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The Journal of Dermatology Oct 2021Comprehensive studies of primary cutaneous extranodal natural killer/T-cell lymphoma (PCENKTL) are scarce. The objectives of this study are to describe PCENKTL in terms...
Comprehensive studies of primary cutaneous extranodal natural killer/T-cell lymphoma (PCENKTL) are scarce. The objectives of this study are to describe PCENKTL in terms of its clinical features, histopathology, immunophenotypes, and prognosis, and to analyze factors affecting patient survival outcomes. We searched four databases and include studies with extractable data. We also searched the Asan Medical Center database for cases of PCENKTL. We include a total of 289 patients. The mean age at diagnosis was 52.8 years and the female to male ratio was 1:1.2. The most common clinical morphology was a subcutaneous nodule, followed by ulceration. About half of the patients presented with disseminated skin lesions. The median overall survival was 12.0 months and the 5-year survival rate was 22.0%. There was no correlation between the clinical morphology or the histopathological features of the skin lesions with the patient outcomes. Advanced TNM stage, a disseminated skin lesion, tumor location on the leg or trunk, the presence of B symptoms, and a high International Prognostic Index score were associated with a worse prognosis, and chemoradiotherapy was associated with a better survival outcome as compared with chemotherapy alone in univariable analyses. In multivariable analyses, only advanced TNM stage and tumor location on the leg were associated with a worse prognosis. In conclusion, PCENKTL is an aggressive cutaneous lymphoma and its prognosis is associated with TNM stage and tumor location.
Topics: Female; Humans; Killer Cells, Natural; Lymphoma, Extranodal NK-T-Cell; Lymphoma, T-Cell, Cutaneous; Male; Prognosis; Retrospective Studies; Skin Neoplasms
PubMed: 34060130
DOI: 10.1111/1346-8138.15972 -
Hematology/oncology and Stem Cell... Jan 2023The aim of this systematic review is to investigate different diagnostic methods and the available treatment options for subcutaneous panniculitis-like T-cell lymphoma...
OBJECTIVES
The aim of this systematic review is to investigate different diagnostic methods and the available treatment options for subcutaneous panniculitis-like T-cell lymphoma (SPTCL).
METHODS
We searched PubMed, Web of Science, SCOPUS, EBSCO, and CINAHL Plus for published case reports of SPTCL. From each record, we extracted data of the diagnostic methods, immunohistochemical profile, clinical characteristics, and the treatment approaches provided. Data were summarized and narratively synthesized to highlight the various diagnostic methods and treatment options of SPTCL.
RESULTS
Our literature search yielded 1293 unique citations. Following screening, nine articles reporting a total of 15 cases were included in this systematic review. All patients presented with subcutaneous nodules. Three of the 15 cases were initially misdiagnosed. The atypical lymphoid cells were positive for CD2, CD3, granzyme B, and TIA-1 and negative for CD1a, EBER, and CD20 in all the reported cases. The atypical lymphoid cells were positive for CD45RO in four out of seven cases, positive for CD56 in three out of 12 cases tested, while positive for CD5 and CD8 in the majority of cases. Therapy ranged from topical agents to immunosuppressive agents all the way to multiagent chemotherapy.
CONCLUSION
SPTCL is a rare lymphoma. Diagnosis is highly dependent on the immunohistochemical stains added to histopathologic and radiologic findings. Therapy is dependent on the pace of the disease, with encouraging results obtained with single-agent cyclosporine.
Topics: Humans; Lymphoma, T-Cell, Cutaneous; Lymphoma, T-Cell; Panniculitis; Skin Neoplasms
PubMed: 34015273
DOI: 10.1016/j.hemonc.2021.04.001 -
Pathogens (Basel, Switzerland) Apr 2021Feline leishmaniosis (FeL) is increasingly reported throughout the world and skin lesions predominate in the clinical picture. There are, however, few evidence-based... (Review)
Review
Feline leishmaniosis (FeL) is increasingly reported throughout the world and skin lesions predominate in the clinical picture. There are, however, few evidence-based data on cutaneous feline leishmaniosis and directions are strongly needed for a better management of the disease. In this study, we systematically reviewed what is currently known about the clinical dermatological presentation of FeL through analysis of the literature and, further, by adding unpublished cases managed by Italian veterinary dermatologists. Sixty-six feline cases of cutaneous leishmaniosis published in 33 articles between 1990 and 2020 met the inclusion criteria and were analyzed. Six unpublished cases of cutaneous FeL managed by Italian dermatologists were also reviewed. The majority of cases were reported from South America, followed by Europe and North America. Nodules were the most frequently reported clinical signs and the presence of Leishmania in lesioned skin was assessed mainly by cytology. A total of six Leishmania species have been identified as being responsible for skin lesions. Coinfections by FIV or FeLV were reported in 12.1% and 9.1% of the cases, respectively. Clinical data including treatment have been analyzed and discussed to provide directives for proper management of the disease for which cats may also serve as domestic reservoirs for human infections.
PubMed: 33924616
DOI: 10.3390/pathogens10040472 -
Facial Plastic Surgery : FPS Aug 2021There has been an increasing role in the use of injectable fillers for rejuvenation of the aging face. In this systematic review, we aim to evaluate the existing...
There has been an increasing role in the use of injectable fillers for rejuvenation of the aging face. In this systematic review, we aim to evaluate the existing literature related to soft tissue fillers of the midface. Specifically, we focus on the non-hyaluronic acid fillers including polymethylmethacrylate (PMMA), poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), and autologous fat. A systematic review was conducted in November 2020 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with PubMed and Embase databases. Medical Subject Headings terms used were "cheek" OR "midface" OR "malar" and "filler" OR "poly-L-lactic acid" OR "calcium hydroxyapatite," "autologous fat" OR "polymethylmethacrylate" OR "Artefill" OR "Bellafill" OR "Radiesse" OR "Sculptra." The initial search identified 271 articles. After 145 duplicates were removed, 126 studies were screened for relevance by title and abstract. A total of 114 studies were eliminated based on inclusion and exclusion criteria. Twelve articles underwent full-text review. Seven articles were included in the final analysis consisting of four non-hyaluronic filler products: PMMA, PLLA, CaHA, autologous fat. Most patients were highly satisfied with their results. Due to the gradual volumizing effects of PMMA, PLLA, and CaHA, patient satisfaction generally improved over time. Minor adverse reactions related to treatment included bruising, swelling, and pain. Nodule formation was reported in PLLA and CaHA studies. For autologous fat, 32% of the original injection volume remained at 16 months post-treatment, which still provided clinically improved malar enhancement. Dermal fillers are an attractive treatment option for the aging face due to their high patient satisfaction, long-lasting effects, and low side-effect profile. Patients should be appropriately counseled on the delayed effects of non-HA fillers. Autologous fat is a good option in many patients with the major drawback of unpredictable longevity, which may require a secondary procedure. Future studies should examine the longevity and long-term side effects of these fillers.
Topics: Cosmetic Techniques; Dermal Fillers; Durapatite; Face; Humans; Hyaluronic Acid; Rejuvenation; Skin Aging
PubMed: 33648015
DOI: 10.1055/s-0041-1725164 -
Asian Journal of Surgery Aug 2021Cough is a common complication following pulmonary resection. Persistent and severe cough after pulmonary resection can cause significant impairments in quality of life... (Review)
Review
Cough is a common complication following pulmonary resection. Persistent and severe cough after pulmonary resection can cause significant impairments in quality of life among postoperative patients. Complications of cough can be life-threatening. To improve patients' probability and quality of life, factors that induce cough after pulmonary resection (CAP) and potential treatments should be explored and summarized. Previous studies have identified various factors related to CAP. However, those factors have not been categorized and analyzed in a sensible manner. Here, we summarized the different factors and classified them into four groups. Potential therapies might be developed to selectively target different factors that affect CAP. However, the exact mechanism underlying CAP remains unknown, making it difficult to treat and manage CAP. In this review, we summarized the latest studies in our understanding of the factors related to CAP and potential treatments targeting those factors. This review can help understand the mechanism of CAP and develop efficient therapies and management.
Topics: Cough; Humans; Quality of Life
PubMed: 33610443
DOI: 10.1016/j.asjsur.2021.01.001 -
Dermatologic Surgery : Official... Feb 2021As the use of injectable skin fillers increase in popularity, an increase in the reported adverse events is expected.
BACKGROUND
As the use of injectable skin fillers increase in popularity, an increase in the reported adverse events is expected.
OBJECTIVE
This systematic review supports the development of American Society for Dermatologic Surgery practice guideline on the management of adverse events of skin fillers.
METHODS AND MATERIALS
Several databases for studies on risk factors or treatments of injection-related visual compromise (IRVC), skin necrosis, inflammatory events, and nodules were searched. Meta-analysis was conducted when feasible.
RESULTS
The review included 182 studies. However, IRVC was very rare (1-2/1,000,000 patients) but had poor prognosis with improvement in 19% of cases. Skin necrosis was more common (approximately 5/1,000) with better prognosis (up to 77% of cases showing improvement). Treatments of IRVC and skin necrosis primarily depend on hyaluronidase injections. Risk of skin necrosis, inflammatory events, and nodules may be lower with certain fillers, brands, injection techniques, and volume. Treatment of inflammatory events and nodules with antibiotics, corticosteroids, 5-FU, and hyaluronidase was associated with high response rate (75%-80%). Most of the studies were small and noncomparative, making the evidence certainty very low.
CONCLUSION
Practitioners must have adequate knowledge of anatomy, elicit history of skin filler use, and establish preemptive protocols that prepare the clinical practice to manage complications.
Topics: Advisory Committees; Clinical Decision-Making; Cosmetic Techniques; Dermal Fillers; Dermatology; Esthetics; Evidence-Based Medicine; Face; Humans; Injection Site Reaction; Interdisciplinary Communication; Necrosis; Practice Guidelines as Topic; Skin; Societies, Medical; Specialties, Surgical; United States
PubMed: 33565776
DOI: 10.1097/DSS.0000000000002911 -
International Journal of Molecular... Nov 2020Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting areas with a high density of apocrine glands and characterized by subcutaneous nodules...
BACKGROUND
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting areas with a high density of apocrine glands and characterized by subcutaneous nodules that may evolve into fistulas with pus secretion.
METHODS
The aim of this review is to investigate all current knowledge on cytokine regulation in the pathogenesis of HS. A systematic literature research using the words "cytokine", "interleukin", "pathway", and "hidradenitis suppurativa" was performed in PubMed/Medline and Scopus/Embase databases. A search of the clinicaltrials.gov website for interventional recruiting and completed trials including the term "hidradenitis suppurativa" was also performed up to August 2020. We will discuss the pathogenetic role of various cytokines in HS and potential therapeutic targets for this debilitating disease.
RESULTS
The pathophysiology underlying this complex condition has not been clearly defined. An upregulation of various cytokines, such as tumor necrosis factor alpha (TNF-α), interleukin (IL)-1, IL-17, IL-23, and other molecules seems to be related to this inflammatory condition. Various cells, such as lymphocytes T Helper 1 and 17 and keratinocytes seem to be involved in the genesis of this condition.
CONCLUSIONS
Several future studies and clinical trials are necessary in order to have new knowledge about HS and to properly treat this complex condition.
Topics: Antibodies, Monoclonal, Humanized; Biofilms; Clinical Trials as Topic; Cytokines; Hidradenitis Suppurativa; Humans; Immunologic Factors; Interleukins; Microbiota; Models, Immunological; Molecular Targeted Therapy; Tumor Necrosis Factor-alpha
PubMed: 33182701
DOI: 10.3390/ijms21228436 -
American Journal of Clinical Dermatology Jan 2021Granulomatous drug eruptions are rare entities, where granuloma formation occurs as an attempt to contain an exogenous or endogenous inciting agent. Granulomatous drug...
BACKGROUND
Granulomatous drug eruptions are rare entities, where granuloma formation occurs as an attempt to contain an exogenous or endogenous inciting agent. Granulomatous drug eruptions may be localized to the skin or may include major systemic involvement, and their characteristics depend both on the properties of the causative irritant and host factors. Because of the overlapping features amongst noninfectious granulomatous diseases, granulomatous drug eruptions are challenging to diagnose and distinguish both histologically and clinically.
OBJECTIVE
The objective of this article is to provide a review and summary of the current literature on the five major types of cutaneous granulomatous drug eruptions: interstitial granulomatous drug reaction, drug-induced accelerated rheumatoid nodulosis, drug-induced granuloma annulare, drug-induced sarcoidosis, and miscellaneous presentations.
METHODS
A systematic review was conducted through PubMed using the search terms "granulomatous drug eruption" and "cutaneous" or "skin". English full-text studies that included human subjects experiencing a cutaneous reaction comprising granulomatous inflammation as the direct result of a drug were included. Of 205 studies identified, 48 articles were selected after a full-text review. Evidence was evaluated using the Tool for evaluating the methodological quality of case reports and case series.
RESULTS
Polypharmacy and a prolonged lag period from drug ingestion to rash onset may create diagnostic challenges. Ruling out tuberculosis is imperative in the endemic setting, particularly where anti-tumor necrosis factor therapy is the presumed cause. Interstitial granulomatous drug reactions and granuloma annulare are often localized to the skin whereas accelerated rheumatoid nodulosis and sarcoidosis may sometimes be associated with systemic features as well. Granulomatous drug eruptions typically resolve on discontinuing the offending medication; however, the decision for drug cessation is dependent on a risk-benefit assessment. In some situations, supplementation of an additional agent to suppress the reaction may resolve symptoms. In some cases, granulomatous drug eruptions may be pivotal in the successful outcome of the drug, as in cases of melanoma treatment. In all situations, the decision to continue or withdraw the drug should be carefully based on the severity of the eruption, necessity of continuing the drug, and availability of a suitable alternative.
CONCLUSIONS
Granulomatous drug eruptions should always be considered in the differential diagnosis of noninfectious granulomatous diseases of the skin. Further research examining dose-response relationships and the recurrence of granulomatous drug eruptions on the rechallenge of offending agents is required. Increased awareness of granulomatous drug eruption types is important, especially with continuous development of new anti-cancer agents that may induce these reactions.
CLINICAL TRIAL REGISTRATION
PROSPERO registration number CRD42020157009.
Topics: Diagnosis, Differential; Dose-Response Relationship, Drug; Drug Eruptions; Granuloma Annulare; Humans; Polypharmacy; Rheumatoid Nodule; Sarcoidosis; Skin
PubMed: 33108647
DOI: 10.1007/s40257-020-00566-4 -
Pediatric Dermatology Nov 2020Hidradenitis suppurativa (HS), characterized by inflammatory nodules, sinus tracts, and abscesses, has been linked to several factors, including immune dysfunction and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hidradenitis suppurativa (HS), characterized by inflammatory nodules, sinus tracts, and abscesses, has been linked to several factors, including immune dysfunction and obesity, which are thought to contribute to its development. Several follicular disorders have also been associated with Down syndrome (DS), a common chromosomal disorder, including HS, although studies on this topic are limited.
OBJECTIVES
To characterize HS in Down syndrome patients and to further examine the association between HS and DS compared to HS patients without DS.
METHODS
We systematically searched MEDLINE, Embase, Web of Science, and CENTRAL electronic databases from their dates of conception to February 2020. Random-effects meta-analyses were performed analyzing (a) HS characteristics between DS and non-DS participants, and (b) prevalence or association between HS and DS compared to non-DS individuals.
RESULTS
Twelve studies were included in this systematic review, with a total of 358 participants presenting with both HS and DS. Pooled analysis of mean differences between DS and non-DS participants presenting with HS found a significantly younger age of HS symptom onset for DS patients (-6.24; 95% CI, -10.01--2.24). A meta-analysis examining the association between HS and DS found a significantly increased likelihood of HS in DS patients (OR 9.61; 95% CI, 5.70-16.20).
CONCLUSIONS
Our findings suggest an association between HS and DS, with DS patients suffering from an earlier onset of HS symptoms compared to non-DS patients.
Topics: Down Syndrome; Hidradenitis Suppurativa; Humans; Inflammation; Obesity; Prevalence
PubMed: 32892406
DOI: 10.1111/pde.14326 -
Veterinary Research Communications Nov 2020Lumpy skin disease (LSD) is a viral disease caused by lumpy skin disease virus (LSDV), a member of Capripoxvirus genus of Poxviridae family. It is a transboundary...
Lumpy skin disease (LSD) is a viral disease caused by lumpy skin disease virus (LSDV), a member of Capripoxvirus genus of Poxviridae family. It is a transboundary disease of the economic importance affecting cattle and water buffaloes. The disease is transmitted by arthropod vectors and causes high morbidity and low mortality. LSD has recently been reported first time in India with 7.1% morbidity among cattle. Generally, fever, anorexia, and characteristic nodules on the skin mucous membrane of mouth, nostrils, udder, genital, rectum, drop in milk production, abortion, infertility and sometimes death are the clinical manifestations of the disease. The disease is endemic in African and Middle East countries but has started spreading to Asian and other countries. It has been recently reported from China and Bangladesh sharing borders with India. We have summarized occurrence of LSD outbreaks in last 10 years in Asian countries for the first time. In India, currently epidemiological status of the disease is unknown. Vaccination along with strict quarantine measures and vector control could be effective for preventing the spread of the disease. This review aims to summarise the latest developments in the epidemiology with the focus on transboundary spread, aetiology and transmission, clinical presentations, diagnostics and management of the disease.
Topics: Animals; Buffaloes; Cattle; Cattle Diseases; Disease Outbreaks; India; Lumpy Skin Disease; Lumpy skin disease virus
PubMed: 32857262
DOI: 10.1007/s11259-020-09780-1