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Yunyan Zheng,1,* Weiwei Shi,1,2,* Huiying Wang,1 Ruzhi Zhang3 1Department of Dermatology, The Third Affiliated Hospital of Soochow University, Changzhou, People’s Republic of China; 2Department of Dermatology, Affiliated Hospital 2 of Nantong University, Nantong, People’s Republic of China; 3Department of Dermatology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ruzhi Zhang, Department of Dermatology, The Second Affiliated Hospital of Wannan Medical College, 10 Kangfu Road, Wuhu, 241000, People’s Republic of China, Email zhangruzhi628@163.comPurpose: This study aimed to improve the understanding of sporotrichosis by analyzing the epidemiological characteristics, clinical manifestations, mycological features, and pathological characteristics of the disease in eastern China.Methods: Clinical data of 49 patients diagnosed with cutaneous sporotrichosis in dermatology clinics over a 20-year period were collected and analyzed retrospectively. The analysis included patient demographics, occupations, clinical types, lesion sites, misdiagnosis rates, laboratory investigations, treatment and outcomes.Results: The study included 22 male and 27 female patients, with a mean age of 52.4 years. Farmers (42.86%) and manual workers (28.57%) had a higher risk of infection. The most common clinical types were lymphocutaneous (30.61%) and fixed (69.39%), predominantly affecting the face and upper limbs. Misdiagnosis as other infectious skin diseases occurred in 35 patients (71.43%). Fungal culture and histopathological examination were important diagnostic tools. Treatment with oral itraconazole for three months led to relief and regression of the skin lesions in most patients, although a few experienced recurrences.Conclusion: Cutaneous sporotrichosis mainly affects individuals working in agriculture and manual labour, with lymphocutaneous and fixed types being the predominant clinical manifestations. The high misdiagnosis rate emphasizes the importance of early recognition, accurate diagnosis and standardized treatment for the prognosis and cure of sporotrichosis. Fungal culture and histopathological examination are essential for diagnosis, and oral itraconazole is an effective treatment option.Keywords: sporotrichosis, cutaneous form, clinical analysis, epidemiology, misdiagnosis

Objectives To characterize patients with positive anti-topoisomerase I (ATA) in lcSSc. Methods SSc patients enrolled in the EUSTAR cohort with a disease duration of ≤3 years at database entry were considered. We assessed the risk of major organ involvement in the following groups: ATA-lcSSc vs ACA-lcSSc and vs ANA without specificity (ANA)-lcSSc, and ATA-lcSSc vs ATA-dcSSc. Cox regression models with time-dependent covariates were performed with the following outcomes: new-onset interstitial lung disease (ILD), ILD progression [forced vital capacity (FVC) decline ≥10% and ≥5% vs values at ILD diagnosis), primary myocardial involvement (PMI), pulmonary hypertension (PH), any organ involvement and all-cause mortality. Results We included 1252 patients [194 ATA-lcSSc (15.5%)], with 7.7 years (s. d. 3.5) of follow-up. ILD risk was higher in ATA-lcSSc vs ACA- and ANA-lcSSc and similar to ATA-dcSSc, although with less frequent restrictive lung disease. The risk of FVC decline ≥10% (35% of ATA-lcSSc) was lower in ATA-lcSSc than in ATA-dcSSc, whereas FVC decline ≥5% occurs similarly between ATA-lcSSc (58% of patients) and other SSc subsets, including ATA-dcSSc. The risk of PMI was similar in ATA-lcSSc and ANA-lcSSc but lower than in ACA-lcSSc; no difference in PH and mortality risk was observed among lcSSc subsets. The risk of any organ involvement, PMI and PH was lower and the mortality tended to be lower in ATA-lcSSc vs ATA-dcSSc. Conclusion ATA-lcSSc patients have a high risk of ILD, albeit with a lower risk of progression compared with ATA-dcSSc, supporting careful screening for ILD in this subgroup. [ABSTRACT FROM AUTHOR]

An extremely rare case of sinus histiocytosis of the non-Langerhans cell histiocytoses type is described in 55-year-old patient with isolated localization of cutanious lesion on the right cheek without involvement of nodular structures. Main skin lesion was an erythematous-cyanotic node with multiple milia-like lesions on the top of it. Histologically revealed feature was a large number of plasma cells, besides phenomenon of emperipolesis was described, which was first falsely perceived by pathologists as phagocytosis. In immu-nohistochemistry assay the changes were characterized by proliferation of large polygonal histiocytes with accumulation of pentalamellar markers in its cytoplasm (protein S-100, CD68).

Fibrosis is a pathological manifestation in which connective tissue replaces normal one. It can affect many tissues from the skin to internal organs such as the lungs. Manifestations of pulmonary involvement can be pulmonary arterial hypertension or pulmonary fibrosis. The latter one is currently the leading cause of death in various autoimmune diseases, including systemic sclerosis. Our study group consists of 50 patients with systemic sclerosis: 24 with limited cutaneous form and 26 with diffuse cutaneous form. This cohort was compared to 50 healthy controls (age and sex matched); our aim is to explore the distribution of TH17 cells (TH17) as well as regulatory T cells (TREG) and study their correlation with the disease's progress. Our results show an increase for IL17A in patients compared to controls and that this increase is correlated with a specific clinical involvement: Pulmonary fibrosis. This correlation suggests a crucial role of IL17A in fibrosis especially in systemic sclerosis. In addition, we have shown that the percentages of TH17 cells are higher in patients; however, the percentages of TREG cells are similar between patients and controls. A study of TREG cell activity showed that TREG lost suppressive activity by inactivating the FOXP3 transcription factor. This proves that despite their presence, TREG does not adequately carry out their regulatory activity. Finally, we analyzed the correlation between TH17/TREG and clinical damage; the results show a positive correlation with pulmonary involvement proving the role of TH17/TREG balance in induced fibrosis in systemic sclerosis. No significative difference was observed, for all the parameters, between the two different forms of the disease. In conclusion, the results associated with the TH17/TREG scale and their correlations with fibrosis in systemic sclerosis open a way for new tools to manage this autoimmune disease, which up to today has neither treatment nor accurate diagnosis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Hemangiosarcoma is a type of malignant vascular tumour that commonly affects the canines and has a very poor prognosis. Five dogs affected with cutaneous hemangiosarcoma were presented to Referral Veterinary Polyclinic, Indian Veterinary Research Institute, Izatnagar, over a 6-month period. All of the cases were subjected to thoracic radiography and intra-abdominal ultrasonography to rule out metastasis. The tumour mass was surgically excised in all the five animals. The cases were diagnosed as hemangiosarcoma on the basis of histopathology and immunohistochemistry. Two of the animals received chemotherapy using either vincristine or doxorubicin after surgical excision. The post-operative survival period was found to be slightly higher in the cases that received combined surgical excision and chemotherapy. The main aim of managing such cases should be to prolong the life of the animal by combining various treatment modalities like surgical excision, chemotherapy, immunotherapy and radiation therapy. This paper concludes that the combined use of surgical excision and chemotherapy can be superior to surgical excision alone in prolonging the life of dogs suffering from a cutaneous form of hemangiosarcoma. [ABSTRACT FROM AUTHOR]

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]

The authors describe case of a 67-year-old woman, who successively developed asymptomatic brownish cutaneous nodules during a two year period. Histological examination disclosed a Rosai-Dorfman disease, while an thorough examination ruled out other organ involvement. Total excision of lesions was an effective treatment. The article mentions a recent literature review on cutaneous variant of a Rosai-Dorfman disease. [ABSTRACT FROM AUTHOR]

A case of the disease in the skin form of anthrax which was held with discrete toksoinfektsionnym syndrome, but with characteristic skin manifestations, etiology, and ended proven recovery.

Abstract: The authors report the clinical history of a patient having presented a cutaneous mucormycosis at the waning of a traumatic dilapidation post of the left lower limb. Mucormycosis is an opportunist fungic infection due to mushrooms of the group of the mucorales present in the environment. There are various clinical forms of the disease; it occurs in general on a defective predisposed ground. The diagnosis rests on the mycologic and anatomopathologic examination. The therapeutic approach must be multidisciplinary; on the precocity of the treatment depends the vital and functional forecast. [Copyright &y& Elsevier]

We describe familial cases of cutaneous infection caused by Mycobacterium avium. A 45-year-old father, his 14-year-old son and 11-year-old daughter, among five persons in a family, presented with a 2-month history of inflammatory subcutaneous nodules and ulcerations. Histology of skin biopsy specimens showed granulomatous inflammation, and mycobacterial colonies isolated from the skin of each patient were identified as M. avium by DNA hybridization analysis. The patients were all treated successfully with combined drug therapy consisting of rifampicin, isoniazid and clarithromycin. Their lesions were purely cutaneous M. avium infection, without any visceral involvement. Neither systemic disease nor immunological impairment was detected in the family. However, they all used a circulating, constantly heated bath water system. The bath water was continuously heated to about 40 °C without changing the water for a few months, and M. avium was isolated from the filter of the bath tub heating unit. It is considered that this unusual familial cluster of cutaneous M. avium infection in healthy persons may have resulted from the use of contaminated bath water. [ABSTRACT FROM AUTHOR]

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