Neoplastic Implications in Patients Suffering from Hidradenitis Suppurativa under Systemic Treatments

Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease of the apocrine glands. It typically involves the axillary, submammary, genital, inguinal, perineal, and perianal regions. The development of abscesses, sinus tracts, and scars can lead to pain, scarring, disfigurement and decreased quality of life. HS is associated with a wide range of comorbidities. Several studies of co-occurrence of HS and nonmelanoma skin cancer suggest a causal relationship. In an attempt to assess the link between HS and cancer, we performed a systematic review of the current scientific knowledge through a PubMed-based literature search. Results show that HS could be associated with an overall risk of cancer and numerous specific cancers such as: nonmelanoma skin cancer (NMSC), hematologic malignancies, and metastatic cancer. Among NMSC, squamous cell carcinoma (SCC) is considered the most common complication arising in long-standing HS. Based on our review, we suggest that cautious surveillance and active intervention may be warranted in patients with HS. Moreover, an age-appropriate cancer screening should be offered to all patients, especially those who developed HS later in their life or in long-standing moderate to severe HS with multiple comorbidities.

Generation of prolactin-inducible protein (Pip) knockout mice by CRISPR/Cas9-mediated gene engineering

Prolactin-inducible protein (PIP) is a multifunctional glycoprotein that is highly expressed and found in the secretions of apocrine glands, such as salivary, lacrimal, and sweat glands including the mammary glands. PIP has been implicated in various diseases, including breast cancer, gross cystic disease of the breast, keratoconus of the eye and the autoimmune Sjögren’s syndrome. Here we have generated a <i>Pip</i> knockout (KO) mouse using the CRISPR/Cas9 system. The Cas9 protein and two single guide RNAs targeting specific regions for both exons 1 and 2 of the <i>Pip</i> gene were microinjected into mouse embryos. The deletions and insertions promoted by CRISPR/Cas9 system on the <i>Pip</i> gene successfully disrupted PIP protein coding, as confirmed by PCR genotyping, sequencing and ultimately Western blot analysis. This mouse model was generated in the inbred C57Bl/6J mouse, which exhibits lower genetic variation. This novel CRISPR <i>Pip</i> KO mouse model will be not only be useful for future studies to interrogate the multifunctional role of PIP in physiological processes but will facilitate a broader understanding of the function of PIP <i>in vivo</i> while providing unprecedented insight into its role in a spectrum of diseases attributed to the deregulation of the <i>PIP</i> gene.

Trop2 Expression in Extramammary Paget’s Disease and Normal Skin

Extramammary Paget’s disease (EMPD) is a rare skin cancer arising in the apocrine gland-rich areas. Most EMPD tumors are dormant, but metastatic lesions are associated with poor outcomes owing to the lack of effective systemic therapies. Trophoblast cell surface antigen 2 (Trop2), a surface glycoprotein, has drawn attention as a potential therapeutic target for solid tumors. Sacituzumab govitecan, an antibody–drug conjugate of Trop2, has recently entered clinical use for the treatment of various solid cancers. However, little is known about the role of Trop2 in EMPD. In this study, we immunohistochemically examined Trop2 expression in 116 EMPD tissue samples and 10 normal skin tissues. In normal skin, Trop2 was expressed in the epidermal keratinocytes, inner root sheaths, and infundibulum/isthmus epithelium of hair follicles, eccrine/apocrine glands, and sebaceous glands. Most EMPD tissues exhibited homogeneous and strong Trop2 expression, and high Trop2 expression was significantly associated with worse disease-free survival (p = 0.0343). These results suggest the potential use of Trop2-targeted therapy for EMPD and improve our understanding of the skin-related adverse effects of current Trop2-targeted therapies such as sacituzumab govitecan.

A Novel Technique for the Treatment of a Case of Verneuil's Disease of Perineum and Axillary Regions

Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving apocrine glands of the skin. It carries out an important burden on the daily life of the patient. Unfortunately, it presents a major concern for medical care management in the absence of clear guidelines for proper medical and surgical treatment. Hence, we report a case of concomitant axillary and perianal HS. We opted for surgical management using a novel technique, which proved efficacy for a year of follow-up recurrence free.

Rarely seen accelerated progression of hidradenitis suppurativa

Malignant nodular hidradenoma, also known as Malignant Hidradenocarcinoma (MHA), is a rare tumor of sweat glands that accounts for less than 0.001% of all tumors [1-3,14]. Although it typically arises de-novo, MHA rarely progresses from hidradenitis suppurativa (HS), a disorder of apocrine glands characterized by chronic inflammation [5,6,9]. HS is due to recurrent follicular occlusion leading to painful debilitating cutaneous/subcutaneous abscesses requiring drainage [5,6,9]. Common sites include axillary, anogenital and inguinal regions [5,6,9]. The worldwide prevalence of HS is 1%-4% [5,6]. Incidence of all eccrine carcinomas is ~ 6% [14]. Risk-factors include family history, obesity, and smoking [5,6,9]. Severe complications associated with HS are squamous cell carcinoma and adenocarcinoma [2,6]. MHA progression is extremely aggressive with 60% cases having metastatic spread within the first 2 years of diagnosis [14].

Hidradenoma papilliferum of the hymen: a case report

Background Hidradenoma papilliferum is a rare benign neoplasm arising from apocrine glands. It occurs commonly on the anogenital region of middle-aged women. It usually presents as a slow growing, solitary asymptomatic, skin colored or red nodule less than 1 cm in diameter. Case presentation The case is a 38-year-old, white woman who presented with a painful nodule occurring within a month in the himenal region of the posterior vaginal introitus. The nodule was excisied and the histology revealed a hidradenoma papilliferum. The diagnosis and treatment of hidradenoma papilliferum is possible with surgical removal and histopathological evaluation of nodules. Conclusion When an adult woman presents with a noduler lesion in the anogenital area, sexually transmitted diseases and other benign and malignant vulvar lesions, as well as malignant transformation is very rare but,should be kept in mind; however because it has been reported and long-term clinical follow-up is suggested

UJI AKTIVITAS ANTIBAKTERI SPRAY BAU KAKI EKSTRAK KULIT JERUK NIPIS (Citrus aurantifolia) DENGAN VARIASI Gelling agent TERHADAP BAKTERI Bacillus subtilis

ABSTRACT Sweat is produced by the apocrine glands, if infected by bacteria that play a role in the decay process will certainly produce foot odor. Some of the bacteria that cause, including Staphylococcus epidermis, Corynebacterium acne and there is one bacterium that causes pungent foot odor that is Bacillus subtilis. Bacillus subtilis enzyme leucine dehydrogenase produced the highest, resulting in isovaleric acid foot odor. Lime peel (Citrus aurantifolia) has the potential to be developed for the antibacterial active ingredient of foot odor contained in tannins, alkaloids and flavonoids. Spray can be effective for inhibition of feet due to water fleas or bacterial infections. The purpose of this research is to test the inhibitory zone of the preparation of foot odor spray ethanol extract of lime peel (Citrus aurantifolia) with variations of gelling agent. Bacterial inhibition zone testing on extracts of lime peel spray preparations using the disc method. This test was carried out on spray with extract concentration of 0% extract base carbopol, 0% extract base HPMC, 0.2% extract base carbopol, 0.2% extract base HPMC, 0.4% extract base carbopol, 0.4% extract base HPMC and positive control with an average inhibition zone of 9,13 mm, 9,12 mm, 11,86 mm, 11,29 mm, 13,17 mm, 12,30 mm, 8,13 mm against the bacterium Bacillus subtilis. Antibacterial test results were analyzed using ONE WAY ANOVA, the results of statistical analysis on the preparation of lime peel extract showed a significant inhibition zone difference of 0.000 (P = <0.05) between all concentrations. Lime peel extract spray is effective in inhibiting the bacterium Bacillus subtilis. Key words: Sweat of foot odor, Lime skin (Citrus aurantifolia), Spray, bacteri Bacillus subtilis

Multi-stage surgical treatment of extensive gluteal localized hidradenitis suppurativa combined with negativ pressure wound therapy

Hidradenitis suppurativa (HS) is a chronic, recurrent infammatory disease of the hair follicles in the skinfolds containing apocrine glands, which greatly impairs the quality of life of patients. The fnal solution in extensive cases is surgical treatment. There is no ideal treatment or uniform therapeutic template equally suitable for all patients. Treatment is personalized. In this paper, we present the case of a 53-year-old patient who underwent a two-stage surgical treatment for therapy-resistant HS, Hurley stage III, causing permanent complaints. During the frst surgery, the fstula openings were flled with methylene blue, then the skin and the scary subcutaneous tissue were excised, and after 10 days, in a second step, the surgical site was covered with split thickness skin graft from the back. After both surgeries, negative pressure wound therapy (NPWT) was initiated. After the applied treatment, 98-100% graft adhesion was observed, and the patient was emitted without complaints after 3 weeks. Our case illustrates that in cases where the prospects for fap replacement in HS are poor or the healing tendency of the faps is questionable (infective wound base, poor quality surrounding skin), split thickness skin grafting combined with negative pressure therapy may be less stressful and provides a successful outcome. The combined treatment (NPWT + split thickness skin graft) is excellent not only for clearing and stimulating the wound base, but also provides an excellent wound base and allows successful wound closure / coverage, signifcantly shortening the duration of the long and cumbersome open treatment has been used so far. In this case, NPWT treatment can also be considered as a “bridging” step.

Expression of E-cadherin and Ki-67 in canine apocrine and sebaceous gland tumors

A histopathological analysis of 13 apocrine gland tumors and 22 sebaceous gland tumors in dogs was performed, which were submitted to the Department of Veterinary Pathology from 1 January 2010 to 31 December 2012. An association between the immunohistochemical expression of E-cadherin and Ki-67, the type, and the biological behavior of the tumors was investigated. The mean age of dogs with apocrine gland tumors was 10.15 years, and 10.91 years for sebaceous gland tumors. According to the histopathological analysis, 53.8% carcinomas and 46.2% adenomas of the apocrine glands were found. In the sebaceous gland tumors, epitheliomas were dominant (50.0%), followed by adenomas (36.4%) and carcinomas (13.6%). Survival time in dogs with sebaceous gland tumors was shortest in patients with diagnosed epitheliomas, intermediate in adenomas, and longest in carcinomas. The incidence of metastases was low in the groups with sebaceous adenomas and epitheliomas, and recurrence was most common in carcinomas. The average survival time was about the same for apocrine gland adenomas and carcinomas, with a higher incidence of metastases and recurrence for carcinomas. Immunohistochemical analysis of E-cadherin and Ki-67 expression confirmed the efficiency of this method for the accurate histological classification of apocrine and especially sebaceous gland tumors. The analyzes performed showed that the location and intensity of E-cadherin expression can be helpful in predicting the biological behavior of sebaceous gland tumors. In contrast to sebaceous gland tumors, the analysis of apocrine gland tumors showed that there was no correlation between E-cadherin expression and the biological behavior of apocrine gland tumors.