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Volume 7, September

Dermatopathology, Volume 7, Issue 3 (December 2020) – 3 articles

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Open AccessCase Report
Type I Interferon Signature in Chilblain-Like Lesions Associated with the COVID-19 Pandemic
Dermatopathology 2020, 7(3), 57-63; https://0-doi-org.brum.beds.ac.uk/10.3390/dermatopathology7030010 - 04 Dec 2020
Cited by 3 | Viewed by 920
Abstract
Contemporarily to the new SARS-CoV-2 mediated COVID-19 pandemic, a rise in patients with acral chilblain lesions has been described. They manifest late after mild disease or asymptomatic exposure to SARS-CoV-2. Their pathogenic evolution is currently unknown. In biopsies from three patients with acral [...] Read more.
Contemporarily to the new SARS-CoV-2 mediated COVID-19 pandemic, a rise in patients with acral chilblain lesions has been described. They manifest late after mild disease or asymptomatic exposure to SARS-CoV-2. Their pathogenic evolution is currently unknown. In biopsies from three patients with acral partially ulcerating chilblain lesions that occurred associated to the COVID-19 pandemic, we analysed the expression of type I interferon induced proteins and signal transduction kinases. Histology demonstrated perivascular and periadnexal lymphohistiocytic infiltrates and endothelial dominated MxA-staining, as well as pJAK1 activation. Our findings demonstrate induction of the type I IFN pathway in lesional sections of COVID-19-associated chilblain-like lesions. This may indicate a local antiviral immune activation status associated with preceding exposure to SARS-CoV-2. Full article
(This article belongs to the Section Clinico-Pathological Correlation in Dermatopathology)
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Open AccessCase Report
Histological Changes Related to Symptomatic Improvement of Spontaneous Keloids Treated with a Low-Dosage Regimen of UVA-1 Phototherapy
Dermatopathology 2020, 7(3), 53-56; https://0-doi-org.brum.beds.ac.uk/10.3390/dermatopathology7030009 - 03 Dec 2020
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Abstract
Keloids are a difficult-to-treat disease characterized by an imbalance in mechanisms of tissue reparation. We present the case of a middle-aged woman with spontaneous keloids which histologically and clinically improved after UVA-1 phototherapy treatment. There are few reported cases of keloids treated with [...] Read more.
Keloids are a difficult-to-treat disease characterized by an imbalance in mechanisms of tissue reparation. We present the case of a middle-aged woman with spontaneous keloids which histologically and clinically improved after UVA-1 phototherapy treatment. There are few reported cases of keloids treated with high doses of UVA-1 phototherapy. We used a low-dosage regimen with a good response in only one cycle, which could diminish the risk of skin cancer development. Full article
(This article belongs to the Section Clinico-Pathological Correlation in Dermatopathology)
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Open AccessCase Report
Voriconazole-Induced Squamous Cell Carcinoma after Hematopoietic Stem Cell Transplantation Showing Early-Stage Vascular Invasion
Dermatopathology 2020, 7(3), 48-52; https://0-doi-org.brum.beds.ac.uk/10.3390/dermatopathology7030008 - 09 Oct 2020
Cited by 1 | Viewed by 1074
Abstract
Voriconazole is a triazole antifungal agent used for the prevention and treatment of fungal infections in immunocompromised patients. Prolonged voriconazole therapy may induce phototoxicity and lead to the development of malignant neoplasms of the epidermis, such as squamous cell carcinoma (SCC), especially in [...] Read more.
Voriconazole is a triazole antifungal agent used for the prevention and treatment of fungal infections in immunocompromised patients. Prolonged voriconazole therapy may induce phototoxicity and lead to the development of malignant neoplasms of the epidermis, such as squamous cell carcinoma (SCC), especially in immunocompromised patients. We report a case of voriconazole-induced phototoxicity and SCC occurring after hematopoietic stem cell transplantation (HSCT) in a 56-year-old man with primary myelofibrosis. The patient developed chronic graft-versus-host disease (GVHD) post-transplantation and had been receiving long-term immunosuppressive treatment. A year after the initiation of voriconazole therapy for prophylaxis, he developed keratotic erythema, followed by SCC with vascular invasion after three years. A review of SCC in HSCT recipients suggests that the prolonged use of voriconazole is regarded as a risk for SCC after HSCT in patients with chronic GVHD on immunosuppressive therapy. Moreover, a histological examination of the completely resected tumor revealed vascular invasion in this case, although neither the clinical features nor the histological findings of the preoperative biopsy suggested invasive carcinoma. This case may partially explain why voriconazole-associated SCCs show a more aggressive clinical course than non-voriconazole SCCs do. Full article
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