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Introduction. Rosai-Dorfman disease is a benign condition, characterized by self limiting proliferation of non-Langerhans histiocytes inside lymph nodes but also in extranodal areas. Clinical case. A 54-year-old patient, diagnosed with arterial hypertension since 2011, is hospitalised in the Dermatology Department of the Emergency County Hospital, Craiova, Romania, in March 2016, for a polymorphous rash composed of violet-erythematous papulonodules with sizes ranging between 0.2 cm and 2 cm, slightly itchy, located in the latero-thoracic region, lumbar region and in the area around the menton area. The lesions appeared 18 months prior to hospitalization. Clinical and paraclinical investigations as well as interdisciplinary consultations revealed no associated pathologies. Histopathological and immunohistochemical examinations confirmed the diagnostic of cutaneous Rosai-Dorfman disease, imaging investigations excluding other localizations. Treatment with Doxycycline, in combination with 20 mg of Rutoside and 50 mg of ascorbic acid, Pentoxifylline and Levocetirizine resulted in remission of the skin lesions. Discussion. Rosai-Dorfman disease is a rare condition, having a reported incidence rate of 1:200.000. It generally affects males, being more frequent in young males and people of African descent. The pathogenesis of Rosai-Dorfman disease is still not fully understood, although immunological and infectious factors may play an important role. Foucar has divided this condition into three types: nodal, extranodal and mixed. Cutaneous lesions have been described in 3% of cases of Rosai-Dorfman disease of the extranodal type. It is more frequent in females (sex ratio of 2/1) and in adults of Asian descent, with a mean age at onset of 45 years. Treatment options include: oral and intralesional corticosteroids, alfa-interferon, retinoids, dapsone, methotrexate, thalidomide, cryo- and radiotherapy.Conclusions. The presented case is an atypical one because of the three locations of the skin lesions. Although we obtained remission of the disease, the patient would remain in direct observation because of the risk of recurrence. [ABSTRACT FROM AUTHOR]

Non-steroidal anti-inflammatory drugs (NSAIDs) showed effects in some hyperproliferative dermatologic pathologies. The aim of the study is the assessment of anti-psoriasis effect of diclofenac and celecoxib using a mice tail model. The topical application of substances on the proximal mice tails was performed for two weeks. The effects on the epidermal granular layer and mean epidermal thickness (excluding the stratum corneum) were evaluated using hematoxylin–eosin staining. Orthokeratosis degree and percentual drug activity were calculated. A positive control group treated with tretinoin and two negative controls (white soft paraffin and untreated mice) were used. Orthokeratosis degree significantly increased in all the NSAIDs groups (celecoxib 1%, 2% and diclofenac 1%, 2%) and in the tretinoin 0.05% group, versus negative controls. Celecoxib 1% and 2%, tretinoin 0.05% and white soft paraffin significantly increased mean epidermal thickness, versus untreated mice. The values obtained in the case of celecoxib 2% ointment regarding the orthokeratosis degree and percentual drug activity are providing premises for further investigations regarding this effect and the mechanisms of action involved. Celecoxib 2% had the greatest percentual drug activity and is a promising substance for the anti-psoriasis topical treatment. Along with the COX-2 inhibition, celecoxib might have an anti-psoriasis effect by other independent mechanisms. [ABSTRACT FROM AUTHOR]

THE clinical presentation of cutaneous toxicities associated with anticancer therapies is common and polymorphic. The decision to continue the treatment is made with the interdisciplinary cooperation between oncologist and dermatologist, who take into account the severity of these side effects, particularly their impact on the vital prognosis. We present two patients with papulopustular follicular eruption during treatment with cetuximab, which did not require cessation of this drug. Laboratory fi ndings were normal. The histopathological samples from these two cases confi rmed the diagnosis of follicular papulopustular eruption. For the assessment of severity and the effectiveness of treatment we used WoMo Score. After systemic antibiotic therapy with Azithromycin and, Cefi xime respectively, combined with application of an anti-infl ammatory mixture, the evolution was favorable, without Cetuximab discontinuation. Daily sunscreen was prescribed at hospital discharge for both patients. Follicular papulopustular eruption is a common side effect of molecularly targeted therapy with Cetuximab, which often does not require discontinuation of this treatment. [ABSTRACT FROM AUTHOR]

Introduction: Worldwide increased consumption of pharmaceuticals products have led to the registration of more and more iatrogenic reactions, 50% of these being cutaneous. Amiodarone-induced skin pigmentation is frequently found in dermatology, with an incidence of 75%, mostly being revealed by photosensitivity and hyperpigmentation. In most cases, these symptoms are reversible, disappearing when the treatment is stopped; the vital prognosis is not affected, though there is a high impact on the patient's quality of life. Patients and Method: We report two patients who presented with blue-gray hyperpigmentation of the face, without other symptoms. We performed clinical examination along with serum biochemical tests and histopathological examination for both patients. Results: The patients' history revealed amiodarone administration for cardiovascular conditions, in both cases, for approximately four years. Laboratory exams were normal. Histopathological exams confirmed the diagnosis of amiodarone-induced skin pigmentation in both cases. Daily sunscreen and local depigmentation treatment was prescribed at hospital discharge for both patients. Amiodarone was replaced with another antiarrhythmic agent. In a follow-up visit two months later, the blue-gray facial hyperpigmentation had faded significantly in both cases. Conclusions: These cases correspond clinically and histologically with typical amiodarone-induced skin pigmentation, which occurred after 48 months of continuous therapy and a cumulative dose of 584 g for the first case, respectively 48 months and a cumulative dose of 365 g for the second case. Amiodarone-induced toxidermia may cause severe aesthetic problems and it may also increase the occurrence of other diseases in the context of skin aging. [ABSTRACT FROM AUTHOR]

The tumor microcirculation is characterized by an abnormal vascular network with dilated, tortuous and saccular vessels. Therefore, imaging the tumor vasculature and determining its morphometric characteristics represent a critical goal for optimizing the cancer treatment that targets the blood vessels (i.e. antiangiogenesis therapy). The aim of this study was to evaluate new vascular morphometric parameters in colorectal cancer, difficult to achieve through conventional immunohistochemistry, by using the confocal laser endomicroscopy method. Fresh biopsies from tumor and normal tissue were collected during colonoscopy from five patients with T3 colorectal carcinoma without metastasis and were marked with fluorescently labeled anti-CD31 antibodies. A series of optical slices spanning 250 µm inside the tissue were immediately collected for each sample using a confocal laser endomicroscope. All measurements were expressed as the mean ± standard error. The mean diameter of tumor vessels was significantly larger than the normal vessels (9.46±0.4 µm vs. 7.60±0.3 µm, p = 0.0166). The vessel density was also significantly higher in the cancer vs. normal tissue samples (5541.05±262.81 vs. 3755.79±194.96 vessels/mm3, p = 0.0006). These results were confirmed by immunohistochemistry. In addition, the tortuosity index and vessel lengths were not significantly different (1.05±0.016 and 28.30±3.27 µm in normal tissue, vs. 1.07±0.008 and 26.49±3.18 µm in tumor tissue respectively, p = 0.5357 and p = 0.7033). The daughter/mother ratio (ratio of the sum of the squares of daughter vessel radii over the square of the mother vessel radius) was 1.15±0.09 in normal tissue, and 1.21±0.08 in tumor tissue (p = 0.6531). The confocal laser endomicroscopy is feasible for measuring more vascular parameters from fresh tumor biopsies than conventional immunohistochemistry alone. Provided new contrast agents will be clinically available, future in vivo use of CLE could lead to identification of novel biomarkers based on the morphometric characteristics of tumor vasculature. [ABSTRACT FROM AUTHOR]