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Mycosis fungoides (MF) and Sezary syndrome (SS) are the most prevalent cutaneous T-cell lymphomas, classified separately in the 2022 WHO Classification due to their distinct features. Despite advances, the mechanisms underlying disease progression—from early patch and plaque lesions to advanced tumor stages—remain incompletely understood. Chemokines and their receptors play crucial roles in the migration and survival of malignant T cells, influencing tissue invasion, immune evasion, and dissemination. This review highlights the altered expression of chemokine receptors like CCR4, CCR7, CCR8, CCR10, CXCR3, and CXCR4 in MF/SS and their contribution to disease evolution. It also explores the transition from a Th1 to a Th2 immune profile, linked to tumor progression. The dual role of chemokines in physiology and pathology is examined, with emphasis on their therapeutic potential in CTCL.

Background: Dermoscopy, a non-invasive diagnostic technique, is being increasingly used to evaluate cutaneous T-cell lymphomas such as mycosis fungoides (MF) and Sézary syndrome (SS). However, its diagnostic accuracy and role in staging remain underexplored. Objective: This study aimed to assess the dermoscopic patterns in MF and SS, correlating the findings with the disease stage and lesion type to evaluate dermoscopy’s diagnostic utility. Methods: A retrospective, monocentric analysis was conducted on patients with histologically confirmed MF or SS. Dermoscopic images were evaluated for vascular patterns, pigmentation, scaling, and keratin plugs. The statistical analysis assessed the correlations between these dermoscopic features and the TNMB staging and lesion type. A literature review was also performed to contextualize the findings, focusing on studies describing dermoscopic features in MF based on retrospective, prospective, and cross-sectional data. Results: The study included 30 patients with histologically confirmed MF or SS (19 males and 11 females; mean age: 64.5 years). The dermoscopic evaluation revealed that all the lesions were pigment-free, with vascular structures as the predominant feature. Linear vessels (40%) and serpentine vessels (13.3%) were the most frequently observed, along with dotted vessels (36.7%) and clods (10%). The vessel distribution was diffuse (40%) or perifollicular (36.7%), with a predominant red (56.7%) or orange (40%) background. Scaling was present in 76.7% of cases, either diffuse (40%) or perifollicular (36.7%), and keratin plugs were detected in 40% of the lesions. No statistically significant correlations were found between dermoscopic features and the TNMB stage or lesion type (p > 0.05). A cluster analysis identified two patient groups with differing vascular and scaling features but no clear association with disease stage. The literature review identified studies that commonly reported features in MF dermoscopy, including fine, short linear vessels and an orange-yellow background, particularly in early-stage MF. Spermatozoa-like structures have been marked as highly specific for diagnosing MF. Some studies also suggested a transition in vascular morphology from linear vessels in early disease to branched vessels and ulceration in advanced stages. Conclusions: Our results showed some vascular patterns have some potential but lack sensitivity for staging MF and SS. The terminology used and the reproducibility of our results compared to those reported in the literature showed little consistency, with none of our cases showing spermatozoa-like structures. Moreover, the same issues with the use of non-reproducible terminology were noted across the studies because it is not standardized and due to different incongruent dermoscopic patterns. More significant prospective studies with standardized descriptors and larger groups are needed to refine its diagnostic and staging utility.

Background A wide variety of hemostats are available as adjunctive measures to improve hemostasis during surgical procedures if residual bleeding persists despite correct application of conventional methods for hemorrhage control. Some are considered active agents, since they contain fibrinogen and thrombin and actively participate at the end of the coagulation cascade to form a fibrin clot, whereas others to be effective require an intact coagulation system. The aim of this study is to provide an evidence-based approach to correctly select the available agents to help physicians to use the most appropriate hemostat according to the clinical setting, surgical problem and patient’s coagulation status. Methods The literature from 2000 to 2016 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses] protocol. Sixty-six articles were reviewed by a panel of experts to assign grade of recommendation (GoR) and level of evidence (LoE) using the GRADE [Grading of Recommendations Assessment, Development and Evaluation] system, and a national meeting was held. Results Fibrin adhesives, in liquid form (fibrin glues) or with stiff collagen fleece (fibrin patch) are effective in the presence of spontaneous or drug-induced coagulation disorders. Mechanical hemostats should be preferred in patients who have an intact coagulation system. Sealants are effective, irrespective of patient’s coagulation status, to improve control of residual oozing. Hemostatic dressings represent a valuable option in case of external hemorrhage at junctional sites or when tourniquets are impractical or ineffective. Conclusions Local hemostatic agents are dissimilar products with different indications. A knowledge of the properties of each single agent should be in the armamentarium of acute care surgeons in order to select the appropriate product in different clinical conditions.

L-lysine (L-Lys) is the first-limiting amino acid in swine nutrition, but free-form supplements exhibit poor intestinal absorption, reducing their bioavailability. This study aimed to enhance the gastric retention, controlled intestinal release, and systemic availability of L-Lys by optimizing solid lipid microcapsules (SLMs). SLMs were formulated using hydrogenated triglycerides (C16:0 or C18:1), free fatty acids, and varying emulsifier concentrations. Gastric retention and intestinal release were evaluated in vitro under simulated gastrointestinal conditions (a pepsin buffer at pH 5.0 for 2 h, followed by a pancreatin buffer at pH 6.5 for up to 8 h at 39 °C). SLMs with hydrogenated triglycerides showed significantly higher gastric retention (94–95%) than those with free fatty acids (48%). Specifically, C16:0 triglyceride-based SLMs achieved 74% intestinal release, which was enhanced to 90% with 1% emulsifier. This refined formulation was subsequently evaluated in vivo using weaned pigs (three groups; n = 4) fed a basal cornmeal diet. The treatments included a single oral administration of saline solution (placebo), free L-Lys (0.17 g/kg BW), or L-Lys SLMs (0.38 g/kg BW, equally providing L-Lys at 0.17 g/kg BW). The SLMs delayed the L-Lys plasma peak (T. max. 3–4 h vs. 1 h) and significantly increased the total L-Lys amount in the plasma over 24 h, demonstrating the enhanced relative bioavailability of encapsulated L-Lys.

Background Constipation and faecal incontinence are not so uncommon in patients with multiple sclerosis, impairing quality of life. The gut microbiota is altered in multiple sclerosis patients and likely contributes to disease pathogenesis. Trans-anal irrigation has been proven to allow treatment of neurogenic bowel dysfunction and may affect gut microbiota. Objectives The primary outcome was trans-anal irrigation effectiveness on constipation and faecal incontinence. The secondary outcome was gut microbiota profiling compared to healthy subjects and during trans-anal irrigation adoption. Methods We conducted a prospective cohort study on multiple sclerosis patients, screened with Patient Assessment of Constipation Quality of Life questionnaire before undergoing constipation and faecal incontinence scoring, abdomen X-ray for intestinal transit time, compilation of food and evacuation diaries and faecal sample collection for gut microbiota analysis before and after 4 weeks of trans-anal irrigation. Results and Conclusions Eighty patients were screened of which nearly half had intestinal symptoms. The included population (n = 37) was predominantly composed of women with significantly longer disease duration, higher mean age and disability than the excluded one (p < 0.05). Twelve patients completed the trans-anal irrigation phase, which led to significant improvement of bowel dysfunction symptom-related quality of life, increase in gut microbiota diversity and reduction of the proportions of pro-inflammatory taxa (p < 0.05). Trans-anal irrigation was safe, satisfactory and could help counteract multiple sclerosis-related dysbiosis.