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PL, both in acute and chronic form, has previously been described following anti-tetanus-diphtheria, measles-mumps-rubella and influenza vaccination.7-9 PL following SARS-CoV-2 vaccination may occur as a delayed hypersensitivity response against vaccine excipients or SARS-CoV-2 spike glycoprotein or through a molecular mimicry mechanism between a viral epitope and host proteins resulting in a T-cell-mediated hypersensitivity skin reaction.10 In conclusion, we described a case of PL following SARS-CoV-2 vaccine never described before. Pityriasis lichenoides chronica after BNT162b2 Pfizer-BioNTech vaccine: A novel cutaneous reaction after SARS-CoV-2 vaccine Dear Editor, We read with interest the review from Gambichler I et al i .1 about cutaneous reactions following coronavirus disease 2019 (COVID-19) vaccination that prompted us to describe a cutaneous reaction after the mRNA vaccine Comirnaty SP ® sp (BNT162b2, Pfizer-BioNTech) that has never been reported before. [Extracted from the article]

Vaccine-associated papulo-pustular rosacea-like eruption was diagnosed, and sun protection cream was prescribed. To our knowledge, these are the first described cases of COVID-19 vaccine-associated rosacea-like eruptions. Two cases of papulo-pustular rosacea-like eruptions following COVID-19 vaccinations. [Extracted from the article]

In Mammals, microglial cells are considered as the resident immune cells in central nervous system (CNS). Many studies demonstrated that, after injury, these cells are activated and recruited at the lesion site. Leech microglia present a similar pattern of microglial activation and migration upon experimental lesion of CNS. This activation is associated with the release of a large amount of extracellular vesicles (EVs). We collected EVs released by microglia primary culture and compared two different protocols of isolation: one with differential ultracentrifugation (UC) and one using an additional Optiprep™ Density Gradient (ODG) ultracentrifugation. Nanoparticles tracking analysis (NTA) and transmission electron microscopy (TEM) were used to assess vesicles size and morphology. The protein content of isolated EVs was assessed by mass spectrometry approaches. Results showed the presence of EV-specific proteins in both procedures. The extensive proteomic analysis of each single ODG fractions confirmed the efficiency of this protocol in limiting the presence of co-isolated proteins aggregates and other membranous particles during vesicles isolation. The present study permitted for the first time the characterisation of microglial EV protein content in an annelid model. Interestingly, an important amount of proteins found in leech vesicles was previously described in EV-specific databases. Finally, purified EVs were assessed for neurotrophic activity and promote neurites outgrowth on primary cultured neurons. [ABSTRACT FROM AUTHOR]

Background and purpose: Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) may share similar clinical findings and tests to distinguish between the two disorders could be useful. We evaluated the blink reflex and R2 blink reflex recovery cycle (R2BRRC), determining diagnostic sensitivity, specificity and positive and negative predictive value of R2BRRC in differentiating patients with PSP from those with CBS. Methods: This was a prospective data collection study investigating blink reflex and R2BRRC at interstimulus intervals (ISIs) of 100, 150, 200, 300, 400, 500 and 750 ms in 12 patients with PSP, eight patients with CBS and 10 controls. Results: Patients with PSP have earlier recruitment of R2BRRC as compared with patients with CBS (ISI: 100 ms, P = 0.002; 150 ms, P < 0.001; 200 ms, P < 0.001; 300 ms, P = 0.02) and controls (ISI: 100 ms, P < 0.001; 150 ms, P < 0.001; 200 ms, P < 0.001; 300 ms, P = 0.004). The presence of an early recovery of the R2 differentiated PSP from CBS with a specificity and sensitivity of 87.5% and 91.7%, respectively. Conclusions: The R2BRRC curve might be considered to be a useful tool in differentiating patients with PSP from those with CBS. [ABSTRACT FROM AUTHOR]

Although neurosyphilis ( NS) keeps plaguing worldwide, often with oligosymptomatic and atypical manifestations, the most recent reports fail to provide useful information, like details of the clinical history and even of the previous early therapy. We conducted a survey of the literature of the last 5 years on the clinical presentation of NS, recording the aforementioned inaccuracies. One hundred and thirty-seven articles were collected, reporting on 286 patients. General paresis was the commonest form (49%), often manifesting with cognitive impairment and psychiatric symptoms. Syphilitic meningitis was found in 63 patients (22%), mainly with ocular or auditory involvement. Meningovascular and tabetic form were both found in 12% of cases. Gummatous and epileptic manifestations were rare. Perusal of the literature confirms that NS prevalence is increasing, often with manifestations that are atypical for timing and type of lesions. Unfortunately, many articles are lacking of critical information, like an accurate clinical history and timing of the therapy making difficult to assess the effectiveness of penicillin in preventing NS. [ABSTRACT FROM AUTHOR]

Background Dermatological emergencies exist and should not be underestimated. On the other hand, many accesses to the emergency department ( ED) of patients with dermatological conditions are unjustified. Objective Our main objective is to describe dermatological conditions seen in an ED observation unit ( EDOU). Secondly, our aim is to identify alarm symptoms and signs of 'true emergencies'. Methods We conducted a prospective study, including dermatological patients admitted to EDOU of the University Hospital of San Martino, Genoa, Italy, in 3 years. Results Overall 372 patients were studied. The most common condition seen was infection (41.67%) (mainly bacterial), followed by atypical exanthem (13.98%) and vasculitis (11.29%). The highest rate of cases peaked in May (13%); infectious diseases showed two peaks (spring and autumn). Conclusion Given constraints involved in health care today, it is crucial to understand which dermatological presentations are 'true emergencies'. In such a scenario knowing the epidemiology of dermatological emergencies and the alarming skin signs and symptoms might be useful. [ABSTRACT FROM AUTHOR]

Linked article: J.M. Neves et al. J Eur Acad Dermatol Venereol 2021; 35: 1712–1716. https://doi.org/10.1111/jdv.17302. [ABSTRACT FROM AUTHOR]

I Editor i Syphilis is known to be "the great imitator": since the patient's history is often deceiving and the spectrum of clinical signs and symptoms is extremely broad, diagnosis may be particularly challenging.1,2 Tertiary syphilis is rarely seen nowadays but it should be taken into account when dealing with granulomatous disorders of unclear nature.1-4 Indeed, up to 25% of the patients with untreated primary syphilis develop symptoms of tertiary syphilis, usually occurring 3-5 years after primary infection and involving several organs, mainly skin, heart and central nervous system.1 We recently observed an unsuspected case of syphilitic I gummas i in a patient whose history was definitively not evocative for sexually transmitted diseases (STDs). This case was interesting not only for the deceiving patient's history but especially for the clinical aspect of the cutaneous lesions, given the rarity, nowadays, of benign tertiary syphilis ( I gummas) i in clinical practice. CSF testing is crucial for the correct diagnosis and therapeutic approach, also in case of asymptomatic neurosyphilis.6 Even if the patient's history is not evocative for STDs, as in our case, syphilis should be considered when approaching granulomatous lesions of unclear nature. [Extracted from the article]

Background The antigens of the Colton blood group system, Coa and Cob, are encoded by a single gene that produces the aquaporin-1 (AQP1) protein, a water channel-forming protein, and are characterized by a single nucleotide polymorphism (SNP). A healthy Caucasoid blood donor originally typed as Co(a−b−) with commercial anti-Cob typed Co(a−b+) when retested with another anti-Cob. Retyped with two different molecular biology methods, the sample came out Co a /Co b. With the aim of understanding these discrepancies, serological, cytometric and molecular biology tests were carried out. Methods Absorption/elution studies with propositus red cells and controls were performed. The region spanning exon 1 to exon 4 of the Colton gene was sequenced, and flow cytometry analyses were carried out. Results Absorption/elution studies showed the absence of Coa and a weak expression of Cob. DNA sequencing confirmed a CT heterozygosity at nucleotide position 134 (i.e. Co a /Co b), and an additional heterozygous CT was found at position 112. The presence of the Co b allele that encodes for the Cob antigen was confirmed. The new allele has the base cytosine at nucleotide 134 ( Co a), in cis with the new nucleotide 112T. The nucleotide substitution 112C>T causes a missense mutation leading to an amino acid change from proline (CCG) to serine (TCG) at codon 38. Conclusion The substitution found at codon 38 results in a modified AQP1 protein which explains the Co(a−b+) phenotype and possibly the weak expression of Cob. [ABSTRACT FROM AUTHOR]

Background: Cryoablation is an effective and safe treatment for children with supraventricular tachycardias when the reentry circuit is located near the atrioventricular (AV) junction. We retrospectively reviewed consecutive cryoablation procedures for the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in children and young adults in a single pediatric center. Methods: From October 2002 to October 2008, cryoablation was attempted in 76 pediatric patients (mean age 11.3 ± 2.4 years, range: 6-16.4 years) with symptomatic typical AVNRT. Cryomapping, used to identify the tissue site for safe arrhythmia ablation, was performed at -30°C for a maximum of 60 seconds. The efficacy of the cryomapping procedure was assessed in terms of disappearance of dual-AV node physiology and noninducibility of AVNRT. Results: Cryoablations were from 4 to 8 minutes long at -75°C. A single 'bonus' cryoapplication (-75°C for minimum 6 minutes) was delivered to consolidate the acutely successful cryoablation for 64 consecutive patients. After the cryoablation procedure, patients were assessed at 1, 3, 6, 12, 18, and 24 months (and then every year thereafter) by a clinical evaluation and standard electrocardiogram, Holter monitoring, and exercise stress testing. No permanent cryo-related complications were reported. Seventy-four (97.4%) patients were successfully acutely ablated. During a mean follow-up of 29.5 months (range 2-74 months), five (6.8%) acutely successful pediatric patients experienced arrhythmia recurrence. We did not identify any predictive factors of AVNRT recurrence. Conclusions: Acute and long-term results demonstrate that cryoablation of AVNRT can be considered a safe and effective procedure in pediatric patients. (PACE 2010; 475-481) [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Necrobiotic granuloma annulare of the penis: a case responding to anti-tuberculosis therapy with a review of the literature," in the previous issue.

The actions of corticotropin-releasing factor (CRF) and related peptides are mediated by two receptors (CRF1 and CRF2). The respective role of each subtype in the control of food intake remains poorly known. In the present study, we examined the quantity and microstructure of ingestive behavior of knockout (KO) mice lacking CRF2 receptors and their wild-type (WT) littermates. Under basal conditions, CRF2 KO mice showed increased nocturnal food intake, evident as an increased zenith in circadian cosinor analysis of food intake. Microstructure analysis revealed that this greater food intake reflected increased meal size, rather than meal frequency, suggesting a decreased satiating value of food. Following acute restraint stress, CRF2 KO mice showed an intact immediate anorectic response with increased latency to eat and decreased meal size. However, CRF2 deletion abolished the prolonged phase of restraint-induced anorexia. CRF2 KO mice did not differ from WT controls in feeding responses to food deprivation or injection of ghrelin receptor agonists. Independent of genotype, food deprivation increased food intake, with dramatic changes in meal size, meal frequency, water : food ratio and eating rate. Acyl-ghrelin or BIM-28131, a potent ghrelin analog, dose-dependently stimulated food intake by increasing meal size (ghrelin, BIM-28131) and meal number (BIM-28131), while slowing the average eating rate (BIM-28131) similarly in WT and KO mice. These results suggest that the CRF2 receptor is involved in the control of meal size during the active phase of eating and following acute exposure to stress. [ABSTRACT FROM AUTHOR]

We propose a fast, high quality tone mapping technique to display high contrast images on devices with limited dynamicrange of luminance values. The method is based on logarithmic compression of luminance values, imitatingthe human response to light. A bias power function is introduced to adaptively vary logarithmic bases, resultingin good preservation of details and contrast. To improve contrast in dark areas, changes to the gamma correctionprocedure are proposed. Our adaptive logarithmic mapping technique is capable of producing perceptually tunedimages with high dynamic content and works at interactive speed. We demonstrate a successful application of ourtone mapping technique with a high dynamic range video player enabling to adjust optimal viewing conditions forany kind of display while taking into account user preference concerning brightness, contrast compression, anddetail reproduction. Categories and Subject Descriptors (according to ACM CCS): I.3.3 [Image Processing and Computer Vision]: Image Representation [ABSTRACT FROM AUTHOR]

The article presents a letter to the editor about the Kidd blood group system in transfusion medicine.

Background: In a previous study we detected virions with electron microscopy features of human herpes viruses in the supernatant of cocultured mononuclear cells from patients with acute pityriasis rosea. Because of their morphology and of polymerase chain reaction studies, we ascribed them to human herpes virus 7. Objective: To find such virions in the lesional skin of pityriasis rosea patients. Methods: Skin speciments from lesions of 21 patients with acute pityriasis rosea were examined by elecron microscopy. Results: In 15 (71%) patients, human herpes virus particles in various stages of morphogenesis were detected. Mature enveloped virions appeared as typical human herpes virus virions, measuring about 160–200 nm in diameter and containing an electrodense cylindrical core, a capsid, an envelope with typical spikes and a very distinct tegument layer between the capsid and the envelope. They were very similar to those we reported in the supernatant of co-cultured circulating mononuclear cells from patients with pityriasis rosea. Conclusion: Our results confirm our previous findings and provides further evidence of a viral etiology for pityriasis rosea. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 74-year-old patient with a 2-year history of pain and burning on the right side of the tongue and symptoms were exacerbated during physical/psychological stress. It mentions his family history revealed psoriasis in maternal grandmother but without mucosal lesions and she was treated with rifaximin. It also mentions glucose breath test (GBT) to investigate the presence of small intestinal bacterial overgrowth (SIBO) was positive.

A letter to the editor is presented which discusses the case study of a 58-year-old man who was diagnosed with late latent syphilis (LLS) and developed Jarisch-Herxheimer reaction (JHR) as effect of antibiotics.

A letter to the editor is presented in response to the article "European guideline on the management of syphilis," by M. Janier and colleagues in the 2014 issue.

A letter to the editor is presented in response to the article "Exanthem subitum (human herpesvirus-6 reactivation) after autologous stem cell transplantation," by S. Schlaweck and colleagues in the 2016 issue.

The article discusses a review of cases of patients with pityriasis rosea (PR) and pityriasis rosea-like eruptions (PR-LE) induced by vaccinations. Topics discussed include more eruptions induced by smallpox vaccine, a comparison of histopathological, clinical and virological characteristics between PR and PR-LE, and other vaccines that induced PR and PR-LE.

The article presents a case study of 78-year-old woman presented with multiple nodules that were arranged in a dermatomeric distribution who was later diagnosed with infliximab induced segmental eruptive neurofibromatosis. Topics discussed include nodules erupting abruptly with dyspnoea, tachycardia and blood pressure failure after therapy with intravenous infliximab for rheumatoid arthritis and lack of other cutaneous findings resulting in diagnosis of segmental neurofibromatosis (SNF).

The article focuses on a study conducted on prevalence of herpes zoster (HZ) and pityriasis rosea in patients with psoriasis. Topics discussed include HZ occurring in a million people in the U.S. annually as a result of declining cellular immunity and transitory immunosuppression, Psoriasis being triggered by pityriasis rosea (PR) and prevalence of HZ in psoriatic patients being higher than expected.

A letter to the editor is presented in response to the article "The changes in the hair cycle during gestation and the post-partum period" by S. Gizlenti and T. R. Ekmecki.

A letter to the editor is presented discussing the case of a 79-year-old woman who had a diffuse pruritus and erythroderma.

A letter to the editor is presented about a rare case of interstitial granuloma annulare and borreliosis.

A letter to the editor on the detection of CX3C-chemokine fractalkine in serum of patients infected by active pityriasis rosea is presented.

Purpose Neovascular diabetic retinopathy (DR) and age-related macular degeneration (AMD) are characterized by increased VEGF signaling. VEGF can be targeted using monoclonal antibody-based drugs (e.g. ranibizumab, aflibercept) or by modified oligonucleotides (e.g. pegaptanib). The main difference between the two classes is that antibodies recognize all VEGF isoforms while oligonucleotides may be more specific for certain isoform such as VEGF165. New ways of intervention stem out from the observation that VEGF expression can be post-transcriptionally regulated by the RNA-binding HuR/Elav-like1 protein. We evaluated if targeting HuR is a potential tool to hinder VEGF overexpression. Methods 2.5 µM HuR si RNA (naked or delivered by nanocarriers) was intravitreally administered in a DR model. Rats were sacrificed 48 h after si RNA injection and retinal tissues collected for Western blot, ELISA, histological examination. Results HuR si RNA treatment blunts both HuR and VEGF increase, restating normal VEGF content in DR retina. HuR si RNA exerts its protective effect when included in liposomal nanocarriers, since the naked molecule does not prevent diabetic retinal damage. Conclusions An HuR-based strategy may be a target in the chain of events controlling VEGF expression synergizing with oligonucleotide-based interventions having the potential to modulate the expression of VEGF without fully blocking it. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the letter to the editor "A novel influenza a (H1N1) virus as a possible cause of pityriasis rosea?" by N. H. Kwon and colleagues in an issue in 2011.

Purpose Carbonic monoxide (CO) is organic gas ubiquitously synthesized in mammalian tissues by enzyme that has constitutive and inducible forms. This gas is produced as metabolic end‐product in specific cell life phases, and may acts as atypical neuronal messenger. Evidence has recently accumulated suggesting that CO may be cytoprotective because its bioactions, including inhibition of apoptosis, platelet aggregation, complement activation, and inflammatory cytokine production. CO appears to be important to counteract the cytotoxicity caused by excessive production of reactive oxygen (ROS) and nitrogen (RNS) species. Methods In vitro and in vivo models. Results Induction of heme oxygenase (HO)‐1 by hemin has been found to prevent retinal cell death after ischemia provoked by ocular hypertension in rats. The LPS‐induced expression of pro‐inflammatory cytokines, in rat eye, is also inhibited by CO. Interestingly, drugs active as inhibitors of iNOS block CO‐induced increases in cGMP in the retina.Drugs inhibiting NO formation by acting on iNOS activity have been found to potently reduce intraocular pressure. Studies from our lab showed that an increase of CO availability by hemin or carbon monoxide‐releasing molecules lower the intraocular pressure, suggesting a suppress action of iNOS‐derived NO production. Conclusion A better understanding of CO regulation may lead to new therapeutic options that are safer and more efficacious than currently available treatments for various sight‐threatening eye diseases, such as retinal degenerations. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article on skin blanching due to hydrogen peroxide that was published in the previous issue.

Background. In recent years DNA analysis has become an important tool to solve phenotyping difficulties in multi-transfused patients, in fetuses at risk for hemolytic disease, in patients with positive direct antiglobulin test (DAT) and in subjects with rare variants of D and other polymorphisms. Buccal cells, hair or fetal cells in amniotic fluid can be used as DNA source. Methods. In this preliminary analysis we evaluated the feasibility of blood group genotyping of difficult samples using a commercial kit. Samples from 20 blood donors, 9 transfused patients (5 with positive DAT), 2 pregnant women and 2 untransfused patients whose phenotype had been previously determined by serology, were tested for ABO (n=5), RHD/CE, (n=13), D weak (n=4), KEL1/KEL2, FYA/FYB, FYnull01, FYX, JKNJKB (n=10) with a polymerase chain reaction-sequence specific primer (PCR-SSP) commercial kit purchased from INNO-TRAIN Diagnostik GmbH (Kronberg-Taunus, Germany) according to manufacturer's instructions. All systems were amplified with the same PCR conditions and 120 minutes were necessary for the completion of the test. Moreover, 22 samples were also genotyped by PCRSSP or polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using a homemade set of primers designed according to the literature data. Results. In all the 32 cases, there was no discrepancy between the genotypes determined with the commercial kit and the serological phenotype. In the 22 cases also genotyped with the homemade set, all genotypes were confirmed with the commercial kit. Conclusions. With respect to molecular methods in place in our laboratory, this procedure reduces the workload (preparation of master mix, pipetting steps) and can be taken to completion in less than 3 hours with equivalent results. This method may be useful for the management of transfusion dependent patients and to improve transfusion safety and efficacy. [ABSTRACT FROM AUTHOR]

Background. The prompt availability of typed units for immunized patients may be facilitated by regular typing of repeat donors. The workload generated by this policy can be reduced by the use of automated instruments. Methods. Typing for Fy[sup a], Fy[sup b], Jk[sup a], Jk[sup b], S, s and k antigens was performed using a semi-automated instrument (ABS Precis, Immucor, USA), a solid phase red cell adherence assay (Select Cell Capture-R, Immucor) and polyclonal antisera provided jointly to the solid phase kit (Capture-Immugene, Immucor). We performed a total of 1,729 typing tests on 247 samples; 163 samples were from blood donors, 79 from patients (48 oncohematology cases transfused 7-30 days before testing, 31 untransfused surgical cases) and 5 from newborns. The test results were compared to those of a manual tube method, performed in parallel following the reagent manufacturer's instructions. In case of discrepancy, the same sample was re-tested and the final agreement was determined. Timing studies were performed by measuring the time needed for each test phase (initial specimen handling, instrument operation and shutdown, recording and reporting results, daily and periodic preparation, regular equipment maintenance). The study was performed on batches of 12 samples, a convenient size with this instrument. We evaluated the method specificity, the occurrence of problems and hands on time needed for the tests. Results. At the initial screening of the 247 samples, 7 (2 recently transfused cases and 5 newborns) gave discrepant results in 22 of the 1,729 typing procedures (1.1%). All discrepant results were still discrepant at retesting. All donor samples showed concordant results at initial testing. No instrument errors were shown. Timing studies showed that the instrument testing required one hour/12 samples vs 3 hours/12 samples required by tube manual tests. Conclusions. Our study indicates that automated red cell phenotyping can be a valuable tool to reduce staff requirements or to increase productivity. [ABSTRACT FROM AUTHOR]

Background. In 1998 we modified our policy for the management of patients refractory to random donor platelet support. In this study we evaluated pre- and post-transfusion platelet counts in the 25 consecutive, refractory and HLA allo-immunized hematology patients transfused in the 18 months after implementation of the new policy. Methods. The policy is based on an automated solid-phase cross-match (XM) procedure performed by testing patient's serum vs platelets obtained from supernatants of complete blood count (CBC) samples routinely collected from blood donors. In our institution approximately 100 whole blood donations are collected per day. All units are deprived of the buffy-coats, which are stored overnight at 20-24 C and pooled on the following morning to prepare platelet pools (1 pool=6 donors). After CBC determination, CBC samples are stored overnight in case platelet XM are needed on the next morning. Patients are considered for XM when they develop on 2-3 occasions 20-24 hour post-transfusion platelet count increments lower than 5×10[sup 9]/L. XM is performed by the automated ABS Precis device with the Immucor (Norcross, GA) Capturo-P assay kit. The operator places donor CBC samples after soft centrifugation or overnight sedimentation into racks of the ABS Precis, which dispenses test platelets from the CBC samples supernatants into the kit plate wells, performs incubations and washings, adds patient's serum, indicator red cells, performs final readings and prints results. Platelet pools are finally prepared with buffy-coats from XM negative donors. Average time to XM 1 serum vs 90 donors is 160 min. Results. Mean ± SD pre-transfusion, 1-hour and 24-hour post-transfusion platelet counts (x10[sup 9]/L) of the 336 XM negative transfusions containing a mean of 302×10[sup 9] platelets, given to the 25 refractory patients, were: 8±6, 32±23, 16±15 respectively. Increments were significantly higher (p<0.05, t-test) than those observed in the same patients with 225 random platelet pools (mean dose 326×10[sup 9] platelets) immediately before the use of XM negative platelets: pre 8±9, 1-hour 15±16, 24-hour 10±13. Conclusions. The automated platelet XM program is a useful tool to rapidly select effective platelets for refractory patients from local inventory. [ABSTRACT FROM AUTHOR]

Different therapeutic modalities for ano-genital warts (AGWs) are available but data on the efficacy of 5-fluorouracil 0.5%/salicylic acid 10% solution (5FU/SAsol) in the treatment of AGWs are scarse. We enrolled 17 patients with AGWs (14 males, 3 females with a mean age of 34.2 years) who gave written informed consent to the off-label use of topical 5FU/Sasol. Response to treatment was assessed based on the AGWs number: complete if there was complete clearance of the lesions; partial if there was >50% decrease in the lesion number and none if there was <50% decrease in the lesion number. Considering together partial and complete treatment response, 88% of the patients at 3 months and 94% at 6 months benefited from the 5FU/SAsol treatment. 5FU/SAsol was well tolerated by all the patients except one who experienced a burning sensation immediately after the application. The clearance rate that we found for 5-FU/SAsol after 3 months of treatment is comparable with that of the other commonly used therapeutic modalities (liquid nitrogen cryotherapy, imiquimod 5% cream). However, several patients on imiquimod and almost who underwent cryotherapy reported pain as adverse event while a mild pain was rarely reported with 5-FU/Sasol. In conclusion, although nowadays in Italy 5-FU/SAsol is marketed only for the treatment of actinic keratosis, our study described its effectiveness and tolerability also in the treatment of AGWs. Our data suggest that 5-FU/SAsol should be considered not only in case of resistant/recurrent AGWs but also as the first therapeutic option, especially when the number of lesions is small., (© 2022 Wiley Periodicals LLC.)

Deletions involving the distal portion of the short arm of chromosome 8(8p23.1) show a high phenotypic variability. Congenital heart diseases (CHD) are often described. GATA4 when mutated or deleted is reported to be involved in cardiac morphogenesis. Only twice, left ventricular non compaction (LVNC) was reported in literature in association with 8p23.1 deletion. The present cohort includes five new patients with 8p23.1 deletions including GATA4. The spectrum of CHD is variable. Moreover, in four patients, LV hypertrabeculation was detected and in the fifth LVNC was recognized. Literature revision identified 45 patients with 8p23.1 deletions (encompassing GATA4) and heart involvement. It included wide spectrum of CHD including: heterotaxy spectrum 7/45 (15, 6%), atrioventricular canal 14/45 (balanced 3/45 including two of them with hypoplastic aortic arch; unbalanced 4/45, Fallot-AVC 1/45, partial AVC 3/45, unspecified 3/45), predominant major left heart lesions included 2/45 (4, 4%): interrupted aortic arch and hypoplastic left heart syndrome. Left ventricular hypertrabeculation might be potentially underestimated in patients with 8p23.1 deletion. These might suggest the importance of including microarray analysis in this group of patients. Moreover, 8p23.1 microdeletion or GATA4 variants can be considered in heterotaxy genetic panels., (© 2021 Wiley Periodicals LLC.)