In this report, we describe the analysis of clonality performed using a PCR-based approach in a group of cutaneous T-cell lymphomas including a case of localised pagetoid reticulosis expressing the gamma delta T-cell receptor. For our PCR analysis DNA was extracted from frozen tissue of 10 cases of cutaneous T-cell lymphomas and subjected to polymerase chain reaction amplification using primers recognizing conserved sequences of the variable and joining regions of the T-cell receptor gamma chain gene. PCR products were then analyzed by high resolution non-denaturing polyacrylamide gel electrophoresis. Clonal TCR gamma gene rearrangements were detected in all the cases investigated including the case of localised pagetoid reticulosis. The PCR-based approach used in this study may provide an alternative to conventional Southern blot analysis for the analysis of cutaneous T-cell lymphomas as it is easy to perform and requires only minimal amounts of DNA. The findings in localized pagetoid reticulosis are consistent with the proliferation of monoclonal T-cells in lesional skin of this condition and provide evidence for the lymphoproliferative nature of this clinically benign disorder.
Only a few studies reported the incidence and risk factors of skin cancers in lung transplant recipients. The aim of this study was to determine the cumulative incidence of skin cancers in a cohort of patients undergoing lung transplantation and to define predictors of their development. About 247 consecutive patients receiving lung transplantation at the Thoracic Surgery Unit of University Hospital of Padova between May 1995 and October 2016 were studied. Cumulative incidence of skin cancers was estimated considering death as a competing event. The effect of potential predictors was evaluated with univariate and multivariable Cox models for competing risks. About 37 (15.0%) patients developed skin tumors. The cumulative incidence of any skin cancer was 14.2% at 5 years, 21.4% at 10 years, and 24.3% at 15 years posttransplantation. Age at transplantation, male gender, phototype II, and voriconazole use were independent risk factors for development of squamous cell carcinoma. Only male gender and phototype II were independent risk factors for development of basal cell carcinoma. Since lung transplant recipients have a greater risk of developing skin cancers, the management of these patients needs a multidisciplinary approach, in which dermatologists and transplant physicians have a primary role.
The aims of this study were to investigate the presence of γδ T cells in normal human skin, and the possible role of these cells in cutaneous reactions. Twenty-eight samples of normal skin from various sites, and 52 biopsies from inflammatory and neoplastic skin conditions were investigated by immunohistochemical techniques. In normal human skin γδ T cells were infrequently seen in the epidermis and dermis. In the inflammatory and neoplastic dermatoses, γδ T cells were occasionally present, accounting for 0–5% of CD3+ cells in most of the biopsies examined. In one case of pityriasis lichenoides chronica and one case of lichen planus γδ T cells were found to be increased, accounting for 15% of the CD3+ cells in each case. Dermal γδ T cells were markedly increased in three of six cases of Langerhans cell histiocytosis. with up to 30% of dermal CD3+ cells showing positive staining to an anti-T-cell receptor γδ monoclonal antibody. In two of these cases γδ T cells were seen in both the dermis and the epidermis. In two further cases dermal γδ T cells were not a prominent feature, but small clusters of epidermal γδ T cells were observed. T cells bearing the γδ T-cell receptor are thus not a major feature of normal human epidermis, unlike the murine system, where the great majority of epidermal lymphocytes express the γδ T-cell receptor. The finding of numerous γδ T cells in Langerhans cell histiocytosis suggests a possible functional relationship between γδ T cells and Langerhans cells or possibly a pathogenic role of these cells in Langerhans cell histiocytosis.
Merkel cell carcinoma (MCC) is a rare neuroendocrine carcinoma of the skin. It is highly aggressive and represents the second most common cause of skin cancer-related death. Ruxolitinib is an orally administered selective inhibitor of Janus associated kinases1 and 2, which is used in the management of patients with symptomatic myelofibrosis and polycythemia vera who are non-responders or intolerant to hydroxyurea. Herein, we report the case of a 47-year-old woman with a 14-year history of chronic myeloproliferative syndrome initially treated with hydroxyurea for 4 years. She was then enrolled in the Response trial and treated for 7 years with ruxolitinib subsequently developing an MCC. This report shows the possibility of development of MCC in patients treated with ruxolitinib. Periodic skin examination is indicated in patients who undergo ruxolitinib therapy, especially if they have a history of skin cancer; dermatologists and oncohematologists should be aware of this possibility in order to introduce appropriate preventive strategies.
Table S1. Genotypic frequencies of MC1R non-synonymous variants. Table S2. Logistic regression analysis for risk of melanoma according to MC1R genotype. Table S3. Risk of melanoma dependent MC1R allelic variants stratified according to clinical risk factors and childhood sunburn. Appendix S1. Material and methods. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
