Choledochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, whi... more Choledochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, which can present as single or multiple dilatations and can appear as both intra-and extrahepatic anomalies. The most widespread classification of CCs is the Todani classification, but there have been numerous reports of cysts that do not fall into any of the types described. We present such a case-a male patient 36 years of age who underwent preoperative CT, MRCP, and ERCP, which mistakenly indicated a type II Todani CC, and intraoperatively was found to be located at the confluence of the hepatic ducts and encompassed the origin of the common bile duct. Complete resection of the cyst and the proximal segment of the common bile duct was performed, and reconstruction was carried out by Roux-en-Y double-tutorized hepaticojejunostomy. Considering the risk of malignant transformation, the frequent preoperative misdiagnosis, as well as the technically challenging surgery required in such cases, we advocate for a revision of the classification and raise awareness of the need for guidelines regarding the proper short-term and long-term management of this disease to ensure adequate quality of life and disease-free survival for patients.
Melanoma is one of the most aggressive forms of skin cancer, with limited therapeutic options. Si... more Melanoma is one of the most aggressive forms of skin cancer, with limited therapeutic options. Since its incidence has been rapidly rising in recent years, the study of new targeted therapeutic strategies has increased. The implication of nanoscience in the development of alternative targeted therapies for melanoma has multiple benefits and could significantly improve the outcome of melanoma patients. In this paper, we review the most recent progress in the field of targeted therapies, emphasizing the impact of nanoscale materials on the targeting and controlled release of anti-tumor drugs. The applications of nanomedicine in the management of melanoma are extensive and refer to sentinel lymph node mapping, chemotherapy, and RNA interference; each of these applications harboring the potential to develop efficient and personalized diagnostic techniques and therapies. Further research, especially in clinical trials, is needed to establish whether fighting melanoma on the nanoscale level represents the key to reaching a critical inflection point in mankind's battle with metastatic melanoma.
Clinical, Cosmetic and Investigational Dermatology
Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of... more Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of COVID-19, causing major emotional distress among the affected patients. The affected individuals are further exposed to a vast amount of misinformation from the internet and social media and it is important for physicians to be familiar with the phenomenon and provide appropriate counselling to their patients regarding this condition. This article aims to review the evidence-based complementary strategies that can help enhance hair regrowth after post-COVID-19 hair loss, from psychological support and patient education to the importance of optimal nutrition and potential indications and benefits of oral nutritional supplementation, as well as the role of both topical and injectable hair growth stimulators.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The ongoing coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic by the World Hea... more The ongoing coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic by the World Health organization in early March 2020. The disease typically presents with viral respiratory symptoms that could progress to acute respiratory distress syndrome. Emerging evidence suggests different possible dermatologic manifestations of COVID-19, including: acral lesions (pernio-like, pseudo-chillblain), vesicular eruptions, macular and papular exanthema, urticaria, livedoid, purpuric and petechial rashes. However, specific skin manifestations of the COVID-19 disease have not yet been clearly established and the relationship between the appearance of skin lesions and SARS-CoV-2 infection is still unclear. These highly variable skin changes could represent a direct consequence of the viral infection, an immunological response to viral nucleotides, adverse reactions to drugs frequently used for the treatment of COVID-19, or other disorders. In a global effort to comprehend the exact cutaneous features of COVID-19, several international dermatological societies have initiated nationwide studies to analyze COVID-19 cutaneous manifestations during this pandemic. This paper represents a literature review of the scientific data available on the clinical characteristics and symptoms of the cutaneous manifestations associated with COVID-19. Such findings are extremely useful in establishing if dermatological manifestations in COVID-19 patients could harbor a diagnostic significance and subsequently be used as prognostic factors for outcomes of COVID-19.
Psoriasis is a chronic, inflammatory, multisystemic disease which affects approximately 2–3% of t... more Psoriasis is a chronic, inflammatory, multisystemic disease which affects approximately 2–3% of the population globally, whose onset is triggered by genetic and environmental factors which activate both dendritic cells and keratinocytes, resulting in the production of proinflammatory cytokines such as tumor necrosis factor alpha, interleukin 17, interleukin 23, interleukin 22, and interleukin 1β. An in-depth understanding of the pathophysiology of psoriasis led to significant advances in the development of safe and efficient novel therapeutic options, with four classes of biologic therapy being approved for the management of moderate to severe psoriasis: tumor necrosis factor alpha inhibitors, interleukin 23 inhibitors, anti-interleukin 12/23 agents, anti-interleukin 17 agents, as well as small-molecule inhibitors, such as apremilast. Psoriasis is associated with comorbid conditions, namely psoriatic arthritis, cardiovascular disease, metabolic syndrome, psychiatric disorders, malig...
Dermatofibroma (DF) or fibrous histiocytoma is one of the most frequent benign cutaneous soft-tis... more Dermatofibroma (DF) or fibrous histiocytoma is one of the most frequent benign cutaneous soft-tissue lesions, characterized by a post-inflammatory tissue reaction associated with fibrosis of the dermis. Clinically DFs have a polymorphous clinical aspect from the solitary, firm, single nodules to multiple papules with a relatively smooth surface. However, multiple atypical clinicopathological variants of DFs have been reported and, therefore, clinical recognition may become challenging, leading to a more burdensome identification and sometimes to misdiagnosis. Dermoscopy is considered an important tool in DFs diagnosis, as it improves diagnostic accuracy for clinically amelanotic nodules. Although typical dermoscopic patterns are most frequently seen in clinical practice, there have also been some atypical variants described, mimicking some underlying recurrent and sometimes harmful skin afflictions. Usually, no treatment is required, although an appropriate work-up may be necessary ...
Focarul aflat în desfășurare a bolii coronavirusului 2019 (COVID-19) a fost declarat pandemie de ... more Focarul aflat în desfășurare a bolii coronavirusului 2019 (COVID-19) a fost declarat pandemie de către organizația Mondială a Sănătății la începutul lunii martie 2020. Boala prezintă de obicei simptome respiratorii virale care ar putea progresa spre sindromul de detresă respiratorie acută. Dovezi emergente sugerează diferite manifestări dermatologice posibile ale COVID-19, incluzând: leziuni acrale (pernio-like, pseudo-chillblain), erupții veziculare, exantemă maculară și papulară, urticarie, livedoid, erupții purpurice și peteşiale. Cu toate acestea, manifestările cutanate specifice ale bolii COVID-19 nu au fost încă stabilite în mod clar, iar relația dintre apariția leziunilor cutanate și infecția cu SARS-CoV-2 este încă neclară. Aceste modificări cutanate extrem de variabile ar putea reprezenta o consecință directă a infecției virale, un răspuns imunologic la nucleotidele virale, reacții adverse la medicamentele utilizate frecvent pentru tratamentul COVID-19 sau alte tulburări. În efortul global de a înțelege caracteristicile cutanate precise ale COVID-19, mai multe societăți dermatologice internaționale au inițiat studii la nivel național pentru a analiza manifestările cutanate COVID-19 în timpul acestei pandemii. Acest referat reprezintă o revizuire a literaturii a datelor științifice disponibile privind caracteristicile clinice și simptomele manifestărilor cutanate asociate cu COVID-19. Aceste constatări sunt extrem de utile pentru a stabili dacă manifestările dermatologice la pacienții cu COVID-19 ar putea avea o semnificație diagnostică și ulterior să fie utilizate ca factori prognostici pentru evoluţia COVID-19.
Platelet-rich plasma (PRP) has emerged as a significant regenerative therapy used alone or combin... more Platelet-rich plasma (PRP) has emerged as a significant regenerative therapy used alone or combined mainly with stem cells, autologous fat grafts, hyaluronic acid, and biomaterials in a variety of medical fields, especially in hair regrowth, wound healing, and sports and rehabilitation medicine. However, the results obtained with this biologic therapy are heterogeneous and conflicting. The observed disparities in the effectiveness of PRP therapies may be due to a lack of standardization in blood processing and preparation. This article is aimed at reviewing the main biological parameters that need to be documented for a thorough reporting of quantitative and qualitative characteristics of the PRP injected, to allow a comparison between the quality of samples and the clinically obtained results and advance the efforts towards treatment standardization.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Romanian Journal of Morphology and Embryology, 2021
Although cutaneous squamous cell carcinomas (cSCCs) account for only 20-25% of non-melanoma skin ... more Although cutaneous squamous cell carcinomas (cSCCs) account for only 20-25% of non-melanoma skin cancers (NMSCs), they are responsible for most deaths attributable to NMSCs. Apart from SCC seric level, which increases in late-stage disease, no other predictive biomarker for cSCC exists. Epidermal growth factor receptor (EGFR) serves as a predictive biomarker and therapeutic target in numerous malignancies. EGFR immunoexpression is highly elevated in head and neck mucosal SCC. However, its immunoexpression pattern, its relationship with prognosis and survival, and the effect of EGFR targeted therapy in advanced cSCC have not been clarified. We assessed EGFR immunoexpression in 18 cases of cSCC and correlated our findings with the clinicopathological features. Immunohistochemical stainings with anti-EGFR monoclonal antibodies were practiced and the membrane and cytoplasmic immunostaining intensity and quality in the tumors and the non-lesional epithelium were analyzed. Membrane EGFR immunoexpression within the tumors increased with the tumor grade. EGFR overexpression was more frequently found in head and neck cSCCs. We did not find a direct relationship between cytoplasmic EGFR immunoexpression and clinicopathological findings and prognosis. Our results confirm that increased EGFR immunoexpression correlates with aggressive cSCC phenotypes and underline the need for novel treatments for these patients.
Treatment of advanced melanoma with selective BRAF and MEK inhibitors is associated with a series... more Treatment of advanced melanoma with selective BRAF and MEK inhibitors is associated with a series of mucocutaneous side effects, among which morphological changes in preexisting nevi and the development of new melanocytic lesions, both benign and malignant. Objective was to describe the changes observed in melanocytic nevi under vemurafenib therapy, followed by combination therapy with dabrafenib and trametinib for metastatic melanoma. The melanocytic lesions of a 51-year-old Caucasian male patient diagnosed with stage IV melanoma were monitored both clinically and dermoscopically throughout vemurafenib, followed by combined treatment with dabrafenib and trametinib. The 65 monitored nevi presented different behaviors under vemurafenib treatment: 18 reticular nevi, 9 reticular-homogenous nevi, 3 reticular-globular nevi, and 2 globular nevi showed a diffuse decrease in pigmentation. Ten reticular nevi remained unchanged, while the rest of the nevi, independent of the dermoscopic patte...
Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest wit... more Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest within the scientific communities worldwide, with new therapeutic targets being constantly identified and tested. Despite the numerous topical and systemic medications available for the treatment of psoriasis, alternative therapies are still needed for the optimal management of some patients who present with localized, resistant lesions. Novel insights into the contribution of cutaneous neurogenic inflammation in the pathogenesis of psoriasis have yielded exciting new potential roles of nerve-targeting treatments, namely botulinum toxin type A (BoNT-A), for the management of this disease. This paper aims to review the existing literature on knowledge regarding the potential role of BoNT-A in psoriasis treatment, with a focus on its ability to interfere with the immunopathogenetic aspects of psoriatic disease. Furthermore, in our paper, we are also including the first report of psoriatic les...
Psoriasis is a chronic multisystem inflammatory disease associated with a plethora of comorbiditi... more Psoriasis is a chronic multisystem inflammatory disease associated with a plethora of comorbidities including metabolic syndrome, cardiovascular disease, hypertension, diabetes, hyperlipidemia, obesity, anxiety, depression, chronic kidney disease, and malignancy. Advancement in unveiling new key elements in the pathophysiology of psoriasis led to significant progress in the development of biologic agents which target different signaling pathways and cytokines involved in the inflammatory cascade responsible for the clinical manifestations found in psoriasis. Currently available novel therapeutic options for moderate-severe psoriasis include tumor necrosis factor alpha inhibitors, inhibitors of the interleukin 17, and inhibitors of the interleukin 23. Nevertheless, concerns have been raised with respect to the possible risks associated with the use of biologic therapy requiring close collaboration between dermatologists and physicians of different specialties. Our aim was to perform ...
Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality,... more Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality, with approximately 1.8 million new cases reported worldwide in 2018. Advancements in understanding pathophysiological key steps in CRC tumorigenesis have led to the development of new targeted therapies such as those based on epidermal growth factor receptor inhibitors (EGFR inhibitors). The cutaneous adverse reactions induced by EGFR inhibitors, particularly papulopustular rash, often require long-term antibiotic treatment with tetracycline agents (mostly minocycline and doxycycline). However, this raises several issues of concern: possible occurrence of gut dysbiosis in already vulnerable CRC patients, selection of highly antibiotic resistant and/or virulent clones, development of adverse reactions related to tetracyclines, interference of antibiotics with the response to oncologic therapy, with a negative impact on disease prognosis etc. In the context of scarce information regarding...
Limfomul cutanat cu celule T CD8+ agresiv epidermotrop prezentare atipicã Introducere: Limfomul p... more Limfomul cutanat cu celule T CD8+ agresiv epidermotrop prezentare atipicã Introducere: Limfomul primar cutanat agresiv epidermotrop cu celule T CD8+ este un tip foarte rar de limfom citotoxic cu o tendinåã crescutã de extensie la situsuri extraganglionare, rãspuns slab la terapiile convenåionale pentru limfoamele cutanate cu celule T CD4+ æi prognostic nefavorabil. Prezentare de caz: Prezentãm cazul unui pacient în vârstã de 40 ani care s-a internat în clinica noastrã pentru papule æi plãci infiltrate, ulcerate, acoperite de cruste necrotice generalizate æi ulceraåii dureroase acoperite de depozite albe la nivelul palatului moale æi dur în evoluåie de 18 luni. Tabloul clinic æi histopatologic particular au ridicat reale dificultaåi diagnostice æi terapeutice, pacientul fiind diagnosticat iniåial cu papulozã limfomatoidã, apoi cu limfom cutanat cu celule T æi tratat cu methotrexate, retinoizi aromatici orali æi fototerapie, fãrã beneficiu clinic. În timpul spitalizãrii în clinica noa...
Electrochemotherapy (ECT) is an effective bioelectrochemical procedure that uses controlled elect... more Electrochemotherapy (ECT) is an effective bioelectrochemical procedure that uses controlled electrical pulses to facilitate the increase of intracellular concentration of certain substances (electropermeabilization/ reversible electroporation). ECT using antitumor drugs such as bleomycin and cisplatin is a minimally invasive targeted therapy that can be used as an alternative for oncologic patients not eligible for surgery or other standard therapies. Even though ECT is mainly applied as palliative care for metastases, it may also be used for primary tumors that are unresectable due to size and location. Skin neoplasms are the main clinical indication of ECT, the procedure reporting good curative results and high efficiency across all tumor types, including melanoma. In daily practice, there are many cases in which the patient’s quality of life can be significantly improved by a safe procedure such as ECT. Its popularity must be increased because it has a safe profile and minor loca...
Over the last decade, chronic wounds such as venous or arterial ulcers, diabetic foot ulcers, pre... more Over the last decade, chronic wounds such as venous or arterial ulcers, diabetic foot ulcers, pressure sores, and nonhealing surgical wounds were brought into the spotlight of the medical community, due to their increasing prevalence and to their significant economic burden. Vascular impairment represents the main cause of chronic ulceration, while the infection is the most frequent complication. Chronic infections persist and progress despite an adequate antimicrobial regimen and are typically caused by monoor polymicrobial biofilms. The persistent bacterial colonization of the wound, as well as the longterm use of antibiotics predispose to the development of nosocomial infections with resistant strains, with the risk of life-threatening septic complications, especially in immunocompromised individuals. In this article, we perform a thorough literature review, in order to answer the main controversies regarding the involvement of planktonic Corresponding author: Cornelia Nitipir, M...
Choledochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, whi... more Choledochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, which can present as single or multiple dilatations and can appear as both intra-and extrahepatic anomalies. The most widespread classification of CCs is the Todani classification, but there have been numerous reports of cysts that do not fall into any of the types described. We present such a case-a male patient 36 years of age who underwent preoperative CT, MRCP, and ERCP, which mistakenly indicated a type II Todani CC, and intraoperatively was found to be located at the confluence of the hepatic ducts and encompassed the origin of the common bile duct. Complete resection of the cyst and the proximal segment of the common bile duct was performed, and reconstruction was carried out by Roux-en-Y double-tutorized hepaticojejunostomy. Considering the risk of malignant transformation, the frequent preoperative misdiagnosis, as well as the technically challenging surgery required in such cases, we advocate for a revision of the classification and raise awareness of the need for guidelines regarding the proper short-term and long-term management of this disease to ensure adequate quality of life and disease-free survival for patients.
Melanoma is one of the most aggressive forms of skin cancer, with limited therapeutic options. Si... more Melanoma is one of the most aggressive forms of skin cancer, with limited therapeutic options. Since its incidence has been rapidly rising in recent years, the study of new targeted therapeutic strategies has increased. The implication of nanoscience in the development of alternative targeted therapies for melanoma has multiple benefits and could significantly improve the outcome of melanoma patients. In this paper, we review the most recent progress in the field of targeted therapies, emphasizing the impact of nanoscale materials on the targeting and controlled release of anti-tumor drugs. The applications of nanomedicine in the management of melanoma are extensive and refer to sentinel lymph node mapping, chemotherapy, and RNA interference; each of these applications harboring the potential to develop efficient and personalized diagnostic techniques and therapies. Further research, especially in clinical trials, is needed to establish whether fighting melanoma on the nanoscale level represents the key to reaching a critical inflection point in mankind's battle with metastatic melanoma.
Clinical, Cosmetic and Investigational Dermatology
Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of... more Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of COVID-19, causing major emotional distress among the affected patients. The affected individuals are further exposed to a vast amount of misinformation from the internet and social media and it is important for physicians to be familiar with the phenomenon and provide appropriate counselling to their patients regarding this condition. This article aims to review the evidence-based complementary strategies that can help enhance hair regrowth after post-COVID-19 hair loss, from psychological support and patient education to the importance of optimal nutrition and potential indications and benefits of oral nutritional supplementation, as well as the role of both topical and injectable hair growth stimulators.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The ongoing coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic by the World Hea... more The ongoing coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic by the World Health organization in early March 2020. The disease typically presents with viral respiratory symptoms that could progress to acute respiratory distress syndrome. Emerging evidence suggests different possible dermatologic manifestations of COVID-19, including: acral lesions (pernio-like, pseudo-chillblain), vesicular eruptions, macular and papular exanthema, urticaria, livedoid, purpuric and petechial rashes. However, specific skin manifestations of the COVID-19 disease have not yet been clearly established and the relationship between the appearance of skin lesions and SARS-CoV-2 infection is still unclear. These highly variable skin changes could represent a direct consequence of the viral infection, an immunological response to viral nucleotides, adverse reactions to drugs frequently used for the treatment of COVID-19, or other disorders. In a global effort to comprehend the exact cutaneous features of COVID-19, several international dermatological societies have initiated nationwide studies to analyze COVID-19 cutaneous manifestations during this pandemic. This paper represents a literature review of the scientific data available on the clinical characteristics and symptoms of the cutaneous manifestations associated with COVID-19. Such findings are extremely useful in establishing if dermatological manifestations in COVID-19 patients could harbor a diagnostic significance and subsequently be used as prognostic factors for outcomes of COVID-19.
Psoriasis is a chronic, inflammatory, multisystemic disease which affects approximately 2–3% of t... more Psoriasis is a chronic, inflammatory, multisystemic disease which affects approximately 2–3% of the population globally, whose onset is triggered by genetic and environmental factors which activate both dendritic cells and keratinocytes, resulting in the production of proinflammatory cytokines such as tumor necrosis factor alpha, interleukin 17, interleukin 23, interleukin 22, and interleukin 1β. An in-depth understanding of the pathophysiology of psoriasis led to significant advances in the development of safe and efficient novel therapeutic options, with four classes of biologic therapy being approved for the management of moderate to severe psoriasis: tumor necrosis factor alpha inhibitors, interleukin 23 inhibitors, anti-interleukin 12/23 agents, anti-interleukin 17 agents, as well as small-molecule inhibitors, such as apremilast. Psoriasis is associated with comorbid conditions, namely psoriatic arthritis, cardiovascular disease, metabolic syndrome, psychiatric disorders, malig...
Dermatofibroma (DF) or fibrous histiocytoma is one of the most frequent benign cutaneous soft-tis... more Dermatofibroma (DF) or fibrous histiocytoma is one of the most frequent benign cutaneous soft-tissue lesions, characterized by a post-inflammatory tissue reaction associated with fibrosis of the dermis. Clinically DFs have a polymorphous clinical aspect from the solitary, firm, single nodules to multiple papules with a relatively smooth surface. However, multiple atypical clinicopathological variants of DFs have been reported and, therefore, clinical recognition may become challenging, leading to a more burdensome identification and sometimes to misdiagnosis. Dermoscopy is considered an important tool in DFs diagnosis, as it improves diagnostic accuracy for clinically amelanotic nodules. Although typical dermoscopic patterns are most frequently seen in clinical practice, there have also been some atypical variants described, mimicking some underlying recurrent and sometimes harmful skin afflictions. Usually, no treatment is required, although an appropriate work-up may be necessary ...
Focarul aflat în desfășurare a bolii coronavirusului 2019 (COVID-19) a fost declarat pandemie de ... more Focarul aflat în desfășurare a bolii coronavirusului 2019 (COVID-19) a fost declarat pandemie de către organizația Mondială a Sănătății la începutul lunii martie 2020. Boala prezintă de obicei simptome respiratorii virale care ar putea progresa spre sindromul de detresă respiratorie acută. Dovezi emergente sugerează diferite manifestări dermatologice posibile ale COVID-19, incluzând: leziuni acrale (pernio-like, pseudo-chillblain), erupții veziculare, exantemă maculară și papulară, urticarie, livedoid, erupții purpurice și peteşiale. Cu toate acestea, manifestările cutanate specifice ale bolii COVID-19 nu au fost încă stabilite în mod clar, iar relația dintre apariția leziunilor cutanate și infecția cu SARS-CoV-2 este încă neclară. Aceste modificări cutanate extrem de variabile ar putea reprezenta o consecință directă a infecției virale, un răspuns imunologic la nucleotidele virale, reacții adverse la medicamentele utilizate frecvent pentru tratamentul COVID-19 sau alte tulburări. În efortul global de a înțelege caracteristicile cutanate precise ale COVID-19, mai multe societăți dermatologice internaționale au inițiat studii la nivel național pentru a analiza manifestările cutanate COVID-19 în timpul acestei pandemii. Acest referat reprezintă o revizuire a literaturii a datelor științifice disponibile privind caracteristicile clinice și simptomele manifestărilor cutanate asociate cu COVID-19. Aceste constatări sunt extrem de utile pentru a stabili dacă manifestările dermatologice la pacienții cu COVID-19 ar putea avea o semnificație diagnostică și ulterior să fie utilizate ca factori prognostici pentru evoluţia COVID-19.
Platelet-rich plasma (PRP) has emerged as a significant regenerative therapy used alone or combin... more Platelet-rich plasma (PRP) has emerged as a significant regenerative therapy used alone or combined mainly with stem cells, autologous fat grafts, hyaluronic acid, and biomaterials in a variety of medical fields, especially in hair regrowth, wound healing, and sports and rehabilitation medicine. However, the results obtained with this biologic therapy are heterogeneous and conflicting. The observed disparities in the effectiveness of PRP therapies may be due to a lack of standardization in blood processing and preparation. This article is aimed at reviewing the main biological parameters that need to be documented for a thorough reporting of quantitative and qualitative characteristics of the PRP injected, to allow a comparison between the quality of samples and the clinically obtained results and advance the efforts towards treatment standardization.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Romanian Journal of Morphology and Embryology, 2021
Although cutaneous squamous cell carcinomas (cSCCs) account for only 20-25% of non-melanoma skin ... more Although cutaneous squamous cell carcinomas (cSCCs) account for only 20-25% of non-melanoma skin cancers (NMSCs), they are responsible for most deaths attributable to NMSCs. Apart from SCC seric level, which increases in late-stage disease, no other predictive biomarker for cSCC exists. Epidermal growth factor receptor (EGFR) serves as a predictive biomarker and therapeutic target in numerous malignancies. EGFR immunoexpression is highly elevated in head and neck mucosal SCC. However, its immunoexpression pattern, its relationship with prognosis and survival, and the effect of EGFR targeted therapy in advanced cSCC have not been clarified. We assessed EGFR immunoexpression in 18 cases of cSCC and correlated our findings with the clinicopathological features. Immunohistochemical stainings with anti-EGFR monoclonal antibodies were practiced and the membrane and cytoplasmic immunostaining intensity and quality in the tumors and the non-lesional epithelium were analyzed. Membrane EGFR immunoexpression within the tumors increased with the tumor grade. EGFR overexpression was more frequently found in head and neck cSCCs. We did not find a direct relationship between cytoplasmic EGFR immunoexpression and clinicopathological findings and prognosis. Our results confirm that increased EGFR immunoexpression correlates with aggressive cSCC phenotypes and underline the need for novel treatments for these patients.
Treatment of advanced melanoma with selective BRAF and MEK inhibitors is associated with a series... more Treatment of advanced melanoma with selective BRAF and MEK inhibitors is associated with a series of mucocutaneous side effects, among which morphological changes in preexisting nevi and the development of new melanocytic lesions, both benign and malignant. Objective was to describe the changes observed in melanocytic nevi under vemurafenib therapy, followed by combination therapy with dabrafenib and trametinib for metastatic melanoma. The melanocytic lesions of a 51-year-old Caucasian male patient diagnosed with stage IV melanoma were monitored both clinically and dermoscopically throughout vemurafenib, followed by combined treatment with dabrafenib and trametinib. The 65 monitored nevi presented different behaviors under vemurafenib treatment: 18 reticular nevi, 9 reticular-homogenous nevi, 3 reticular-globular nevi, and 2 globular nevi showed a diffuse decrease in pigmentation. Ten reticular nevi remained unchanged, while the rest of the nevi, independent of the dermoscopic patte...
Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest wit... more Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest within the scientific communities worldwide, with new therapeutic targets being constantly identified and tested. Despite the numerous topical and systemic medications available for the treatment of psoriasis, alternative therapies are still needed for the optimal management of some patients who present with localized, resistant lesions. Novel insights into the contribution of cutaneous neurogenic inflammation in the pathogenesis of psoriasis have yielded exciting new potential roles of nerve-targeting treatments, namely botulinum toxin type A (BoNT-A), for the management of this disease. This paper aims to review the existing literature on knowledge regarding the potential role of BoNT-A in psoriasis treatment, with a focus on its ability to interfere with the immunopathogenetic aspects of psoriatic disease. Furthermore, in our paper, we are also including the first report of psoriatic les...
Psoriasis is a chronic multisystem inflammatory disease associated with a plethora of comorbiditi... more Psoriasis is a chronic multisystem inflammatory disease associated with a plethora of comorbidities including metabolic syndrome, cardiovascular disease, hypertension, diabetes, hyperlipidemia, obesity, anxiety, depression, chronic kidney disease, and malignancy. Advancement in unveiling new key elements in the pathophysiology of psoriasis led to significant progress in the development of biologic agents which target different signaling pathways and cytokines involved in the inflammatory cascade responsible for the clinical manifestations found in psoriasis. Currently available novel therapeutic options for moderate-severe psoriasis include tumor necrosis factor alpha inhibitors, inhibitors of the interleukin 17, and inhibitors of the interleukin 23. Nevertheless, concerns have been raised with respect to the possible risks associated with the use of biologic therapy requiring close collaboration between dermatologists and physicians of different specialties. Our aim was to perform ...
Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality,... more Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality, with approximately 1.8 million new cases reported worldwide in 2018. Advancements in understanding pathophysiological key steps in CRC tumorigenesis have led to the development of new targeted therapies such as those based on epidermal growth factor receptor inhibitors (EGFR inhibitors). The cutaneous adverse reactions induced by EGFR inhibitors, particularly papulopustular rash, often require long-term antibiotic treatment with tetracycline agents (mostly minocycline and doxycycline). However, this raises several issues of concern: possible occurrence of gut dysbiosis in already vulnerable CRC patients, selection of highly antibiotic resistant and/or virulent clones, development of adverse reactions related to tetracyclines, interference of antibiotics with the response to oncologic therapy, with a negative impact on disease prognosis etc. In the context of scarce information regarding...
Limfomul cutanat cu celule T CD8+ agresiv epidermotrop prezentare atipicã Introducere: Limfomul p... more Limfomul cutanat cu celule T CD8+ agresiv epidermotrop prezentare atipicã Introducere: Limfomul primar cutanat agresiv epidermotrop cu celule T CD8+ este un tip foarte rar de limfom citotoxic cu o tendinåã crescutã de extensie la situsuri extraganglionare, rãspuns slab la terapiile convenåionale pentru limfoamele cutanate cu celule T CD4+ æi prognostic nefavorabil. Prezentare de caz: Prezentãm cazul unui pacient în vârstã de 40 ani care s-a internat în clinica noastrã pentru papule æi plãci infiltrate, ulcerate, acoperite de cruste necrotice generalizate æi ulceraåii dureroase acoperite de depozite albe la nivelul palatului moale æi dur în evoluåie de 18 luni. Tabloul clinic æi histopatologic particular au ridicat reale dificultaåi diagnostice æi terapeutice, pacientul fiind diagnosticat iniåial cu papulozã limfomatoidã, apoi cu limfom cutanat cu celule T æi tratat cu methotrexate, retinoizi aromatici orali æi fototerapie, fãrã beneficiu clinic. În timpul spitalizãrii în clinica noa...
Electrochemotherapy (ECT) is an effective bioelectrochemical procedure that uses controlled elect... more Electrochemotherapy (ECT) is an effective bioelectrochemical procedure that uses controlled electrical pulses to facilitate the increase of intracellular concentration of certain substances (electropermeabilization/ reversible electroporation). ECT using antitumor drugs such as bleomycin and cisplatin is a minimally invasive targeted therapy that can be used as an alternative for oncologic patients not eligible for surgery or other standard therapies. Even though ECT is mainly applied as palliative care for metastases, it may also be used for primary tumors that are unresectable due to size and location. Skin neoplasms are the main clinical indication of ECT, the procedure reporting good curative results and high efficiency across all tumor types, including melanoma. In daily practice, there are many cases in which the patient’s quality of life can be significantly improved by a safe procedure such as ECT. Its popularity must be increased because it has a safe profile and minor loca...
Over the last decade, chronic wounds such as venous or arterial ulcers, diabetic foot ulcers, pre... more Over the last decade, chronic wounds such as venous or arterial ulcers, diabetic foot ulcers, pressure sores, and nonhealing surgical wounds were brought into the spotlight of the medical community, due to their increasing prevalence and to their significant economic burden. Vascular impairment represents the main cause of chronic ulceration, while the infection is the most frequent complication. Chronic infections persist and progress despite an adequate antimicrobial regimen and are typically caused by monoor polymicrobial biofilms. The persistent bacterial colonization of the wound, as well as the longterm use of antibiotics predispose to the development of nosocomial infections with resistant strains, with the risk of life-threatening septic complications, especially in immunocompromised individuals. In this article, we perform a thorough literature review, in order to answer the main controversies regarding the involvement of planktonic Corresponding author: Cornelia Nitipir, M...
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