Publications by authors named "Gerardo Cazzato"

Hidradenocarcinoma (HAC) is a rare malignant neoplasm originating from eccrine sweat glands, often presenting diagnostic challenges because of its resemblance to other malignancies, particularly breast cancer when occurring in the chest region. This report describes 2 cases of HAC with axillary lymph node metastasis, both initially misinterpreted clinically. The first case involved a 63-year-old woman with a sternal mass, near the right breast, initially suspected to be a sebaceous cyst.

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: Wound healing is a complex process involving cellular, anatomical, and functional repair, often hindered in chronic wounds associated with diseases like diabetes and vascular disorders. This study investigated the efficacy of conventional and regenerative wound healing approaches in a sheep surgical wound model. : Six female Bergamasca sheep underwent five full-thickness skin lesions treated with various methods: sterile gauze (control), chlorhexidine, sodium hypochlorite, micronized dermis system application, and dermal matrix.

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Background: The aim of the paper is to present a single-center experience with two-stage pre-pectoral breast reconstruction using tissue expander entirely covered by acellular dermal matrix (ADM), reporting surgical indications, technique, clinical and histological outcomes.

Materials And Methods: A prospectively maintained database of consecutive patients who had undergone immediate pre-pectoral expander-based breast reconstruction with ADM over a two years period (2019-2021) was analyzed. The primary clinical outcome measures included patients' subjective assessment of satisfaction and pain.

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Over the past decade, advancements in molecular biology have contributed to changes in the diagnostic classification of Spitz neoplasms, including Spitz nevi, atypical Spitz tumors, and Spitz melanomas. The recent World Health Organization classification of skin tumors identifies fusion kinases, including NTRK1, NTRK2, and NTRK3, as critical drivers of these lesions. New fusion genes have continued to expand the spectrum of known molecular alterations, particularly within the category of Spitz NTRK-rearranged lesions.

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Article Synopsis
  • Pathology is essential for accurately diagnosing skin tumors, which is important for creating tailored treatment plans and improving patient care in dermatology.
  • The updated WHO classification of skin tumors includes new sections on nail unit tumors, skin metastases, and genetic syndromes, alongside advancements in understanding various skin tumors on molecular levels.
  • Recent findings, particularly regarding melanocytic tumors, have led to new terminology and an integrated diagnostic approach that emphasizes morphology, immunohistochemistry, and molecular features, aiding clinical decision-making and fostering collaboration in treatment development.
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Background: Risk stratification and treatment benefit prediction models are urgent to improve negative sentinel lymph node (SLN-) melanoma patient selection, thus avoiding costly and toxic treatments in patients at low risk of recurrence. To this end, the application of artificial intelligence (AI) could help clinicians to better calculate the recurrence risk and choose whether to perform adjuvant therapy.

Methods: We made use of AI to predict recurrence-free status (RFS) within 2-years from diagnosis in 94 SLN- melanoma patients.

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Angiogenesis, the formation of new blood vessels from pre-existing ones, is a crucial process in the progression and metastasis of melanoma. Recent research has highlighted the significant role of epigenetic modifications in regulating angiogenesis. This review comprehensively examines the current understanding of how epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs, influence angiogenic pathways in melanoma.

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Purpose: Even today, melanoma is a highly aggressive neoplasm with a high mortality rate. The nodular type is very aggressive and has cerebroid nests of melanocytes (CNMs) at the growth edge, morphologically similar to the poorly differentiated neoplastic epithelial cell clusters described in colorectal, breast, and endometrioid endometrial cancers.

Patients And Methods: We selected 25 nodular melanomas (NMs) with known molecular profiles, of which the entire paraffin-embedded lesion was available.

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Non-Hodgkin lymphomas (NHLs) encompass a diverse group of malignancies arising from B cells, T cells, and natural killer (NK) cells at various stages of differentiation. Conversely, classical Hodgkin lymphomas (cHLs) primarily feature Reed-Sternberg cells (RSCs) amid a background of reactive immune cells. Immunomodulatory pathways, notably the PD-1/PD-L1 axis, play pivotal roles in tumor immune evasion across both NHLs and cHLs.

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  • Nodular fasciitis (NF) and proliferative fasciitis (PF) are benign tumors that can appear like cancer due to their fast growth and tissue characteristics, with NF mostly seen in young adults and PF in older adults.* * The article discusses two rare pediatric cases: a six-year-old with NF in the vulvar area and a ten-year-old with PF in the gluteal region, both showing rapid growth and unique tissue features.* * These cases emphasize the need for accurate diagnosis to prevent misdiagnosis and ensure proper treatment, especially since such conditions are rare in children and require more awareness among healthcare professionals.*
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  • The diagnosis of herpes zoster (HZ) can be complicated by atypical histological presentations that don’t show the usual viral changes.
  • The review focuses on the existing research around these atypical skin manifestations and highlights the importance of recognizing subtle hints in the histology.
  • Techniques like immunohistochemistry are discussed to aid in accurate diagnosis, along with common mistakes that can occur in this process.
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  • * The exact cause of cCS is unknown; it may arise from a single cell capable of differentiating into both types of tissue or from the interaction of existing carcinoma and sarcoma cells.
  • * Histologically, cCS can show various types of epithelial and sarcomatous characteristics, necessitating further research to improve understanding of its development and treatment options.
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ACE2 is a mono-carboxypeptidase with remarkable vasculo-protective properties, and its expression in the human placenta plays a central role in blood pressure homeostasis and fetal perfusion. Therefore, an alteration in the placental expression of ACE2 could be responsible for reduced placental perfusion and infantile hemangioma (IH) development. Study placentae were collected from patients affected by IHs who were referred to our Dermatology Clinic from 2016 to 2022, while control placentae were randomly collected while matching cases for gestational age.

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Merkel cell carcinoma (MCC) is a rare, highly aggressive, primitive neuroendocrine carcinoma of the skin, the origin of which is not yet fully understood. Numerous independent prognostic factors have been investigated in an attempt to understand which are the most important parameters to indicate in the histological diagnostic report of MCC. Of these, mast cells have only been studied in one paper before this one.

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Background: Accurate characterization of newly diagnosed a solid adnexal lesion is a key step in defining the most appropriate therapeutic approach. Despite guidance from the International Ovarian Tumor Analyzes Panel, the evaluation of these lesions can be challenging. Recent studies have demonstrated how machine learning techniques can be applied to clinical data to solve this diagnostic problem.

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Artificial intelligence (AI) has evolved to become a significant force in various domains, including medicine. We explore the role of AI in pathology, with a specific focus on dermatopathology and neoplastic dermatopathology. AI, encompassing machine learning and deep learning, has demonstrated its potential in tasks ranging from diagnostic applications on whole slide imaging to predictive and prognostic functions in skin pathology.

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  • Acral amelanotic melanomas (AAMs) are rare skin cancers found on areas like palms and soles, often misdiagnosed due to their lack of pigmentation and benign appearance, which leads to treatment delays and worse outcomes.
  • A systematic review analyzed 26 cases of AAMs misdiagnosed as other conditions, revealing a balanced gender distribution, an age range of 38-91 years, and highlighting that the foot was the most common site of these lesions.
  • The study emphasizes the need for more biopsy evaluations in lower extremity lesions to improve diagnosis rates, as only 7.1% of foot lesions underwent histological assessment, compared to 50% for upper extremity cases.
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Angiogenesis plays a pivotal role in tumor progression, particularly in melanoma, the deadliest form of skin cancer. This review synthesizes current knowledge on the intricate interplay between angiogenesis and tumor microenvironment (TME) in melanoma progression. Pro-angiogenic factors, including VEGF, PlGF, FGF-2, IL-8, Ang, TGF-β, PDGF, integrins, MMPs, and PAF, modulate angiogenesis and contribute to melanoma metastasis.

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Epidermolysis Bullosa (EB) is an extremely rare and disabling inherited genetic skin disease with a predisposition to develop bullous lesions on the skin and inner mucous membranes, occurring after mild friction or trauma, or even spontaneously. Within the spectrum of EB forms, dystrophic EB (DEB) represents the most intriguing and challenging in terms of clinical management, especially with regard to pregnancy, due to the highly disabling and life-threatening phenotype. Disappointingly, in the literature little focus has been directed towards pregnancy and childbirth in DEB patients, resulting in a lack of sound evidence and guidance for patients themselves and clinicians.

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  • Lichen amyloidosis (LA) is a skin condition with itchy brownish papules mainly on the lower legs and sometimes linked to atopic dermatitis (AD), though its exact cause is unclear.
  • Treatment options include antihistamines, laser therapy, and corticosteroids, but Dupilumab may also be beneficial due to its connection with AD.
  • A case study of a 52-year-old woman with LA and AD showed that after using Dupilumab, both conditions resolved after one year, suggesting Dupilumab's effectiveness and safety for LA treatment.
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Cutaneous perivascular hemophagocytosis (CH) is a histological manifestation that manifests as systemic hemophagocytic syndrome, also known as hemophagocytic lymphohistiocytosis, when accompanied by fever, hepatosplenomegaly, liver dysfunction, and cytopenia, and may rarely manifest independently of hemophagocytic lymphohistiocytosis. CH typically presents as purpuric or brownish macules and patches on the extremities, abdomen, and trunks. Histopathologically, the hallmark of CH includes extravasated erythrocytes and karyorrhectic debris phagocytized by histiocytes, associated with dermal capillary ectasia, perivascular infiltration of neutrophils, nuclear dust, and histiocytes without atypia.

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Thymic epithelial tumors (TETs) are rare mediastinal cancers originating from the thymus, classified in two main histotypes: thymoma and thymic carcinoma (TC). TETs affect a primary lymphoid organ playing a critical role in keeping T-cell homeostasis and ensuring an adequate immunological tolerance against "self". In particular, thymomas and not TC are frequently associated with autoimmune diseases (ADs), with Myasthenia Gravis being the most common AD present in 30% of patients with thymoma.

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