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M Rotoli

Publications and source records attributed to M Rotoli.

At least 19 recordsLinked to original sources

A case of Sweet's syndrome associated with monoclonal immunoglobulin of IgG-lambada type and p-ANCA positivity.

We report a case of Sweet's syndrome associated with monoclonal gammopathy of uncertain significance (MGUS) and positivity for perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). A 65-year-old man patient came to our hospital complaining of remittent-intermittent fever, weight loss, associated with papules affecting all his body and without mucosal or ocular involvement. Histology of biopsy specimens of papules allowed the diagnosis of Sweet's syndrome. This is the first case of this rare syndrome associated both with MGUS and p-ANCA positivity. The monoclonal immunoglobulin, possibly directed to neutrophils like an antibody, may cause both their fragmentation and release of antigens responsible of p-ANCA appearance.

Aged↗

Non-Herlitz junctional epidermolysis bullosa without hair involvement associated with BP180 deficiency.

Junctional epidermolysis bullosa (JEB) is a clinically and genetically heterogeneous recessively inherited blistering disease of the skin and mucous membranes due to impaired epithelial adhesion. In particular, defective expression of the 180-kD bullous pemphigoid antigen (BP180) has been correlated to a non-lethal (non-Herlitz) form of JEB, generalized atrophic benign epidermolysis bullosa (GABEB), characterized by widespread skin blistering healing with atrophy and by atrophic alopecia with onset in childhood. We report the case of a 33-year-old man suffering from a generalized blistering skin disorder since birth. He also presented nail dystrophy and tooth abnormalities. Mucosal involvement was limited to gingival erosion. Alopecia was absent and body, axillary and pubic hair were normal. Immunofluorescence analysis showed a markedly reduced expression of BP180, electron microscopy studies evidenced hypoplastic hemidesmosomes and Northern blot analysis confirmed a striking decrease in the amount of BP180 mRNA. The clinical features of our patient confirm that BP180 deficiency usually results in a non-Herlitz JEB form. However, the degree of skin, mucous membranes and hair involvement appears more variable and less typical than originally described for GABEB.

Adult↗

Multiple squamous cell carcinomas of the skin during long-term treatment with hydroxyurea.

Hydroxyurea is a chemotherapeutic agent used extensively for myeloproliferative disorders. Cutaneous side effects have been described during long-term hydroxyurea treatment. We described the occurrence of multiple squamous cell skin carcinomas in a patient treated with hydroxyurea for chronic myelogenous leukemia. The lesions were removed and the hematological therapy switched to busulfan. In a previously reported case, the development of cutaneous epithelial cancers required the discontinuation of hydroxyurea, in addition to the surgical excision of the neoplastic lesions. Since squamous cell carcinoma is a malignant cutaneous neoplasm that can metastatize, the surveillance of skin changes is advisable during hydroxyurea treatment.

Aged↗

Anaplastic progression of classic Kaposi's sarcoma.

We describe a case of classic Kaposi's sarcoma (KS) in an Italian HIV-negative patient, with bone involvement and progression to anaplastic histotype. At the age of 22, violaceous patches of KS appeared on his feet. At the age of 50, he noted the appearance of a violaceous firm nodule on his right wrist. The lesions grew rapidly and became ulcerated. Radiotherapy led to a complete remission of symptoms. At the age of 55, a subcutaneous nodule developed on the proximal third of the right forearm associated with a wide painful edema of the right forearm and the proximal third of the right arm. The nodule enlarged rapidly, and an X-ray of the right forearm revealed the presence of a large osteolytic area of the ulna. A biopsy specimen from the right ulna showed bone erosion by a mesenchymal neoplasia with a high degree of malignancy. The right arm was amputated, and histologic examination of the surgical material confirmed the diagnosis of undifferentiated spindle-cell malignant neoplasia strongly positive for factor-VII-related antigen and CD34 antigen. Three years after surgical treatment, no recurrences have been observed.

Adult↗

[Huangdi Neijing: a classic book of traditional Chinese medicine].

According to the data of the recent archaeological excavations, the history of traditional Chinese medicine begins in the neolithic period (10,000-4,000 years ago). The fundamental principles of the traditional Chinese medicine may be interpreted on the basis of two classic theories of Chinese thought: the Yin-Yang theory and the five phases theory. The former stated that our reality is the product of the continuous interaction and transformation of the Yin and Yang principles. The latter recognise the existence of five emblematic groups in which everything regarding humankind and nature may be classified. The five phases interact in two different ways: the cycle of production (Sheng) and the cycle of control (Ke). Theoretical basis of traditional Chinese medicine are described on the Huangdi Neijing (The Book of Yellow Emperor's: a classic of internal medicine) written during the period 475-225 b.C. as a dialogue between the mythical Emperor Huangdi and his physician Qibo. The book is divided into two parts: the Suwen (Questions about living matter) and Lingshu (The vital axe). Each part is composed of 81 sections. In this book are set correspondences between phases and organs, viscera, feelings, body fluids, flavours, foods, colours, and so on. We can also find the description of blood (Xue) and energy (Qi) circulation and the pathways of main, collateral and curious vessels. The origins of disease are also reported on the Huangdi Neijing. As regards the psychological point of view, special attention is dedicated to dreams and their possible causes and to the description of various kind of mental illness. The unknown Authors underline the five defects and the four mistakes of the physician, pointing out the importance to avoid them. Finally, it must be mentioned their special care to the principles of preventive medicine.

History, Ancient↗

[Eosinophilic pustular folliculitis and Ofuji disease. A case report].

We describe the case of a young man of Calabrian origin, who came to our observation for the appearance of erythematous pustular, intensely itching, lesions on the arms, trunk and, in a less extent, on the face. The blood count revealed a differential cell count of 16.8% eosinophils. Serum IgE levels were elevated (1000 IU/ml), and T cell subsets showed an increase in CD8+ and a decrease in CD4+ with an inversion of CD4+/CD8+ ratio (= 0.78). The result of the following investigations were either normal or negative: anti-(ds)DNA antibody, anti-nuclear antibody, anti-smooth muscle antibody, anti-striated muscle antibody, serological tests for viral, bacterial, fungal and parasitic diseases and cultural examination of the material from lesion. Histopathological examination of a biopsy specimen from the left arm showed the presence of abundant perivascular inflammatory infiltrate in the dermis and inflammatory infiltrate, with numerous eosinophils, around sebaceous glands. Taken together, all these data suggest the diagnosis of eosinophilic pustular folliculitis, a dermatosis of unknown etiology, with a histopathological picture identical to Ofuji's disease. Eosinophilic pustular folliculitis can be associated with HIV infection or haematological diseases (as non-Hodgkin lymphomas, myeloma, etc.); it was also reported in adult immunocompetent healthy individuals and in children. On the basis of our findings, we propose that this case should be classified as an idiopathic form, as we were not able to demonstrate any associated disease.

Adult↗

[Cutaneous tuberculosis: a case of difficult classification].

We describe a case of cutaneous tuberculosis in a 25-year-old Philippine man. Erythematous papulo-nodular lesions, measuring 0.5 to 1 cm, were present on lower limbs; a 2 cm nodule was located on the left flank. The examination of the skin biopsy showed the presence of a superficial and deep perivascular dermatitis with histiocytes, lymphocytes and plasma cells. Ziehl-Nielsen stain for mycobacterium were negative, while the cultural examination led to the isolation of M. tuberculosis. Direct smear and cultural examination of sputum for M. tuberculosis were negative; chest and skeletal roentgenograms, syphilis and HIV infection serology, haematological and hematochemical examinations and urinalysis were negative. Specific treatment with isoniazid, rifampin and ofloxacin led to a rapid remission of cutaneous lesions. This case was particularly difficult to classify, but the Authors think it would be considered a tuberculid.

Adult↗

[Skin manifestations in 140 kidney transplants].

Cutaneous lesions can be a significant problem in kidney transplant recipients. The AA report a clinical spectrum of iatrogenic, infectious, preneoplastic and neoplastic skin diseases in 140 renal transplant recipients observed, from march 1988 to july 1991, at the Catholic University in Rome. Iatrogenic skin manifestations were the most common, followed by infections of the skin and preneoplastic and neoplastic cutaneous lesions.

Adult↗

Apparent isolated skin relapse in acute monocytic leukemia. A case report.

A case of acute monocytic leukemia with an apparent isolated skin relapse is reported. The cutaneous involvement was associated with a morphological bone marrow remission but a cytogenetic relapse was present. Regression of the skin lesions was obtained with a protocol including daunoblastine, aracytin and thioguanine, but the patient relapsed and died a few months later without achieving another remission. The relation between cutaneous and medullary disease is discussed.

Adult↗