A Prototype Skin Substitute, Made of Recycled Marine Collagen, Improves the Skin Regeneration of Sheep

Skin wound healing is a complex and dynamic process that aims to restore lesioned tissues. Collagen-based skin substitutes are a promising treatment to promote wound healing by mimicking the native skin structure. Recently, collagen from marine organisms has gained interest as a source for producing biomaterials for skin regenerative strategies. This preliminary study aimed to describe the application of a collagen-based skin-like scaffold (CBSS), manufactured with collagen extracted from sea urchin food waste, to treat experimental skin wounds in a large animal. The wound-healing process was assessed over different time points by the means of clinical, histopathological, and molecular analysis. The CBSS treatment improved wound re-epithelialization along with cell proliferation, gene expression of growth factors (VEGF-A), and development of skin adnexa throughout the healing process. Furthermore, it regulated the gene expression of collagen type I and III, thus enhancing the maturation of the granulation tissue into a mature dermis without any signs of scarring as observed in untreated wounds. The observed results (reduced inflammation, better re-epithelialization, proper development of mature dermis and skin adnexa) suggest that sea urchin-derived CBSS is a promising biomaterial for skin wound healing in a “blue biotechnologies” perspective for animals of Veterinary interest.

Malignant melanoma of the nasal mucosa

Nose's Paranasal sinus & malignant melanoma are rarely seen, bold tumor with a prevalence rates of 0.68 percent across every malignant tumor. The neuroectodermal cells which are termed as Melanomas are found in skin's base layer, iris’s vascular intraocular coat, skin adnexa, & infrequently into outer covering of mucous. Blockage feeling of nose & bleeding from the nose are the symptoms which are most commonly reported, however patient may have symptoms that are nonspecific, leading to a delay in diagnosis which results in appropriate prediction of treatment's outcome. This study defines a 70 years female with the history of nose blockage feeling. Physicians suggest performing Nose’s CT scan, in which they came to know that large polypoidal portion in right nostril, extending to the nasopharynx, and eroded part of the sinus wall, septum and right medial pterygoid plate. Immunochemical study done revealed positive results for S100, vimentin, & HMB-45, which made the outcome suitable for tumor. An individual suffering from this will have no recurrence.

Development and Maintenance of Epidermal Stem Cells in Skin Adnexa

The skin surface is modified by numerous appendages. These structures arise from epithelial stem cells (SCs) through the induction of epidermal placodes as a result of local signalling interplay with mesenchymal cells based on the Wnt–(Dkk4)–Eda–Shh cascade. Slight modifications of the cascade, with the participation of antagonistic signalling, decide whether multipotent epidermal SCs develop in interfollicular epidermis, scales, hair/feather follicles, nails or skin glands. This review describes the roles of epidermal SCs in the development of skin adnexa and interfollicular epidermis, as well as their maintenance. Each skin structure arises from distinct pools of epidermal SCs that are harboured in specific but different niches that control SC behaviour. Such relationships explain differences in marker and gene expression patterns between particular SC subsets. The activity of well-compartmentalized epidermal SCs is orchestrated with that of other skin cells not only along the hair cycle but also in the course of skin regeneration following injury. This review highlights several membrane markers, cytoplasmic proteins and transcription factors associated with epidermal SCs.

Appearance of 4 Degree Rash While Treating Advanced Lung Cancer with Icotinib – Whether to Stop the Drug: A Case Report

Skin and skin adnexa toxicities are the most common side effects associated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Previous research showed that the rash appeared, and the severity of EGFR-TKIs may be a marker of clinical benefit. In this context, we report a 75-year-old man with advanced lung cancer who on receiving icotinib developed severe adverse reactions, 4 degree rash (NCI-CTC AE version 4.0 common toxicity grading standards grade), and refused to stop taking the drug; but with the anti-infection and symptomatic nursing, the patient recovered, the rash disappeared, and the patient received a better prognosis. Thus, we would like to emphasize the importance of deciding whether to stop the drug when patients developed adverse reactions of 3-4 degree rash.

Malignant teratoid tumor of the thyroid gland: an aggressive primitive multiphenotypic malignancy showing organotypical elements and frequent DICER1 alterations—is the term “thyroblastoma” more appropriate?

Primary thyroid teratomas are exceedingly rare. Mature and immature variants recapitulate their gonadal counterparts (predilection for infants/children, triphasic germ layer differentiation, and favorable outcome). On the other hand, the so-called malignant teratomas affect predominantly adults and elderly, are highly aggressive, and, according to a few published cases, harbor DICER1 mutations. We describe three highly aggressive sporadic malignant teratoid thyroid tumors in 2 females (17 and 45 years) and one male (17 years). Histology showed triphasic neoplasms composed of solid nests of small primitive monomorphic cells embedded in a cellular stroma with primitive immature rhabdomyosarcoma-like (2) or pleomorphic sarcoma-like (1) phenotype. The third component was represented by TTF1+/PAX8+ primitive teratoid epithelial tubules reminiscent of primitive thyroid follicles and/or Wilms tumor, admixed with scattered respiratory- or enteric-type tubules, neuroepithelial rosettes, and fetal-type squamoid nests. Foci of cartilage were seen in two cases, but none contained mature organoid adult-type tissue or skin adnexa. SALL4 was expressed in the small cell (2) and stromal (1) component. Other germ cell markers were negative. Molecular testing revealed a known “hotspot” pathogenic DICER1 mutation in two cases. In addition, case 1 had a missense TP53 variant. This type of thyroid malignancy is distinct from genuine teratomas. The immunoprofile suggests primitive thyroid- or branchial cleft-like differentiation. Given that “blastoma” is a well-accepted terminology in the spectrum of DICER1-associated malignancies, the term “thyroblastoma” might be more convenient for these malignant teratoid tumors of the thyroid gland. Relationship of thyroblastoma to the DICER1 syndrome remains to be addressed.

Case report: removal of a proliferating pilomatricoma with a CO2 laser

Tumors of the skin/skin adnexa are astonishingly diverse. The diagnostic algorithms for skin neoplasms includes history taking, the assessment of clinical data, dermoscopy and a histopathological examination. Literature descriptions of a histologically confirmed pilomatricoma are scarce. If the lesion is localized to an esthetically sensitive body area, it is important to minimize the postoperative cosmetic defect. In the case described below, we were able to achieve a positive esthetic outcome in a patient with a facial pilomatricoma sized < 2 cm2 using a СО2 laser.

A Case of Scheuermann’s Disease Co-Occurrence with Idiopathic Scoliosis and Intradural-Extramedullary Epidermoid Cyst: The First Case Report in Literature

Background and importance: Scheuermann’s disease (SD), intradural-extramedullary epidermoid cysts and idiopathic scoliosis (IS) are all rare conditions. The co-occurrence of the three condition on one case has not been reported in literature before. We describe an extremely rare case of SD co-occurrence with IS and intradural-extramedullary epidermoid cyst, which is the first in the literature. Clinical presentation: A 13-year old boy and his parents presented at Honghui Hospital complaining of progressive hyperkyphosis for 5 years and back pain for 2 months. Thorough medical examination and radiology confirmed the diagnosis of SD kyphosis, IS, and intradural-extramedullary epidermoid cyst. Medical panel with spine surgeons, oncologists, neurosurgeons, histopathologists and radiologists were consulted. Tumor excise, kyphosis recorrection and spine reconstruction surgery was conducted. Postoperative histological examination detected desquamation of keratin from the epithelial lining and stratified squamous epithelium without skin adnexa. The boy was ambulant 2 days postoperative with walking aids. Conclusion: This is the first case report of Scheuermann’s disease (SD) co-occurrence with idiopathic scoliosis (IS) and intradural-extramedullary epidermoid cyst. The co-occurrence of intradural epidermoid cyst, SD and IS might not be a coincidence, indicating a kind of genetic etiology need to be illuminated.

Kissing sebaceous carcinoma of the eyelids: a rare case report

Sebaceous gland carcinomas are tumours of the skin adnexa which occur around the periocular region of elderly females. It is a rare malignancy usually involving the upper eyelid and has an indolent course. Treatment is surgical excision of the lesion with lid reconstruction. Here authors discuss a case of swellings involving both the eyelids of an elderly female diagnosed as sebaceous gland carcinoma on biopsy for which wide local excision and primary eyelid repair was done. This case has been presented as the lesion masquerades as a benign one but is malignant with multifocal spread.

Diagnostic dilemma in skin adnexa malignancy: a rare case report with review of literature

Apocrine malignancies are rare to occur. Axilla and the anogenital skin are the most common sites of primary tumour. Apocrine malignancy carries high risk of lymphatic and vascular spreading to lung, liver and bone. A 40 years old painter, presents with diffuse swelling and pain in the left lower limb up to left inguinal region since 5 to 6 months. With generalised lymphadenopathy. On evaluation, revealed adenocarcinoma of apocrine, skin adnexa in the extremities of the limb with extensive distant metastasis. Apart from Dermatologists other board specialty consultant should be aware of the possibility of apocrine adenocarcinoma while differentiating cutaneous tumor located in the extremities. Apocrine malignancy should be treated aggressively with wide local excision or amputation the involved part for improving the life expectancy. Since prevalence of apocrine malignancy are rare, and it is associated with increased mortality, it provoke us the field of research for discovering other modalities of treatment.

Giant Sublingual Epidermoid Cyst

Epidermoid and dermoid cysts represent less than 0.01% of all oral cavity cysts. The cysts can be defined as epidermoid when the lining presents only epithelium, dermoid cysts when skin adnexa are found, and teratoid cysts when other tissue such as muscle, cartilage, and bone are present. In this article, we present a case of sublingual epidermoid cyst with a submental component in a 15 years old girl. She presented with complaints of a mass in the oral cavity, difficulty in speaking, dysphagia, progressive snoring during sleep, occasional shortness of breath and cosmetic problems for last 6 months. A mass displacing the tongue superiorly and posteriorly was noticed in oral cavity and a firm diffuse swelling was also noticed in the submental area, extending down to the thyroid notch. The differential diagnosis includes infectious process, ranula, lymphatic malformation, tumours etc. FNAC revealed preoperative diagnosis of an epidermoid cyst . Under general anesthesia a submental horizontal incision was made and the mass was excised completely. Histopathological examination of the mass confirmed diagnosis of an epidermoid cyst. DOI: http://dx.doi.org/10.3329/jbcps.v31i3.20984 J Bangladesh Coll Phys Surg 2013; 31: 159-161