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Vladulescu D, Scurtu LG, Simionescu AA, Scurtu F, Popescu MI, Simionescu O. Platelet-Rich Plasma (PRP) in Dermatology: Cellular and Molecular Mechanisms of Action. Biomedicines 2023; 12:7. [PMID: 38275368 PMCID: PMC10813350 DOI: 10.3390/biomedicines12010007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Platelet-rich plasma (PRP) therapy has gained attention in the scientific field due to its potential regenerative effects and great benefit-risk ratio. This review extensively explores the most studied mechanisms of this therapy according to the etiopathogenesis of skin diseases: cellular proliferation, matrix formation, regulation of inflammation, angiogenesis, collagen synthesis, and the remodeling of new tissue. Moreover, it draws on newly reported and lesser-known effects of PRP: its anti-apoptotic effects, immunological suppression, decrease in melanin synthesis, anti-microbial effects, overexpression of miR-155, antioxidant effects, and their involved pathways. This work aims to provide a complete update for understanding PRP's benefits and clinical relevance in wound healing, alopecia, pigmentary disorders, scars, rejuvenation, lichen sclerosus, and other inflammatory dermatoses, based on the current evidence. Furthermore, recent reports with novel indications for PRP therapy are highlighted, and new potential pathways correlated with the pathogenesis of skin diseases are explored.
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Affiliation(s)
- Denisa Vladulescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology I, Colentina Hospital, 020125 Bucharest, Romania
| | - Lucian G. Scurtu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology I, Colentina Hospital, 020125 Bucharest, Romania
| | - Anca Angela Simionescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Francesca Scurtu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Marco I. Popescu
- Faculty of Medicine, “Titu Maiorescu” University, 040441 Bucharest, Romania
| | - Olga Simionescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology I, Colentina Hospital, 020125 Bucharest, Romania
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Grigore M, Costache M, Simionescu O. Paraneoplastic Pemphigus Mimicking Pemphigus Vulgaris Associated With Castleman Disease. Cureus 2023; 15:e36114. [PMID: 37065416 PMCID: PMC10098500 DOI: 10.7759/cureus.36114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/16/2023] Open
Abstract
Paraneoplastic pemphigus (PNP) is a rare bullous disease with a polymorphic presentation. Diagnosis can be difficult because it can mimic other bullous diseases, while the underlying neoplasm may be completely asymptomatic. We present the case of a 19-year-old female with a four-year history of exclusively oral bullous lesions, mimicking pemphigus vulgaris, before the diagnosis of a retroperitoneal Castleman disease. While PNP is a severe and sometimes deadly condition, our patient had a mild and long evolution on minimal treatment, with complete resolution after tumor excision. Practitioners should be aware of PNP in young patients presenting with bullous disease and should conduct prompt systemic investigations in refractory or long-evolving cases, even when PNP diagnostic criteria are not fully met.
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Avram A, Scurtu LG, Costache M, Simionescu O. A Disguising Fast-Growing Metachronous Melanoma and COVID-19. Cureus 2023; 15:e36108. [PMID: 37065319 PMCID: PMC10101186 DOI: 10.7759/cureus.36108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/15/2023] Open
Abstract
An unusual case of a 52-year-old female with two metachronous melanomas is presented. An atypical fast-growing nodular melanoma appeared 18 months after the complete excision of an in situ melanoma and one month afterward a SARS-CoV-2 infection. Intra-nodal melanocytic proliferations were identified during lymph node assessment, raising important diagnostic and prognostic concerns. No melanoma susceptibility genes were found. This case report raises the question about the COVID-19 immunosuppression effect on the tumor microenvironment and the oncogenic potential of SARS-CoV-2. It also highlights the importance of clinical follow-up in melanoma patients, which was significantly delayed during the COVID-19 pandemic.
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Scurtu LG, Costache M, Opriș-Belinski D, Simionescu O. Hypocomplementemic Urticarial Vasculitis Associated With Hashimoto’s Thyroiditis and Hepatitis B Virus Infection: A Case Report. Cureus 2022; 14:e29643. [PMID: 36320953 PMCID: PMC9607984 DOI: 10.7759/cureus.29643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 11/24/2022] Open
Abstract
Urticarial vasculitis (UV) is an uncommon condition characterized by recurrent episodes of urticarial lesions and angioedema and the pathological features of leukocytoclastic vasculitis. UV divides into two subgroups based on the level of serum complement. Usually, patients with hypocomplementemia experience internal organ involvement and an unfavorable prognosis. We report the case of a 33-year-old woman with a history of hepatitis B infection and autoimmune thyroiditis who developed hypocomplementemic urticarial vasculitis with recurrent angioedema and arthralgia. Complete remission was achieved using dapsone in monotherapy. We suggest dapsone as a potential treatment of choice for hypocomplementemic urticarial vasculitis. This clinical case emphasizes the need for urticarial vasculitis treatment guidelines.
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Scurtu LG, Petrica M, Grigore M, Avram A, Popescu I, Simionescu O. A Conservative Combined Laser Cryoimmunotherapy Treatment vs. Surgical Excision for Basal Cell Carcinoma. J Clin Med 2022; 11:jcm11123439. [PMID: 35743507 PMCID: PMC9224731 DOI: 10.3390/jcm11123439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/21/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
Surgical excision is the standard treatment for basal cell carcinoma (BCC), but it can be challenging in elderly patients and patients with comorbidities. The non-surgical guidelines procedures are usually regarded as monotherapy options. This quasi-experimental, non-randomized, comparative effectiveness study aims to evaluate the efficacy of a combined, conservative, non-surgical BCC treatment, and compare it to standard surgical excision. Patients with primary, non-ulcerated, histopathologically confirmed BCCs were divided into a conservative treatment (129 patients) and a standard surgery subgroup (50 patients). The conservative treatment consisted of ablative CO2 laser, cryosurgery, topical occlusive 5-fluorouracil, and imiquimod. The follow-up examinations were performed 3 months after remission, then every 3 to 6 months, and were extended with telephone follow-ups. Cosmetic-self assessment was recorded during a telephone follow-up. Subjects from the conservative subgroup presented a clearance rate of 99.11%, and a recurrence rate of 0.98%. No recurrences were recorded in the surgical group, nor during the telephone follow-up. There were no differences regarding adverse events (p > 0.05). A superior self-assessment cosmetic outcome was obtained using the conservative method (p < 0.001). This conservative treatment is suitable for elders and patients with comorbidities, is not inferior to surgery in terms of clearance, relapses, or local adverse events, and displays superior cosmetic outcomes.
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Affiliation(s)
- Lucian G. Scurtu
- Department of Dermatology I, Colentina Hospital, “Carol Davila” University of Medicine and Pharmacy, 19-21 Stefan Cel Mare Road, 020125 Bucharest, Romania; (L.G.S.); (M.G.); (A.A.)
| | - Marian Petrica
- Faculty of Mathematics and Computer Science, University of Bucharest, 010014 Bucharest, Romania; (M.P.); (I.P.)
- Institute of Mathematical Statistics and Applied Mathematics of the Romanian Academy, 050711 Bucharest, Romania
| | - Mariana Grigore
- Department of Dermatology I, Colentina Hospital, “Carol Davila” University of Medicine and Pharmacy, 19-21 Stefan Cel Mare Road, 020125 Bucharest, Romania; (L.G.S.); (M.G.); (A.A.)
| | - Alina Avram
- Department of Dermatology I, Colentina Hospital, “Carol Davila” University of Medicine and Pharmacy, 19-21 Stefan Cel Mare Road, 020125 Bucharest, Romania; (L.G.S.); (M.G.); (A.A.)
| | - Ionel Popescu
- Faculty of Mathematics and Computer Science, University of Bucharest, 010014 Bucharest, Romania; (M.P.); (I.P.)
- Institute of Mathematics of the Romanian Academy, 010702 Bucharest, Romania
| | - Olga Simionescu
- Department of Dermatology I, Colentina Hospital, “Carol Davila” University of Medicine and Pharmacy, 19-21 Stefan Cel Mare Road, 020125 Bucharest, Romania; (L.G.S.); (M.G.); (A.A.)
- Correspondence: ; Tel.: +40-74-241-8662
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Scurtu LG, Jinga V, Simionescu O. Fascinating Molecular and Immune Escape Mechanisms in the Treatment of STIs (Syphilis, Gonorrhea, Chlamydia, and Herpes Simplex). Int J Mol Sci 2022; 23:ijms23073550. [PMID: 35408911 PMCID: PMC8998805 DOI: 10.3390/ijms23073550] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023] Open
Abstract
The incidence of syphilis, gonorrhea, chlamydia, and herpes simplex has increased over the last decade, despite the numerous prevention strategies. Worldwide scientists report a surge in drug-resistant infections, particularly in immunocompromised patients. Antigenic variations in syphilis enable long-term infection, but benzathine penicillin G maintains its efficiency, whereas macrolides should be recommended with caution. Mupirocin and zoliflodacin were recently introduced as therapies against ceftriaxone-resistant gonococcus, which poses a larger global threat. The gastrointestinal and prostatic potential reservoirs of Chlamydia trachomatis may represent the key towards complete eradication. Similar to syphilis, macrolides resistance has to be considered in genital chlamydiosis. Acyclovir-resistant HSV may respond to the novel helicase-primase inhibitors and topical imiquimod, particularly in HIV-positive patients. Novel drugs can overcome these challenges while nanocarriers enhance their potency, particularly in mucosal areas. This review summarizes the most recent and valuable discoveries regarding the immunopathogenic mechanisms of these sexually transmitted infections and discusses the challenges and opportunities of the novel molecules and nanomaterials.
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Affiliation(s)
- Lucian G. Scurtu
- Department of Dermatology I, Colentina Clinical Hospital, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020125 Bucharest, Romania;
| | - Viorel Jinga
- Department of Urology, Clinical Hospital Prof. Dr. Th. Burghele, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 030167 Bucharest, Romania;
| | - Olga Simionescu
- Department of Dermatology I, Colentina Clinical Hospital, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020125 Bucharest, Romania;
- Correspondence:
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Abstract
Psoriasis is a chronic, immune mediated disorder affecting approximately 2% of the population. Even in our days, patients with psoriasis are confronted with stigmatization and social rejection. As a result, their quality of life is significantly impaired. Biological therapies have revolutionized the treatment of moderate to severe psoriasis. The aim of this paper is to look over the most important biological therapies available for the management of plaque-type psoriasis.
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Affiliation(s)
| | - Simona-Roxana Georgescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Victor Babeş" Hospital of Infectious and Tropical Diseases, Dermatology Department, Bucharest, Romania
| | - Mircea Tampa
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Victor Babeş" Hospital of Infectious and Tropical Diseases, Dermatology Department, Bucharest, Romania
| | | | - Olga Simionescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Colentina" Clinical Hospital, Dermatology Department I, Bucharest, Romania
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Grigore M, Furtunescu F, Minca D, Costache M, Garbe C, Simionescu O. The iris signal: blue periphery, tan collaret and freckles pattern - strong indicators for epidermal skin cancer in South-Eastern Europe. J Eur Acad Dermatol Venereol 2018. [PMID: 29524265 DOI: 10.1111/jdv.14929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Eye and skin share the embryological origin. Both are established risk factors in epidermal skin cancer. There are few reports using iris colour classification scales, most of them analyse colour in general or are too complex to use in daily practice. OBJECTIVES To investigate which iris colour pattern is associated with epidermal skin cancer in a S-E European Caucasian population. METHODS A case-control study was conducted on 480 patients: 229 skin cancers patients and 251 controls (dermatological patients free of skin cancers) admitted in two medical clinics of Dermatology in Bucharest, between October 2011 and May 2014. High-resolution iris photographs were taken for each patient. Three parameters of the iris were analysed individually and in association patterns for each patient: periphery, collaret and freckles. RESULTS The most frequent iris colour pattern associated with epidermal skin cancer was blue periphery with light brown collaret and freckles present. In terms of individual parameters, the strongest indicators for skin cancer patients were blue periphery and blue collaret. CONCLUSIONS The results of this study sustain the hypothesis that blue periphery with light brown collaret and freckles iris pattern is a reliable phenotypic marker for epidermal skin cancer. The results of this study differ from previous reports in which skin cancer risk was associated with a homogeneous blue iris. We account these differences in the characteristics of the recruited patients (S-E European, skin type II and III). The assessment of iris colour patterns is an easy and inexpensive detection tool in skin cancer risk assessment.
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Affiliation(s)
- M Grigore
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, Colentina Hospital, Bucharest, Romania
| | - F Furtunescu
- Department of Public Health, 'Carol Davila' University of Medicine and Pharmacy, Institute of National Health, Bucharest, Romania
| | - D Minca
- Department of Public Health, 'Carol Davila' University of Medicine and Pharmacy, Institute of National Health, Bucharest, Romania
| | - M Costache
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, University Hospital, Bucharest, Romania
| | - C Garbe
- Division of Dermatooncology, Department of Dermatology, University of Tübingen, Tübingen, Germany
| | - O Simionescu
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, Colentina Hospital, Bucharest, Romania
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Blum A, Siggs G, Marghoob AA, Kreusch J, Cabo H, Campos-do-Carmo G, Shiraishi AFC, Kienitz A, Maldonado-Seral C, Maltagliati-Holzner P, Mijuskovic ZP, Yoshimura AM, Moscarella E, Rabinovitz HS, Rodriguez-Garcia C, Saa SR, Rubegni P, Savoia F, Simionescu O, Diego PZ, Hofmann-Wellenhof R. Collision skin lesions-results of a multicenter study of the International Dermoscopy Society (IDS). Dermatol Pract Concept 2017; 7:51-62. [PMID: 29230351 PMCID: PMC5720595 DOI: 10.5826/dpc.0704a12] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 06/07/2017] [Accepted: 08/20/2017] [Indexed: 11/25/2022] Open
Abstract
Background Collision lesions as two independent and unrelated skin tumors often manifest an atypical morphology. Objective To determine the combinations of collision skin lesions (CSLs). Methods Twenty-one pigmented lesion clinics in nine countries included 77 histopathologically proven CSLs in this retrospective observational study. Results Seventy-seven CSLs from 75 patients (median age 59.8 years) were analyzed; 24.7% of CSLs were located on the head and neck area, 5.2% on the upper extremities, 48.1% on the trunk, and 11.7% on the lower extremities; 40.3% revealed a melanocytic component (median age 54.7 years), followed by 45.5% with a basal cell carcinoma (BCC) (median age 62.4 years) and 11.7% with a seborrheic keratosis (median age 64.7 years). CSLs with a BCC component were more often found on the head and neck area compared to tumors with a melanocytic component (34.3% versus 16.1%). Lesions with a melanocytic component were more often detected on the trunk compared to lesions with a BCC (64.5% versus 37.1%). Patients with CSLs with epidermal-epidermal cell combination were older than patients with epidermal-dermal cell combination (63 versus 55.2 years), were more often male than female (63% versus 43.3%), more often had the lesion on the head and neck area (32.6% versus 13.3%), and less often on the upper (2.2 % versus 10%) or lower extremities (8.7% versus 16.6%). Conclusions CSLs consist of a heterogeneous group of lesions of varying cell types. They are associated with advancing age and cumulative UV-exposure. CSLs manifest a complex morphology making it challenging to diagnose correctly.
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Affiliation(s)
- Andreas Blum
- Public, Private and Teaching Practice of Dermatology, Konstanz, Germany
| | - Graeme Siggs
- SunDoctors Skin Cancer Clinic, Glenunga, Adelaide, Australia
| | - Ashfaq A Marghoob
- Department of Dermatology, Memorial Sloan Kettering Skin Cancer Center, New York, NY, USA
| | - Jürgen Kreusch
- Public and Private Practice of Dermatology, Lübeck, Germany
| | - Horacio Cabo
- Research Institut, University of Buenos Aires, Argentina
| | | | | | | | | | | | - Zeljko P Mijuskovic
- Department of Dermatology and Venereology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | | | - Elvira Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | | | | | | | - Pietro Rubegni
- Department of Clinical Medicine and Immunological Science, Dermatology Section, University of Siena, Siena, Italy
| | | | - Olga Simionescu
- 1st Clinic of Dermatology, Carol Davila University of Medicine and Pharmacy, Colentina Hospital, Bucharest, Romania
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David M, Gospodinov DK, Gheorghe N, Mateev GS, Rusinova MV, Hristakieva E, Solovastru LG, Patel RV, Giurcaneanu C, Hitova MC, Purcaru AI, Horia B, Tsingov II, Yankova RK, Kadurina MI, Ramon M, Rotaru M, Simionescu O, Benea V, Demerdjieva ZV, Cosgarea MR, Morariu HS, Michael Z, Cristodor P, Nica C, Silverman MH, Bristol DR, Harpaz Z, Farbstein M, Cohen S, Fishman P. Treatment of Plaque-Type Psoriasis With Oral CF101: Data from a Phase II/III Multicenter, Randomized, Controlled Trial. J Drugs Dermatol 2016; 15:931-938. [PMID: 27537992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND CF101, an adenosine A3 receptor agonist, is an orally bioavailable small molecule drug presenting an anti-psoriatic effect demonstrated in a Phase 2 clinical trial in psoriasis patients.<BR /> OBJECTIVE To evaluate the safety and efficacy of CF101 treatment in a Phase 2/3 study in patients with moderate to severe plaque-type psoriasis.<BR /> METHODS This multicenter, double-blind, 2-segment, placebo-controlled study randomized subjects with moderate to severe plaque psoriasis to CF101 1 or 2 mg, or placebo twice daily. At either week 12 (Segment 1) or 16 (Segment 2), the placebo group crossed over to CF101 BID through week 32 in an open-label fashion. At week 12, following an interim analysis, the CF101 1mg group was discontinued due to futility. The primary endpoint was proportion of patients achieving ≥75% improvement in Psoriasis Area Severity Index (PASI 75). Efficacy testing was performed using the Cochran-Mantel Haenszel test, the primary analysis of PASI 75 was performed at the 0.035 significance level.<BR /> RESULTS CF101 had an excellent safety profile at all tested dosages with a profile similar to the placebo group. The most common adverse events were infections and gastrointestinal events, and there was no cumulative intolerance over the 32-week dosing period. The study did not meet the primary endpoint of PASI 75 at week 12 (2 mg: 8.5% vs. placebo: 6.9%, <em>P</em>=0.621). However, at week 32, PASI mean percent improvement with CF101 2 mg was 57% (<EM>P</EM><0.001) compared to baseline, with linear improvement in PASI 50 (63.5%), 75 (35.5%), 90 (24.7%), and 100 (10.6%).<BR /> CONCLUSIONS Oral CF101 was found to be safe and very well tolerated, demonstrating evidence of efficacy in patients with moderate to severe plaque psoriasis through 32 weeks of treatment.<BR /><BR /> <em>J Drugs Dermatol</em>. 2016;15(8):931-938.
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Cretoiu D, Gherghiceanu M, Hummel E, Zimmermann H, Simionescu O, Popescu LM. FIB-SEM tomography of human skin telocytes and their extracellular vesicles. J Cell Mol Med 2016; 19:714-22. [PMID: 25823591 PMCID: PMC4395186 DOI: 10.1111/jcmm.12578] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [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: 12/09/2014] [Accepted: 02/15/2015] [Indexed: 12/19/2022] Open
Abstract
We have shown in 2012 the existence of telocytes (TCs) in human dermis. TCs were described by transmission electron microscopy (TEM) as interstitial cells located in non-epithelial spaces (stroma) of many organs (see www.telocytes.com). TCs have very long prolongations (tens to hundreds micrometers) named Telopodes (Tps). These Tps have a special conformation with dilated portions named podoms (containing mitochondria, endoplasmic reticulum and caveolae) and very thin segments (below resolving power of light microscopy), called podomers. To show the real 3D architecture of TC network, we used the most advanced available electron microscope technology: focused ion beam scanning electron microscopy (FIB-SEM) tomography. Generally, 3D reconstruction of dermal TCs by FIB-SEM tomography revealed the existence of Tps with various conformations: (i) long, flattened irregular veils (ribbon-like segments) with knobs, corresponding to podoms, and (ii) tubular structures (podomers) with uneven calibre because of irregular dilations (knobs) – the podoms. FIB-SEM tomography also showed numerous extracellular vesicles (diameter 438.6 ± 149.1 nm, n = 30) released by a human dermal TC. Our data might be useful for understanding the role(s) of TCs in intercellular signalling and communication, as well as for comprehension of pathologies like scleroderma, multiple sclerosis, psoriasis, etc.
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Affiliation(s)
- Dragos Cretoiu
- Department of Cellular and Molecular Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Victor Babeș National Institute of Pathology, Bucharest, Romania
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Simionescu O, Blum A, Grigore M, Costache M, Avram A, Testori A. Learning from mistakes: errors in approaches to melanoma and the urgent need for updated national guidelines. Int J Dermatol 2015; 55:970-6. [PMID: 26712381 DOI: 10.1111/ijd.13165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 06/01/2015] [Accepted: 07/23/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The tracking and identification of errors in the detection and follow-up of melanoma are important because there is huge potential to increase awareness about the most vulnerable aspects of diagnosis and treatment, and to improve both from the perspective of healthcare economics. The present study was designed to identify where errors occur and to propose a minimum set of rules for the routine guidance of any specialist in melanoma management. METHODS This report describes the evaluation of a unique series of 33 cases in which errors applying to many steps in the diagnosis and treatment of melanoma were detected. Cases were collected at two centers in Romania, one public and one private, as part of a process of obtaining patient-requested second opinions. RESULTS A total of 166 errors were identified across the 33 patients, most of which were treatment errors. The errors fell into six categories: clinical diagnostic errors (36 errors among 30 patients); primary surgical errors (31 errors among 16 patients); pathology errors (24 errors among 17 patients); sentinel lymph node biopsy errors (13 errors among 13 patients); staging errors (17 errors among 13 patients); and treatment or management errors (45 errors among 33 patients). CONCLUSIONS Based on the present results, we propose that in countries lacking national guidelines, clinicians should adhere to international evidence-based guidelines for the diagnosis and treatment of melanoma.
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Affiliation(s)
- Olga Simionescu
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Andreas Blum
- Dermatology, Public, Private and Teaching Practice, Konstanz, Germany
| | - Mariana Grigore
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Mariana Costache
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alina Avram
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alessandro Testori
- Dermato-Oncological Division, European Institute of Oncology, Milan, Italy
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Abstract
The presence of telocytes (TCs) as distinct interstitial cells was previously documented in human dermis. TCs are interstitial cells completely different than dermal fibroblasts. TCs are interconnected in normal dermis in a 3D network and may be involved in skin homeostasis, remodelling, regeneration and repair. The number, distribution and ultrastructure of TCs were recently shown to be affected in systemic scleroderma. Psoriasis is a common inflammatory skin condition (estimated to affect about 0.1-11.8% of population), a keratinization disorder on a genetic background. In psoriasis, the dermis contribution to pathogenesis is frequently eclipsed by remarkable epidermal phenomena. Because of the particular distribution of TCs around blood vessels, we have investigated TCs in the dermis of patients with psoriasis vulgaris using immunohistochemistry (IHC), immunofluorescence (IF), and transmission electron microscopy (TEM). IHC and IF revealed that CD34/PDGFRα-positive TCs are present in human papillary dermis. More TCs were present in the dermis of uninvolved skin and treated skin than in psoriatic dermis. In uninvolved skin, TEM revealed TCs with typical ultrastructural features being involved in a 3D interstitial network in close vicinity to blood vessels in contact with immunoreactive cells in normal and treated skin. In contrast, the number of TCs was significantly decreased in psoriatic plaque. The remaining TCs demonstrated multiple degenerative features: apoptosis, membrane disintegration, cytoplasm fragmentation and nuclear extrusion. We also found changes in the phenotype of vascular smooth muscle cells in small blood vessels that lost the protective envelope formed by TCs. Therefore, impaired TCs could be a 'missed' trigger for the characteristic vascular pathology in psoriasis. Our data explain the mechanism of Auspitz's sign, the most pathognomonic clinical sign of psoriasis vulgaris. This study offers new insights on the cellularity of psoriatic lesions and we suggest that TCs should be considered new cellular targets in forthcoming therapies.
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Affiliation(s)
- C G Manole
- Department of Cell Biology and Histology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.,Laboratory of Ultrastructural Research, 'Victor Babeş' National Institute of Pathology, Bucharest, Romania
| | - Mihaela Gherghiceanu
- Laboratory of Ultrastructural Research, 'Victor Babeş' National Institute of Pathology, Bucharest, Romania
| | - Olga Simionescu
- Department of Dermatology, Colentina University Hospital, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
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Costache M, Dumitru AV, Pătraşcu OM, Popa-Cherecheanu DA, Bădilă P, Miu JC, Procop A, Popa M, Tampa MŞ, Sajin M, Simionescu O, Cîrstoiu MM. A challenging case of ocular melanoma. Rom J Morphol Embryol 2015; 56:817-22. [PMID: 26429178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ocular melanoma is a rare malignancy found in clinical practice. In this paper, we present a case of highly aggressive ocular melanoma, which was surgically removed at the Department of Ophthalmology and diagnosed at the Department of Pathology, Emergency University Hospital, Bucharest, Romania, using conventional histopathological techniques. Uveal melanoma, a subset of ocular melanoma, has a distinct behavior in comparison to cutaneous melanoma and has a widely divergent prognosis. Approximately half of patients with ocular melanoma will develop metastatic disease, predominantly with hepatic, pulmonary or cerebral location, over a 10 to 15 years period. No systemic therapy was associated with an evident clinical outcome for patients with advanced disease and overall survival rate remains poor.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, Emergency University Hospital, Bucharest, Romania;
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15
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Costache M, Stoica A, Contolenco A, Costache D, Cirstoiu C, Simionescu O, George S. Metastatic Melanoma in the Femur - Case Report with Review of Literature: a Pathologist's Point of View. Maedica (Bucur) 2014; 9:62-67. [PMID: 25553128 PMCID: PMC4268294] [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] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 03/05/2014] [Indexed: 06/04/2023]
Abstract
The aim of this case report was to evaluate the histopathological characteristics on a patient with metastases in the femur from malignant melanoma. A review from the literature is also mentioned.We present a case of metastatic malignant melanoma in the femur with known primary site in a 44-year-old-female. Diagnosis was confirmed by histopathology.Malignant melanoma is a cancer that may metastasise in the skeleton. However most of bone metastases are found in the axial skeleton and they rarely involve the femur, as in our case. Only a few case reports are published in the literature. Clinicians must be aware of the varied clinical manifestations of disseminated malignant melanoma.The diagnosis for metastatic malignant melanoma is confirmed due to pathological examination. Immunohistochemical study is useful in diagnosis, mainly when malignant melanoma is poorly differen-tiated.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexandra Stoica
- Department of Pathology, Emergency University Hospital Bucharest, Romania
| | - Andreea Contolenco
- Department of Pathology, Emergency University Hospital Bucharest, Romania
| | - Diana Costache
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Catalin Cirstoiu
- Department of Orthopaedics and Traumatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Olga Simionescu
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Simion George
- Department of Pathology, Emergency University Hospital Bucharest, Romania
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Blum A, Hofmann-Wellenhof R, Marghoob AA, Argenziano G, Cabo H, Carrera C, Costa Soares de Sá B, Ehrsam E, González R, Malvehy J, Manganoni AM, Puig S, Simionescu O, Tanaka M, Thomas L, Tromme I, Zalaudek I, Kittler H. Recurrent Melanocytic Nevi and Melanomas in Dermoscopy. JAMA Dermatol 2014; 150:138-45. [DOI: 10.1001/jamadermatol.2013.6908] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Andreas Blum
- Public, Private, and Teaching Practice of Dermatology, Konstanz, Germany
| | | | - Ashfaq A. Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | | | - Horacio Cabo
- Medical Research Institute “A. Lanari,” University of Buenos Aires, Buenos Aires, Argentina
| | - Cristina Carrera
- Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER) Enfermedades rara, Barcelona, Spain
| | | | - Eric Ehrsam
- Public and Private Practice of Dermatology, Lille, France
| | - Roger González
- Departamento de Introducción a la Clínica, Facultad de Medicina, UANL, Monterrey, México
| | - Josep Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER) Enfermedades rara, Barcelona, Spain
| | | | - Susana Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER) Enfermedades rara, Barcelona, Spain
| | - Olga Simionescu
- First Dermatological Clinic, Carol Davila University of Medicine and Pharmacy, Colentina Hospital, Bucharest, Romania
| | - Masaru Tanaka
- Department of Dermatology, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan
| | - Luc Thomas
- Department of Dermatology, Lyon 1 University Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Isabelle Tromme
- Department of Dermatology, Centre du Cancer, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | - Harald Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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17
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Costache M, Pătraşcu OM, Dumitru A, Costache D, Voinea LM, Simionescu O, Sajin M. Histopathological findings concerning ocular melanomas. Rom J Morphol Embryol 2014; 55:649-653. [PMID: 25178339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ocular melanoma is rare in clinical practice. In this study, we present three cases of ocular melanoma surgically removed in the Department of Ophthalmology of the Emergency University Hospital of Bucharest, Romania, and diagnosed in the Department of Pathology of the same hospital using conventional histopathological techniques and immunohistochemical tests.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
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18
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Costache M, Desa LT, Mitrache LE, Pătraşcu OM, Dumitru A, Costache D, Albu E, Sajin M, Simionescu O. Cutaneous verrucous carcinoma - report of three cases with review of literature. Rom J Morphol Embryol 2014; 55:383-388. [PMID: 24969990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Verrucous carcinoma is a rare variant of squamous cell carcinoma. It is well differentiated and rarely metastases but can sometimes be very aggressive locally in depth. The paper presents three cases of cutaneous verrucous carcinoma with different localizations. The first patient shows a lesion in the sacrogluteal region, the second one presented a tumor localized on the auricle (external ear), and the third patient showed a tumor on the sole of the foot. All patients underwent tumor excision and the histopathological diagnosis was verrucous carcinoma. In the first two cases, the surgery was completely curative by excision of the tumors. In the last case, the patient had relapsed and due to the aggressive nature of the tumor, which infiltrated the deeper plans, the tumor had reached the bone. None of the patients showed any metastases.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
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Sajin M, Hodorogea Prisăcaru A, Luchian MC, Pătraşcu OM, Dumitru A, Costache D, Dumitrescu D, Vrînceanu D, Voinea LM, Simionescu O, Costache M. Acantholytic squamous cell carcinoma: pathological study of nine cases with review of literature. Rom J Morphol Embryol 2014; 55:279-283. [PMID: 24969975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Squamous cell carcinoma (SCC) is classified in many subtypes or forms; one of them is the acantholytic squamous cell carcinoma, also called pseudoglandular, adenoid, epithelioma dyskeratoticum segregans, or adenoacanthoma. Researching and analyzing nine cases of acantholytic squamous cell carcinoma, we intend to verify if the data provided by the cases studied can be validated by the scientific literature. All the cases presented lesions found on the head and neck skin, with two exceptions - one on the larynx and the other one on the tonsil, all of them ulcerated lesions. In two cases, the tumors developed on the skin, in preneoplasic lesions (actinic keratosis). The tumors had dimensions between 4/3/4 mm and 100/90/36 mm. During one year, two of the cases studied presented multiple recurrences. We also found two cases of metatypical carcinoma accompanied the acantholytic variant of squamous cell carcinoma. None of the analyzed cases presented distant metastasis. The histopathological criteria for selection were: keratinised squamous tumor cell type, adenoid structures with round spaces with a defined wall of at least one cell width, spaces with isolated or grouped dyskeratotic acantholytic cells.
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Affiliation(s)
- Maria Sajin
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
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Sajin M, Luchian MC, Hodorogea Prisăcaru A, Dumitru A, Pătraşcu OM, Costache D, Dumitrescu D, Oproiu AM, Simionescu O, Costache M. Trichilemmal carcinoma - a rare cutaneous malignancy: report of two cases. Rom J Morphol Embryol 2014; 55:687-691. [PMID: 25178345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The trichilemmal carcinoma is a rare low-grade malignant lesion originating from hair follicle cells that usually occurs on sun-exposed skin of older individuals. A differential diagnostic is required with other skin carcinomas. We report two cases of trichilemmal carcinoma admitted at the Emergency University Hospital of Bucharest, Romania, in 2012, one of these cases being localized in the periocular area and the other one resembling a cutaneous horn. These cases present several unusual aspects that are rarely described in the literature namely the site of the tumor which in the eyelid, development of a cutaneous horn, IHC tests which revealed EMA (epithelial membrane antigen) positivity in tumor cells. Considering that this type of tumor seldom develops metastases or local recurrences, and all the cases had free margins, there was no adjuvant therapy.
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Affiliation(s)
- Maria Sajin
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
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Blum A, Kittler H, Zalaudek I, Simionescu O, Marghoob AA, Hofmann-Wellenhof R, Argenziano G, Soyer HP. [Unclear clinical change on the glans penis leads to different dermoscopic diagnoses]. Hautarzt 2013; 64:768-9. [PMID: 24071999 DOI: 10.1007/s00105-013-2664-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- A Blum
- Hautarztpraxis Konstanz, Seestr. 3a, 78464, Konstanz, Deutschland,
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22
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Menzies SW, Moloney FJ, Byth K, Avramidis M, Argenziano G, Zalaudek I, Braun RP, Malvehy J, Puig S, Rabinovitz HS, Oliviero M, Cabo H, Bono R, Pizzichetta MA, Claeson M, Gaffney DC, Soyer HP, Stanganelli I, Scolyer RA, Guitera P, Kelly J, McCurdy O, Llambrich A, Marghoob AA, Zaballos P, Kirchesch HM, Piccolo D, Bowling J, Thomas L, Terstappen K, Tanaka M, Pellacani G, Pagnanelli G, Ghigliotti G, Ortega BC, Crafter G, Ortiz AMP, Tromme I, Karaarslan IK, Ozdemir F, Tam A, Landi C, Norton P, Kaçar N, Rudnicka L, Slowinska M, Simionescu O, Di Stefani A, Coates E, Kreusch J. Dermoscopic evaluation of nodular melanoma. JAMA Dermatol 2013; 149:699-709. [PMID: 23553375 DOI: 10.1001/jamadermatol.2013.2466] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical. OBJECTIVE To determine the dermoscopy features of NM. DESIGN Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/hypomelanotic or pigmented to assess outcomes. SETTING Predominantly hospital-based clinics from 5 continents. MAIN OUTCOME MEASURES Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma. RESULTS Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, blue-white veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (>98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM. CONCLUSIONS AND RELEVANCE When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.
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Affiliation(s)
- Scott W Menzies
- Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
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23
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Costache M, Patrascu OM, Adrian D, Costache D, Sajin M, Ungureanu E, Simionescu O. Ciliary body melanoma - a particularly rare type of ocular tumor. Case report and general considerations. Maedica (Bucur) 2013; 8:360-364. [PMID: 24790669 PMCID: PMC3968473] [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] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 12/06/2013] [Indexed: 06/03/2023]
Abstract
Uveal melanoma is the most common primary malignancy of the eye in white adults. Frequently, uveal melanoma arises from choroid or iris. Ciliary body melanoma is a rare if not exceptional subtype of uveal melanoma. Furthermore, ciliary melanoma is often seen in association with the other two subtypes of uveal melanoma. This paper presents a case of primary ciliary melanoma with invasion of the iris. The patient presented with blurred vision, but this symptom could not doubtless be related with the existence of the tumor, because of the small dimension of the malignancy and the lack of medical history of the patient.This tumor was included in the category of "very small ciliary melanoma", a rare diagnosis considering the fast local invasion and the lack of symptoms in such a small tumor. Histopathological and imunohistochemical examinations confirmed the diagnosis of ciliary melanomaThis type of ocular melanoma has a low prognosis due to early metastases.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Dumitru Adrian
- Department of Pathology, Emergency University Hospital, Bucharest, Romania
| | - Diana Costache
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Maria Sajin
- Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Emil Ungureanu
- Department of Ophthalmology, Emergency University Hospital Bucharest, Romani
| | - Olga Simionescu
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Abstract
Telocytes (TCs), a particular interstitial cell type, have been recently described in a wide variety of mammalian organs (www.telocytes.com). The TCs are identified morphologically by a small cell body and extremely long (tens to hundreds of μm), thin prolongations (less than 100 nm in diameter, below the resolving power of light microscopy) called telopodes. Here, we demonstrated with electron microscopy and immunofluorescence that TCs were present in human dermis. In particular, TCs were found in the reticular dermis, around blood vessels, in the perifollicular sheath, outside the glassy membrane and surrounding sebaceous glands, arrector pili muscles and both the secretory and excretory portions of eccrine sweat glands. Immunofluorescence screening and laser scanning confocal microscopy showed two subpopulations of dermal TCs; one expressed c-kit/CD117 and the other was positive for CD34. Both subpopulations were also positive for vimentin. The TCs were connected to each other by homocellular junctions, and they formed an interstitial 3D network. We also found TCs adjoined to stem cells in the bulge region of hair follicles. Moreover, TCs established atypical heterocellular junctions with stem cells (clusters of undifferentiated cells). Given the frequency of allergic skin pathologies, we would like to emphasize the finding that close, planar junctions were frequently observed between TCs and mast cells. In conclusion, based on TC distribution and intercellular connections, our results suggested that TCs might be involved in skin homeostasis, skin remodelling, skin regeneration and skin repair.
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Affiliation(s)
- Laura Ceafalan
- Molecular Medicine Laboratory, V. Babeş National Institute of Pathology, Bucharest, Romania
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Simionescu O, Popescu BO, Costache M, Manole E, Spulber S, Gherghiceanu M, Blum A. Apoptosis in seborrheic keratoses: an open door to a new dermoscopic score. J Cell Mol Med 2012; 16:1223-31. [PMID: 22404841 PMCID: PMC3494979 DOI: 10.1111/j.1582-4934.2012.01558.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 03/09/2012] [Indexed: 12/18/2022] Open
Abstract
The aetiology of seborrheic keratoses (SK), the most common benign epithelial tumours, and any relationship with malignancy are not yet known. As a protective anti-cancer mechanism, apoptosis reflects cellular loss as a reaction to proliferative activity. The objective of this study was to quantify apoptosis in different SK types (acanthotic, hyperkeratotic, reticulated, irritated and clonal) and correlate the dermoscopic picture with apoptosis rate. After a qualitative and quantitative analysis of dermoscopic images, we defined a new quantitative dermoscopic score (C3V2F, crypts, millia cysts, colours, hairpin vessels, irregular vessels, fissures) from 0 to 22, which enabled us to establish cut-offs correlating with apoptosis rates. All five SK forms were associated with lower apoptosis rates compared with normal skin. A C3V2F score >10 and greater number of crypts and colours reflected a higher apoptosis rate, which implies a benign character of evolution. In contrast, the presence of irregular vessels on more than 50% of the lesion surface implied a lower rate of apoptosis and probably associated with a risk of malignant transformation. On the basis of dermoscopic information, we used multiple regression to establish a model for estimating the rate of apoptosis with a 0.7 prediction interval (approximately 1S.D.). The new C3V2F score could be valuable for the clinical evaluation of possible SK prognosis and decisions regarding excision.
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Affiliation(s)
- Olga Simionescu
- Department of Dermatology, Colentina University Hospital, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.
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Blum A, Simionescu O, Argenziano G, Braun R, Cabo H, Eichhorn A, Kirchesch H, Malvehy J, Marghoob AA, Puig S, Ozdemir F, Stolz W, Tromme I, Weigert U, Wolf IH, Zalaudek I, Kittler H. Dermoscopy of pigmented lesions of the mucosa and the mucocutaneous junction: results of a multicenter study by the International Dermoscopy Society (IDS). ACTA ACUST UNITED AC 2011; 147:1181-7. [PMID: 21680757 DOI: 10.1001/archdermatol.2011.155] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To better characterize the dermoscopic patterns of mucosal lesions in relation to the histopathologic characteristics. DESIGN Retrospective and observational study. SETTING Fourteen referral pigmented lesion clinics in 10 countries. PATIENTS A total of 140 pigmented mucosal lesions (126 benign lesions, 11 melanomas, 2 Bowen disease lesions, and 1 metastasis) from 92 females (66%) and 48 males (34%) were collected from October 2007 through November 2008. MAIN OUTCOME MEASURES Scoring the dermoscopic patterns (dots, globules, or clods, circles, lines, or structureless) and colors (brown, black, blue, gray, red, purple, and white) and correlation with the histopathologic characteristics. RESULTS Based on univariate analysis and 2 diagnostic models, the presence of structureless zones inside the lesions with blue, gray, or white color (the first model) had a 100% sensitivity for melanoma and 92.9% sensitivity for any malignant lesion, and 82.2% and 83.3% specificity for benign lesions in the group with melanoma lesions and the group with malignant lesions, respectively. Based on the colors (blue, gray, or white) only (the second model), the sensitivity for the group with melanoma was 100% and for the group with any malignant lesion was 92.9%, and the specificity was 64.3% and 65.1%, respectively. Patients with malignant lesions were significantly older than patients with benign lesions (mean [SD] ages, 60.1 [22.8] years vs 43.2 [17.3] years, respectively). CONCLUSION The combination of blue, gray, or white color with structureless zones are the strongest indicators when differentiating between benign and malignant mucosal lesions in dermoscopy.
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Affiliation(s)
- Andreas Blum
- Private and Teaching Practice of Dermatology, Seestrasse 3a, 78464 Konstanz, Germany.
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27
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Costache M, Ene AM, Simionescu O, Sajin M. Histopathological diagnosis of cutaneous vascular sarcomas. Rom J Morphol Embryol 2010; 51:105-109. [PMID: 20191128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Cutaneous sarcomas represent a heterogeneous group of mesenchymal lesions. This study investigates the histopathological and immunohistochemical features in different cases of angiosarcoma and Kaposi's sarcoma (cutaneous vascular sarcomas), which are representative for medical practice. The clinical-histopathological-immunohistochemical correlations render possible the differential diagnosis and a proper treatment can be applied to obtain a favorable prognosis.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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28
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Costache M, Neagu M, Petrescu A, Constantin C, Manda G, Vrabie CD, Waller M, Petrescu CS, Simionescu O. Statistical correlations between peripheral blood lymphocyte subpopulations and tumor inflammatory infiltrate in stage I of skin melanoma. Rom J Morphol Embryol 2010; 51:693-699. [PMID: 21103628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The article presents statistical correlations of immune cell parameters investigated in patients diagnosed with skin melanoma stage I. Recent data indicate a suppressed immune response, probably sustained by immune-regulating molecules expressed or shed from the tumor. These molecules block an efficient immune response and thus the tumor develops. All the molecules that are part of the tumor escape mechanisms can be targets for immune-mediated anti-tumor agents. We try to find the significance of some immunohistochemical markers (UCHL1, CD4, CD8) in tumoral inflammatory infiltrate and to establish the statistical correlations between molecular markers and tumor grade and stage. The studied parameters were: CD3+, CD4+, CD8+, CD56+16+ and CD19+. The statistical results were performed with SPSS v. 15.0. We demonstrate that a CD4+ on-going immune response is elicited in the investigated patients. We found a possible compensatory mechanism between T-lymphocytes and NK-cells and also between the antibodies generating cells and the natural cytotoxic cells. We are confident that these statistical correlations between clinical, immunological and immunohistochemical data can be useful in the disease management and personalized immune-therapy.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, Victor Babes, National Institute of Pathology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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Simionescu O, Dumitrescu D, Costache M, Blum A. Dermatoscopy of an invasive melanoma on the upper lip shows possible association with Laugier-Hunziker syndrome. J Am Acad Dermatol 2009; 59:S105-8. [PMID: 19119112 DOI: 10.1016/j.jaad.2008.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 06/12/2008] [Accepted: 07/15/2008] [Indexed: 12/12/2022]
Abstract
We report mucosal melanoma of the upper lip in a patient affected by the Laugier-Hunziker disease. Using dermatoscopy, two distinct parts were identified in the same mucosal area: nodular (malignant) and macular (benign). A complete surgical excision was performed and the patient has been free of disease for 16 months.
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Affiliation(s)
- Olga Simionescu
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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Costache M, Simionescu O, Sajin M, Chefani A. Cutaneous metastases carcinoma. Case report and pathological considerations. Rom J Morphol Embryol 2007; 48:177-80. [PMID: 17641806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Diagnostic of cutaneous metastases is relatively rare; this is important because sometimes may be the first manifestation of an undiscovered internal malignancy. Usually dissemination may take place through the lymphatics or the blood stream. The case of a patient, female, which has on the inferior 1/3 part of the abdominal wall skin a multinodular tumor mass, which evolves from about three months ago and accompanying by lymphoedema of the legs, is presented.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, Victor Babeş National Institute for Pathology and Biomedical Sciences, Carol Davila University of Medicine and Pharmacy, 8 Eroilor Sanitari Avenue, Bucharest, Romania.
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Costache M, Simionescu O, Sajin M, Chefani A, Ene AM, Teodorov AM, Ionica E. Apoptosis in cutaneous melanomas. Rom J Morphol Embryol 2007; 48:343-347. [PMID: 18060183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Cutaneous melanomas has become one of the most discussed and studied tumor because its particular immunologic development but also its increasing rate worldwide in the last decades. Even thought many patients are diagnosed at an early stage, the death rate continues to rise due to the increasing incidence of more advanced lesions. The aim of this study is to detect apoptosis in 30 cases of cutaneous melanomas using the in situ end-labeling technique (TUNEL) who quantify apoptotic cell death at single cell level and tissues.
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Affiliation(s)
- Mariana Costache
- Department of Pathology, Victor Babes National Institute for Pathology and Biomedical Sciences, Bucharest, Romania.
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Abstract
Cutaneous melanoma is a "perfid", aggressive and hard to be treated malignant tumor in case of delayed diagnosis. However, patients still have a chance to escape progressive disease if the lesion is recognized early, when the surgical approach is curative. Dermoscopy has the important advantage of rapidity and non-invasivity in a field with (still) contradictory algorithms of diagnosis and treatment. The recognition of the elementary dermoscopic lesions enables accurate diagnosis for cutaneous melanoma. In our opinion, dermoscopy appears compulsory in the routine dermatologic examination. In vivo microscopy (dermoscopy) together with histopathology (plus or minus immunohistochemistry) seem, at present, to provide the most reliable diagnosis of melanoma.
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Affiliation(s)
- Olga Simionescu
- The 1st Department of Dermatology, Colentina Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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Abstract
Epidermal stem cells (ESC) are responsible for maintaining skin cellular homeostasis, as they give rise to fast-dividing transit amplifying cells committed to terminal differentiation, while retaining their self-renewal capacity. However, no pure ESC cultures are available and no highly specific cytochemical marker was identified. We report here the experimental conditions allowing the selective enrichment in ESC, using cultured adult human keratinocytes. The main step was the selection of cells able to rapidly adhere to human collagen type IV in vitro. Thus, an increased proportion of putative ESC of about 65% was obtained, as demonstrated by p63 expression.
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Affiliation(s)
- E Radu
- Department of Cellular and Molecular Medicine, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Nitzulescu V, Simionescu O, Lucian O, Corijescu V. [Research on the treatment of ascariasis with L-tetramisole]. Pediatria (Bucur) 1971; 20:169-74. [PMID: 5581856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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35
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Nitzulescu V, Simionescu O, Lucian O, Corijescu V, Brînzei A, Juvara AM. [Treatment of trichocephaliasis with Bemarsal]. Pediatria (Bucur) 1970; 19:373-5. [PMID: 5485450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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36
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Roman N, Rădulescu S, Iancu L, Simionescu O, Scarlat S, Sima A. [Biochemical diagnosis in ascariasis]. Microbiol Parazitol Epidemiol (Bucur) 1970; 15:255-8. [PMID: 5426399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Nitzulescu V, Simionescu O, Lucian O, Corijescu V, Brinzei A, Juvara AM. [Treatment of trichocephalosis with Bemarsal]. Bull Soc Pathol Exot Filiales 1970; 63:251-5. [PMID: 5536452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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38
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Lucian O, Simionescu O, Pompan L, Boian A, Ionescu L, Juvara AM, Mărăndici A. [Clinical and laboratory aspects of lambliasis in children]. Pediatria (Bucur) 1966; 15:421-8. [PMID: 5975961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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39
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Lucian O, Simionescu O, Pompan L, Boian A, Brinzei A, Juvara AN, Pescaru E. Study of the efficacy of various methods for the treatment of giardiasis. Rom Med Rev 1966; 20:38-42. [PMID: 5954278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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