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Biomedical subjects

V Brazzelli

Publications and source records attributed to V Brazzelli.

16 recordsLinked to original sources

The role of the intercellular matrix in dermal calcinosis of the CRST syndrome. An electron-microscopic study.

We performed an electron-microscopic study on calcium deposits in two patients with calcifying scleroderma (CRST syndrome). Calcium deposits were detected both intracellularly in the mitochondria of phagocytic cells and extracellularly. Needle-like crystals measuring up to 4,500 A in length and approximately 60 A in width were present in both the Von Kossa-positive regions and the apparently normal dermal areas around the calcification sites. Although the fibrillar matrix's ultrastructure was normal, hollow oxytalan fibrils were detected. Slightly electron-opaque, star-shaped material was observed among the fibrillar component of the matrix (matrix granules), which is the ultrastructural expression of some types of proteoglycans containing keratan sulphate and chondroitin sulphate. These granules cannot be detected in normal dermis. The extrafibrillary calcium deposits on these mucopolysaccharide structures may represent an early event in the complex pathogenesis of calcification in the CRST syndrome.

Actin Cytoskeleton

Bullous lesions in acrodermatitis enteropathica. Histopathologic findings regarding two patients.

Acrodermatitis enteropathica (AE) is an autosomic recessive disorder affecting early infancy. Two cases of infantile AE with low plasma zinc levels are reported in which unusually prominent bullous and vesicobullous lesions were seen on the hands and feet, in addition to the more typical erythematous and scaly patches. Both psoriasiform and bullous lesions responded dramatically to oral zinc-sulfate supplementation. The histopathologic features of the bullous lesions of AE have not previously been fully examined. Histologically, the bullous lesions were characterized by intraepidermal vacuolar changes with massive ballooning, leading to intraepidermal vesiculation and blistering, with prominent epidermal necrosis and with no acantholysis. The bullous lesions did not arise on erythematous patchy lesions, but developed ex novo on unaffected skin. The histopathologic differential diagnosis with other bullous conditions is discussed.

Acrodermatitis

Prevalence of dermatophytes and yeasts (Candida spp., Malassezia furfur) in HIV patients. A study of former drug addicts.

The prevalence of dermatophytes and yeasts (Candida spp. and Pityrosporum spp.) was studied in 40 former drug-addicts, all of whom were HIV seropositive but otherwise had no other symptoms (2nd Stage CDC Atlanta, 1987). We considered 7 skin areas for dermatophytes and Pityrosporum spp. (scalp, forehead, nose, back, chest, groin, toe webs) and the mouth for yeasts. Dermatophytes were found in 8 (20%) and tinea pedis was the most common dermatophytosis: Tricophyton rubrum was the fungus most frequently isolated (6 cases or 15%). The HIV+ group showed almost the same rate of dermatophytes colonisation compared to a group of 121 athletes and to the control group. Candida spp. was present in 27 cases (67.5%) but clinical oral lesions were evident only in 5 patients (12.5%). Statistically significant differences were found in the presence of Candida spp. in HIV patients and controls (p less than 0.05). The lipophilic yeast Pityrosporum ovale was evaluated with quantitative and qualitative methods. Quantitative variations were evident between HIV patients and controls. P. ovale was present in 10 cases: 3 (7.5%) of them showed dischromic lesions while in 7 cases (17.5%) no clinical symptoms were evident.

Adult

Paederus fuscipes dermatitis. A histopathological study.

Paederus fuscipes (PF) dermatitis is a self-healing blistering disorder of the skin caused by a small insect belonging to genus Paederus, family Staphylinidae, order Coleoptera. Crushing PF on the skin causes acute dermatitis within 24 hours, corresponding in shape and dimensions to the area affected by the substance released (pederin). The acute vesicular lesions become crusted and scaly within a few days and heal completely in 10-12 days, with a transitory postinflammatory hypercromic patch. Twenty consecutive cases of PF dermatitis at different stages were studied histologically by routine light microscopy. The pederin causes a spectrum of histopathologic changes ranging from acute epidermal necrosis and blistering in acute stages, to marked acanthosis with mitotic figures in the late stages. PF dermatitis is an entomological model of irritant contact dermatitis, having histopathologic features of intraepidermal and subepidermal blistering, epidermal necrosis and acantholysis. The presence of some acantholytic foci, relatively far from the foci of clinically involved skin, in four of the cases considered suggests a possible role of pederin in inducing acantholysis indirectly. Acantholysis is probably caused by the release of epidermal proteases.

Animals

Lymphopenia and decrease in the total number of circulating CD3+ and CD4+ T cells during 'long-term' PUVA treatment for psoriasis.

The relationship between high-dose PUVA treatment in psoriatic patients and peripheral T lymphocyte subsets (total number and percentage) has been studied. Of the two groups of patients considered, the first included 19 patients, all affected by chronic, progressively worsening psoriasis; they had never been previously treated by photochemotherapy. The second group included 13 psoriatic patients, who had received an average cumulative dose of 2,007.69 +/- 1,191.05 J/cm2. The 'long-term' PUVA-treated group was assessed while undergoing maintenance therapy. No significant differences were found between untreated patients and healthy controls for any of the parameters considered. A significant reduction (p less than 0.05) in the total number of lymphocytes in long-term PUVA-treated patients both versus untreated patients and controls was found. Furthermore, long-term PUVA-treated patients showed a significant reduction (p less than 0.05) in the percentage of lymphocytes as compared with controls. The reduction in the total number of CD3+ and CD4+ T cells was, moreover, significant (p less than 0.05) as compared with untreated patients. The impairment of circulating CD3+ and CD4+ T cells (total number) was only on the borderline of statistical significance vis-à-vis controls. These findings suggest the usefulness of a careful assessment of circulating T lymphocyte subsets in patients who undergo long-term PUVA therapy.

Adult

[Amiodarone-induced pigmentation. A histological, ultrastructural study and review of the literature].

Amiodarone is an iodinated cardiac antiarrhythmic drug that causes a slate- gray discoloration of sun-exposed skin. Histopathologically, biopsy specimens of two patients affected by amiodarone pigmentations reveal yellow-brown granules in the reticular dermis, both in the cytoplasm of macrophages and between the collagen bundles. The histochemical stainings of the granules suggest that a lipofuscin pigment rather than melanin is present in the granules. Electron microscopy displays distinctive intracytoplasmic inclusions in many dermal cell types. Six morphologic types can be seen: 1) electron-lucent, membrane bound granules, 2) granules with electron dense nucleus, 3) lamellar "myelin-like" granules, 4) granules with a combination of electron-dense and electron-lucent areas, 5) electron-dense membrane-bound granules, 6) electron-dense no-membrane granules. The different dimensions, structure and shape are related to the structural and aggregational phases of the granules. In particular their pathogenesis may be related to the action of the drug on cell membranes with thesaurismosis, local metabolic damage, accumulation of the drug in the lysosomes and acceleration of the physiological ageing cell process.

Aged

[Early and late histologic aspects of atrophodermia vermiculata. A case study].

Atrophoderma Vermiculatum (AV) is a rare disease characterized by the occurrence on the face and the cheeks in particular, of fine, atrophic pits, with a bilateral distribution, producing a honeycomb, reticulate appearance. All the cases reported in the literature focus on the atrophic changes of the disease while no attention has been paid to the condition which causes atrophy. The early stages are not usually reported. MC is a girl aged 13. She had multiple, fine, pale-brown papules (1-2 mm in diameter) on her right cheek. The histopathological findings of these lesions predominantly showed lymphocytic perifolliculitis with perifollicular fibrosis. The epidermis was normal. No specific diagnosis other than perifolliculitis was possible. Eight months later the patient showed tiny, atrophic depressions and follicular plugs with reticulate teleangectases in the same area of the right cheek (with disappearance of the tiny papules). A clinical diagnosis of AV was done. The histological findings of a further biopsy showed atrophy of the epidermis, less severe perifollicular inflammation and decrease in number of the follicles. The hair follicles were widely dilated and were either empty or contained keratinous materials. Dermal atrophy and disappearance of elastic fibers was noticeable. In conclusion the late clinical features of the lesions, through unusual (asymmetry of the lesion, small and superficial atrophic scars), make the diagnosis of the early clinical and histological features of papules and perifolliculitis possible and suggest a specific name: early stages of AV.

Adolescent

Familial steatocystoma multiplex: HLA, Gm, Km genotyping and chromosomal analysis in two unrelated families.

Steatocystoma Multiplex (S.M.) is an inherited condition characterized by the appearance of cysts during the first or second decade of life. Familial cases have occasionally been reported. We studied 13 patients affected by S.M. from two unrelated families, focusing our attention on HLA, Gm and Km genotypes and on chromosomal analyses. Although we failed to correlate the syndrome with a particular HLA, Gm or Km haplotype, we report some peculiarities and differences between these two families and the healthy Italian population.

Epidermal Cyst

Effects of medium-term PUVA therapy on peripheral T-lymphocyte subsets in psoriatic patients.

Three to four months' PUVA treatment is a widely-adopted procedure to induce psoriasis remission and for the purpose of this study is called "medium-term". The 32 psoriatic patients considered revealed a statistically significant baseline decrease in OKT3+ (p less than 0.001), OKT4+ (p less than 0.001) and OKT8+ (p less than 0.001) as compared with 40 healthy controls, while OKT4/OKT8 was normal. Variance analysis within the psoriatic group failed to reveal further significant variation in the immunological parameters during the 3 months under study. Nevertheless, there was a marked trend towards a reduction in OKT4+ cells and OKT4/OKT8 as compared with baseline values after 3 months. These results suggest that "medium-term" PUVA therapy does not statistically restore the pre-existing baseline changes in T-lymphocyte subsets of the psoriatic patients. The non-statistically significant effects as regards OKT4+ may be due to the small number of patients who reached 3 months' treatment (9 patients) but could be regarded as the first step towards the significant changes described here in long-term PUVA-treated psoriatic patients.

Adult

Changes in the water holding capacity of psoriatic stratum corneum in vivo.

This study investigated the functional capacity of the stratum corneum of psoriatic skin to bind water in vivo during a relatively long period of time (water holding capacity--WHC). An electrical capacitance test was applied to the psoriatic skin on the elbows, perilesional skin and apparently normal skin of 11 patients and the elbows of 10 controls. Measurements of electrical capacitance were performed using a Corneometer Schwarzhaupt for 25 min. The WHC levels were calculated for this period. Our results demonstrate that the WHC of psoriatic stratum corneum does not differ from controls in the first 10 min. Only after the 20th min do the WHCs differ significantly (p less than 0.02). Despite the biochemical keratin changes in psoriatic plaque, the latter is highly hygroscopic, in particular in the first minute after bathing. Perilesional skin binds water like the stratum corneum of controls, though not beyond the 20th minute after bathing.

Adult

[Changes in the biomechanic property of the skin after hemodialysis treatment].

Skin extensibility in 21 subjects (belonging to two different age groups) undergoing hemodialysis has been investigated. Measurements have been performed on the forearm before and after two hours of dialytic treatment. A significant decrease of skin extensibility (P less than 0.02) has been recorded in the elderly prior to the dialytic procedure; the data is consistent with an increased dermal water content. Water removal during treatment led to normalization of extensometric levels (P less than 0.05). However, improvement of skin extensibility is not directly related to the amount of water withdrawn. The study support the importance of water in determining skin viscoelastic responses; hemodialysis is a useful model to monitor the effects of water on skin biomechanics.

Age Factors

[Werner's syndrome and intracranial meningioma].

A case of Werner's Syndrome in a 47-year-old man, with typical features of progeria associated with intracranial meningioma is described. A revision of the literature showed that meningioma is the most frequent benign neoplasm in Werner's Syndrome. Meningioma is a peculiar model of neoplasm, because of the frequency of cytogenetical aberrations concerning chromosome n. 22. Either chromosome n. 22 and other chromosomal alterations could be detected in peripheral blood lymphocytes of our patient. These findings suggest a correlation between chromosomal instability and the onset of neoplasms in Werner's Syndrome. Furthermore, the possibility of detecting chromosome n. 22 aberrations in peripheral blood lymphocytes of Werner's Syndrome patients could provide a clue to the presence of a meningioma at a preclinical stage.

Humans

[Thallium-induced alopecia].

A case of accidental Thallium intoxication showing, as the only sign, alopecia of the scalp with depigmentation of the hair, is described. A 21 year old woman developed acute loss of hair after ingestion of contaminate tomatoes. No further signs of intoxication were evident. The diagnosis has been made by evidencing Thallium in the urine (colorimetric method) and in the hair (atomic absorption spectrophotometry). Moreover, the clinical and histopathological findings of Thallium alopecia are described.

Adult

[Erythema pernio of the face: clinical and histopathological aspects].

A case of chilblains on the face of a man is described. An acute episode of chilblains occurred after a long period of exposure to cold. The unusual site and unusual clinical aspect raised problems of differential clinical diagnosis. Moreover histological diagnosis is easy to perform only after a correct clinical diagnosis has been carried out. For these reasons the literature on chilblains needs to be updated, even though, thanks to impaired living and working conditions, this disease is becoming uncommon.

Adult