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Biomedical subjects

Maria Concetta Fargnoli

Publications and source records attributed to Maria Concetta Fargnoli.

32 records · Page 2Linked to original sources

Constitutional and environmental risk factors for cutaneous melanoma in an Italian population. A case-control study.

The aim of this study was to determine the relative risk for cutaneous melanoma associated with phenotypic and environmental variables in a population in central Italy and to assess how the combination of the different risk factors contributes to the overall risk for melanoma. We performed a case-control study of 100 patients with sporadic cutaneous melanoma and 200 controls matched for sex, age, ethnicity and residential area. Individuals were interviewed concerning pigmentary traits and sun exposure, and underwent a total body skin examination. Logistic regression models were used to evaluate the association between cutaneous melanoma and constitutional and environmental variables. The strongest risk factors were prolonged recreational sun exposure (odds ratio [OR] 5.010, 95% confidence interval [CI] 2.110-11.891), the presence of clinically atypical naevi (OR 4.916, 95% CI 2.496-9.995) and the presence of >50 common melanocytic naevi (OR 4.684, 95% CI 2.442-9.231). In addition, occupational sun exposure (OR 2.573, 95% CI 1.399-4.732), light brown hair (OR 2.336, 95% CI 1.328-4.138), high density of solar lentigos and/or actinic keratoses (OR 1.824, 95% CI 1.0-3.510) and type II, fair skin (OR 1.815, 95% CI 1.031-3.193) and blue eyes (OR 1.757, 95% CI 1.0-3.477) were each significantly associated with cutaneous melanoma risk. The combination of individual strong risk factors was associated with up to a 46-fold increase in the risk for cutaneous melanoma. Selected pigmentary traits, sun exposure and melanocytic naevi, individually and in combination, are important risk factors for cutaneous melanoma in an Italian population.

Adolescent↗

Identification of four novel melanocortin 1 receptor (MC1R) gene variants in a Mediterranean population.

The melanocortin 1 receptor (MC1R) gene is a major determinant of human pigmentation and specific allelic variants have been associated with red hair and sun sensitive skin types as well as increased skin cancer risk in Caucasian individuals. We screened for allelic variants the entire MC1R coding region of 100 unrelated individuals sampled from an Italian population who has darker pigmentary traits than populations analyzed to date. Twenty MC1R variants were identified, eighteen located at non-synonymous sites and two at synonymous sites. We report four novel MC1R allelic variants: C35Y (g.104G>A), V38M (g.112G>A), L44V (g.130C>G) and I120T (g.359T>C).

Alleles↗

Microabrasion versus microabrasion followed by 15% trichloroacetic acid for treatment of cutaneous hyperpigmentations in adult females.

BACKGROUND: Cutaneous hyperpigmentations are common skin disorders that are often refractory to currently available treatments. OBJECTIVE: To evaluate the efficacy of microabrasion alone or microabrasion with 15% trichloroacetic acid (TCA) for treatment of cutaneous hyperpigmentations. METHODS: Twenty female patients were treated with microabrasion alone every 2 weeks (group 1), and 20 female patients were treated with microabrasion and application of 15% TCA every 3 weeks (group 2). All patients underwent up to eight treatments. The overall duration of treatment ranged from 2 to 4 months. RESULTS: In group 1, a complete remission was observed in 8 of 20 cases (40%), partial remission in 10 of 20 cases (50%), and no remission in 2 of 20 cases (10%). In group 2, a complete remission was observed in 10 of 20 cases (50%), a partial remission in 8 of 20 cases (40%), and no remission in 2 of 20 cases (10%). No unexpected or serious side effects were observed in either group. CONCLUSIONS: Microabrasion alone or microabrasion with 15% TCA is an effective, well-tolerated treatment for cutaneous hyperpigmentations.

Adolescent↗

Interobserver agreement on dermoscopic features of pigmented basal cell carcinoma.

BACKGROUND: A dermoscopic method based on the absence of a pigment network and the presence of at least one of six positive features has been described for diagnosis of pigmented basal cell carcinoma (BCC). OBJECTIVE: To evaluate the observers' global agreement and interobserver agreement on each dermoscopic parameter of the method recently proposed. METHODS: Dermoscopic images of 56 pigmented BCCs were examined by five observers with different degrees of experience in dermoscopy. RESULTS: An overall full agreement was reached for the absence of pigment network (k = 1). Very good agreement was detected for the presence of spoke wheel areas (k = 0.85) and arborizing vessels (k = 0.72), and good agreement was shown for ulceration (k = 0.49) and multiple blue-gray globules (k = 0.41). No agreement was identified on large blue-gray ovoid nests (k = 0.28) and leaflike areas (k = 0.26). CONCLUSION: We confirm the reproducibility of the method and show that ulceration, spoke wheel areas, and arborizing tel- angiectases represent the most robust positive parameters.

Basal Cell Carcinoma↗

Granulomatous mycosis fungoides responsive to gemcitabine.

We report a 61-year-old woman with a 1-year-history of widespread erythematous scaly patches and plaques as well as red/purplish to brownish confluent plaques. Ulcerated lesions with a purulent, hemorrhagic exudate and sharp elevated borders were located on the lower extremities. Diagnosis of granulomatous mycosis fungoides was supported by histopathologic findings showing an inflammatory reaction with epithelioid and large giant cells associated with features characteristic of mycosis fungoides. Immunohistochemical studies showed a T-helper phenotype of neoplastic cells (CD3+, CD4+, CD45RO+) with expression of the cytotoxic protein TIA-1. Molecular analysis of TCRgamma gene demonstrated a monoclonal rearrangement in the lesional skin. After failure of conventional therapies, 6 cycles of gemcitabine treatment produced partial remission of cutaneous lesions and stable disease throughout a 12-month follow-up period, suggesting that gemcitabine is a promising chemotherapeutic agent for refractory mycosis fungoides.

Antimetabolites, Antineoplastic↗

Acneiform follicular mucinosis of the head and neck region.

Follicular mucinosis has a protean clinical presentation and can be differentiated in a benign-idiopathic type and an evolutive lymphoma-associated type. Young age and single localization, especially in the head and neck region, are suggestive of the benign type. Reviewing the literature of follicular mucinosis appearing as an acneiform eruption of the face and neck, we were unable to find any case evolving in lymphoma, suggesting that this form is a particular clinical sub-type of follicular mucinosis with a favorable prognosis. We report two cases of this variant of follicular mucinosis and discuss the clinical characteristics and differential diagnosis.

Acne Vulgaris↗

Kaposi's sarcoma of the glans penis in an immunocompetent patient.

We report a 39-year-old HIV negative man with a solitary reddish-brown papule located on the glans penis, which had developed 6 months previously. Histopathologic examination showed spindle-shaped cells scattered between collagen bundles and intermingled with small, pointed vascular-like spaces. Spindle-shaped cells stained positively for antiFactor VIII and anti-CD34 antibodies. Human herpes virus-8 DNA was detected in tumor tissue and in peripheral blood mononuclear cells. Based on clinicopathologic and molecular findings, the diagnosis of classic Kaposi's sarcoma was made. Two months after the initial observation, three additional papules developed on the glans penis. Histopathologic examination of one lesion confirmed the diagnosis of classic Kaposi's sarcoma. The remaining lesions were treated with electrodessication and curettage. After a follow-up period of 6 months no evidence of recurrence was observed. We report this case for the unusual localization of Kaposi's Sarcoma in a young, HIV-negative patient.

Adult↗