Vesna Rosic - Academia.edu (original) (raw)
Papers by Vesna Rosic
Skinmed
Almost 2 centuries after its recognition, basal cell carcinoma (BCC) remains the most common canc... more Almost 2 centuries after its recognition, basal cell carcinoma (BCC) remains the most common cancer worldwide, with a 30% overall lifetime risk in the United States and an incidence that continues to increase annually. The increasing incidence of BCC is multifactorial and likely correlates to multiple risk factors, including exposure to both ionizing and UV radiation. Despite its relatively indolent growth, what was once referred to as a rodent ulcer or basal cell epithelioma is now identified as a full-fledged malignancy. The authors describe the societal burden of this disease and characterize its malignant potential, emphasizing associated clinical and histopathologic prognostic features.
The American Journal of dermatopathology, Jan 10, 2015
Morphea is a rare fibrosing condition of the skin and underlying tissues characterized histopatho... more Morphea is a rare fibrosing condition of the skin and underlying tissues characterized histopathologically by thickened collagen bundles throughout the dermis, loss of adnexal structures, and "fat trapping." In the early stages of morphea, the absence of the fully developed characteristic findings may cause diagnostic confusion for the practicing pathologist. The authors report an unusual case of early morphea misdiagnosed as patch-stage poikilodermatous mycosis fungoides (MF) based on the initial clinical, histopathologic, and molecular findings. However, as time elapsed, well-developed lesions revealed clinical and histopathologic features diagnostic of morphea. The authors report this case to illustrate that lesions of early morphea may simulate MF. Given the similarities in clinicopathologic presentation, dermatologists and dermatopathologists should be cautious not to inadvertently misinterpret early morphea as MF.
Psoriasis: Targets and Therapy, 2012
Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin an... more Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. Genetic susceptibility as well as environmental factors play an important role in determining the development and prognosis of psoriasis. Genomewide association studies have identified many genetic loci as potential psoriasis susceptibility regions, including PSORS1 through PSORS7. Histocompatibility antigen (HLA) studies have also identified several HLA antigens, with HLA-Cw6 being the most frequently associated antigen. Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. The exact mechanism by which they trigger psoriasis remains to be elucidated; however, existing data suggest that they are linked through Th1-mediated immunological pathways. The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations. The differential diagnosis is vast and includes many other immunemediated, inflammatory disorders.
Clinics in Dermatology, 2007
Physicians in the United States, and even more so on the European continent, still use Latin in t... more Physicians in the United States, and even more so on the European continent, still use Latin in their everyday practice. Some diseases do not have lay names, and others were learned that way from the outset. With the dwindling of proper instruction during undergraduate and graduate studies, use of Latin has become an art of copying rather than knowledge of the language. Copying can lead to silly mistakes that, by being further copied, establish a new incorrect name that is taught to generations of upcoming physicians. I wish to draw your interest to the history and complexity (or simplicity) of the Latin language and encourage physicians to also be scholars and correctly use Latin words when they choose to employ them for medical text writing.
Clinical and Experimental Dermatology, 2006
The Ras-Raf-MEK-ERK signalling pathway is frequently dysregulated in human malignancies, as is an... more The Ras-Raf-MEK-ERK signalling pathway is frequently dysregulated in human malignancies, as is angiogenesis and the vascular endothelial growth factor receptor (VEGF/VEGFR) pathway. These kinases are therefore important anticancer targets. The novel, oral treatment sorafenib (BAY 43-9006), has been shown to be an inhibitor of VEGFR, Raf and platelet-derived growth factor in clinical trials against a variety of cancers, with the greatest activity to date observed in metastatic renal cancer. Although side-effects with this targeted therapy are usually not dose-limiting, they frequently involve the skin, and consist of a maculopapular rash, palmar-plantar dysaesthesia, alopecia and xerosis. In this report, we present two patients in whom treatment with sorafenib resulted in inflammation of actinic keratosis, which in some cases progressed to invasive squamous cell carcinoma. This side-effect is of clinical importance, as early recognition is critical for early treatment and may represent a source of additional morbidity to these patients.
Archives of Dermatology, 2008
Page 1. lesions and a history of depression, treatment with es-tablished therapies such as excisi... more Page 1. lesions and a history of depression, treatment with es-tablished therapies such as excision, cryotherapy, radio-therapy, intralesional or systemic chemotherapy, or in-terferon alfa was problematic. Eight weeks after initiation ...
Leukemia & Lymphoma, 2010
A 73-year-old man with a history of a right frontal meningioma treated with resection and 30 frac... more A 73-year-old man with a history of a right frontal meningioma treated with resection and 30 fractions of cranial irradiation 6 years earlier presented with hundreds of 1–3 cm raised violaceous papules and nodules on his chest, back, neck, scalp, and abdomen [Figure 1(A)]. There were no lesions below the waist. The nodules were non-tender, non-pruritic, and slightly elevated, and had developed gradually over the previous two and a half months. His other medical problems included hypertension, end-stage renal disease requiring hemodialysis, and diabetes. Skin biopsy of one of the nodules demonstrated a neoplastic population of cells diffusely infiltrating the dermis, with a distinct grenz zone. Immature blastic cells with round to slightly irregular folded nuclei, indistinct nucleoli, and a scant to moderate amount of cytoplasm infiltrated between collagen bundles in sheets and singly, as well as through the fat in a honeycomb pattern [Figure 1(B)]. Immunoperoxidase staining demonstrated that the neoplastic cells were CD347, CD33þ, lysozymeþ, CD68(KP1)þ, weakly CD4þ, CD56þ, weakly MPOþ, and weakly CD123þ, consistent with myeloid lineage. NPM1 expression was positive by immunohistochemistry in the nucleus and cytoplasm of the neoplastic cells, which is characteristic of a mutation in the NPM1 gene, whereas the normal keratinocytes in the epidermis showed only nuclear staining [Figure 1(C)]. His blood counts were normal except for mild thrombocytopenia (126 000/mL). A bone marrow biopsy showed no evidence of acute myeloid leukemia (AML), and the karyotype was normal 46,XY. Molecular analyses on the myeloid sarcoma tissue showed a 4 bp insert in exon 12 of the NPM1 gene; the signal intensity was approximately equal to the wild-type allele. There was no evidence of an internal tandem duplication (ITD) or D835 mutation of the FLT3 gene. The karyotype on the skin biopsy was also normal. The patient was not a candidate for systemic chemotherapy due to his serious comorbidities. He received 5 weeks of electron beam therapy to the head, chest, back, and abdomen, with near complete resolution of the skin lesions. Shortly afterward, Figure 1. (A) Leukemia cutis. Physical exam reveals diffuse nodular and papular rash with lesions ranging from 1 to 3 cm throughout back (pictured), neck, face, and chest. (B) Skin biopsy. A neoplastic population of cells diffusely infiltrating the dermis and distinct grenz zone. (C) Keratinocytes display nucleus-restricted NPM1 positivity. Myeloid sarcoma cells show the expected nuclear localization in addition to aberrant expression in the cytoplasm.
Journal of the European Academy of Dermatology and Venereology, 1997
Posters-Autoimmune diseases s155 Conclusions: Sclerodermiform c-GVHD is a rare complication of al... more Posters-Autoimmune diseases s155 Conclusions: Sclerodermiform c-GVHD is a rare complication of allogenic bone marrow transplantation that can be severe. All patients with generalized disease should be treated to halt the evolution to incapacitating disease. rl PO09 Porphyria cutanea tarda and lupus erythematosus
Skinmed, 2017
A 79-year-old man with a recent diagnosis of acute myeloblastic leukemia received induction chemo... more A 79-year-old man with a recent diagnosis of acute myeloblastic leukemia received induction chemotherapy with daunorubicin and cytarabine, plus moxifloxacin and fluconazole prophylaxis. Approximately 2 weeks later, an asymptomatic eruption appeared on his trunk. He then developed a neutropenic fever and was started on aztreonam, vancomycin, voriconazole, and amikacin and was transferred to our facility from an outside hospital. Micafungin was subsequently added, and the patient defervesced within a few days.
Skinmed, 2017
There are many molecular variations in the histologic subtypes of basal cell carcinoma (BCC); Ki6... more There are many molecular variations in the histologic subtypes of basal cell carcinoma (BCC); Ki67 and Bcl-2 expression differs among them and might relate to their prognostic features. The clinically notable friability and its histologic counterpart, retraction, are dependent on cell-cell adhesion and basement membrane characteristics, which may be altered in different ways depending on the tumor morphology and phenotype. Finally, we discuss the pathogenesis of BCCs and recent molecular advances with a review of new and upcoming molecular-based therapeutics.
Clinics in Dermatology, 2016
Clinics in Dermatology, 2016
This group of biologically diverse entities is united by topographic localization to the hands an... more This group of biologically diverse entities is united by topographic localization to the hands and feet. Categorizing tumors by body site narrows the differential into a short list of possibilities that can facilitate accurate and rapid diagnosis. The goal of this review is to provide a practical approach to soft tissue tumors of acral locations for clinicians, pathologists, and researchers alike. What ensues in the following text is that tight coupling of the clinical picture and histopathologic findings should produce the correct diagnosis, or at least an abbreviated differential. The salient clinicopathologic, immunohistochemical, and molecular features are presented alongside current treatment recommendations for each entity.
Skinmed
A 46-year-old African American man presented with a 3- to 4-day history of a new painful lesion o... more A 46-year-old African American man presented with a 3- to 4-day history of a new painful lesion on his left lower extremity. Other reported symptoms included a productive cough and chest pain; the patient denied fever and chills. His medical history was significant for a heart transplant 4 months prior to presentation followed by transplant rejection 2 weeks after the transplant. Medications included an antirejection/immunosuppressive regimen consisting of prednisone, tacrolimus, mycophenolate mofetil, and prophylaxis treatment with valganciclovir and trimethoprim-sulfamethoxazole.
Clinics in Dermatology, 2016
Serbian Journal of Experimental and Clinical Research, 2014
ABSTRACTHepatorenal syndrome (HRS) involves reversible renal failure in patients with advanced ci... more ABSTRACTHepatorenal syndrome (HRS) involves reversible renal failure in patients with advanced cirrhosis or acute liver failure. The aim of the study was to determine the pathogenetic mechanisms of the development of hepatorenal syndrome and to emphasise the clinical importance of early detection and timely treatment of patients with this condition. Th e one-year incidence rate of hepatorenal syndrome in patients with liver cirrhosis is 18-20%. Th e risk factors for the development of hepatorenal syndrome include the following: spontaneous bacterial peritonitis, gastrointestinal bleeding, nephrotoxic drugs, diuretics, non-steroidal anti-inflammatory drugs, and hyponatraemia. The primary plan of treatment is a liver transplantation, while a secondary plan of treatment is the use of a vasoconstrictor in conjunction with albumin. Early diagnosis and prompt appropriate treatment can significantly reduce the mortality rate of patients with hepatorenal syndrome.
Pediatric dermatology, 2015
Skinmed
Almost 2 centuries after its recognition, basal cell carcinoma (BCC) remains the most common canc... more Almost 2 centuries after its recognition, basal cell carcinoma (BCC) remains the most common cancer worldwide, with a 30% overall lifetime risk in the United States and an incidence that continues to increase annually. The increasing incidence of BCC is multifactorial and likely correlates to multiple risk factors, including exposure to both ionizing and UV radiation. Despite its relatively indolent growth, what was once referred to as a rodent ulcer or basal cell epithelioma is now identified as a full-fledged malignancy. The authors describe the societal burden of this disease and characterize its malignant potential, emphasizing associated clinical and histopathologic prognostic features.
The American Journal of dermatopathology, Jan 10, 2015
Morphea is a rare fibrosing condition of the skin and underlying tissues characterized histopatho... more Morphea is a rare fibrosing condition of the skin and underlying tissues characterized histopathologically by thickened collagen bundles throughout the dermis, loss of adnexal structures, and "fat trapping." In the early stages of morphea, the absence of the fully developed characteristic findings may cause diagnostic confusion for the practicing pathologist. The authors report an unusual case of early morphea misdiagnosed as patch-stage poikilodermatous mycosis fungoides (MF) based on the initial clinical, histopathologic, and molecular findings. However, as time elapsed, well-developed lesions revealed clinical and histopathologic features diagnostic of morphea. The authors report this case to illustrate that lesions of early morphea may simulate MF. Given the similarities in clinicopathologic presentation, dermatologists and dermatopathologists should be cautious not to inadvertently misinterpret early morphea as MF.
Psoriasis: Targets and Therapy, 2012
Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin an... more Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. Genetic susceptibility as well as environmental factors play an important role in determining the development and prognosis of psoriasis. Genomewide association studies have identified many genetic loci as potential psoriasis susceptibility regions, including PSORS1 through PSORS7. Histocompatibility antigen (HLA) studies have also identified several HLA antigens, with HLA-Cw6 being the most frequently associated antigen. Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. The exact mechanism by which they trigger psoriasis remains to be elucidated; however, existing data suggest that they are linked through Th1-mediated immunological pathways. The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations. The differential diagnosis is vast and includes many other immunemediated, inflammatory disorders.
Clinics in Dermatology, 2007
Physicians in the United States, and even more so on the European continent, still use Latin in t... more Physicians in the United States, and even more so on the European continent, still use Latin in their everyday practice. Some diseases do not have lay names, and others were learned that way from the outset. With the dwindling of proper instruction during undergraduate and graduate studies, use of Latin has become an art of copying rather than knowledge of the language. Copying can lead to silly mistakes that, by being further copied, establish a new incorrect name that is taught to generations of upcoming physicians. I wish to draw your interest to the history and complexity (or simplicity) of the Latin language and encourage physicians to also be scholars and correctly use Latin words when they choose to employ them for medical text writing.
Clinical and Experimental Dermatology, 2006
The Ras-Raf-MEK-ERK signalling pathway is frequently dysregulated in human malignancies, as is an... more The Ras-Raf-MEK-ERK signalling pathway is frequently dysregulated in human malignancies, as is angiogenesis and the vascular endothelial growth factor receptor (VEGF/VEGFR) pathway. These kinases are therefore important anticancer targets. The novel, oral treatment sorafenib (BAY 43-9006), has been shown to be an inhibitor of VEGFR, Raf and platelet-derived growth factor in clinical trials against a variety of cancers, with the greatest activity to date observed in metastatic renal cancer. Although side-effects with this targeted therapy are usually not dose-limiting, they frequently involve the skin, and consist of a maculopapular rash, palmar-plantar dysaesthesia, alopecia and xerosis. In this report, we present two patients in whom treatment with sorafenib resulted in inflammation of actinic keratosis, which in some cases progressed to invasive squamous cell carcinoma. This side-effect is of clinical importance, as early recognition is critical for early treatment and may represent a source of additional morbidity to these patients.
Archives of Dermatology, 2008
Page 1. lesions and a history of depression, treatment with es-tablished therapies such as excisi... more Page 1. lesions and a history of depression, treatment with es-tablished therapies such as excision, cryotherapy, radio-therapy, intralesional or systemic chemotherapy, or in-terferon alfa was problematic. Eight weeks after initiation ...
Leukemia & Lymphoma, 2010
A 73-year-old man with a history of a right frontal meningioma treated with resection and 30 frac... more A 73-year-old man with a history of a right frontal meningioma treated with resection and 30 fractions of cranial irradiation 6 years earlier presented with hundreds of 1–3 cm raised violaceous papules and nodules on his chest, back, neck, scalp, and abdomen [Figure 1(A)]. There were no lesions below the waist. The nodules were non-tender, non-pruritic, and slightly elevated, and had developed gradually over the previous two and a half months. His other medical problems included hypertension, end-stage renal disease requiring hemodialysis, and diabetes. Skin biopsy of one of the nodules demonstrated a neoplastic population of cells diffusely infiltrating the dermis, with a distinct grenz zone. Immature blastic cells with round to slightly irregular folded nuclei, indistinct nucleoli, and a scant to moderate amount of cytoplasm infiltrated between collagen bundles in sheets and singly, as well as through the fat in a honeycomb pattern [Figure 1(B)]. Immunoperoxidase staining demonstrated that the neoplastic cells were CD347, CD33þ, lysozymeþ, CD68(KP1)þ, weakly CD4þ, CD56þ, weakly MPOþ, and weakly CD123þ, consistent with myeloid lineage. NPM1 expression was positive by immunohistochemistry in the nucleus and cytoplasm of the neoplastic cells, which is characteristic of a mutation in the NPM1 gene, whereas the normal keratinocytes in the epidermis showed only nuclear staining [Figure 1(C)]. His blood counts were normal except for mild thrombocytopenia (126 000/mL). A bone marrow biopsy showed no evidence of acute myeloid leukemia (AML), and the karyotype was normal 46,XY. Molecular analyses on the myeloid sarcoma tissue showed a 4 bp insert in exon 12 of the NPM1 gene; the signal intensity was approximately equal to the wild-type allele. There was no evidence of an internal tandem duplication (ITD) or D835 mutation of the FLT3 gene. The karyotype on the skin biopsy was also normal. The patient was not a candidate for systemic chemotherapy due to his serious comorbidities. He received 5 weeks of electron beam therapy to the head, chest, back, and abdomen, with near complete resolution of the skin lesions. Shortly afterward, Figure 1. (A) Leukemia cutis. Physical exam reveals diffuse nodular and papular rash with lesions ranging from 1 to 3 cm throughout back (pictured), neck, face, and chest. (B) Skin biopsy. A neoplastic population of cells diffusely infiltrating the dermis and distinct grenz zone. (C) Keratinocytes display nucleus-restricted NPM1 positivity. Myeloid sarcoma cells show the expected nuclear localization in addition to aberrant expression in the cytoplasm.
Journal of the European Academy of Dermatology and Venereology, 1997
Posters-Autoimmune diseases s155 Conclusions: Sclerodermiform c-GVHD is a rare complication of al... more Posters-Autoimmune diseases s155 Conclusions: Sclerodermiform c-GVHD is a rare complication of allogenic bone marrow transplantation that can be severe. All patients with generalized disease should be treated to halt the evolution to incapacitating disease. rl PO09 Porphyria cutanea tarda and lupus erythematosus
Skinmed, 2017
A 79-year-old man with a recent diagnosis of acute myeloblastic leukemia received induction chemo... more A 79-year-old man with a recent diagnosis of acute myeloblastic leukemia received induction chemotherapy with daunorubicin and cytarabine, plus moxifloxacin and fluconazole prophylaxis. Approximately 2 weeks later, an asymptomatic eruption appeared on his trunk. He then developed a neutropenic fever and was started on aztreonam, vancomycin, voriconazole, and amikacin and was transferred to our facility from an outside hospital. Micafungin was subsequently added, and the patient defervesced within a few days.
Skinmed, 2017
There are many molecular variations in the histologic subtypes of basal cell carcinoma (BCC); Ki6... more There are many molecular variations in the histologic subtypes of basal cell carcinoma (BCC); Ki67 and Bcl-2 expression differs among them and might relate to their prognostic features. The clinically notable friability and its histologic counterpart, retraction, are dependent on cell-cell adhesion and basement membrane characteristics, which may be altered in different ways depending on the tumor morphology and phenotype. Finally, we discuss the pathogenesis of BCCs and recent molecular advances with a review of new and upcoming molecular-based therapeutics.
Clinics in Dermatology, 2016
Clinics in Dermatology, 2016
This group of biologically diverse entities is united by topographic localization to the hands an... more This group of biologically diverse entities is united by topographic localization to the hands and feet. Categorizing tumors by body site narrows the differential into a short list of possibilities that can facilitate accurate and rapid diagnosis. The goal of this review is to provide a practical approach to soft tissue tumors of acral locations for clinicians, pathologists, and researchers alike. What ensues in the following text is that tight coupling of the clinical picture and histopathologic findings should produce the correct diagnosis, or at least an abbreviated differential. The salient clinicopathologic, immunohistochemical, and molecular features are presented alongside current treatment recommendations for each entity.
Skinmed
A 46-year-old African American man presented with a 3- to 4-day history of a new painful lesion o... more A 46-year-old African American man presented with a 3- to 4-day history of a new painful lesion on his left lower extremity. Other reported symptoms included a productive cough and chest pain; the patient denied fever and chills. His medical history was significant for a heart transplant 4 months prior to presentation followed by transplant rejection 2 weeks after the transplant. Medications included an antirejection/immunosuppressive regimen consisting of prednisone, tacrolimus, mycophenolate mofetil, and prophylaxis treatment with valganciclovir and trimethoprim-sulfamethoxazole.
Clinics in Dermatology, 2016
Serbian Journal of Experimental and Clinical Research, 2014
ABSTRACTHepatorenal syndrome (HRS) involves reversible renal failure in patients with advanced ci... more ABSTRACTHepatorenal syndrome (HRS) involves reversible renal failure in patients with advanced cirrhosis or acute liver failure. The aim of the study was to determine the pathogenetic mechanisms of the development of hepatorenal syndrome and to emphasise the clinical importance of early detection and timely treatment of patients with this condition. Th e one-year incidence rate of hepatorenal syndrome in patients with liver cirrhosis is 18-20%. Th e risk factors for the development of hepatorenal syndrome include the following: spontaneous bacterial peritonitis, gastrointestinal bleeding, nephrotoxic drugs, diuretics, non-steroidal anti-inflammatory drugs, and hyponatraemia. The primary plan of treatment is a liver transplantation, while a secondary plan of treatment is the use of a vasoconstrictor in conjunction with albumin. Early diagnosis and prompt appropriate treatment can significantly reduce the mortality rate of patients with hepatorenal syndrome.
Pediatric dermatology, 2015