Search

Immune-mediated necrotizing myopathy (IMNM) is an idiopathic inflammatory myopathy (IIM). Though patients with IMNM were considered to show skin rash, several reports have showed atypical skin conditions in patients with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibody-positive IMNM (HMGCR-IMNM); however, the incidence and phenotype of skin conditions in patients with HMGCR-IMNM are not fully known. This cross-sectional study was a retrospective analysis of the clinical manifestations of 88 patients diagnosed with IIM from April 2015 through August 2022. Patients with cutaneous manifestations were analyzed more specifically. Patients with polymyositis or inclusion body myositis were excluded due to the absence of dermal manifestations in the diagnostic criteria of these two diseases. Among the 88 IIM patients, 34 (39%) presented some form of skin condition, with 27 having typical skin rashes; this included 13 patients with dermatomyositis (DM), 8 with anti-synthetase syndrome (ASS), and 6 with IMNM. Meanwhile, 8 of 19 patients with HMGCR-IMNM (42%) presented atypical skin lesions, but no patients with other IIMs did (p<0.001). Skin eruption with ash-like scales was observed in four HMGCR-IMNM patients, and non-scaly red patches and lumps in the other four patients; accordingly, their skin manifestations were considered as other dermal diseases except for IIM. Skin biopsies from the atypical skin conditions of patients with HMGCR-IMNM revealed Bcl-2-positive lymphocyte infiltrations which were same as their muscle biopsy specimens. HMGCR-IMNM patients frequently have atypical skin conditions of the neck and back. Skin biopsy specimens from these lesions showed the same Bcl-2-positive lymphocytic infiltrations as muscle biopsy specimens regardless of the different gross dermal findings. Thus, such atypical skin conditions may be suggestive for HMGCR-IMNM. [ABSTRACT FROM AUTHOR]

Abstract: This paper describes new fossil materials recovered at the Duoi U’Oi site, in December 2003, by a Vietnamese-French-Japanese team. The Duoi U’Oi cave is located in Man Duc village, 25km of Hoà Binh city in northern Vietnam. It belongs to a karstic network developed in a dark grey micritic marine limestone dated from the Lower to the Middle Triassic. The sedimentary fill produced a rich mammalian fauna, essentially composed of isolated teeth of middle- to large-sized mammals (Artiodactyla, Perissodactyla, Proboscidea, Carnivora, Rodentia, Primates), and characteristic of Late Pleistocene. The results of the Duoi U’Oi fieldwork are of great interest for the following reasons: (1) the biochronological age of the fauna is consistent with 230Th/234U/238U dating from the calcitic floors (66±3ka). The Duoi U’Oi fauna is thus the oldest well-dated modern fauna known for the Southeast Asian mainland; (2) in terms of sedimentology, the analysis of the formation of the fossiliferous breccia and that of the processes of deposits shows a close relation between the karstic deposits inside the cave and the deposits in the alluvial terraces. The observation of three levels of alluvial terraces associated with three caves situated at 62, 10 and 3m above the present alluvial plain suggests that exokarstic and endokarstic sediments evolved together; (3) in terms of palaeobiogeography, Duoi U’Oi is the continental fauna showing the strongest resemblance with the Late Pleistocene faunas from Indonesian islands (Punung, Gunung Dawung, Lida Ajer, Sibrambang and Djambu caves); this implies that, at the time of Duoi U’Oi, ca 70ka, the Sundaland was mainly characterised by faunas of modern aspect; (4) the analysis of major taphonomic factors that led to the mammal assemblage reveals a combination of selective agents (selective role of predators and porcupines, selective destruction of age classes for some species, selective preservation of fossils due to the deposition processes in the karstic network), which contribute to the poor representation of the diversity of the fauna; no arguments show that humans, present at Duoi U’Oi, might have a possible role in the taphonomic process; (5) the palaeoenvironmental reconstruction based on the composition of the faunal assemblage suggests a forested area and some open habitats, under warm and humid conditions. [Copyright &y& Elsevier]