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Biomedical subjects

A Tosti

Publications and source records attributed to A Tosti.

At least 145 records · Page 8Linked to original sources
PubMed1994

Expression of integrins in human nail matrix.

The aim of this study was to characterize cell-cell and cell-matrix interaction by evaluating the expression of different integrins in the nail matrix. Nail biopsies were obtained from two cadaver fingers, and eight patients with ingrowing toenails. Frozen sections were stained by indirect immunofluorescence using anti-alpha 1, anti-alpha 2, anti-alpha 3, anti-alpha 4, anti-alpha 5, anti-alpha 6, anti-alpha v, anti-beta 1, anti-beta 4 and anti-ICAM-1 monoclonal antibodies. Biopsies from normal human foreskin were evaluated as controls. alpha 1, alpha 4 and alpha 5 subunits were absent from both nail matrix and normal human skin. alpha 2, alpha 3 and beta 1 subunits were expressed in the basal and suprabasal layers of nail matrix, but only in the basal layer of skin epidermis. alpha 6 and beta 4 subunits were strongly expressed in the basement membrane zone and in the basal layer of both nail matrix and epidermis. The alpha v subunit was expressed in the basal layer of nail matrix. ICAM-1 was not expressed in nail matrix epidermis. Our findings show that despite the distinctive features of the nail apparatus, compared with the epidermis, the pattern of integrin expression is similar, although some differences in the distribution of alpha 2, alpha 3 and beta 1 subunits are detectable. These are probably related to the peculiar differentiation and keratinization of the nail.

Basement Membrane↗
PubMed1994

Prevalence of nail abnormalities in children with alopecia areata.

We assessed the prevalence of nail abnormalities in 272 children with alopecia areata who were seen in our department during an eight-year period. Of these, 126 (46%; 50 girls, 76 boys) had nail abnormalities that were related to alopecia areata. Nail pitting was detected in 92 patients, including 37 with alopecia totalis or alopecia universalis. Three patients experienced an onychomadesis of all 20 nails during the acute onset of alopecia areata universalis. Thirty-two (11.7%) had nail thinning and severe nail plate surface abnormalities that were consistent with a diagnosis of trachyonychia.

Adolescent↗
PubMed1994

Sunscreen sensitization: a three-year study.

BACKGROUND: In the last decade UV filters have been incorporated in a large number of cosmetic products. OBJECTIVE: The purpose of our study was to evaluate the prevalence of sunscreen allergy in patients with a suspected photodermatitis. METHODS: 108 patients were patch-tested with the Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali (GIRDCA) standard series and photopatch-tested with the photopatch series. RESULTS: Allergy and/or photoallergy to sunscreening agents was diagnosed in 8 subjects (7.4%). Oxybenzone was positive in 4 patients, isoproyl dibenzoylmethane in 3 patients, p-aminobenzoic acid and 2-ethylhexyl-p-methoxycinnamate in 1 patient, respectively. CONCLUSION: Our results obtained during a 3-year period (January 1990 to June 1993) confirm that sunscreens are presently the commonest photoallergens.

Adolescent↗
PubMed1994

Histiocytoid hemangioma with prominent fingernail involvement.

Only 2 cases of histiocytoid hemangioma localized in the nail apparatus have been reported in the literature. We describe here a patient affected by multiple histiocytoid hemangiomas involving the 3rd right digit and fingernail. The pathological features were typical for a diagnosis of histiocytoid hemangioma showing vascular proliferation characterized by enlarged endothelial cells associated with inflammatory cells. Phenotypic characterization of the proliferating cells confirmed their vascular origin.

Fingers↗
PubMed1994

Cutaneous amputation of the terminal phalanges in syringomyelia.

We describe a 30-year-old woman with syringomyelia, who developed recurrent painless whitlows of the left hand that led to amputation of the terminal phalanx of the 4th finger and considerable shortening of the terminal phalanges of the 1st, 2nd, 3rd and 5th fingers. A roentgenogram of the left hand showed a complete resorption of the terminal phalanges of the 3rd, 4th and 5th fingers and partial resorption of the terminal phalanx of the 2nd finger. Although the defective sensory function undoubtedly contributes to the development of bone resorption by facilitating mechanical repetitive injuries and infections, impaired vasomotor function possibly plays an equally important role.

Adult↗
PubMed1994

Progressive hyperpigmentation: case report with a clinical, histological, and ultrastructural investigation.

A clinical, histological and ultrastructural study of a 38-year-old woman with generalized progressive hyperpigmentation is reported. Hyperpigmentation started in early infancy, progressed during childhood and has increased to a dark bronze-brown color with 'mottling' in the last 8 years. Histology and electron microscopy revealed epidermal hypermelanosis and 'negroid' distribution of melanosomes in keratinocytes. In our family, autosomal dominant phenotype transmission with 'variable expression' is suggested. The literature on the entity has been reviewed. This case is another rare example of familial progressive hyperpigmentation.

Adult↗
PubMed1994

Phalangeal osteomyelitis due to nail biting.

The authors report a 39-year-old man who developed a phalangeal osteomyelitis of the right thumb in consequence of nail biting. Cultures grew Staphylococcus aureus. Treatment with intravenous teicoplamine 400 mg/day for 3 weeks resulted in complete cure of infection.

Adult↗
PubMed1994

Hallopeau's acrodermatitis continua of the nail apparatus: a clinical and pathological study of 20 patients.

The clinical diagnosis of Hallopeau's acrodermatitis (HA) restricted to nail and digital pulp may be difficult, and even dermatologists often fail to recognize this condition. The aim of this study was to review the clinical and pathological features of 20 patients, observed over a period of 5 years (1988-1993), who were affected by HA limited to the nails. Our study shows that HA of the nail unit more commonly affects middle-aged females. In all our patients HA of the nail was restricted to one digit and not associated with other manifestations of pustular psoriasis. HA of the nail unit is characterized by a chronic course. None of our patients had a complete clearing of the dermatitis during the follow-up period. In 4 patients the acute phases of HA were treated with the non-steroidal anti-inflammatory agent nimesulide 200 mg/day, with great improvement of inflammatory signs and subjective pain within a few days. In these patients, prolongation of treatment with nimesulide during remission phases prevented relapses of the dermatitis.

Acrodermatitis↗
PubMed1994

Alopecia areata. A pathological study of nonresponder patients.

Fourteen patients, four male and 10 female and ranging in age from 11 to 57 years, affected by longstanding alopecia areata that had not responded to sensitizing treatments, were submitted to scalp biopsy. Five patients had alopecia totalis and nine had alopecia universalis. The biopsy was performed on a scalp area that had been bald for > or = 1 year. We distinguished four distinct pathological patterns, which we termed "established bald patch," "early regrowth," "telogen," and "scarring," in four, seven, one, and two patients, respectively. Our study shows that, from a pathological point of view, nonresponder patients constitute a heterogeneous population. The pathological study of the scalp helps predict therapeutic failure only in the small proportion of nonresponder patients that shows a scarring pathological pattern.

Adolescent↗
PubMed1994

Intermittent cyclosporin A treatment of severe plaque psoriasis. Long-term follow-up of 26 patients.

The aim of this study was to evaluate the long-term effects of intermittent Cyclosporin A treatment of severe plaque psoriasis. For this purpose we considered the clinical records of 26 patients who had been intermittently treated with Cyclosporin A for 2 to 4 years. All 26 patients had severe plaque-type psoriasis (PASI score > 18) that was unresponsive to conventional treatment. The initial Cyclosporin A dosage was 5 mg/kg/day in 8 cases and 3 mg/kg/day in 18 cases. In all patients, Cyclosporin A treatment was prolonged until complete or nearly complete remission of psoriasis (mean 2 months; range 1-4 months). All patients subsequently underwent a 2-4 months maintenance treatment with Cyclosporin A dosages that were gradually reduced until tapering off. In order to maintain clinical improvement after Cyclosporin A withdrawal, patients were treated with topical steroids, topical tar, emollients and UVA exposure and/or eliotherapy. Cyclosporin A treatment (2.5-3 mg/kg/day) was reintroduced only when clinical relapses reached a PASI score of 12 or more. Duration and dosages of Cyclosporin A cycles were always adapted for the purpose of obtaining an improvement acceptable to the patient (PASI < 8) rather than total clearance of psoriasis. So far, the 26 patients have undergone 3-5 cycles of therapy with low doses of Cyclosporin A. None of these 26 patients interrupted Cyclosporin A treatment because of side effects. In conclusion, in our experience cyclic CyA treatment is effective for the long-term treatment of psoriatic patients.

Adult↗
PubMed1993

Nail lichen planus: clinical and pathologic study of twenty-four patients.

BACKGROUND: We studied a large series of patients with lichen planus (LP) limited to the nails. OBJECTIVE: Our purpose was to review the clinical and histopathologic features of 24 patients with LP limited to the nails and to discuss treatment and long-term prognosis. METHODS: The records of 24 patients with biopsy-confirmed nail LP were analyzed. Clinical and follow-up data were obtained. RESULTS: Nail LP usually appears during the fifth or sixth decade of life. Neither gender-associated susceptibility nor seasonal influences were detected. In most cases, nail LP is self-limiting or promptly regresses with treatment. Recurrences of nail lesions as well as development of LP in other regions of the body are possible. The development of severe and early destruction of the nail matrix characterizes a small subset of patients with nail LP. CONCLUSION: Approximately 25% of patients with nail LP have LP in other sites before or after the onset of nail lesions. Long-term observation indicates that permanent damage to the nail is rare even in patients with diffuse involvement of the matrix.

Administration, Oral↗
PubMed1993

Carpal tunnel syndrome presenting with ischemic skin lesions, acroosteolysis, and nail changes.

A 58-year-old woman had a chronic necrotic ulceration of the fingertip of the third finger and nail plate abnormalities of the first, second, and third fingers of the right hand. Roentgenograms of the hands showed acroosteolysis of the distal phalanges of the second and third right fingers. Skin and nail lesions showed considerable improvement after surgical treatment of carpal tunnel syndrome. The authors review the clinical and radiologic features of similar cases that have previously been reported.

Carpal Tunnel Syndrome↗
PubMed1993

Reflex sympathetic dystrophy with prominent involvement of the nail apparatus.

After closed hand trauma, a 17-year-old boy had acute inflammatory changes that resembled bacterial whitlows of the third and fourth right fingers. Clearing of the inflammatory changes was followed by the development of cyanosis, hyperhidrosis, and roentgenographic evidence of patchy osteoporosis in the involved extremity. Findings of a biopsy specimen revealed that the inflammatory lesions in the proximal nail folds were caused by proliferation of capillary vessels embedded in edematous loose connective tissue. This is the first report of cutaneous histopathologic findings in the first stage of reflex sympathetic dystrophy, although similar features have been described in synovial and bone biopsy specimens of patients with reflex sympathetic dystrophy.

Adolescent↗
PubMed1993

Recurrent basal cell carcinoma of the back infiltrating the spine. Recurrent basal cell carcinoma.

BACKGROUND: Risk of basal cell carcinoma (BCC) recurrence appears to be related to tumor location, tumor size, treatment modality, radicalness of excision, and histologic type. Recurrences of BCC on the trunk and extremities are rare, with 97% of all recurrent lesions being located in the head and neck region. OBJECTIVE: This report concerns a man who had a BCC of the back removed with electrodesiccation and curettage in 1980 at the age of 36. In the following 10 years the patient experienced five recurrences and finally developed infiltration of the thoracic spine that precluded further attempts at radical excision of the neoplasm. METHODS AND RESULTS: The pathology of the BCC in our patient revealed a number of histologic features that have been associated with aggressive behaviour. These include an infiltrative growth pattern characterized by an irregular and acute tapered profile of the tumor cell groups and fibroblast-rich stroma, infiltrating invading tumour edges, poorly peripheral palisading, nuclear pleomorphism, and perineural invasion. CONCLUSION: Basal cell carcinomas that occur in sunlight-protected areas of the trunk of middle-aged individuals can occasionally exhibit aggressive and highly invasive features as well as a marked tendency for local uncontrollable recurrences. The prognosis for patients with this variety of BCC is poor, especially when progressive infiltration of deep tissues does not permit, as in our case, any possible further radical surgical procedure.

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