 11/30/2022]
Affiliation(s)
- Yehuda Zadik
- Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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Horev L, Babay S, Ramot Y, Saad-Edin B, Moorad S, Ingber A, Maly A, Zlotogorski A. Mutations in two genes on chromosome 13 resulting in a complex hair and skin phenotype due to two rare genodermatoses: KLICK and autosomal recessive woolly hair/hypotrichosis simplex. Br J Dermatol 2011; 164:1113-6. [PMID: 21275938 DOI: 10.1111/j.1365-2133.2011.10229.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hochberg M, Kunicher N, Gilead L, Maly A, Falk H, Ingber A, Panet A. Tropism of herpes simplex virus type 1 to nonmelanoma skin cancers. Br J Dermatol 2011; 164:273-81. [DOI: 10.1111/j.1365-2133.2010.10094.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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