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  1. Article ; Online: A plantar subcutaneous nodule in a healthy infant.

    Borg, Luca / Micallef, Daniel / Betts, Alexandra / Boffa, Michael J

    Pediatric dermatology

    2024  

    Language English
    Publishing date 2024-04-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605539-4
    ISSN 1525-1470 ; 0736-8046
    ISSN (online) 1525-1470
    ISSN 0736-8046
    DOI 10.1111/pde.15609
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    Zs.A 1882: Show issues Location:
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  2. Article ; Online: Nodular vasculitis (erythema induratum) associated with systemic minocycline.

    Farrugia, Stephanie / Cachia, Monique / Betts, Alexandra / Clark, Eileen

    The Australasian journal of dermatology

    2023  Volume 65, Issue 2, Page(s) 167–170

    Abstract: A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations ... ...

    Abstract A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations showed deranged liver function test with positive ANA and mixed antinuclear factor (ANF) pattern. A skin biopsy was in keeping with a diagnosis of nodular vasculitis. Her skin lesions and liver function test improved within 3 months of stopping the minocycline treatment. This case report raises the awareness that minocycline could be a potential cause of nodular vasculitis, patients on minocycline should be closely monitored and minocycline should ideally not be prescribed for more than 12 weeks, given the possible adverse effects.
    MeSH term(s) Female ; Humans ; Adult ; Erythema Induratum ; Minocycline/adverse effects ; Skin/pathology ; Acne Vulgaris/complications ; Vasculitis/chemically induced ; Vasculitis/drug therapy ; Vasculitis/complications
    Chemical Substances Minocycline (FYY3R43WGO)
    Language English
    Publishing date 2023-12-06
    Publishing country Australia
    Document type Case Reports ; Journal Article
    ZDB-ID 138052-7
    ISSN 1440-0960 ; 0004-8380
    ISSN (online) 1440-0960
    ISSN 0004-8380
    DOI 10.1111/ajd.14195
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  3. Article ; Online: Tattoo-associated acquired cutaneous lymphangiectasia: A complication of axillary hidradenitis suppurativa?

    Booker, Bettina / Mintoff, Dillon / Pace, Nikolai P / Degaetano, James / Boffa, Michael J / Betts, Alexandra

    Journal of the European Academy of Dermatology and Venereology : JEADV

    2024  

    Language English
    Publishing date 2024-03-25
    Publishing country England
    Document type Letter
    ZDB-ID 1128828-0
    ISSN 1468-3083 ; 0926-9959
    ISSN (online) 1468-3083
    ISSN 0926-9959
    DOI 10.1111/jdv.19969
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    Zs.A 3492: Show issues Location:
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  4. Article: Importance of 3-dimensional imaging in the early diagnosis of chondroblastic osteosarcoma.

    Cuschieri, Laura Althea / Schembri-Higgans, Rebecca / Bezzina, Nicholas / Betts, Alexandra / Cortes, Arthur Rodriguez Gonzalez

    Imaging science in dentistry

    2023  Volume 53, Issue 3, Page(s) 247–256

    Abstract: The aim of this report is to present a case of chondroblastic osteosarcoma located in the right maxillary premolar region of a 17-year-old female patient. The initial clinical presentation and 2-dimensional (2D) radiographic methods proved inadequate for ...

    Abstract The aim of this report is to present a case of chondroblastic osteosarcoma located in the right maxillary premolar region of a 17-year-old female patient. The initial clinical presentation and 2-dimensional (2D) radiographic methods proved inadequate for a definitive diagnosis. However, a cone-beam computed tomography scan revealed a hyperdense, heterogeneous lesion in the right maxillary premolar region, exhibiting a characteristic "sun-ray" appearance. To assess soft tissue involvement, a medical computed tomography scan was subsequently conducted. A positron emission tomography scan detected no metastasis or indications of secondary tumors. T1- and T2-weighted magnetic resonance imaging showed signal heterogeneity within the lesion, including areas of low signal intensity at the periphery. A histological examination conducted after an incisional biopsy confirmed the diagnosis of high-grade chondroblastic osteosarcoma. The patient was then referred to an oncology department for chemotherapy before surgery. In conclusion, these findings suggest that early diagnosis using 3-dimensional imaging can detect chondroblastic osteosarcoma in its early stages, such as before metastasis occurs, thereby improving the patient's prognosis.
    Language English
    Publishing date 2023-08-02
    Publishing country Korea (South)
    Document type Case Reports
    ZDB-ID 2631801-5
    ISSN 2233-7830 ; 2233-7822
    ISSN (online) 2233-7830
    ISSN 2233-7822
    DOI 10.5624/isd.20220223
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  5. Article: Scleroderma Secondary to Pembrolizumab: A Case Report and Review of 19 Cases of Anti-PD-1-Induced Scleroderma.

    Farrugia, Stephanie / Mercieca, Liam / Betts, Alexandra / Refalo, Nick / Boffa, Michael J

    Case reports in oncology

    2023  Volume 16, Issue 1, Page(s) 846–856

    Abstract: Immune checkpoint inhibitors are increasingly being used to treat various malignancies. Despite their efficacy, they are known to potentially cause immune-related adverse effects, including dermatological manifestations. A rare cutaneous immune-related ... ...

    Abstract Immune checkpoint inhibitors are increasingly being used to treat various malignancies. Despite their efficacy, they are known to potentially cause immune-related adverse effects, including dermatological manifestations. A rare cutaneous immune-related adverse effect is scleroderma, which has been reported to occur with anti-programmed cell death-1 (PD-1) agents such as pembrolizumab and nivolumab. This may present with skin tightening and hardening at any point during or after immunotherapy. We present the case of a 54-year-old Caucasian woman who, following 16 doses of pembrolizumab for breast cancer, developed clinical features of scleroderma confirmed on histology. She was initially treated with oral corticosteroids, followed by oral psoralen-UVA, with poor response, but eventually improved with methotrexate. A literature review revealed 12 other cases of scleroderma following pembrolizumab treatment and 6 cases of scleroderma following nivolumab treatment. Males and females were both affected, and their ages ranged from 33 to 81 years. Scleroderma developed at different stages of pembrolizumab or nivolumab therapy. Although scleroderma is not commonly drug-induced, anti-PD-1 agents may be a rare cause and it is important to elicit an accurate drug history, including immunotherapy, in such cases.
    Language English
    Publishing date 2023-09-06
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2458961-5
    ISSN 1662-6575
    ISSN 1662-6575
    DOI 10.1159/000533373
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  6. Article ; Online: Neuroendocrine Transdifferentiation in Cutaneous Melanoma: A Case Report and Review of the Literature.

    Pisani, David / Micallef, Daniel / Scerri, Jeanesse / Betts, Alexandra / Degaetano, James / Baldacchino, Shawn

    The American Journal of dermatopathology

    2023  Volume 45, Issue 4, Page(s) 264–268

    Abstract: Abstract: Neuroendocrine transdifferentiation refers to the progressive transformation of a nonneuroendocrine tumor to the one showing evidence of neuroendocrine differentiation on morphological and immunohistochemical grounds. Although this phenomenon ... ...

    Abstract Abstract: Neuroendocrine transdifferentiation refers to the progressive transformation of a nonneuroendocrine tumor to the one showing evidence of neuroendocrine differentiation on morphological and immunohistochemical grounds. Although this phenomenon has been well-documented in certain malignancies, particularly prostatic adenocarcinoma after androgen deprivation, cases of neuroendocrine transdifferentiation in melanomas are exceptionally rare. Herein, we report a case of a conventional superficial spreading melanoma occurring on the skin of the leg in a young male which showed progressive neuroendocrine transdifferentiation as it progressed through 2 in-transit metastases and a nodal metastatic deposit over a 4-year period. The tumor retained the BRAF V600E mutation throughout the disease process, and disease control was achieved through dual BRAF inhibition therapy. The possibility of melanoma masquerading as a high-grade neuroendocrine malignancy when investigating tumors of unknown primary should be kept in the mind of clinicians and histopathologist alike as a potential diagnostic pitfall, thus helping avoid misdiagnosis and guide appropriate treatment strategies.
    MeSH term(s) Male ; Humans ; Melanoma/genetics ; Melanoma/therapy ; Melanoma/pathology ; Skin Neoplasms/pathology ; Cell Transdifferentiation ; Proto-Oncogene Proteins B-raf/genetics ; Androgen Antagonists ; Immunohistochemistry ; Prostatic Neoplasms ; Mutation ; Melanoma, Cutaneous Malignant
    Chemical Substances Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; Androgen Antagonists
    Language English
    Publishing date 2023-02-17
    Publishing country United States
    Document type Review ; Case Reports ; Journal Article
    ZDB-ID 448469-1
    ISSN 1533-0311 ; 0193-1091
    ISSN (online) 1533-0311
    ISSN 0193-1091
    DOI 10.1097/DAD.0000000000002377
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    Zs.A 1518: Show issues Location:
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  7. Article ; Online: Dark perifollicular macules and granulomatous rosacea secondary to vandetanib.

    Farrugia, Stephanie / Cassar, Paula / Betts, Alexandra / Mercieca, Liam / Boffa, Michael J

    International journal of dermatology

    2023  Volume 63, Issue 2, Page(s) 210–212

    MeSH term(s) Humans ; Rosacea/chemically induced ; Rosacea/diagnosis ; Rosacea/drug therapy ; Skin ; Skin Abnormalities
    Language English
    Publishing date 2023-11-29
    Publishing country England
    Document type Case Reports
    ZDB-ID 412254-9
    ISSN 1365-4632 ; 0011-9059 ; 1461-1244
    ISSN (online) 1365-4632
    ISSN 0011-9059 ; 1461-1244
    DOI 10.1111/ijd.16950
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  8. Article ; Online: Papillomatosis cutis lymphostatica and 'Ski-Jump' nails.

    Mintoff, Dillon / Betts, Alexandra / Aquilina, Susan

    Pediatric dermatology

    2020  Volume 38, Issue 1, Page(s) 332–333

    Abstract: Papillomatosis cutis lymphostatica is an uncommon condition usually associated with lymphedema. "Ski-jump" nails are upward sloping concave nails that can be an important diagnostic sign which may be overlooked in the setting of lymphedema. A diagnosis ... ...

    Abstract Papillomatosis cutis lymphostatica is an uncommon condition usually associated with lymphedema. "Ski-jump" nails are upward sloping concave nails that can be an important diagnostic sign which may be overlooked in the setting of lymphedema. A diagnosis of papillomatosis cutis lymphostatica should be suspected in patients presenting with persistent, bland papilliform plaques, supported by the additional presence of "ski-jump" nails.
    MeSH term(s) Humans ; Lymphedema ; Nails ; Nails, Malformed ; Papilloma/diagnosis ; Skin
    Language English
    Publishing date 2020-11-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605539-4
    ISSN 1525-1470 ; 0736-8046
    ISSN (online) 1525-1470
    ISSN 0736-8046
    DOI 10.1111/pde.14457
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  9. Article ; Online: Retiform Purpura of the Lower Limbs Associated with Levamisole-Adulterated Cocaine.

    Farrugia, Stephanie / Micallef, Daniel / Pisani, David / Betts, Alexandra / Vella, Sandro / Boffa, Michael J

    European journal of case reports in internal medicine

    2022  Volume 9, Issue 4, Page(s) 3353

    Abstract: A young man was treated in hospital for sepsis, disseminated intravascular coagulation and multi-organ failure. He was a regular intranasal cocaine user up to 1 day prior to symptom onset. Clinical examination revealed extensive retiform purpura ... ...

    Abstract A young man was treated in hospital for sepsis, disseminated intravascular coagulation and multi-organ failure. He was a regular intranasal cocaine user up to 1 day prior to symptom onset. Clinical examination revealed extensive retiform purpura affecting both his lower limbs. Skin biopsy revealed widespread thrombosis in the small- and medium-sized vessels of the mid dermis and the subcutaneous fat with surrounding leucocytoclasis. There was also extensive ischaemic necrosis of the upper reticular and papillary dermis and focal ischaemic necrosis of the epidermis. These findings were in keeping with a thrombotic vasculopathy with associated cutaneous ischaemic necrosis, likely associated with levamisole-adulterated cocaine (LAC). An autoimmune screen showed extremely raised levels of anti-B2-glycoprotein IgM, IgG and anti-cardiolipin IgG antibodies, usually seen in antiphospholipid syndrome (APS). The literature describes how APS could be secondary to various underlying conditions, including LAC, and that levamisole toxicity may mimic APS and hence be missed.
    Learning points: Levamisole is a common adulterant found in cocaine; the resultant toxicity can present with cutaneous manifestations, namely retiform purpura and skin necrosis, similar to antiphospholipid syndrome.Patients presenting with such features should be asked about illicit drug use, specifically cocaine, and investigated by screening urine for drugs of abuse and serum antihuman elastase antibody when possible.
    Language English
    Publishing date 2022-04-28
    Publishing country Italy
    Document type Journal Article
    ISSN 2284-2594
    ISSN (online) 2284-2594
    DOI 10.12890/2022_003353
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  10. Article: Superimposed esophageal pemphigus vulgaris and herpes simplex infection.

    Gatt, Kelly / Conti, Luca / Betts, Alexandra / Ellul, Pierre

    Annals of gastroenterology

    2019  Volume 32, Issue 6, Page(s) 654

    Language English
    Publishing date 2019-07-25
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2032850-3
    ISSN 1108-7471
    ISSN 1108-7471
    DOI 10.20524/aog.2019.0408
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