Immunocompromised areas of the skin, caused by chronic lymphoedema, paraplegia, infections or traumas, represent a site of regional neuroimmunocutaneous destabilization, termed the immunocompromised cutaneous district (ICD), in which malignancies and other opportunistic disorders are more likely to occur. We report the case of a metastatic porocarcinoma (PC) occurring on a lymphoedematous limb in a 72-year-old man. We reviewed the literature to better understand the potential pathogenetic mechanisms behind this condition. It has been reported that removal of the leg vein destroys the medial group of the superficial lymphatic vessels and alters the normal lymph drainage of the leg, predisposing to recurrent cellulitis. Our observations suggest that saphenous venectomy can induce development of an ICD. We suggest that PC, a rare cutaneous tumour, should be included in the growing list of tumours arising in the ICD.

Journal Article Verrucous epidermal naevus and naevus spilus associated with lower limb asymmetry and right bundle‐branch block: a case of phacomatosis pigmentokeratotica? Get access A. Baroni, A. Baroni Deparment of Dermatology and Venereology, Second University of Naples, Naples, Italy Search for other works by this author on: Oxford Academic Google Scholar S. Staibano, S. Staibano Biomophological and Functional Sciences, Section of Anatomical Pathology, University Federico II of Naples, Naples, Italy E‐mail: adone.baroni@gmail.com Search for other works by this author on: Oxford Academic Google Scholar T. Russo, T. Russo Deparment of Dermatology and Venereology, Second University of Naples, Naples, Italy Search for other works by this author on: Oxford Academic Google Scholar V. Piccolo, V. Piccolo Deparment of Dermatology and Venereology, Second University of Naples, Naples, Italy Search for other works by this author on: Oxford Academic Google Scholar R. A. Satriano, R. A. Satriano Deparment of Dermatology and Venereology, Second University of Naples, Naples, Italy Search for other works by this author on: Oxford Academic Google Scholar A. Vozza, A. Vozza Deparment of Dermatology and Venereology, Second University of Naples, Naples, Italy Search for other works by this author on: Oxford Academic Google Scholar G. Vozza G. Vozza Deparment of Dermatology and Venereology, Second University of Naples, Naples, Italy Search for other works by this author on: Oxford Academic Google Scholar Clinical and Experimental Dermatology, Volume 37, Issue 1, 1 January 2012, Pages 74–75, https://doi.org/10.1111/j.1365-2230.2011.04134.x Published: 01 January 2012

AIM:Seborrheic dermatitis is a chronic inflammatory disease aggravated by Malassezia species. Toll-like receptors (TLR) are part of innate immune system that can be activated by yeasts. Previous studies showed that an association of Umbelliferae extract with a lipid (TLR2-Regul™) decreases the IL-8 expression in human skin in contact with M. furfur. The aim of this study was to assess the activity of a topical formulated with TLR2-Regul™ in the prevention of seborrheic dermatitis (SD) relapses.METHODS:Immune-competent SD adult patients were treated for SD (topical imidazoles or steroids). Cleared patients were randomized and received a topical containing TLR2-Regul™ (A) or its vehicle (B). Erythema, scales and pruritus were assessed during two months.RESULTS:The study included 115 patients, mean age 43.4, sex ratio m/f 1.5. At week 4 the relapse rate was 26% (N.=15) in group A and 43% (N.=25) in group B. At W8 the relapse rate was 21% (N.=12) in group A and 40% (N.=23) (P=0.0309).CONCLUSION:In this series of 115 adults with seborrheic dermatitis, patients treated with a topical containing TLR-Regul™ showed a significantly less relapse rate compared with the excipient group (P<0.05). TLR modulation could represent a new therapeutic approach in the prevention of seborrheic dermatitis relapses.

British Journal of DermatologyVolume 164, Issue 3 p. 673-675 Correspondence Coexistence of malignancy (skin cancer) and immune disorder (discoid lupus erythematosus) on a burn scar: a concrete example of ‘immunocompromised district’ A. Baroni, A. Baroni Department of Dermatology, Second University of Naples,via Sergio Pansini, 5, 80131 Naples, ItalySearch for more papers by this authorG. Brunetti, G. Brunetti Department of Dermatology, Second University of Naples,via Sergio Pansini, 5, 80131 Naples, ItalySearch for more papers by this authorE. Ruocco, E. Ruocco Department of Dermatology, Second University of Naples,via Sergio Pansini, 5, 80131 Naples, ItalySearch for more papers by this author A. Baroni, A. Baroni Department of Dermatology, Second University of Naples,via Sergio Pansini, 5, 80131 Naples, ItalySearch for more papers by this authorG. Brunetti, G. Brunetti Department of Dermatology, Second University of Naples,via Sergio Pansini, 5, 80131 Naples, ItalySearch for more papers by this authorE. Ruocco, E. Ruocco Department of Dermatology, Second University of Naples,via Sergio Pansini, 5, 80131 Naples, ItalySearch for more papers by this author First published: 09 December 2010 https://doi.org/10.1111/j.1365-2133.2010.10170.xCitations: 5 Giampiero Brunetti.E-mail: bgiampy@alice.it Funding sources: none. Conflicts of interest: none declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume164, Issue3March 2011Pages 673-675 RelatedInformation

Conflicts of interest: none declared. Madam, The immunocompromised district is a novel concept referring to a site in which there is an obstacle to the normal trafficking of immunocompetent cells through lymphatic channels, or an interference with the signals that the neuropeptides and neurotransmitters, released by peripheral nerves, send to cell membrane receptors of immunocompetent cells.1 While congenital and acquired immunodeficiencies represent the prototypes of generalized immunosuppression paving the way to systemic diseases, regional chronic lymphoedema, herpes‐infected sites and otherwise damaged areas are clear examples of locally immunocompromised cutaneous districts which are prone to developing circumscribed immunity‐related disorders (malignant tumours, opportunistic infections and immune disorders).1 Cutaneous regions that have been affected by chronic lymphoedema, herpes infection and traumas, such as areas that have undergone various physical injuries (ionizing or ultraviolet radiation, thermal burns, vaccinations), share one common feature: the propensity to harbour a secondary disease, which can appear after an extremely variable lapse of time (days, months, years, decades) on the altered site.2

Journal of the European Academy of Dermatology and VenereologyVolume 25, Issue 10 p. 1242-1242 LETTERS TO THE EDITOR The correct meaning of the term ‘immunocompromised’: a necessary explanation V. Ruocco, Corresponding Author V. Ruocco V. Ruocco. E-mail:[email protected]Search for more papers by this authorE. Ruocco, E. Ruocco Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Napoli, Naples, ItalySearch for more papers by this authorG. Brunetti, G. Brunetti Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Napoli, Naples, ItalySearch for more papers by this authorA. Baroni, A. Baroni Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Napoli, Naples, ItalySearch for more papers by this author V. Ruocco, Corresponding Author V. Ruocco V. Ruocco. E-mail:[email protected]Search for more papers by this authorE. Ruocco, E. Ruocco Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Napoli, Naples, ItalySearch for more papers by this authorG. Brunetti, G. Brunetti Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Napoli, Naples, ItalySearch for more papers by this authorA. Baroni, A. Baroni Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Napoli, Naples, ItalySearch for more papers by this author First published: 29 December 2010 https://doi.org/10.1111/j.1468-3083.2010.03955.xCitations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume25, Issue10October 2011Pages 1242-1242 RelatedInformation

Objectives:Melanoma cells take advantage of impaired ability to undergo programmed cell death in response to different external stimuli and chemotherapeutic drugs; this makes prevention of tumour progression very difficult. The aim of this study was to demonstrate whether 3-O-methylfunicone (OMF), a metabolite of Penicillium pinophilum, has the ability to arrest cell population growth and to induce apoptosis in A375P (parental) and A375M (metastasis derivatived) melanoma cell lines.Materials and methods:Cell proliferation and apoptosis were analysed by flow cytometry, DNA fragmentation, caspase-3 and caspase-9 activation, and PARP-1 cleavage.Results:We demonstrated that OMF affected cell proliferation in a time- and dose-dependent manner, reaching the best effect at concentration of 80 mu g/ml for 24 h. Flow cytometry revealed that OMF caused significant G(2) phase arrest, which was associated with marked decrease in cyclin B1/p34(cdc2) complex and p21 induction. OMF also induced marked decrease of survivin expression. Reduced levels of apoptosis were evident after silencing p21 expression in both cell lines. Finally, the effect exercised by OMF on hTERT and TEP-1 gene expression confirmed the ability of this molecule to interfere with replicative ability of cells.Conclusions:The results reported here seem to suggest that OMF as a promising molecule to include in strategies for treatment of melanoma.

Leishmaniasis is a human disease produced by a parasite of the Leishmania genus transmitted by prick of an infected female sandfly. The disease occurs clinically with either cutaneous, mucocutaneous or visceral form, depending on the infective species and the immune status of the patient. Antimonial drugs are the current treatment of choice for all clinical forms. We report a case of cutaneous Leishmaniasis in a young girl successfully treated with itraconazole.

We report a case of tinea capitis mimicking tufted hair folliculitis in a 56-year-old European man, who presented with a 4-year history of pain and erythema in an area of scarring alopecia of the occipital scalp, with scales and tufts of hair emerging from individual follicles. Histological examination showed hair plugging, and a dense perifollicular infiltrate of plasma cells, lymphocytes, and neutrophils. There was widespread scarring and fibrosis. Bacterial cultures were negative for Staphylococcus aureus, but fungal cultures and periodic-acid-Schiff stain were positive for Trichophyton tonsurans. Videodermatoscopy of the lesion showed a pattern consistent with folliculitis decalvans. Diagnosis was made on the basis of the clinical, histological, microbiological and videodermatoscopy data. After 30 days of systemic antifungal treatment, there were a substantial clinical improvement and disappearance of pain. After 5 months, a residual cicatricial area was seen with some hair tufts emerging from a single orifice.

P>Pemphigus erythematosus (Senear-Usher syndrome) is a variant of superficial pemphigus with features of both lupus erythematosus and pemphigus. It affects mainly middle-aged adults, and is rarely observed before the age of 20 years. The case of a 14-year-old boy who showed cutaneous lesions suggestive for pemphigus erythematosus is described. Not all laboratory and histopathological investigations confirmed the hypothesis, so a diagnosis of clinical pemphigus erythematosus was made. Systemic steroid therapy was effective in controlling the disease. This case is interesting because of the rare occurrence of pemphigus erythematosus in adolescence and the possibility of another drug being added to the list of pemphigus inducers.

Pemphigus is an autoimmune disease that results from the interaction between predisposing genetic factors and exogenous agents, mainly drugs and viruses. Herein we report the case of a 66-year-old woman referred to our department for the onset of painful oral erosions and bullous lesions on the torso. Clinical, laboratory and histopathological investigations led to the diagnosis of pemphigus vulgaris. Two weeks before the outbreak of the lesions, the patient had suffered from a viral pharyngitis, subsequently diagnosed as herpangina, and had been taking an oral cephalosporin (cefixime) for 1 week to prevent possible bacterial complications. A relationship between the onset of pemphigus and coxsackievirus infection or cefixime administration or both was supposed. The case may represent a peculiar paraviral eruption, where a predisposing pemphigus-prone genetic background paved the way for the acantholytic autoimmune disorder as a consequence of the combined effect of the coxsackievirus infection and the cephalosporin treatment.

During tissue regeneration and wound healing of the skin, migration, proliferation and differentiation of keratinocytes are important processes. Here we assessed the effect of a neuropeptide, bombesin, on keratinocytes during regeneration from scratch wounding. Bombesin purified from amphibian skin, is homologous of mammalian gastrin-releasing peptide and is active in mammals. Its pharmacological effects mediate various physiological activities: hypertensive action, stimulating action on gastric secretion, hyperglycemic effect or increased insulin secretion. In vitro it shows a hyperproliferative effect on different experimental models and is involved in skin repair. The aim of this study was to elucidate the effect of Bombesin in an in vitro experimental model on a mechanically injured human keratinocyte monolayer. We evaluated different mediators involved in wound repair such as IL-8, TGFbeta, IL-1, COX-2, VEGF and Toll-like receptors 2 and 4 (TLR2 and TLR4). We also studied the effects of bombesin on cell proliferation and motility and its direct effect on wound repair by observing the wound closure after mechanical injury. The involvement of the bombesin receptors neuromedin receptor (NMBR) and gastrin-releasing peptide receptor (GRP-R) was also evaluated. Our data suggest that bombesin may have an important role in skin repair by regulating the expression of healing markers. It enhanced the expression of IL-8, TGFbeta, COX-2 and VEGF. It also enhanced the expression of TLR2, while TLR4 was not expressed. Bombesin also increased cell growth and migration. In addition, we showed that NMBR was more involved in our experimental model compared to GRP-R.

Quinine sulfate (QS), the first antimalarial agent, was derived from the cinchona tree. At the beginning of the 1970s, researchers became interested in the antiviral properties of antimalarial drugs. Interestingly, antimalarials were recently found effective as additional therapy for AIDS and other viral diseases [ 1 Wolf R. Wolf D. Ruocco V. Antimalarials: unapproved uses or indications. Clin Dermatol. 2000; 18: 17-35 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar , 2 Paton N.I. Aboulhab J. Hydroxychloroquine, hydroxyurea and didanosine as initial therapy for HIV-infected patients with low viral load: safety, efficacy and resistance profile after 144 weeks. HIV Med. 2005; 6: 13-20 Crossref PubMed Scopus (45) Google Scholar ].

Stress-activated protein kinase (SAPK) cascades control a variety of cellular activities such as survival, differentiation and apoptosis. Recent studies have revealed that SAPKs play important roles in the regulation of homeostasis of skin. This report focuses on SAPK-mediated signal transduction and provides advanced findings on the physiological roles of SAPKs in skin.

Background As some of the many patients who receive antimalarials for the treatment of noninfective inflammatory diseases (lupus erythematosus, collagen vascular diseases, rheumatoid arthritis, and others) are also immunosuppressed because of their disease and/or treatments, and may have concomitant bacterial infections, we investigated the effect of these drugs on the growth and invasion of several bacteria that are commonly associated with skin and soft tissue infections to determine whether they could protect against such conditions and obviate the need for an additional antibiotic drug.Methods The effect of quinine sulfate (QS) at concentrations of 50 and 100 mu m on the entry process of Enterobacter agglomerans, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae into Caco-2 cells was studied during the infection period. The invasive efficiency was expressed as the number of viable internalized bacteria obtained by counting the colony-forming units (CFUs).Results The invasive ability of E. agglomerans and S. aureus was significantly inhibited by 50 and 100 mu m QS in a dose-dependent manner when the drug was added to Caco-2 cell monolayers during the infection period; however, QS had no significant effect on the internalization of P. aeruginosa or K. pneumoniae.Discussion and conclusions Antimalarial drugs are currently widely used to treat patients with autoimmune dermatologic and rheumatologic diseases, and have also been recently proposed as additional therapy for patients with human immunodeficiency virus (HIV) infection. These patients, who are often immunocompromised, may receive a secondary advantage from these antimalarials, which may provide some protection against staphylococci (amongst the most important human pathogens causing many superficial and systemic infections) and E. agglomerans.

Previous studies showed that long-wave ultraviolet (UVA) radiation induces severe skin damage through the generation of reactive oxygen species and the depletion of endogenous antioxidant systems. Recent results from our laboratory indicate a dramatic increase of both lipid peroxidation products (TBARS) and abnormal L-isoaspartyl residues, marker of protein damage, in UVA-irradiated human melanoma cells. In this study, the effects of hydroxytyrosol (DOPET), the major antioxidant compound present in olive oil, on UVA-induced cell damages, have been investigated, using a human melanoma cell line (M14) as a model system. In UVA-irradiated M14 cells, a protective effect of DOPET in preventing the uprise of typical markers of oxidative stress, such as TBARS and 2'7'-dichlorofluorescein (DCF) fluorescence intensity, was observed. In addition, DOPET prevents the increase of altered L-isoAsp residues induced by UVA irradiation. These protective effects are dose dependent, reaching the maximum at 400 microM DOPET. At higher concentrations, DOPET causes an arrest of M14 cell proliferation and acts as a proapoptotic stimulus by activating caspase-3 activity. In the investigated model system, DOPET is quantitatively converted into its methylated derivative, endowed with a radical scavenging ability comparable to that of its parent compound. These findings are in line with the hypothesis that the oxidative stress plays a major role in mediating the UVA-induced protein damage. Results suggest that DOPET may exerts differential effects on melanoma cells according to the dose employed and this must always be taken into account when olive oil-derived large consumer products, including cosmetics and functional foods, are employed.