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Miraglia E, Laghi A, Moramarco A, Giustini S. Juvenile xanthogranuloma in neurofibromatosis type 1. Prevalence and possible correlation with lymphoproliferative diseases: experience of a single center and review of the literature. Clin Ter 2022; 173:353-355. [PMID: 35857053 DOI: 10.7417/ct.2022.2445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Neurofibromatosis type 1 (NF1), is a rare genetic disorder that may involve almost every organ system in the body such as cutaneous, ophthalmologic and central and peripheral nervous system. Cutaneous findings are usually the first sign of the disease. In this study, we investigate the real prevalence of xanthogranulomas juvenile (JXG) and possible correlation with lymphoproliferative diseases. This is a retrospective study conducted on a population with NF1 followed by February 1983 to February 2022 at the "Sapienza" University of Rome, Italy. We investigate the real prevalence of juvenile xanthogranuloma in NF1 and possible correlation with lymphoproliferative diseases. JXG was present in 39 cases (3.1%). JXG is more frequent in NF1 than in the general population while the possible association with lymphoproliferative diseases in NF1 remains controversial.
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Affiliation(s)
- E Miraglia
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - A Laghi
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - A Moramarco
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - S Giustini
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
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Roberti V, Miraglia E, Laghi A, Iacovino C, Moliterni E, Giustini S. Tumors in patients with neurofibromatosis type 1: a single- center retrospective study. Clin Ter 2022; 173:135-140. [PMID: 35385036 DOI: 10.7417/ct.2022.2407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the risk and pattern of tumors in italian neurofibromatosis type 1 (NF1) patients. MATERIALS AND METHODS A retrospective single institution case review of 711 patients (seen between March 1992 and February 2018) with NF1 was conducted to identify individuals with diagnoses of both NF1 and neoplasm. NF1-associated tumors have been collected and analyzed. RESULTS We identified 221 tumors in 191 subjects with a percentage of 26.9%, diagnosed at a median age of 32.5 years (range, 0.6-70.1 years); 111 of these patients were females (58%) and all were fol-lowed up for a median of 5.3 years. The cumulative risks for tumor in patients with NF1 by the ages of 30 and 60 years were 10% and 42.5%, respectively. In our patients with tumor, overall survival at 70 years was significantly shorter than in those without it (50% vs 95%, P<0.0001). We found an unequivocally increased incidence for breast cancer in females (33 cases observed). CONCLUSIONS Tumors that develop in patients with NF1 are heterogeneous, our data are consistent with other reports suggesting an increase in some cancers risk among these individuals, therefore systematic medical follow-up in people with NF1 is important.
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Affiliation(s)
- V Roberti
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - E Miraglia
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - A Laghi
- Department of Medicine, Dermatology Unit, Celio Military Hospital, Rome, Italy
| | - C Iacovino
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - E Moliterni
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - S Giustini
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
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Miraglia E, Moliterni E, Iacovino C, Chello C, Laghi A, Giustini S. Madelung's disease. Two case reports with pseudoathletic appearance. Clin Ter 2021; 172:190-192. [PMID: 33956034 DOI: 10.7417/ct.2021.2311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract Madelung's disease is a rare syndrome characterized by the pre-sence of multiple masses of unencapsulated adipose tissue, symme-trically distributed throughout different regions. It predominantly affects middle-aged men of Mediterranean origin with a history of alcoholism. The pathogenesis is still unknown. Diagnosis is essentially established through clinical history and physical examination. We report two cases for their unusual presentation and to emphasize the importance of early diagnosis.
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Affiliation(s)
- E Miraglia
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - E Moliterni
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - C Iacovino
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - C Chello
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - A Laghi
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - S Giustini
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
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Iacovino C, Miraglia E, Moramarco A, Corbo G, Lambiase A, Giustini S. Ectropion Uveae in neurofibromatosis type 1: a new manifestation. Clin Ter 2021; 172:206-208. [PMID: 33956037 DOI: 10.7417/ct.2021.2314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract Neurofibromatosis type 1 (NF1) is a rare genetic disorder with an autosomal dominant transmission and an estimated incidence of 1:2500-3500 live birth. Penetrance is virtually 100%, but the expression is highly variable and almost every organ can be affected. Diagnosis of NF1 is made with at least two of the following diagnostic criteria: six or more cafè-au-lait spots, two neurofibromas or one plexiform neurofibroma, axillary or groin freckling, optic glioma, two Lisch nodules, bone dysplasia and first-degree relative with NF1. Other ocular manifestations include orbital neurofibromas, cafè-au-lait spots on the eyelids, congenital dysplasia of the sphenoids wing and con-genital glaucoma and choroidal abnormalities. Congenital Ectropion Uveae (CEU) is a rare, non-progressive anomaly characterized by the presence of iris pigment epithelium on the anterior surface of the iris stroma, resulting from its proliferation. CEU probably depends on embryological disorders in neural cells and/or neuroectoderm of the optic cell. In this paper the authors describe three patients with CEU and NF1 found in 243 consecutive NF1 patients.
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Affiliation(s)
- C Iacovino
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - E Miraglia
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
| | - A Moramarco
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - G Corbo
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - A Lambiase
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - S Giustini
- Dermatologic Clinic, "Sapienza" University of Rome, Rome, Italy
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Miraglia E, Moliterni E, Iacovino C, Roberti V, Laghi A, Moramarco A, Giustini S. Cutaneous manifestations in neurofibromatosis type 1. Clin Ter 2020; 171:e371-e377. [PMID: 32901776 DOI: 10.7417/ct.2020.2242] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To better understand the real prevalence of cutaneous manifestations, in Neurofibromatosis type 1. MATERIALS AND METHODS We reviewed all clinical charts of 1102 NF1 patients followed by February 1983 to February 2020 at the "Sapienza" University of Rome, Italy. NF1 patients are seen usually every year by a dermatologist. RESULT Café-au-lait macules were shown in 1063 patients (96.5%), axillary and inguinal freckling in 991 (90%) and neurofibromas in 861 (78.1%). Other skin manifestations included: lipoma (6.2%), nevus anemicus (3.9%), psoriasis (3.4%), spilus nevus (3.2%), juvenile xanthogranuloma (3.2%), vitiligo (2.3%), Becker's nevus (1.9%), melanoma (0.7%) and poliosis (0.5%). CONCLUSION Neurofibromatosis type 1 is a multisystem disorder primarily involving the skin and nervous system. The clinical manifestations are extremely variable even within a family. This study was performed to delineate the prevalence of cutaneous manifestations in NF1.
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Affiliation(s)
- E Miraglia
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - E Moliterni
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - C Iacovino
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - V Roberti
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - A Laghi
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - A Moramarco
- Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy
| | - S Giustini
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
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Celli M, Iacovino C, Febbo A, Lotti LV, Miraglia E, Celli L, Roberti V, Sernicola A, Zambrano A, Turchetti A, Vespa S, Giustini S. Ultrastructure study of skin fibroblasts in patients with Ehlers-Danlos Syndrome (EDS): preliminary results. Clin Ter 2020; 171:e431-e436. [PMID: 32901788 DOI: 10.7417/ct.2020.2253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM OF THE STUDY To investigate, in vivo and in vitro, the fibroblast-to-myofibroblast transition in patients with hypermobile Ehlers-Danlos Syndrome (EDS). To analyze the dermis of patients with classical form of EDS (cEDS) and with hEDS, to identify qualitative and/or quantitative differences in ECM component and ultrastructural changes in collagen. MATERIALS AND METHODS Seven subjects, aged over 18, two with cEDS and five with hEDS underwent two skin biopsy. One sample was prepared for transmission electron microscopy (TEM), the other for immunofluorescence. The diameter of collagen fibers was measured with TEM. Fibrils were analyzed in four patients: the two with cEDS and two with hEDS. For each patient, the diameter of n=250 collagen fibrils was measured. αSMA was used as specific marker for myofibroblast to highlight their presence in vivo in the skin of patients with hEDS. RESULT IF observation could not assess an increased expression of αSMA in hEDS patients, which showed no statistical difference compared to classic form patients. The major result from the analysis of TEM images is the clear difference in ECM composition between the two forms of EDS: ECM in hEDS is optically more dense and more prominently composed of elastic fibers. CONCLUSION Our study provides the following important evidence: 1) the absence in vivo of dermal fibroblasts in patients with hEDS, demonstrated by αSMA negativity; 2) the presence of statistically significant changes in the diameter of collagen fibrils between the classic and the hypermobile forms.
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Affiliation(s)
- M Celli
- Department of Pediatrics, "Sapienza", University of Rome, Rome
| | - C Iacovino
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - A Febbo
- Department of Pediatrics, "Sapienza", University of Rome, Rome
| | - L V Lotti
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome
| | - E Miraglia
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - L Celli
- Department of Pediatrics, "Sapienza", University of Rome, Rome
| | - V Roberti
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - A Sernicola
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
| | - A Zambrano
- Department of Pediatrics, "Sapienza", University of Rome, Rome
| | - A Turchetti
- Department of Pediatrics, "Sapienza", University of Rome, Rome
| | - S Vespa
- Center of Sciences on Aging and Translational Medicine (CeSI-MeT), "G. d'Annunzio" University, Chieti, Italy
| | - S Giustini
- Dermatologic Clinic, "Sapienza" University of Rome, Rome
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Talamonti M, Galluzzo M, Chiricozzi A, Quaglino P, Fabbrocini G, Gisondi P, Marzano AV, Potenza C, Conti A, Parodi A, Belloni Fortina A, Bardazzi F, Argenziano G, Rongioletti F, Stingeni L, Micali G, Loconsole F, Venturini M, Bongiorno MR, Feliciani C, Rubegni P, Amerio P, Fargnoli MC, Pigatto P, Savoia P, Nisticò SP, Giustini S, Carugno A, Cannavò SP, Rech G, Prignano F, Offidani A, Lombardo M, Zalaudek I, Bianchi L, Peris K. Management of biological therapies for chronic plaque psoriasis during COVID-19 emergency in Italy. J Eur Acad Dermatol Venereol 2020; 34:e770-e772. [PMID: 32735716 PMCID: PMC7436412 DOI: 10.1111/jdv.16841] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 01/07/2023]
Affiliation(s)
- M Talamonti
- Dermatology Department, University of Rome 'Tor Vergata', Rome, Italy
| | - M Galluzzo
- Dermatology Department, University of Rome 'Tor Vergata', Rome, Italy
| | - A Chiricozzi
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Quaglino
- Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - G Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - C Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi' Sapienza University of Rome - Polo Pontino, Rome, Italy
| | - A Conti
- Dermatologic Unit, Department of Specialized Medicine, AOU Policlinico di Modena, Modena, Italy
| | - A Parodi
- Ospedale-Policlinico San Martino IRCCS Genova, Clinica Dermatologica DiSSal Università di Genova, Genova, Italy
| | - A Belloni Fortina
- Dermatology Unit - Department of Medicine DIMED, University of Padova, Padova, Italy
| | - F Bardazzi
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - F Rongioletti
- Section of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - L Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Loconsole
- Department of Biomedical Science and Human Oncology, Unit of Dermatology, University of Bari, Bari, Italy
| | - M Venturini
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - M R Bongiorno
- Section of Dermatology, Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization, University of Palermo, Palermo, Italy
| | - C Feliciani
- Department of Medicine and Surgery, Section of Dermatology, University of Parma, Parma, Italy
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Italy
| | - P Amerio
- Department of Medicine and Aging Science, Dermatologic Clinic, G. D'Annunzio University, Chieti, Italy
| | - M C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Pigatto
- Department of Biomedical, Surgical and Dental Sciences, Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, University of Milan, Milan, Italy
| | - P Savoia
- Department of Health Science, Dermatologic Clinic, University of Eastern Piedmont, Novara, Italy
| | - S P Nisticò
- Dermatology Unit, Department of Health Sciences, Università Magna Graecia, Catanzaro, Italy
| | - S Giustini
- Department of Dermatology, Sapienza' University of Rome, Rome, Italy
| | - A Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - S P Cannavò
- Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G Rech
- Division of Dermatology, Santa Chiara Hospital, Trento, Italy
| | - F Prignano
- Dermatology Clinic, Department of Health Sciences, University of Florence, Florence, Italy
| | - A Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - M Lombardo
- Unit of Dermatological Diseases, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - L Bianchi
- Dermatology Department, University of Rome 'Tor Vergata', Rome, Italy
| | - K Peris
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Moramarco A, Sacchetti M, Franzone F, Segatto M, Cecchetti D, Miraglia E, Roberti V, Iacovino C, Giustini S. Ocular surface involvement in patients with neurofibromatosis type 1 syndrome. Graefes Arch Clin Exp Ophthalmol 2020; 258:1757-1762. [PMID: 32388624 DOI: 10.1007/s00417-020-04717-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 01/19/2023] Open
Abstract
PURPOSE The aim of this study is to evaluate ocular surface morphological and functional changes in patients with neurofibromatosis type 1 (NF1). METHODS Twenty-eight patients with NF1 and 14 healthy subjects were included in this study. All participants underwent a medical history collection, a complete ophthalmological examination including slit lamp exam and assessment of best-corrected visual acuity (BCVA), corneal sensitivity, and lacrimal function (Schirmer test and fluorescein tear break-up time test). Corneal nerves' morphology and endothelial cells density were evaluated by in vivo corneal confocal microscopy (IVCM). Tear and conjunctiva epithelium samples were collected to evaluate nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) tear levels and conjunctival expression of their receptors TrkA and p75NTR. RESULTS Patients with NF1 showed a significant decrease of FTBUT when compared with healthy subjects (p < 0.001). Corneal sensitivity was ≤ 50 mm in 46% of NF1 patients. IVCM showed a significant increase of corneal nerve branching and of corneal endothelial cells density. No significant difference was observed between the two groups on NGF and BDNF tear levels and conjunctival expression of their receptors. CONCLUSION This study demonstrated the presence of ocular surface changes in NF-1 patients including decrease of tear stability and of corneal sensitivity. Patients with NF1 also showed changes of corneal endothelial cells' density.
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Affiliation(s)
- Antonietta Moramarco
- Department of Sense Organs, 'Sapienza' University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - M Sacchetti
- Department of Sense Organs, 'Sapienza' University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - F Franzone
- Department of Sense Organs, 'Sapienza' University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Segatto
- Department of Biosciences and Territory, University of Molise, Contrada Fonte Lappone, 86090, Pesche, Italy
| | - D Cecchetti
- Department of Sense Organs, 'Sapienza' University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Miraglia
- Department of Dermatology, 'Sapienza' University of Rome, Rome, Italy
| | - V Roberti
- Department of Dermatology, 'Sapienza' University of Rome, Rome, Italy
| | - C Iacovino
- Department of Dermatology, 'Sapienza' University of Rome, Rome, Italy
| | - S Giustini
- Department of Dermatology, 'Sapienza' University of Rome, Rome, Italy
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9
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Moramarco A, Lambiase A, Mallone F, Miraglia E, Giustini S. A characteristic type of retinal microvascular abnormalities in a patient with Neurofibromatosis type 1. Clin Ter 2019; 170:e4-e9. [PMID: 30789191 DOI: 10.7417/ct.2019.2101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study aims to describe a typical retinal microvascular abnormality in patients with neurofibromatosis type 1 (NF-1). A 64-year-old man with diagnosis of NF-1 was evaluated by complete ophthalmological examination, including fluorescein angiography and spectral Domain OCT in Near-Infrared (NIR-OCT) modality. Slit lamp exam showed the presence of more than 10 Lisch nodules for each eye. Ophthalmic examinations and NIR-OCT scans showed the presence of retinal tortuous vessels ending in a 'puff of smoke' arrangement. The clinical significance as diagnostic and prognostic factor of this novel type of retinal microvascular abnormality in NF-1 should be further investigated.
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Affiliation(s)
- A Moramarco
- Department of Organ of Sense, Sapienza University of Rome, Rome
| | - A Lambiase
- Department of Organ of Sense, Sapienza University of Rome, Rome
| | - F Mallone
- Department of Organ of Sense, Sapienza University of Rome, Rome
| | - E Miraglia
- Department of Dermatology, Sapienza University of Rome, Rome, Italy
| | - S Giustini
- Department of Dermatology, Sapienza University of Rome, Rome, Italy
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10
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Rossi A, Miraglia E, Fortuna M, Calvieri S, Giustini S. Topical cetirizine and oral vitamin D: a valid treatment for hypotrichosis caused by ectodermal dysplasia. J Eur Acad Dermatol Venereol 2017; 31:367-370. [DOI: 10.1111/jdv.13864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/21/2016] [Indexed: 11/28/2022]
Affiliation(s)
- A. Rossi
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - E. Miraglia
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - M.C. Fortuna
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - S. Calvieri
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - S. Giustini
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
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11
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Miraglia E, Fabbrini G, Di Biasi C, Iacovino C, Ferrazzano G, Gualdi G, Calvieri S, Giustini S. Chiari type 1 malformation in Neurofibromatosis type 1: experience of a center and review of the literature. Clin Ter 2016; 167:e6-10. [PMID: 26980639 DOI: 10.7417/t.2016.1912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the possible correlation and the true incidence between Neurofibromatosis type 1 and Arnold-Chiari malformation type I. MATERIALS AND METHODS We reviewed all clinical charts, neurological consultations and MRI scans of 428 NF1 patients followed by 1994 to 2014 in our Department. NF1 patients in our clinic are seen usually every year by both the dermatologist and the neurologist. All patients also undergo a brain and spinal cord with the same 1.5 Tesla MRI scan. RESULTS We found a diagnosis of Arnold Chiari malformation type I in 9 of the 428 NF1 cases (2%). CONCLUSION This frequency is higher than that expected on the basis of a chance association. Therefore we underline the importance of serial MRI studies in patients with NF1 to assess the presence of cranio-cervical anomalies. Future studies should try to better understand what are the pathogenetic mechanisms underlying this close association.
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Affiliation(s)
- E Miraglia
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
| | - G Fabbrini
- Department of Neurology and Psychiatry, Sapienza - University of Rome, Rome - IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | - C Di Biasi
- Department of Radiology DEA, Sapienza - University of Rome, Rome
| | - C Iacovino
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
| | - G Ferrazzano
- Department of Neurology and Psychiatry, Sapienza - University of Rome, Rome
| | - G Gualdi
- Department of Radiology DEA, Sapienza - University of Rome, Rome
| | - S Calvieri
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
| | - S Giustini
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
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12
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Cantisani C, Miraglia E, Giustini S, Calvieri S. Multiple painful papulo-nodular lesions: clinical pitfall. Clin Ter 2014; 165:e423-5. [PMID: 25524199 DOI: 10.7417/ct.2014.1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 43-year-old male presented with multiple (>10) painful, papulo-nodular lesions, associated with paresthesia, over the face, neck and trunk, appeared 15 years prior and increased with time. The patient's brother has cutaneous leiomyomas and testicle cancer, his mother underwent hysterectomy for symptomatic leiomyomas while his maternal grandfather died from aggressive renal cell carcinoma at age 57 years. The patient reported that he had removed a kidney cancer 5 years prior. Dermoscopy, histologic evaluation and genetical analysis were done and Hereditary leiomyomatosis and renal cell carcinoma was diagnosed.
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Affiliation(s)
- C Cantisani
- Department of Dermatology. "Sapienza" University, Rome, Italy
| | - E Miraglia
- Department of Dermatology. "Sapienza" University, Rome, Italy
| | - S Giustini
- Department of Dermatology. "Sapienza" University, Rome, Italy
| | - S Calvieri
- Department of Dermatology. "Sapienza" University, Rome, Italy
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13
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Miraglia E, Cantisani C, Giustini S, Ambrifi M, Soda G, Calvieri S. Basal cell carcinomas in a young woman with Steinert's disease. Dermatol Online J 2014; 20:13030/qt15k425wz. [PMID: 25148278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 08/15/2014] [Indexed: 06/03/2023] Open
Abstract
Steinert's disease or Myotonic dystrophy type I (DM1) is an autosomal dominant disease characterized by myotonia, muscular dystrophy, cataracts, hypogonadism, frontal balding, and electrocardiographic alterations.Several tumors have been associated with DM1 such as pilomatricoma, thymomas and insulinomas. Herein, we describe the unusual onset of multiple basal cell carcinomas in a young woman with DM1.
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Miraglia E, Pecorella I, Persechino F, Visconti B, Calvieri S, Giustini S. A rare association between neurofibromatosis type 1 and vulvar sarcoma. GIORN ITAL DERMAT V 2014; 149:374-376. [PMID: 24819769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- E Miraglia
- Department of Dermatology, La Sapienza University of Rome, Policlinico Umberto I, Rome, Italy -
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15
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Miraglia E, Cantisani C, Giustini S, Ambrifi M, Soda G, Calvieri S. Basal cell carcinomas in a young woman with Steinert’s disease. Dermatol Online J 2014. [DOI: 10.5070/d3208023530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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16
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Curatolo P, Rotunno R, Miraglia E, Mancini M, Calvieri S, Giustini S. Complete remission of Merkel cell carcinoma treated with electrochemotherapy and etoposide. GIORN ITAL DERMAT V 2013; 148:310-311. [PMID: 23670070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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17
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Cavallaro G, Pedullà G, Crocetti D, D'Ermo G, Giustini S, Calvieri S, De Toma G. Vacuum-assisted closure treatment of leg skin necrosis after angiographic embolization of a giant plexiform neurofibroma. G Chir 2012; 33:239-242. [PMID: 22958807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Type 1 neurofibromatosis is a relatively common inherited disease of the nervous system, with a frequency of almost 1 in 3000. It is associated with neurofibromas of various sites. Our case report is about the surgical management of a giant neurofibroma of the right gluteal fold in a 46-year-old male with NF1. The patient presented with increasing edema and accelerated growth of the mass; he underwent percutaneous embolization of lesion vessels that induced necrosis of the neurofibroma. The patient was taken to the operating room, where surgical resection of the bulk of the lesion was undertaken. The postoperative course was complicated by delayed wound closure managed with antibiotics and vacuum-assisted wound closure. Giant neurofibromas similar to this tumor require complex preoperative, intraoperative and postoperative management strategies. Surgical debulk is best managed with preoperative percutaneous embolization that help to avoid surgical bleeding. Postoperative delayed wound closure was managed with the application of negative pressure in a closed environment that triggers granulation and tissue formation.
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Affiliation(s)
- G Cavallaro
- Department of Medico-Surgical Sciences and Biotechnologie, Sapienza University of Rome, Italy
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18
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Cavallaro G, Crocetti D, Pedullà G, Giustini S, Letizia C, De Toma G. Retrocaval mass in patient with von Recklinghausen disease: case report. G Chir 2012; 33:26-30. [PMID: 22357435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Type I Neurofibromatosis (NF1) is an autosomal-dominant inheritable disorder, with an incidence of 1:3,000, and a prevalence of 1:4,000 to 5,000. Pathogenesis is based on mutations of the NF1 gene, a tumor suppressor gene encoding a cytoplasmic protein named neurofibromin that controls cellular proliferation. Patients affected by NF1 typically present with cutaneous neurofibromas, cafè au lait spots and eye involvement, but they can also be affected by various visceral tumors, such as neurofibromas (nodular or plexiform type), gastrointestinal stromal tumors or endocrine tumors, such as pheochromocytomas. Visceral neurofibromas are often asymptomatic but when growing in size they may present with pain, palpable abdominal mass, symptoms secondary to bowel obstruction or main vessels compression, and even gastrointestinal bleeding when mucosa or submucosa are involved. In these cases surgery becomes mandatory in order to remove all neoplastic tissue. The Authors describe a case of a young man affected by NF1 with associated retrocaval abdominal mass with compression and displacement of the inferior vena cava, thus requiring a complex surgical procedure.
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Affiliation(s)
- G Cavallaro
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza " University of Rome, Italy
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19
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Onesti MG, Carella S, Spinelli G, Martano A, Giustini S, Scuderi N. A study of 17 patients affected with plexiform neurofibromas in upper and lower extremities: comparison between different surgical techniques. Acta Chir Plast 2009; 51:35-40. [PMID: 20050419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Plexiform neurofibromas (PN) are one of the most common and severe types of neurofibroma that occur in neurofibromatosis type I. These tumours affect long portions of nerves, infiltrating the nerve and surrounding tissue thus causing significant pain, deformity and functional problems in the affected part of the body. Treatment of this variant of neurofibromas is currently surgical. The aim of this study was to analyze the surgical treatment of plexiform neurofibromas in the lower and upper extremities. The clinical pathological features of 29 neurofibromas, 12 in the upper extremities and 17 in the lower extremities, as diagnosed at the Department of Plastic and Reconstructive Surgery of University "La Sapienza" in Rome from 2000 to 2007, were reviewed. We established that subtotal and total resection without functional destruction is often possible for superficial PN.
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Affiliation(s)
- M G Onesti
- Department of Dermatology and Plastic Reconstructive Surgery, University of Rome "Sapienza", Rome, Italy.
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Porciello R, Divona L, Strano S, Carbone A, Calvieri C, Giustini S. Leopard syndrome. Dermatol Online J 2008; 14:7. [PMID: 18627709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
The L.E.O.P.A.R.D. syndrome is an autosomal, dominant disorder with characteristic features that include: multiple lentigines, café au lait spots, electrocardiographic conduction abnormalities, ocular hypertelorism, obstructive cardiomyopathy, pulmonary stenosis, abnormal (male) genitalia, retardation of growth, and deafness. Patients do not usually present all the clinical features traditionally associated with the disorder. Indeed, several features are not present until late in life and do not become clinically manifest until puberty. It has been observed that this syndrome is caused by a "missense" mutation in PTPN11, a gene encoding the protein tyrosine phosphatase SHP-2 located on chromosome 12q22. A diagnosis of LEOPARD syndrome may be established exclusively on the basis of clinical criteria. In our case, the patient was diagnosed with the syndrome late in his life when he was already exhibiting all its distinctive clinical features. We have reported the case of a LEOPARD syndrome patient exhibiting extremely elongated vertebral and basilar arteries previously undescribed in the literature.
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Affiliation(s)
- R Porciello
- University of Rome La Sapienza, Department of Dermatology, Policlinico Umberto I, Viale del Policlinico, 155 Rome, Italy
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De Luca A, Bottillo I, Dasdia MC, Morella A, Lanari V, Bernardini L, Divona L, Giustini S, Sinibaldi L, Novelli A, Torrente I, Schirinzi A, Dallapiccola B. Deletions of NF1 gene and exons detected by multiplex ligation-dependent probe amplification. J Med Genet 2007; 44:800-8. [PMID: 18055911 PMCID: PMC2652822 DOI: 10.1136/jmg.2007.053785] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2007] [Revised: 08/10/2007] [Accepted: 08/13/2007] [Indexed: 11/04/2022]
Abstract
To estimate the contribution of single and multi-exon NF1 gene copy-number changes to the NF1 mutation spectrum, we analysed a series of 201 Italian patients with neurofibromatosis type 1 (NF1). Of these, 138 had previously been found, using denaturing high-performance liquid chromatography or protein truncation test, to be heterozygous for intragenic NF1 point mutations/deletions/insertions, and were excluded from this analysis. The remaining 63 patients were analysed using multiplex ligation-dependent probe amplification (MLPA), which allows detection of deletions or duplications encompassing >or=1 NF1 exons, as well as entire gene deletions. MLPA results were validated using real-time quantitative PCR (qPCR) or fluorescent in situ hybridisation. MLPA screening followed by real-time qPCR detected a total of 23 deletions. Of these deletions, six were single exon, eight were multi-exon, and nine were of the entire NF1 gene. In our series, deletions encompassing >or=1 NF1 exons accounted for approximately 7% (14/201) of the NF1 gene mutation spectrum, suggesting that screening for these should now be systematically included in genetic testing of patients with NF1.
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Affiliation(s)
- A De Luca
- IRCCS-CSS, San Giovanni Rotondo and CSS-Mendel Institute, Rome, Italy
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23
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De Toma G, Letizia C, Cavallaro G, Polistena A, Cotesta D, Petramala L, Porciello R, Giustini S, Calvieri S. Adrenal pheochromocytoma and jejunal neurofibroma in type 1 neurofibromatosis: report of a case. G Chir 2007; 28:199-202. [PMID: 17547785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Neurofibromatosis type 1 (NF1), known as von Recklinghausen's disease, is characterized by presence of café au lait spots, and neurofibromas in the skin or along the course of peripheral nerves. Diagnosis, despite extreme clinical variability, is defined by established diagnostic criteria. Clinical status is frequently complicated by systemic disorders and neoplasias. CASE REPORT A case of a patient affected by NF1, with hypertension due to adrenal pheochromocytoma and with jejunal neurofibroma, is reported. DISCUSSION AND CONCLUSIONS Variability in clinical presentation of NF1 with possible manifestation of severe systemic benign and malignant diseases requires strict follow-up and specific screening of extra-cutaneous lesions.
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Affiliation(s)
- G De Toma
- University of Rome La Sapienza, Policlinico Umberto I, Department of Surgery P. Valdoni, Italy
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Cotesta D, Petramala L, Serra V, Giustini S, Divona L, Calvieri S, De Toma G, Ciardi A, Corsi A, Massa R, Reale MG, Letizia C. Pheochromocytoma associated with adrenocortical tumor in the same gland. Two case reports and literature review. MINERVA ENDOCRINOL 2006; 31:183-9. [PMID: 16682942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Pheochromocytomas are catecholamine-producing neuroendocrine tumours arising from chromaffin cells of the adrenal medulla or extra-adrenal paraganglionic system that show 2 distinctive features, rarity and clinical variability. Pheochromocytoma occasionally is associated with pathological lesions of the adrenal cortex. We present 2 cases of patients referred to our hospital with a finding of clinical suspected pheochromocytoma. Both of them were hypertensive; the first patient with typical symptoms of pheochromocytoma and the second patient with chest pain and hypertension resistant to pharmacological treatment. The diagnosis of pheochromocytoma was confirmed in both cases with laboratory analysis and the lesion was achieved by employing 3 imaging techniques: computed tomography (CT), magnetic resonance imaging (MRI) and scintigraphy with (123)I-metaiodobenzilguanidine (MIBG). The patients underwent adrenalectomy and in the same adrenal gland we found a pheochromocytoma associated with a nonfunctioning cortical adenoma. As far as we know few cases with this association are available in the literature.
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Affiliation(s)
- D Cotesta
- Day Hospital of Internal Medicine and Hypertension, Department of Clinical Sciences, University La Sapienza, Rome Italy
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Abstract
Neurofibromatosis type 1 (NF1) is a common autosomal dominant disease. The Lisch nodule represents one of the most common NF1 ocular manifestations. Several studies have reported that the Lisch nodule is a melanocytic hamartoma but its pathogenesis is still debated. We have studied the histopathological and ultrastructural features of a Lisch nodule of a 50-year-old woman biopsied during an intracapsular cataract extraction. Our researches revealed that it was composed of three main cytotypes: pigmented cells, fibroblast-like cells and mast cells, showing a pattern similar to a neurofibroma. Furthermore, we hypothesize that Lisch nodules are compatible with neurofibromas.
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Affiliation(s)
- A Richetta
- Università degli Studi di Roma La Sapienza, Dipartimento di Malattie Cutanee-Veneree e Chirurgia Plastica-Ricostruttiva, Viale del Policlinico 155, 00161 Rome, Italy
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Iannicelli E, Rossi G, Almberger M, Drudi FM, Giustini S, Calvieri S, David V. Integrated imaging in peripheral nerve lesions in type 1 neurofibromatosis. Radiol Med 2002; 103:332-43. [PMID: 12107383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
PURPOSE Our aim was to evaluate the role of Ultrasonography (US) and Magnetic Resonance (MR) in the staging and follow-up of peripheral nerve lesions in type 1 Neurofibromatosis (NF1). MATERIAL AND METHODS We evaluated forty-six NF1 patients (16 males and 30 females, age range 12-65 years, mean age 34 years) affected by 51 soft tissue lesions, clinically diagnosed as subcutaneous (18 cases) and plexiform (33 cases) neurofibromas. The lesions were studied to identify site, size, extension, relationship with surrounding structures, and any features indicating malignant transformation. All patients underwent at least one US examination performed with a 7.5 - 10 MHz linear multi-frequency probe. All subcutaneous neurofibromas larger than 2 cm, all superficial or deep plexiform neurofibromas not clearly defined at US, and all large plexiform neurofibromas with massive involvement of surrounding tissues were studied by MR using 0.2 T magnet (Artoscan) or 1.5 T magnet (Magnetom Vision Plus Siemens). Fifteen patients underwent surgery; the remaining cases (31) were followed up according to the National Institutes of Health (NIH) protocol. RESULTS The subcutaneous neurofibromas smaller than 2 cm showed homogeneous hypoechoic echotexture (10 cases), whereas lesions equal to or larger than 2 cm showed a characteristic target pattern (peripheral hypoechoic rim with hyperechoic core). All lesions larger than 2 cm studied by MRI displayed the target pattern in T2-weighted sequences, with peripheral signal hyperintensity and central signal hypointensity. At US, the 33 plexiform neurofibromas had an irregular shape with undefined borders; the patterns were classified as follows: 1) superficial plate-like lesions (14 cases); 2) superficial lesions with deep digitations (8 cases); 3) deep multi-lobulated lesions (5 cases); 4) extensive lesions massively involving soft tissues (6 cases). MRI was performed in 11 cases, showing an isointense or moderately hyperintense signal on T1-weighted sequences, high signal intensity on T2-weighted sequences, and, after intravenous gadolinium administration, variable enhancement on T1-weighted sequences. CONCLUSIONS The results obtained in subcutaneous neurofibromas indicate a clear relationship between lesion size and US-MR imaging, with similar local staging. Since MRI failed to provide additional information, US may be considered the first-choice, and sometimes decisive, examination in these cases. As regards plexiform neurofibromas, US only proved useful in staging superficial lesions and partly deep multi-lobulated lesions as it accurately depicted lesion size, but not local extension; MRI is therefore useful in the preoperative staging of lesions. In extensive lesions, US proved unable to provide accurate and complete local staging of the lesions, so that MRI should be systematically used in these cases.
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Affiliation(s)
- E Iannicelli
- Istituto di Radiologia, II Facoltà di Medicina, Università degli Studi di Roma La Sapienza, Rome, Italy
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Giustini S, Richetta A, Divona L, Faiola R, Trasimeni G, Pezza M, Amoruso G, Calvieri S. Neurofibromatosis type I and Arnold-Chiari malformation. J Eur Acad Dermatol Venereol 2002; 16:180-1. [PMID: 12046833 DOI: 10.1046/j.1468-3083.2002.00392_7.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND Myotonic dystrophy is a systemic genetic disorder, with dominant transmittance. It is characterized by generalized progressive muscular abnormality. Although frontoparietal alopecia is one of the most common symptoms in myotonic dystrophy, it has not received much attention. METHODS We examined 25 subjects from two families: 10 patients were affected by Steinert disease and 15 were not. The various morphologic and biochemical hair alterations are reported. RESULTS All investigated subjects (affected or not) presented the same type of morphologic and biochemical hair alterations. CONCLUSIONS These findings could be used to construct a hypothesis to explain the cause of the disease.
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Affiliation(s)
- B Amorosi
- Istituto di Clinica Dermatologica, Università La SaPienza di Roma, Rome, Italy
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30
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Amorosi B, Giustini S, Canci C, Silipo V, Richetta A, Calvieri S. Neurofibromatosis type 1 associated with systemic vasculopathy. Eur J Dermatol 1998; 8:271-3. [PMID: 9649715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Systemic vasculopathy in patients with neurofibromatosis type 1 is rare. We describe a case of unusual cerebral and renal involvement in a young, 29-year-old patient, who died of a cerebral ischemic attack one year after our observation.
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Affiliation(s)
- B Amorosi
- Istituto di Clinica Dermatologica, Università La Sapienza , Viale del Policlinico, 155, 00161 Rome, Italy
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Caronti B, Buttarelli FR, Giustini S, Calderaro C, Calandriello L, Calvieri S, Palladini G. Serum mitogenic activity on in vitro glial cells in Neurofibromatosis type 1. Brain Res 1998; 793:21-8. [PMID: 9630487 DOI: 10.1016/s0006-8993(98)00016-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Glial mitogenic effect was investigated in sera from the following groups of subjects: group (1) 31 patients clinically and genetically affected by Neurofibromatosis type 1 (NF1) belonging to different families; group (2) 42 patients without family history of NF1 affected by sporadic neoplasms of the same histogenetic origin as the proliferative lesions that are present in NF1; group (3) 51 healthy volunteers without family history of NF1 nor of neoplastic disease; group (4) 54 clinically healthy relatives of the NF1 patients included in the first group. All NF1 patients and 3/54 healthy relatives had alterations of exons 31 or 32 of NF1 gene. Glial proliferation, measured by [3H]thymidine incorporation, was significantly increased by sera from all NF1 patients and from 23/54 of clinically healthy relatives, as compared to sera from healthy volunteers. This serum mitogenic activity strongly suggests the existence of soluble glial proliferating molecules in NF1 families. The molecular weight (3-30 kDa), the heat- and freeze-stability and the specificity for glial cells, suggest that the molecules responsible for this mitogenic effect are different from the growth factors previously described in NF1-associated tumor extracts and from lymphokines. Within each NF1 family, the maximal serum dilution stimulating glial proliferation was similar both in affected members and in their clinically healthy relatives. Since none of the clinically healthy relatives showing serum mitogenic activity was positive for the NF1 mutation analysis and, conversely, those having altered exons 31 or 32 of NF1 gene did not show any mitogenic activity; these results suggest that the phenotype expression of NF1 might depend not only on the NF1 mutations per se, but also on other genetic or epigenetic factors, such as serum glial proliferating molecules.
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Affiliation(s)
- B Caronti
- Dipartimento di Scienze Neurologiche, Università 'La Sapienza', Rome, Italy
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32
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Giustini S, Amorosi B, Canci C, Camplone G, Bottoni U, Porciello R, Calvieri S. Pachyonychia congenita with steatocystoma multiplex. A report of two cases and a discussion of the classification. Eur J Dermatol 1998; 8:158-60. [PMID: 9649680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pachyonychia congenita is a rare syndrome in which the main and most common clinical sign is onychodystrophy of all finger and toe nails. The most frequent type of transmission seems to be autosomal dominant, but recessive forms have also been described. Typical onychodystrophy can be associated with other clinical manifestations. The most recent literature refers to descriptions of about 250 cases up until 1993. Numerous classifications of pachyonychia congenita have been suggested by several authors over the years. We report two cases of pachyonychia congenita in association with steatocystoma multiplex in a mother and son.
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Affiliation(s)
- S Giustini
- Università La Sapienza , Istituto di Clinica Dermatologica, Viale del Policlinico 155, 00161-Roma, Italia
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Innocenzi D, Giustini S, Barduagni F, Silipo V, Bosman C, Calvieri S. Ossifying fasciitis of the nose. J Am Acad Dermatol 1997; 37:357-61. [PMID: 9270548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A case of ossifying fasciitis in a 22-year-old woman is described. The lesion, which appeared suddenly, was located on the tip of the nose. Histologically the lesion contained spindle-shaped myofibroblastic cells, trabeculae of woven bone rimmed by plump osteoblasts within a myxoid stroma.
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Affiliation(s)
- D Innocenzi
- Department of Dermatology, University of Rome La Sapienza, Italy
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Carlesimo M, Giustini S, Richetta A, Ottini L, Marianicostantini R, Falcioni R, Calvieri S. Integrin b4 expression in peripheral-nerve tumors. Oncol Rep 1995; 2:997-1000. [PMID: 21597841 DOI: 10.3892/or.2.6.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The alpha 6 beta 4 integrin complex is expressed in epithelial, endothelial and nerve cells. We analyzed the immunohistochemical expression of the beta 4 subunit in normal peripheral nerves, in neurofibromas associated with type 1 neurofibromatosis and in sporadic neurofibrosarcomas. In normal peripheral nerves (4 samples), the beta 4 integrin was diffusely expressed at the level of the perinevrium and at the interface between axons and Schwann cells. In neurofibromas (6 cases), beta 4 was undetectable or markedly decreased relative to normal peripheral nerves. Neurofibrosarcomas (3 cases) were immunohistochemically negative for beta 4 expression. These observations suggest that a down-regulation of the alpha 6 beta 4 integrin is associated with the neoplastic progression of peripheral nerve tumors.
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Affiliation(s)
- M Carlesimo
- UNIV GABRIELE DANNUNZIO,PATOL GEN LAB,I-66013 CHIETI,ITALY. UNIV ROMA LA SAPIENZA,DERMATOL CLIN,I-00161 ROME,ITALY. UNIV ROMA LA SAPIENZA,DIPARTIMENTO MED SPERIMENTALE,I-00161 ROME,ITALY. CRS IST REGINA ELENA STUDIO CURA TUMORI,ONCOGENESI MOLEC LAB,I-00158 ROME,ITALY
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Abstract
Many therapeutic agents have been proposed for treatment of steroid-resistant sarcoidosis. Because administration of low doses of thalidomide has been successful in treating other inflammatory diseases, it was used in a patient with systemic sarcoidosis who was unresponsive to corticosteroids and in a patient with pulmonary sarcoidosis, in whom Kaposi's sarcoma developed after a course of corticosteroid therapy. Thalidomide, 200 mg/day for 2 weeks followed by 100 mg/day for 11 weeks, was given. This treatment was effective in both patients. No adverse reactions were observed. Thalidomide, 100 mg on alternate days, is still being administered. No relapse has occurred. Thalidomide, particularly because of its inhibition of the macrophage function, may be a useful alternative therapy in steroid-resistant cases. In addition, the correlation between the angiotensin-converting enzyme level and the clinical improvement observed in our patients suggests a direct parallel between angiotensin-converting enzyme and the activity of the granulomatous process.
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Affiliation(s)
- M Carlesimo
- Department of Dermatology, University of Rome La Sapienza, Italy
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Ruggieri V, Giustini S. Styles of interpersonal contact and muscular tone at rest of some muscles of the shoulder. Percept Mot Skills 1994; 79:688-90. [PMID: 7808910 DOI: 10.2466/pms.1994.79.1.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Styles of interpersonal contact are related, we hypothesized, to particular postural attitude showing the tendency to interact with or to avoid the environment. Those attitudes are expressed through myographic patterns. Now we examined the interpersonal contact styles and the muscular activity at rest (frequency and amplitude) of some muscles of the shoulders of 54 undergraduate women in psychology. All subjects declared they were right-handed. Increased myographic frequency seems associated with the perception of some levels of interpersonal barrier while increased amplitude seems to facilitate contact with other persons.
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Affiliation(s)
- V Ruggieri
- Dipartimento di Psicologia, Università degli Studi di Roma La Sapienza, Italia
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37
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Abstract
The aim of the present study is to investigate further the ultrastructural skin patterns in five cases of late infantile ceroid-lipofuscinosis: two of these were classic forms, the others were variants. Ultrastructural examinations of skin biopsies revealed the presence of characteristic cytosomes; typical lipofuscin, consisting of osmiophilic granular materials, curvilinear bodies, and fingerprint bodies. Different ultrastructural profiles were found simultaneously in each case, without a significant prevalence of any specific one, and were often associated with lipid droplets. These inclusions were found in several epidermal and dermal cells. A different degree of involvement of the myelinated sheaths in the five cases was observed. This difference could be genetically determined or perhaps related to different stages of the disease. The findings demonstrate the involvement of clinically unaffected skin and confirm the relevance of electron microscopic studies in diagnosing these disorders. In fact, recognition of typical ultrastructural changes is a valuable diagnostic tool that can be used in supplementing clinical and electrophysiological examinations, especially when the metabolic error is unknown and no diagnostic biochemical assay is available.
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Affiliation(s)
- M Carlesimo
- Institute of Dermatology, University of Rome La Sapienza, Italy
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38
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Abstract
An 18-month-old and an 8-year-old girl had trichothiodystrophy (TTD). Microscopic observation of the hair under polarized light showed typical alternation of bright and dark bands; amino acid analysis of the hair demonstrated a marked reduction of cystine levels. Both patients had skin lesions consisting in the older child of diffuse follicular keratosis since birth, and in the younger of an ichthyosiform dermatitis on the lower legs that appeared at age 4 months. Ultrastructural studies of the skin showed striking similarities in both cases: perinuclear vacuoles with a unit membrane in the keratinocytes, and dispersed, irregularly arranged bundles of tonofilaments particularly at the desmosome junction. The origin of the vacuoles is unknown; the abnormalities of the tonofilaments could be explained on the basis of a generalized abnormality in sulfur-containing proteins, reflecting a disturbance in the synthesis of keratins. These electron microscopy findings could be considered as a peculiar feature of ichthyotic skin in patients with TTD.
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Affiliation(s)
- S Calvieri
- Department of Dermatology, University of Rome La Sapienza, Italy
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39
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Abstract
A 16-year-old girl had a three-year history of many café au lait spots and freckles in a dermatomal distribution. The diagnosis of segmental neurofibromatosis (NF-5) was made on the basis of the clinical features, distribution of the lesions, and absence of systemic involvement. Only a few cases in the literature describe NF-5 with only macular lesions. An accurate clinical examination is important to identify this unusual presentation.
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Affiliation(s)
- G Micali
- Clinica Dermatologica, Università di Catania, Italy
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40
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Ruggieri V, Giustini S. Styles of modulation of emotional behavior: relationship with myographic tension and morphology of the shoulder. Percept Mot Skills 1991; 72:1167-71. [PMID: 1961663 DOI: 10.2466/pms.1991.72.3c.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We examined the morphology of the shoulder through anthropometric measures and the style of modulation of emotions of 54 women. The hypothesis was that the morphology of the shoulder (angles related to the position of the scapula, etc.) can be considered as partially inhibited gestures. The hypothesized relationship between emotions and shape of the shoulder is supported by the suggestion that some aspects of the morphology of the shoulder, as, for example, the habitual position of the scapulae, are an expression of particular gestures. The research indicates interesting relationships between morphological aspects of the shoulder and styles of modulation of emotion. These are discussed within the framework of a psychophysiological model.
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Bianchi L, Gatti S, Carrozzo AM, Iraci S, Marinaro C, Giustini S, Calvieri S, Nini G. [Clinical variants of pachydermoperiostosis: complete, incomplete and atypical forms]. GIORN ITAL DERMAT V 1989; 124:441-6. [PMID: 2635689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We describe two cases of pachydermoperiostosis, that, with the case that we have already published, allow us to present the complete clinical picture of the disease in the three forms: complete, incomplete and "forme fruste". It is interesting to note that the lack of an important symptom (digital clubbing or CVG) does not exclude the diagnosis but defines the clinical variant. The primitive hypertrophic osteoarthropathy is a common feature for the three patients, marked for I and III case, mild, but important from the diagnostic point of view, for the II case. The identification of a new marker of osteoblastic activity: osteocalcin blood level, is very important to determine the degree of activity of the disease. EM study, performed for the first time, shows an enhanced activity of the fibroblasts and a thickening of the basal membrane of the blood vessels. It is own opinion that the clinical picture observed, the vascular, the metabolic, the EM investigations give a further contribution to the understanding of this disease.
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Calvieri S, Giustini S, Giannelli V, Carlesimo M, Amorosi B, Balestri P, Farnetani MA. [The hair in a case of biotinidase deficiency]. GIORN ITAL DERMAT V 1988; 123:563-4. [PMID: 3254327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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43
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Calvieri S, Zampetti M, Corbo A, Giustini S, Rossi A, Giannelli V. [Preliminary results of the use of a microanalysis system of the hair in patients with trichothiodystrophy]. GIORN ITAL DERMAT V 1988; 123:583-5. [PMID: 3254334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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44
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Calvieri S, Zampetti M, Grieco T, Giustini S, Corbo A, Giannelli V. [Ito's hypomelanosis. Ultrastructural investigation of the skin and the hair]. GIORN ITAL DERMAT V 1988; 123:603-5. [PMID: 3254341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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45
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Fois A, Balestri P, Calvieri S, Zampetti M, Giustini S, Stefanini M, Lagomarsini P. Trichothiodystrophy without photosensitivity. Biochemical, ultrastructural and DNA repair studies. Eur J Pediatr 1988; 147:439-41. [PMID: 3396600 DOI: 10.1007/bf00496431] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A case of trichothiodystrophy (TTD) without photosensitivity is reported in an 8-year-old girl. Electron microscopic (EM) examination of the keratinocytes showed fibrillary bundles in the cytoplasm thinner and less electron dense than those of the normal cells and large membrane-bound vacuoles filled with granular-filamentous material. These findings could indicate a disturbance in the protein metabolism in tissues of ectodermal origin, explaining also the functional abnormalities of the central nervous system in TTD patients. The results of cellular DNA repair studies after UV irradiation in cultured fibroblasts showed normal levels of unscheduled DNA synthesis. This finding indicates that UV hypersensitivity is not constantly present in TTD.
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Affiliation(s)
- A Fois
- Clinica Pediatrica Università di Siena, Italy
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