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Background: Tumour-like calcinosis is a rare cause of tissue calcification in patients on maintenance haemodialysis for chronic renal failure. Its estimated incidence is between 0.5 and 7% of haemodialysis patients., Patients and Methods: A 29-year-old male patient was referred to our department with a large cervical mass lesion increasing in size for two months. The patient had been on maintenance haemodialysis for one year for chronic renal failure during which time he reported multiple episodes of cervical trauma. Cervical MRI demonstrated a 11 x 9 cm calcified tumoral mass extending to the cervical muscles and the lower cervical spine (C6, C7, T1), accompanied by C6 osteolysis. Laboratory studies revealed secondary hyperparathyroidism with elevated calcium-phosphorus product. The patient underwent parathyroidectomy and several weeks later, there was a dramatic regression of the tumoral calcinosis. Renal transplantation was performed secondarily with no recurrence of the tumoral calcification after six years of follow-up., Discussion: Tumour-like calcinosis of the lower cervical spine with osteolysis of the cervical vertebrae is very rare. The principal contributing factors are hyperparathyroidism, elevation of calcium-phosphorus product and local trauma. Optimal treatment of these calcifications remains controversial. While surgical resection of the mass is commonly recommended, in our case report, despite the initial aggressiveness of the lesion, surgery was not performed and treatment of hyperparathyroidism alone was sufficient to ensure dramatic improvement with complete resolution of the calcinosis within few weeks.

Cutaneous melanoma is a highly malignant tumor type which is characterized by its tendency to give rise to metastases. Stromal relationships are essential for growth and metastasis of solid tumors. In cutaneous melanoma, microscopic level of invasion (Breslow index), overall architecture of cells (horizontal or vertical growth phase), angiogenesis, vessel invasion are morphological features which may carry prognostic significance. As demonstrated by in vivo studies, stromal reaction in melanoma is mainly characterized by collagen and elastin proteolysis preferentially localized around the tumor at the invasive front along with variable angiogenesis and lymphocyte infiltration. On the basis of recent findings, it becomes increasingly evident that resident stromal cells (fibroblasts, endothelial cells) are implicated in the metastatic process, including proliferation, matrix degradation, or migration of melanoma cells through cell-cell cross-talk by soluble factors (proteases, cytokines, growth factors) or by direct contact.

Type I collagen mediates melanoma cells invasion through upregulation of matrix metalloproteinases-1 and -2 (MMP-1 and -2) expression and activation. We investigated here the contribution of elastin-derived peptides (ED), degradation products of elastin, the main component of elastic fibers in melanoma cells invasion and MMP-1 and -2 expression. Our results evidenced fragmentation of elastin at the invasive front of melanoma, particularly in the most invasive tumors where those fibers nearly totally vanished. By electron microscopy, elastolysis was found to occur mainly at the periphery of melanoma cells, where close contact between elastic fibers and cells could be noticed. Therefore, we showed in vitro that plating melanoma cells high tumorigenic potential on ED-coated dishes, selectively enhanced MMP-2, as membrane-type MMP-1 (MT1-MMP) production and activation. Nevertheless, pro-MMP-2 activation was not observed owing to the parallel increase in tissue inhibitor of metalloproteinase (TIMP)-2 expression. The effects of ED on melanoma cells were found to be mediated by splicing form of beta-galactosidase (S-Gal) occupancy, as being suppressed by lactose. Supplementing collagen lattices with ED led to consistent activation of MMP-2 that can be attributed to TIMP-2 downregulation. Upregulation of MMP-2 activation by ED led to enhanced melanoma cells invasion through S-Gal occupancy. Immunohistochemistry studies, confirmed that S-Gal expression was more prominent at the melanoma invasion site associated with a strong expression of MMP-2 and MT1-MMP. We hypothesize that ED following interactions with S-Gal elastin receptor can favor melanoma cells invasion through a three-dimensional type I collagen matrix by upregulating MMP-2 activation.

Background: Jessner's lymphocytic infiltration of the skin is a rare and benign disorder. Its clinical course is cyclic with remissions and exacerbations. In this disease, photosensitivity was previously noticed by authors and recently demonstrated. We report four new cases with positive photobiological investigation., Case Reports: Four patients (2 males, 2 females), with a mean age 36 years were seen with erythematous papules or discoid plaques on face, arms and upper trunk. The onset of disease occurred after sun exposure in summer. Skin biopsies showed perivascular lymphocytic infiltration in the dermis. All patients relapsed cyclically with incomplete healing during winter. Photobiological investigation elicited skin lesions in a broad spectrum of UV: UVB (2 cases), UVA (1 case), UVA and UVB (1 case). In all patients treatment with oral antimalarials and external photoprotection was effective., Discussion: Our data suggest that photosensitivity history in patients with Jessner's lymphocytic infiltration of the skin should be searched for, and confirmed by provocative phototesting. This relevant event could guide the therapeutic strategy because antimalarials were effective for the Jessner's lymphocytic infiltration cases with photosensitivity.

The constitutive shedding of BP180 (collagen XVII) from human keratinocytes in culture was totally prevented by batimastat (5 microM), a wide spectrum matrix metalloprotease (MMP) inhibitor. However, keratinocytes did not express active MMP and generation of active Gelatinase A (MMP-2) and Gelatinase B (MMP-9) at the cell plasma membrane by increasing the ceramide content of keratinocytes did not influence BP180 processing to a 120 kDa species. A disintegrin and metalloprotease (ADAM) is probably involved in such a shedding event since release of 120 kDa polypeptide was inhibited by Decanoyl-Arg-Val-Lys-Arg CH2Cl (30 microM), a specific furin convertase inhibitor; culturing cells on to several matrix substrata i.e. type I collagen, type IV collagen, laminin-1 or laminin-5 had no effect on BP180 processing. Overall our data indicated that the metalloprotease-mediated shedding of BP180 from keratinocytes in culture is insensitive either to agents which activate MAP kinase pathway (ceramide) or to cell-matrix interactions.

We report the case of a 4-year-old girl, who had been suffering for 2 years from a recurrent, painful crisis affecting both hands, following sun exposure. There were no obvious cutaneous lesions, which initially caused us to consider a diagnosis of a psychiatric disorder. However, the diagnosis of erythropoietic protoporphyria was then established by the demonstration of elevated levels of free protoporphyrin in erythrocytes. The present case illustrates the effectiveness of beta-carotene associated with canthaxanthin in erythropoietic protoporphyria.