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Bobeica C, Niculet E, Musat CL, Iancu L, Craescu M, Luca AM, Stefanescu BI, Gheorghe E, Debita M, Vasile CI, Balan G, Busila C, Tatu AL. The Association of Telangiectasias with Other Peripheral Vascular Lesions of Systemic Sclerosis. Clin Cosmet Investig Dermatol 2024; 17:211-218. [PMID: 38292323 PMCID: PMC10826706 DOI: 10.2147/ccid.s432422] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/25/2023] [Indexed: 02/01/2024]
Abstract
Purpose Systemic sclerosis (SSc) is a relatively rare collagenosis manifested as microvasculopathy, excessive cutaneous and visceral fibrosis in a background of autoimmune alteration. Autoimmune vasculopathy in SSc occurs early and begins with endothelial cell activation followed by blood vessel intimal proliferation in a context of defective angiogenesis. The alteration of peripheral micro and macrocirculation in SSc is evident through vascular lesions, such as Raynaud's phenomenon, telangiectasias, acrocyanosis, digital ulcers, gangrene, peripheral pulse deficiency. Our paper details the results of the study on the association between telangiectasias and other types of immune-mediated peripheral vascular lesions that can be identified in SSc. The presence of these peripheral vascular lesions can provide information about the magnitude of the peripheral vasculopathy. Patients and Methods A total of 37 patients diagnosed with SSc, recruited from a university clinic in Bucharest between February 2019 and March 2020, were enrolled in an observational study. We evaluated the presence of telangiectasias, as a stigma of autoimmune microvasculopathy, and their association with other immune-mediated peripheral vascular lesions that may be present in SSc. Results The presence of telangiectasias was identified in the absence, but especially in the presence of acrocyanosis and digital ulcerations, and patients with peripheral pulse deficiency almost always had telangiectasias. Less than a quarter of the patients with digital ulcers progressed unfavorably to gangrene, and only one required amputation, telangiectasias being present not only in the patient with amputation but in all patients with gangrene. Conclusion We appreciate that telangiectasias may be the clinical expression of peripheral vasculopathy characteristic of SSc, they can often be present in association with other peripheral vascular lesions and may represent a valuable indicator for the gangrene risk of digital ulcerations in SSc.
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Affiliation(s)
- Carmen Bobeica
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Lina Iancu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Andreea Mioara Luca
- Department of Plastic Surgery, “Sf. Ioan” Clinical Emergency Hospital for Children, Galați, 800487, Romania
| | - Bogdan Ioan Stefanescu
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Emma Gheorghe
- Department No. 1 (Preclinical), Faculty of Medicine and Pharmacy, “Ovidius” University, Constanța, 900527, Romania
| | - Mihaela Debita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Claudiu-Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Gabriela Balan
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Department of Gastroenterology, “Sf. Apostol Andrei” County Emergency Clinical Hospital, Galaţi, 800578, Romania
- Research Center in the Field of Medical and Pharmaceutical Sciences, “Dunărea de Jos” University, Galaţi, 800008, Romania
| | - Camelia Busila
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galați, 800179, Romania
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Musat CL, Niculet E, Craescu M, Nechita L, Iancu L, Nechita A, Voinescu DC, Bobeica C. Pathogenesis of Musculotendinous and Fascial Injuries After Physical Exercise - Short Review. Int J Gen Med 2023; 16:5247-5254. [PMID: 38021047 PMCID: PMC10655743 DOI: 10.2147/ijgm.s432749] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The identification of sports and physical exercises with injury risk is necessary to preserve the capacity of athletes and people who perform physical education and also to prevent the installation of functional deficiencies. Methods We have selected the articles related to the pathogenic mechanisms involved in musculotendinous and fascial injuries produced as a result of physical exercise. Results and Discussions The lesional pathogenesis is complex and incompletely clarified. Recent theories put in a new light the mechanisms of muscle pain and tendinopathy production. The accumulation of lactate anion, known to be a residue that induces fatigue and muscle pain, has been reconsidered by some authors. It appears that lactate anion is an excellent fuel for the myocardial fiber. Moreover, the accumulation of lactic acid after intense physical exercise could prevent the inexcitability of the sarcolemma induced by the increased concentration of interstitial K+. Most of the time, overuse injuries are not limited to muscles. They can cause myofascial, myotendinous or purely muscular injuries. The muscular fascia is more susceptible to injuries produced under the action of large external forces. Also, fascia is more sensitive to pain compared to muscle when external forces act eccentrically. Overloading the tendon and putting it under tension repeatedly is followed by ruptures of the tendon fibers. The regeneration of the degenerated tendon is defective in the context of the inflammation produced by the injury. Tendon fibers undergo a process of fibrosis, scarring, adhesion and heterogeneous calcification. Oxidative stress is responsible for inflammation, degeneration and apoptosis of tenocytes. Conclusion The benefits brought by physical education and sports are indisputable, but their practice requires a coordinated program to prevent possible traumatic and overuse injuries.
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Affiliation(s)
- Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Lina Iancu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Doina-Carina Voinescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Carmen Bobeica
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
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Bobeica C, Niculet E, Craescu M, Parapiru EL, Corduneanu-Luca AM, Debita M, Pelin AM, Tiutiuca C, Vasile CI, Nicolescu AC, Miulescu M, Balan G, Tatu AL. Immunologic and nonimmunologic sclerodermal skin conditions - review. Front Immunol 2023; 14:1180221. [PMID: 37600771 PMCID: PMC10432860 DOI: 10.3389/fimmu.2023.1180221] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/16/2023] [Indexed: 08/22/2023] Open
Abstract
Scleroderma-like cutaneous lesions have been found in many pathological conditions and they have the clinical appearance of sclerotic or scleroatrophic lesions. Affected skin biopsies described histopathological changes similar to those of scleroderma located strictly on the skin or those of systemic sclerosis. These skin lesions can be found in inflammatory diseases with autoimmune substrate (generalized morphea, chronic graft versus host disease, eosinophilic fasciitis), tissue storage diseases (scleredema, scleromyxedema, nephrogenyc systemic fibrosis, systemic amyloidosis), metabolic diseases (porphyrya cutanea tarda, phenylketonuria, hypothyroidism, scleredema diabeticorum), progeroid syndromes. Given the multiple etiologies of sclerodermal lesions, a correct differential diagnosis is necessary to establish the appropriate treatment.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galaţi, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galaţi, Romania
| | - Elena-Laura Parapiru
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
| | | | - Mihaela Debita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
| | - Ana Maria Pelin
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
| | - Carmen Tiutiuca
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
| | - Claudiu Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
| | - Alin Codrut Nicolescu
- Dermatology Department “Agrippa Ionescu” Emergency Clinical Hospital, Bucharest, Romania
| | - Magdalena Miulescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
| | - Gabriela Balan
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
- Research Center in the Field of Medical and Pharmaceutical Sciences, “Dunărea de Jos” University, Galaţi, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galaţi, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galaţi, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galaţi, Romania
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Niculet E, Bobeica C, Onisor C, Gurau G, Nechita A, Radaschin DS, Tutunaru D, Bujoreanu-Bezman L, Tatu AL. Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion-Findings and Perspectives. Life (Basel) 2023; 13:1406. [PMID: 37374188 DOI: 10.3390/life13061406] [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: 02/18/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Basal cell carcinoma (BCC) is a malignant tumor with a rising incidence and is the beneficiary of several innovative evaluation techniques. Histopathology remains the gold standard for assessment, having the possibility of addressing multiple high-risk factors such as perineural invasion (PNI). The current study included a number of 244 BCC patients and targeted the identification of positive PNI and its suggestive signs, and whether they correlated or not with other high-risk tumor signs. PNI was found in 20.1% of patients, with 30.7% of patients having perineural chronic inflammation (PCI), which is a suggestive sign of PNI. PNI was also found in larger tumors, with deeper Clark levels, in high-risk BCCs and high-grade tumors. PNI and PCI are both important for pathology reporting, aiding in treatment choice and further patient management, with possibly positive outcomes concerning morbidity and mortality.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica-CIM-CID), "Dunărea de Jos" University, 800201 Galati, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
| | - Aurel Nechita
- Department of Pediatrics, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galati, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
| | - Diana Sabina Radaschin
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica-CIM-CID), "Dunărea de Jos" University, 800201 Galati, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
- Dermatology Department, "Sfanta Cuvioasa Parascheva" Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Dana Tutunaru
- Department of Pharmaceutical Sciences, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
| | - Laura Bujoreanu-Bezman
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica-CIM-CID), "Dunărea de Jos" University, 800201 Galati, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Medicine and Pharmacy, 800008 Galati, Romania
- Dermatology Department, "Sfanta Cuvioasa Parascheva" Hospital of Infectious Diseases, 800179 Galati, Romania
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Tatu AL, Nadasdy T, Arbune A, Chioncel V, Bobeica C, Niculet E, Iancu AV, Dumitru C, Popa VT, Kluger N, Clatici VG, Vasile CI, Onisor C, Nechifor A. Interrelationship and Sequencing of Interleukins4, 13, 31, and 33 - An Integrated Systematic Review: Dermatological and Multidisciplinary Perspectives. J Inflamm Res 2022; 15:5163-5184. [PMID: 36110506 PMCID: PMC9468867 DOI: 10.2147/jir.s374060] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 05/10/2022] [Accepted: 08/13/2022] [Indexed: 11/23/2022] Open
Abstract
The interrelations and sequencing of interleukins are complex (inter)actions where each interleukin can stimulate the secretion of its preceding interleukin. In this paper, we attempt to summarize the currently known roles of IL-4, IL-13, IL-31, and IL-33 from a multi-disciplinary perspective. In order to conduct a comprehensive review of the current literature, a search was conducted using PubMed, Google Scholar, Medscape, UpToDate, and Key Elsevier for keywords. The results were compiled from case reports, case series, letters, and literature review papers, and analyzed by a panel of multi-disciplinary specialist physicians for relevance. Based on 173 results, we compiled the following review of interleukin signaling and its clinical significance across a multitude of medical specialties. Interleukins are at the bed rock of a multitude of pathologies across different organ systems and understanding their role will likely lead to novel treatments and better outcomes for our patients. New interleukins are being described, and the role of this inflammatory cascade is still coming to light. We hope this multi-discipline review on the role interleukins play in current pathology assists in this scope.
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Affiliation(s)
- Alin Laurentiu Tatu
- Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania.,Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR) [Centrul Integrat Multi disciplinar de Cercetare de Interfata Dermatologica (CIM-CID)], Galați, Romania
| | - Thomas Nadasdy
- Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR) [Centrul Integrat Multi disciplinar de Cercetare de Interfata Dermatologica (CIM-CID)], Galați, Romania.,Dermatology Department, Municipal Emergency Hospital, Timişoara, Romania
| | - Anca Arbune
- Neurology Department, Fundeni Clinical Institute, Bucharest, Romania
| | - Valentin Chioncel
- Neurology Department, "Bagdasar-Arseni" Emergency Clinical Hospital, Bucharest, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Elena Niculet
- Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR) [Centrul Integrat Multi disciplinar de Cercetare de Interfata Dermatologica (CIM-CID)], Galați, Romania
| | - Alina Viorica Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Caterina Dumitru
- Pharmaceutical Sciences Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania
| | - Valentin Tudor Popa
- Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR) [Centrul Integrat Multi disciplinar de Cercetare de Interfata Dermatologica (CIM-CID)], Galați, Romania.,Dermatology Department, Center for the Morphologic Study of the Skin MORPHODERM, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Nicolas Kluger
- Department of Dermatology, Allergology and Venereology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.,Apolo Medical Center, Bucharest, Romania
| | | | - Claudiu Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania
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Niculet E, Bobeica C, Craescu M, Nicolescu AC, Tocu G, Onisor C, Arbune M, Tatu AL. Multimodal Considerations Concerning Basal Cell Carcinoma Clefting – Profile of Structural and Aggressive Traits – Perspectives. Clin Cosmet Investig Dermatol 2022; 15:2087-2095. [PMID: 36199384 PMCID: PMC9529228 DOI: 10.2147/ccid.s385213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/11/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Correspondence: Mihaela Craescu, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40751869864, Email
| | | | - George Tocu
- Department of Pharmaceutical Sciences, “Dunărea de Jos” University, Galati, Romania
- George Tocu, Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40773819438, Email
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Manuela Arbune
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galați, Romania
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Bobeica C, Niculet E, Craescu M, Parapiru EL, Musat CL, Dinu C, Chiscop I, Nechita L, Debita M, Stefanescu V, Stefanopol IA, Nechifor A, Pelin AM, Balan G, Chirobocea S, Vasile CI, Tatu AL. CREST Syndrome in Systemic Sclerosis Patients - Is Dystrophic Calcinosis a Key Element to a Positive Diagnosis? J Inflamm Res 2022; 15:3387-3394. [PMID: 35706527 PMCID: PMC9191197 DOI: 10.2147/jir.s361667] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 02/09/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction CREST syndrome is a clinical entity associated with systemic sclerosis, which meets at least three of the five clinical features: calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. Three of these clinical features (Raynaud’s phenomenon, sclerodactyly and esophageal dysmotility) are often present in classical subsets of SSc: limited and diffuse, and their presence in association does not define CREST syndrome. Calcinosis seems to be less common in SSc and its association with other clinical features is characteristic of CREST syndrome. Therefore, it can be appreciated that calcinosis is the key element of CREST syndrome. Methods This study included a number of 37 candidates with SSc, diagnosed with the help of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) 2013 criteria. Results and Discussions These three elements (calcinosis, Raynaud’s phenomenon, esophageal dysmotility) were recorded both in the limited subset of SSc, but especially in the subset of diffuse SSc, contrary to the data in the literature. Conclusion We appreciate that CREST syndrome is a clinical entity that can overlap with both subsets of SSc. Given the divergent views of the authors on the classification of CREST syndrome, future studies may contribute to a reassessment of SSc classification.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunărea de Jos' University, Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Elena-Laura Parapiru
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Ciprian Dinu
- Dental Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Iulia Chiscop
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Mihaela Debita
- Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Victorita Stefanescu
- Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Ioana Anca Stefanopol
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Department of Pediatrics, Clinical Emergency Hospital for Children "Sf. Ioan", Galati, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Ana Maria Pelin
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Gabriela Balan
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania.,Department of Gastroenterology, "Sf. Apostol Andrei" County Emergency Clinical Hospital, Galați, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, "Dunărea de Jos" University, Galați, Romania
| | - Silvia Chirobocea
- Department of Neurology, Municipal Emergency Hospital, Moinești, Romania
| | - Claudiu Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunărea de Jos' University, Galați, Romania.,Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania.,Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania
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8
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Bobeica C, Niculet E, Craescu M, Parapiru EL, Musat CL, Dinu C, Chiscop I, Nechita L, Stefanescu V, Stefanopol IA, Pelin AM, Nechifor A, Balan G, Tatu AL. Hearing Loss Secondary to Systemic Sclerosis Vasculopathy: Case Study with a Short Review. Clin Cosmet Investig Dermatol 2022; 15:967-973. [PMID: 35669089 PMCID: PMC9166376 DOI: 10.2147/ccid.s356818] [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: 01/02/2022] [Accepted: 04/15/2022] [Indexed: 11/23/2022]
Abstract
Systemic sclerosis (SSc) is a collagenosis with a substrate of chronic inflammation, which is determined by autoimmunity. The pathogenesis of this disease involves microvasculopathy (small vessel pathology) followed by excessive cutaneous and visceral fibrosis. Although acoustic and vestibular impairment is not classified as being a secondary pathology of SSc, several studies have identified cases of SSc that associate hearing loss and especially vertigo and tinnitus. This paper presents data from the medical literature that have identified vestibular and auditory symptoms among patients with SSc, associating the clinical case presentation of a patient suffering from SSc, which is associated with hearing loss. The need for additional studies on larger groups of patients is underlined, in order to clarify the impact of vasculopathy and fibrosis on the acoustic and vestibular analyzer in patients with SSc.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunărea de Jos' University, Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Elena-Laura Parapiru
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Ciprian Dinu
- Dental Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Iulia Chiscop
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Victorita Stefanescu
- Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Ioana Anca Stefanopol
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Department of Pediatrics, Clinical Emergency Hospital for Children "Sf. Ioan", Galati, Romania
| | - Ana Maria Pelin
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Gabriela Balan
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania.,Department of Gastroenterology, "Sf. Apostol Andrei" County Emergency Clinical Hospital, Galați, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, "Dunărea de Jos" University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunărea de Jos' University, Galați, Romania.,Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania.,Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania
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9
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Stefanopol IA, Baroiu L, Chirila S, Miulescu M, Anghel L, Nechita L, Dinu CA, Stefanescu V, Bobeica C, Nechifor A, Tatu AL. The Influence of Living in Rural Areas on the Evolution and Management of Pediatric Ovarian Cystic Lesions: A Retrospective Study on a Cohort from South Eastern Romania. Int J Gen Med 2022; 15:5273-5284. [PMID: 35655655 PMCID: PMC9153997 DOI: 10.2147/ijgm.s368202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ioana Anca Stefanopol
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Department of Pediatric Surgery and Orthopedy, “Sf Ioan” Clinical Emergency Hospital for Children, Galati, Romania
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Infectious Diseases Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania
- Correspondence: Liliana Baroiu, Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 47 Domnească Street, Galati, 800010, Romania, Tel +40723201241, Email
| | - Sergiu Chirila
- Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University, Constanta, Romania
- Sergiu Chirila, Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University, 1 University Alee, Campus B, Constanta, 900470, Romania, Tel +407213320668, Email
| | - Magdalena Miulescu
- Research Center in the Functional Cardiorespiratory and Neuromotor Exploration, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Lucreţia Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Internal Medicine Department, “sf Andrew the Apostle” County Emergency Clinical Hospital, Galati, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Ciprian Adrian Dinu
- Dental Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Victorita Stefanescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Alin Laurenţiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Research Center in the Field of Medical and Pharmaceutical Sciences, Reform-UDJ, Galati, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC DIR, Galati, Romania
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10
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Bobeica C, Niculet E, Musat CL, Craescu M, Stefanescu BI, Dinu C, Chiscop I, Chirobocea S, Nechita L, Iancu AV, Stefanescu V, Balan G, Stefanopol IA, Pelin AM, Tatu AL. Paraclinical Aspects in Systemic Sclerosis. Int J Gen Med 2022; 15:4391-4398. [PMID: 35502184 PMCID: PMC9056056 DOI: 10.2147/ijgm.s355662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/05/2022] [Indexed: 11/23/2022] Open
Abstract
Systemic sclerosis (SSc) is a chronic inflammatory disease with an autoimmune substrate that affects the skin and a large number of internal organs. The chronic inflammatory process is sustained by a wide range of cytokines and chemokines, which are discharged by inflammatory cells, with fibrosis and nail bed vascular changes (disorganized vasculature architecture with microhemorrhages, megacapillaries and areas without capillaries). Confocal microscopy contributes to the understanding of the molecular mechanism involved in chronic inflammation and mainly targets the field of research. Coherent optical tomography, capillaroscopy, and skin biopsy are useful for the differential diagnosis of SSc with other sclerodermoid syndromes. The immunological profile is a classification criterion for SSc and directs the diagnosis to the two subsets of the disease. Multisystemic damage requires evaluation with the help of a set of investigations specific to each affected organ, such as: diffusing capacity for carbon monoxide, forced vital capacity, 6-minute walk test, high-resolution computed tomography standard and reduced sequential, cardiac ultrasound and right cardiac catheterization. The current possibilities of diagnosis, treatment and monitoring are permanently adapting to new medical discoveries.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, 800008, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, 800008, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, 800008, Romania
- Correspondence: Elena Niculet; Carmina Liana Musat, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40741398895; +40723338438, Email ;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, 800008, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, 800008, Romania
| | - Bogdan Ioan Stefanescu
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Ciprian Dinu
- Dental Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Iulia Chiscop
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Silvia Chirobocea
- Department of Neurology, Municipal Emergency Hospital, Moinești, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Alina Viorica Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, 800008, Romania
| | - Victorita Stefanescu
- Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
| | - Gabriela Balan
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
- Department of Gastroenterology, “Sf. Apostol Andrei” County Emergency Clinical Hospital, Galați, Romania
- Research Center in the Field of Medical and Pharmaceutical Sciences, “Dunărea de Jos” University, Galați, Romania
| | - Ioana Anca Stefanopol
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, 800008, Romania
- Department of Pediatrics, Clinical Emergency Hospital for Children “Sf. Ioan”, Galati, Romania
| | - Ana Maria Pelin
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, 800008, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galați, Romania
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11
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Niculet E, Bobeica C, Stefanopol IA, Pelin AM, Nechifor A, Onisor C, Tatu AL. Once-Daily Abrocitinib for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults and Adolescents Aged 12 Years and Over: A Short Review of Current Clinical Perspectives. Ther Clin Risk Manag 2022; 18:399-407. [PMID: 35444421 PMCID: PMC9014825 DOI: 10.2147/tcrm.s338661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disorder with high prevalence and a complex pathophysiology. This relapsing and remitting skin disorder has many negative consequences on the patient’s quality of life and that of his family. Until now, moderate-to-severe AD treatment was a symptomatic one, using skin emollients, topical corticosteroids, phototherapy, antihistamines and systemic drugs – immune suppressants and other systemic treatments (dupilumab). Starting from 2021, abrocitinib, a Janus kinase-1 inhibitor, was approved for the treatment of moderate-to-severe cases of AD in Europe, in adults. Multiple phase three studies (JADE MONO-1 [NCT03349060]; JADE MONO-2 [NCT03575871]; JADE TEEN [NCT03796676]; JADE COMPARE; GOODERHAM; JADE EXTEND) have yielded positive results in adults and adolescents suffering from this disease, with efficacy, a good tolerance, safe profile, and with generally mild side effects. The positive results were obtained even starting from the first stages of the oral drug administration. The low frequency of side effects and the advantage of having an orally administered medication makes abrocitinib an important additional tool for the treatment of moderate-to-severe forms of AD.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), ‘Dunărea de Jos’ University, Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Correspondence: Carmen Bobeica; Ioana Anca Stefanopol, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, Dunărea de Jos University, Galați, 800008, Romania, Tel +40744368150; +40 744 222 488, Email ;
| | - Ioana Anca Stefanopol
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Department of Pediatrics, Clinical Emergency Hospital for Children “Sf. Ioan”, Galati, Romania
| | - Ana Maria Pelin
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alexandru Nechifor
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), ‘Dunărea de Jos’ University, Galați, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galați, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), ‘Dunărea de Jos’ University, Galați, Romania
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galați, Romania
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12
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Niculet E, Craescu M, Rebegea L, Bobeica C, Nastase F, Lupasteanu G, Stan DJ, Chioncel V, Anghel L, Lungu M, Tatu AL. Basal cell carcinoma: Comprehensive clinical and histopathological aspects, novel imaging tools and therapeutic approaches (Review). Exp Ther Med 2021; 23:60. [PMID: 34917186 PMCID: PMC8630439 DOI: 10.3892/etm.2021.10982] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
Basal cell carcinoma (BCC) is one of the most common malignant tumors worldwide, involving the skin. It is also part of keratinocyte carcinomas, alongside its squamous counterpart. It has low mortality and extremely low metastatic rates (although when present, it indicates a poor patient prognosis); it also has a high morbidity rate through local destruction and recurrence, particularly when perineural invasion is observed, clinically or histopathologically. BCC development is the result of environmental and patient factors, with genetics and ultraviolet radiation playing major roles. The clinical and histopathological aspects vary according to tumor subtype, being classified as high-risk tumors (nodular, superficial, pigmented and infundibulocystic BCC with adnexal differentiation) and fibroepithelial subtypes, or as high-risk tumors (micronodular, infiltrating, sclerosing/morphoeic and basosquamous subtype or the type with sarcomatoid differentiation). Dermoscopy is now complimented by novel in vivo diagnostic tools (optical coherence tomography, reflectance confocal microscopy, high-resolution ultrasonography, Raman spectroscopy or terahertz pulse imaging), improving the diagnostic accuracy and providing tumor depth and lateral margins without the use of invasive techniques. Novel treatment approaches for the treatment of BCC have recently been investigated with the use of hedgehog pathway inhibitors, such as Vismodegib. These approaches aim for complete resolution, minimal side-effects, high patient satisfaction with the optimal cosmetic results, particularly in key areas, such as the face. The present review article summarizes and discusses the comprehensive clinical and histopathological aspects of BCC, and presents novel imaging tools and therapeutic approaches that have been identified.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania
| | - Laura Rebegea
- Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania.,Department of Neuropsychomotor Rehabilitation, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Florentina Nastase
- Department of Neuropsychomotor Rehabilitation, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galați, Romania
| | - Gabriela Lupasteanu
- Department of Infectious Diseases, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Medical Doctoral School, 'Ovidius' University, 900573 Constanta, Romania
| | - Daniela Jicman Stan
- Department of Otorhinolaryngology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania.,Biomedical Doctoral School, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galați, 800010 Galați, Romania
| | - Valentin Chioncel
- Department of Cardio-Thoracic Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Clinical Cardiology, 'Bagdasar Arseni' Emergency Hospital, 041915 Bucharest, Romania
| | - Lucretia Anghel
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Mihaela Lungu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Alin Laurentiu Tatu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Dermatology, 'Sfanta Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunărea de Jos' University, 800010 Galați, Romania
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13
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Bobeica C, Niculet E, Tatu A, Craescu M, Vata D, Statescu L, Iancu A, Musat C, Draganescu M, Onisor C, Lungu M, Fotea S, Nechita A, Stefanescu B, Gheuca‑Solovastru L. Old and new therapeutic strategies in systemic sclerosis (Review). Exp Ther Med 2021; 23:134. [PMID: 35069815 PMCID: PMC8756424 DOI: 10.3892/etm.2021.11057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 11/05/2022] Open
Abstract
Systemic sclerosis (SSc) is a chronic inflammatory disease with autoimmune determinism having an incompletely known pathogenesis. Although not all links in the pathogenic chain are known, studies have shown that vasculopathy is the initial event and is followed by extensive fibrosis of the skin and internal organs. New therapeutic strategies have been developed in recent years, thanks to innovative research which has increased understanding of the disease mechanisms. No curative treatment for SSc is currently known. Therefore, the therapeutic target in SSc is its symptomatology. Peripheral vasculopathy can be improved by administering vasodilators. Endothelin receptor antagonists and 5-phosphodiesterase inhibitors have a double benefit, both on peripheral and on pulmonary vasculopathy. Several molecules with antifibrotic effects are currently available; however, further studies are needed to confirm their beneficial effects. Immunosuppressants manage to control the cutaneous and visceral fibrotic process, thereby remaining as first-line drugs in the treatment of SSc. Although biological therapy using rituximab and tocilizumab has shown promising results in pulmonary fibrosis, ongoing studies are needed to determine their exact impact. The authors have differing views on the triggering role of glucocorticoids and the benefits of angiotensin-converting enzyme inhibitors in renal scleroderma. Some aspects of this disease such as calcinosis and pruritus, asthenia, or joint and muscle damage, remain difficult to manage.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Alin Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), ‘Dunarea de Jos’ University, 800010 Galati, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Dan Vata
- Clinical Department, Faculty of Medicine and Pharmacy, ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Laura Statescu
- Clinical Department, Faculty of Medicine and Pharmacy, ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Alina Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Carmina Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Miruna Draganescu
- Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Mihaela Lungu
- Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Silvia Fotea
- Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Aurel Nechita
- Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Bogdan Stefanescu
- Department of Clinical Surgery, Faculty of Medicine and Pharmacy, ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Laura Gheuca‑Solovastru
- Clinical Department, Faculty of Medicine and Pharmacy, ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
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14
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Bobeica C, Rebegea L, Murariu G, Dobre M, Nechita A, Tatu AL, Niculet E, Anghel L, Fotea S, Craescu M. Cutaneous adverse reactions in a lung cancer patient treated with pembrolizumab: A case report. Exp Ther Med 2021; 23:15. [PMID: 34815767 PMCID: PMC8593923 DOI: 10.3892/etm.2021.10937] [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: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/05/2022] Open
Abstract
Lung cancer is the main cause of oncological death in the US and worldwide, constituting a significant public health problem. The incidence of lung cancer is on the increase. In the present study, the diagnostic process was carried out and treatment options were considered to determine the therapeutic response of a patient diagnosed with lung cancer. The case of an early stage lung cancer patient who benefited from surgical treatment was presented. The pathology report stated the complete diagnosis to be pleomorphic lung cancer with an adenocarcinoma component, pT2aN0M0, with focal positivity for thyroid transcription factor 1 (TTF1), without epidermal growth factor receptor (EGFR) mutations and ALK recombinations, having an initial clinical stage of IB and programmed death ligand-1 (PD-L1) positivity with a tumor proportion score of over 70%. The patient underwent radiotherapy treatment and was administered osteoclast inhibitors and immunotherapy, with no favorable therapeutic effect and with the presence of secondary cutaneous adverse effects to pembrolizumab. As a main cause of death, lung cancer registers a low general survival rate even in patients with targeted therapies or immunotherapy. By better identifying the patients at risk, one can establish a more efficient personalized treatment; the future objective of scientific studies is the follow-up of adverse effects of new therapies.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Laura Rebegea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Gabriel Murariu
- Department of Chemistry, Physics and Environment, Faculty of Sciences and Environment, 'Dunarea de Jos' University, 800201 Galati, Romania
| | - Michaela Dobre
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
| | - Lucretia Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
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15
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Jicman Stan D, Niculet E, Lungu M, Onisor C, Rebegea L, Bobeica C, Elisei AM, Anghel L, Tatu AL. Rare case of metachronous tumor: Nasopharyngeal and colorectal carcinoma. Exp Ther Med 2021; 22:1417. [PMID: 34707699 PMCID: PMC8543177 DOI: 10.3892/etm.2021.10852] [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: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
The study presents an unusual case of a patient with a personal history of a rectal malignant tumor in 2013, who after a period of 6 years, was diagnosed with an advanced nasopharyngeal carcinoma, locally and regionally invasive. It is possible that the colorectal malignant tumor affected the development of the nasopharyngeal carcinoma, or the other way around, depending on the presence of genetic instabilities. These two types of malignant tumors share a series of genes that can influence their progression, i.e., SPINK-6 and Bcl-2. The particularity of this case stems from the development of a metachronous tumor, a rectal adenocarcinoma and nasopharyngeal carcinoma, two malignant tumors with different patient prognosis and disease progression. Research needs to be continued on the multidisciplinary therapeutic management of nasopharyngeal cancer and the ways of identifying this cancer type in its early stages, considering that most patients come from a rural environment, have poor medical education, a number of comorbidities, and who frequently ignore the signs, symptoms and sometimes the treatment offered.
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Affiliation(s)
- Daniela Jicman Stan
- Department of Otorhinolaringology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Biomedical Doctoral School, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
| | - Mihaela Lungu
- Department of Neurology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Laura Rebegea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Alina Mihaela Elisei
- Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG, 800010 Galati, Romania.,Research Centre in The Field of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Department of Pharmaceutical Sciences, 'Dunărea de Jos' University of Galați, 800010 Galati, Romania
| | - Lucretia Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG, 800010 Galati, Romania.,Department of Dermatology, 'Sfanta Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
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16
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Bujoreanu FC, Bezman L, Radaschin DS, Niculet E, Bobeica C, Craescu M, Nadasdy T, Jicman DS, Ardeleanu V, Nwabudike LC, Marinescu SA, Tatu AL. Nevi, biologics for psoriasis and the risk for skin cancer: A real concern? (Case presentation and short review). Exp Ther Med 2021; 22:1354. [PMID: 34659500 PMCID: PMC8515562 DOI: 10.3892/etm.2021.10789] [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: 07/02/2021] [Accepted: 08/02/2021] [Indexed: 11/06/2022] Open
Abstract
Psoriasis is a systemic inflammatory cutaneous disease that affects approximately 2% of the world's population. Systemic treatments and biologic treatment therapies are a powerful option for patients with moderate to severe psoriasis. Some studies from the literature indicate an overall small, but increased, risk of neoplasia in patients with psoriasis treated with phototherapy or systemic medication. The relationship between psoriasis and malignancy is not very well established; there are few studies with conflicting results. We present the case of a 31-year-old male patient, diagnosed with psoriasis, who was deemed eligible for systemic therapy. Treatment with methotrexate was initiated, but without a satisfactory outcome. Given the patient's resistant disease involving 15% of his body surface, his desire to have a clear skin, besides his being naïve to biologic therapy, he was proposed to start treatment with secukinumab 300 mg monthly. The patient experienced complete clearance of lesions and was followed-up on the basis of clinical and biological parameters. There are limited data concerning the relationship between melanocytic lesions, psoriasis and melanoma. Immunologic pathways implicated in psoriasis induce a reduction in the number of melanocytic nevi. Nevertheless, little is known concerning the association of melanocytic nevi with psoriasis. Thorough skin examination, meaning clinical and dermoscopic evaluation of melanocytic lesions, must be encouraged in patients treated with systemic therapies such as biologic agents.
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Affiliation(s)
- Florin Ciprian Bujoreanu
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania.,Department of Dermatology, Doctoral School of Biological and Medical Sciences, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Laura Bezman
- Ophthalmology Department, 'Sf. Apostol Andrei' Clinical Emergency Hospital, 800578 Galați, Romania.,Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Diana Sabina Radaschin
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Thomas Nadasdy
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania
| | - Daniela Stan Jicman
- ENT Department, 'Sf. Apostol Andrei' Clinical Emergency Hospital, 800578 Galați, Romania
| | - Valeriu Ardeleanu
- Surgery Department, Arestetic Plastic Surgery Clinic, 800098 Galați, Romania.,Faculty of Medicine, Doctoral School, 'Ovidius' University, 900533 Constanța, Romania.,Surgery Department, CFR General Hospital, 800223 Galați, Romania
| | - Lawrence Chukwudi Nwabudike
- Outpatient Dermatology Department, 'Prof. N. Paulescu' National Institute of Diabetes, 011233 Bucharest, Romania
| | - Silviu Adrian Marinescu
- Department of Plastic and Reconstructive Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alin Laurentiu Tatu
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania.,Research Center of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 800010 Galați, Romania
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17
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Bobeica C, Niculet E, Halip AI, Gheuca-Solovastru L, Draganescu ML, Popescu IA, Onisor C, Chirobocea S, Lungu M, Craescu M. Predictive value of immunological markers in systemic sclerosis. Exp Ther Med 2021; 22:994. [PMID: 34345276 PMCID: PMC8311248 DOI: 10.3892/etm.2021.10426] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022] Open
Abstract
Systemic sclerosis (SSc) is a collagenosis characterized by excessive deposition of collagen in the skin and viscera, in a background of immune disorder. The immunological profile of SSc often shows elevated levels of antinuclear antibodies (ANAs). However, many authors have identified cases of SSc having normal ANA levels, framed as paraneoplastic SSc. Among patients with negative ANAs in our group, we did not identify any neoplastic process that could support this hypothesis. The extended detection of autoantibodies is extremely useful in establishing the subset of SSc. Thus, anti-Scl70 antibodies are specific for the diffuse subset of SSc, while anticentromere antibodies (ACAs) have specificity for a limited subset. However, studies have shown the existence of cases of diffuse SSc having high titers of ACAs and cases of limited SSc with high titers of anti-Scl70 antibodies. This indicates an inconsistent association between the disease subset and the autoantibodies specific to each subset. Our study found a more balanced consistency between disease subsets and autoantibodies specific for each subset. Therefore, the percentages of patients having an immunological profile inconsistent with the subset of SSc, are lower than those found by other authors. This observation opens the perspective of larger studies on the immunological profile in SSc.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Alina Ioana Halip
- Department of Dermato-Venereology, Doctoral School of ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Laura Gheuca-Solovastru
- Department of Clinical Dermato-Venereology, Faculty of Medicine and Pharmacy, ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Miruna Luminita Draganescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Ioana Adriana Popescu
- Department of Dermato-Venereology, Doctoral School of ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Silvia Chirobocea
- Department of Neurology, Municipal Emergency Hospital, 605400 Moinești, Romania
| | - Mihaela Lungu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
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18
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Niculet E, Chioncel V, Elisei AM, Miulescu M, Buzia OD, Nwabudike LC, Craescu M, Draganescu M, Bujoreanu F, Marinescu E, Arbune M, Radaschin DS, Bobeica C, Nechita A, Tatu AL. Multifactorial expression of IL-6 with update on COVID-19 and the therapeutic strategies of its blockade (Review). Exp Ther Med 2021; 21:263. [PMID: 33603870 PMCID: PMC7851683 DOI: 10.3892/etm.2021.9693] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
Interleukin 6 (IL-6), a cytokine produced by various cells of the human body (macrophages, lymphocytes, astrocytes, ischemic myocytes, endothelial cells) has both pro-inflammatory and anti-inflammatory properties, being a key component in regulating various physiologic and pathological processes. The structure of this molecule and the receptor system it possesses are important due to the different activities that IL-6 can exert; through trans-signaling pro-inflammatory activities are mediated, while through classic signaling, IL-6 is responsible for anti-inflammatory and regenerative activities. IL-6 signaling is involved in coronary artery disease and the global COVID-19 pandemic. This proatherogenic cytokine reaches elevated serum levels in the cytokine storm generated by SARS-CoV-2, and is also associated with smoking or obesity-classic cardiovascular risk factors which promote inflammatory states. IL-6 levels are proportionally correlated with dyslipidemia, hypertension and glucose dysregulation, and they are associated with poor outcomes in patients with unstable angina or acute myocardial infarction. IL-6 targeting for treatment development (not only) in cardiovascular disease and COVID-19 is still a matter of ongoing research, although tocilizumab has proven to be effective in reducing the proatherogenic effects of IL-6 and is suggested to improve COVID-19 patient survival.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Valentin Chioncel
- Cardio-Thoracic Department, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Clinical Cardiology Department, 'Bagdasar Arseni' Emergency Hospital, 041915 Bucharest, Romania
| | - Alina M Elisei
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Magdalena Miulescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Olimpia D Buzia
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Lawrence C Nwabudike
- Department of Diabetic Foot Care, 'Prof. N. Paulescu' National Institute of Diabetes, 011233 Bucharest, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Miruna Draganescu
- Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Florin Bujoreanu
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Elisabeta Marinescu
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Manuela Arbune
- Centre of Medical-Pharmaceutical Research, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Diana Sabina Radaschin
- Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Carmen Bobeica
- Department of Dermato-Venereology, Doctoral School, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania
| | - Aurel Nechita
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Department of Pediatrics, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galati, Romania
| | - Alin L Tatu
- Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
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19
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Niculet E, Bobeica C, Tatu AL. Glucocorticoid-Induced Skin Atrophy: The Old and the New. Clin Cosmet Investig Dermatol 2020; 13:1041-1050. [PMID: 33408495 PMCID: PMC7779293 DOI: 10.2147/ccid.s224211] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022]
Abstract
Glucocorticoids are major therapeutic agents highly used in the medical field. Topical glucocorticoids have biologic activities which make them useful in dermatology – anti-inflammatory, vasoconstrictive, immune suppressive and antiproliferative, in treating inflammatory skin disorders (allergic contact eczema, atopic hand eczema, nummular eczema, psoriasis vulgaris or toxic-irritative eczema). Unfortunately, the beneficial effects of topical glucocorticoids are shadowed by their potential for adverse effects – muscle or skin atrophy, striae distensae, rubeosis or acne. Skin atrophy is one of the most prevalent side-effects, with changes found in all skin compartments – marked hypoplasia, elasticity loss with tearing, increased fragility, telangiectasia, bruising, cutaneous transparency, or a dysfunctional skin barrier. The structure and function of the epidermis is altered even in the short-term topical glucocorticoid treatment; it affects stratum corneum components, subsequently affecting skin barrier integrity. The dermis is altered by directly inhibiting fibroblast proliferation, reducing mast cell numbers, and loss of support; there is depletion of mucopolysaccharides, elastin fibers, matrix metalloproteases and inhibition of collagen synthesis. Atrophogenic changes can be found also in hair follicles, sebaceous glands or dermal adipose tissue. Attention should be paid to topical glucocorticoid treatment prescription, to the beneficial/adverse effects ratio of the chosen agent, and studies should be oriented on the development of newer, innovative targeted (gene or receptor) therapies.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania
| | - Carmen Bobeica
- Department of Dermato-Venereology, Doctoral School, University of Medicine and Pharmacy "Gr. T. Popa", Iași, Romania
| | - Alin L Tatu
- Clinical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, Galati, Romania.,Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania
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20
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Bobeica C, Niculet E, Craescu M, Onisor C, Bujoreanu F, Draganescu ML, Halip IA, Gheuca-Solovastru L. Epidemiological profile of systemic sclerosis in the southeast region of Romania. Exp Ther Med 2020; 21:77. [PMID: 33363588 PMCID: PMC7725015 DOI: 10.3892/etm.2020.9509] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022] Open
Abstract
Systemic sclerosis (SSc) is a collagenosis, in which the microvasculature of the skin and internal organs becomes affected, followed by excessive deposition of connective tissue. It has been included in the group of rare diseases, and it seems to have had an increasing incidence over the last two decades. Statistics show, not only an increase in the incidence of SSc, but that of autoimmune diseases as a whole. The present study aimed to outline the epidemiological profile of SSc in the southeast region of Romania and to identify similarities and differences concerning the epidemiology of this disease in other countries. The current observational study was carried out on a group of 22 patients who were diagnosed with SSc and who were hospitalized at a university clinic in Bucharest. Our research revealed a higher prevalence of women suffering from SSc, with higher numbers suffering from the diffuse subset of this disease. In addition, we found that the majority of patients came from urban areas. SSc has an important impact on the quality of life of patients, thus opening the opportunity for studies to be carried out on larger populations of patients in order to identify epidemiological similarities and differences in various countries, as well as finding new experimental models useful for future research.
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Affiliation(s)
- Carmen Bobeica
- Department of Dermato‑Venereology, 'Gr. T. Popa' Doctoral School University of Medicine and Pharmacy, Iași 700115, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, Galați 800216, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, Galați 800216, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, Galați 800216, Romania
| | - Florin Bujoreanu
- Department of Clinical Dermato‑Venereology, 'Sf. Cuvioasă Parascheva' Infectious Diseases Clinical Hospital, Galați 800179, Romania
| | - Miruna Luminita Draganescu
- Department of Clinical Infectious Diseases, 'Dunărea de Jos' University, Faculty of Medicine and Pharmacy, Galați 800216, Romania
| | - Ioana Alina Halip
- Department of Dermato‑Venereology, 'Gr. T. Popa' Doctoral School University of Medicine and Pharmacy, Iași 700115, Romania
| | - Laura Gheuca-Solovastru
- Department of Clinical Dermato-Venereology, 'Gr. T. Popa' University of Medicine and Pharmacy, Faculty of Medicine and Pharmacy, Iași 700115, Romania
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21
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Bobeica C, Niculet E, Craescu M, Halip AI, Popescu IA, Draganescu ML, Onisor C, Stefanescu B, Gheuca-Solovastru L. Etiological factors of systemic sclerosis in the southeast region of Romania. Exp Ther Med 2020; 21:79. [PMID: 33363590 PMCID: PMC7725016 DOI: 10.3892/etm.2020.9511] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022] Open
Abstract
Systemic sclerosis (SSc) is a relatively rare autoimmune disease with skin and visceral involvement, having a yet unknown etiopathogenesis. Research has shown that professional exposure to various polluting chemicals such as dyes, aliphatic and aromatic organic solvents, inhalable silica dust or certain heavy metals, can be triggering factors for this disease when they overlap a predisposing genetic profile. Smoking is still a debated factor involved in the etiology of SSc, as authors have divergent opinions on this matter. The present study was designed to analyze the etiological factors identified in the group of 37 patients with diffuse and limited SSc from the southeast region of Romania and the results were compared to the literature data. In the group of patients included in this study, occupational exposure and smoking history were not present in all patients, and a hereditary factor was identified only in an isolated case. The majority of patients suffered from a major negative psychological event or from long-term stressful situations and these factors were associated with smoking history or occupational exposure; this suggests that SSc is initiated in a set of cumulative triggering factors.
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Affiliation(s)
- Carmen Bobeica
- Department of Dermato-Venereology, 'Grigore T. Popa' Doctoral School University of Medicine and Pharmacy, Iași 700115, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, 'Dunărea de Jos' University, Faculty of Medicine and Pharmacy, Galați 800216, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, 'Dunărea de Jos' University, Faculty of Medicine and Pharmacy, Galați 800216, Romania
| | - Alina Ioana Halip
- Department of Dermato-Venereology, 'Grigore T. Popa' Doctoral School University of Medicine and Pharmacy, Iași 700115, Romania
| | - Ioana Adriana Popescu
- Department of Dermato-Venereology, 'Grigore T. Popa' Doctoral School University of Medicine and Pharmacy, Iași 700115, Romania
| | - Miruna Luminita Draganescu
- Clinical Infectious Diseases, 'Dunărea de Jos' University, Faculty of Medicine and Pharmacy, Galați 800216, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, 'Dunărea de Jos' University, Faculty of Medicine and Pharmacy, Galați 800216, Romania
| | - Bogdan Stefanescu
- Department of Clinical Surgery, 'Dunărea de Jos' University, Faculty of Medicine and Pharmacy, Galați 800216, Romania
| | - Laura Gheuca-Solovastru
- Department of Clinical Dermato‑Venereology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine and Pharmacy, Iași 700115, Romania
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Draganescu M, Baroiu L, Iancu A, Dumitru C, Radaschin D, Polea ED, Bobeica C, Tatu AL, Niculet E, Fekete GL. Perspectives on skin disorder diagnosis among people living with HIV in southeastern Romania. Exp Ther Med 2020; 21:97. [PMID: 33363608 DOI: 10.3892/etm.2020.9529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/21/2020] [Accepted: 10/21/2020] [Indexed: 12/13/2022] Open
Abstract
The beginnings of the human immunodeficiency virus (HIV) pandemic are closely linked to dermatological conditions. A large part of the population living with HIV (PLWH) has a series of skin conditions that determine at some point, a visit to the dermatologist. The introduction of highly active antiretroviral therapy (HAART) more than 20 years ago has diminished the range of dermatological conditions, with improved immunosuppression of CD4 lymphocytes. The study aimed to describe the prevalence of the diagnosed type of skin changes in PLWH receiving antiretroviral therapy and their stratification according to the degree of immunodeficiency. A prospective study was conducted on 57 PLWH evaluated monthly at an HIV outpatient clinic, from a tertiary hospital in southeastern Romania. Clinical examination and dermoscopy revealed the existence of a wide range of dermatological conditions; all 57 patients (100%) being diagnosed with one or more dermatological conditions. As our study shows, the prevalence of different dermatoses among PLWH varies depending on the geographical region. At the same time, under HAART, the image of dermatoses associated with decreased immunity from HIV infection has changed. The skin changes of PLWH no longer fully follow the classical staging, based on the degree of immunosuppression.
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Affiliation(s)
- Miruna Draganescu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Liliana Baroiu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Alina Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Caterina Dumitru
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Diana Radaschin
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Eduard Drima Polea
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Carmen Bobeica
- Department of Demato-Venereology, Doctoral School, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania
| | - Alin Laurentiu Tatu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, Galați 800010, Romania
| | - Gyula Laszlo Fekete
- Department of Dermatology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, Târgu Mureș 540142, Romania
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