Physiological palpation serves as a primary clinical modality for identifying pathological changes in tissue compliance. However, its diagnostic precision is inherently limited by the subjective nature of human haptic perception and the lack of quantifiable mechanical metrics. This work describes a bio-inspired, portable tactile interface engineered for the non-invasive and real-time characterization of tissue stiffness. The system incorporates multimodal piezoresistive sensing elements that emulate the specific mechanotransduction functions of cutaneous receptors, namely Merkel disks and Ruffini endings. By integrating Hertzian contact mechanics to decouple pressure and strain signals, the platform analytically derives the effective Young's modulus of heterogeneous soft tissues. The developed sensor architecture exhibits a functional range of 0-600 kPa and a gauge factor of 10.8, facilitating high-fidelity detection of subcutaneous anomalies. Validation against various nodule geometries and depths demonstrates that the system achieves a diagnostic resolution surpassing conventional manual assessments. Furthermore, the integration of wireless data processing enables instantaneous, on-site mechanical profiling. This platform provides a scalable framework for objective diagnostics, robotic haptics, and continuous physiological monitoring, establishing a robust bridge between qualitative clinical observation and quantitative biomechanical analysis.

Cutaneous metastases from breast cancer (CMBC), including those involving the scalp, are typically observed in advanced stages of the disease and are relatively uncommon, particularly in hormone receptor-positive subtypes. We present the case of a 68-year-old woman with breast cancer metastatic to the skin, characterized by multiple firm, hyperpigmented, painless nodules distributed over the body, including the scalp. The patient has been treated with a CDK4/6 inhibitor (ribociclib) in combination with endocrine therapy (ET) (letrozole) since April 2024. During follow-up, all subcutaneous nodular lesions showed significant regression. By April 2026, skin color had returned to normal in most previously affected areas, and the majority of nodules had resolved. The scalp lesion completely disappeared, with full hair regrowth at the affected site. Treatment of CMBC with CDK4/6 inhibitor-based therapy has been scarcely reported, with most cases describing ET alone. This case highlights the potential role of CDK4/6 inhibitors and documents a notable response in the scalp, skin, and subcutaneous tissue, which has not been widely described.

Herein, we report the case of a woman in her mid-forties with stage IIB cervical squamous cancer status post-chemoradiation and brachytherapy with curative intent one year prior, who subsequently presented with lacy red to violaceous patches on the forehead, abdomen, back, and legs, as well as mildly tender, ill-defined, purpuric dermal nodules on the right upper back and right inner thigh. Hypercoagulability work-up was negative, and biopsy was consistent with metastatic, intravascular squamous cell carcinoma of cervical origin. This prompted repeat imaging, which was suspicious for metastatic disease to lymph nodes, lungs, and pericardium with multiple bilateral acute/subacute embolic brain infarcts and left ventricular thrombus, and the patient was subsequently started on pembrolizumab, carboplatin, and paclitaxel. Dermatology recommended warming the skin during infusions to promote vasodilation and improve intravascular medication distribution. Despite almost complete resolution of purpuric skin findings and initial improvement in metastatic bone and lymph node disease, the patient had disease progression with worsening bone and new leptomeningeal metastases, as well as subcutaneous metastatic nodules, and was switched to second-line immunotherapy, tisotumab and bevacizumab. Unfortunately, the patient continued to have progressive metastatic disease, leading to multiple complications and hospitalizations, and was ultimately transitioned to hospice care. She passed eleven months post-presentation. Our case highlights the importance of considering retiform purpura as a rare manifestation of intravascular metastases in patients with cervical squamous cell carcinoma, the value of cutaneous metastases in the management of oncologic patients, and the need to further assess the prognostic utility of cutaneous metastases in the era of immunotherapy, which, based on our case, appears to remain a poor prognostic sign.

A relatively uncommon occurrence of multiple unusual distant metastasis in a patient with thyroglobulin-elevated negative iodine scintigraphy (TENIS) (subcutis, skeletal muscle, kidney, and pericardium) is presented. A 65-year-old man with papillary thyroid carcinoma post two cycles of radioactive iodine therapy on subsequent follow-up showed elevated serum thyroglobulin (>300 ng/mL) and negative iodine scintigraphy (TENIS). [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for disease restaging revealed extensive metastatic disease involving cervical and mediastinal nodes, bones, liver, subcutis, skeletal muscle, kidney, and pericardium. [68Ga]-fibroblast activation protein inhibitor (FAPI)-04 PET/CT was done to evaluate for fibroblast activation protein (FAP) expression, and the feasibility of targeted radionuclide therapy showed nil to very low FAP expression at the metastatic sites, except for the few cervical and mediastinal nodes, subcutaneous nodule in the left arm, and L3 vertebral lesion. In addition to illustrate the rare presentation in TENIS, this case demonstrates the superiority of [18F]-FDG PET/CT over FAPI PET/CT in this patient. However, FAPI-PET/CT may be used as a theranostic tool for assessing radionuclide therapy prospects in selected cases.

Onchocerca flexuosa is a vector-borne filarial nematode infecting red deer (Cervus elaphus) throughout Europe. Despite numerous reports from Central, Northern, and Southern Europe, its occurrence in South-Eastern Europe has remained largely undocumented. This study provides the first molecularly confirmed report and the first systematic epidemiological assessment of O. flexuosa in red deer in Croatia. During the 2024-2025 hunting season, 110 legally harvested red deer from central Croatia were examined for subcutaneous nodules. Nodules were evaluated morphologically, and adult nematodes were identified and confirmed by sequencing of a fragment of the mitochondrial cytochrome c oxidase subunit I (COI) gene. Subcutaneous nodules were detected in 53.6% (59/110) of examined animals. O. flexuosa was confirmed in 52 deer, corresponding to an overall prevalence of 47.3%. Co-infection with Hypoderma diana occurred in 21.2% of infected animals. Sequence similarity ranged from 96.37% to 99.85% compared to published European O. flexuosa isolates. Phylogenetic analysis placed Croatian sequences within the established European lineage, without evidence of regional genetic divergence. The observed prevalence falls within the intermediate range reported across Europe and indicates stable local transmission. These findings close an important geographical knowledge gap and demonstrate that nodular onchocercosis is established in red deer populations in South-Eastern Europe.

Insulin is a hormone that physiologically contributes to the control of glucose metabolism and therefore insulin self-injection has been one of the highly effective therapeutic approaches for diabetes. However, repeated injection of insulin preparations into the same site induces the formation of insulin amyloid. The amyloid adheres to native insulin, reduces the absorption of native insulin into blood vessels and eventually leads to high blood glucose levels. However, less-invasive radical treatments have not been explored. In this study, we examined whether free electron laser (FEL) irradiation of insulin amyloid reduces the toxicity elicited by the amyloid. FEL irradiation decreased the size of insulin amyloid as proved by transmission electron microscopy (TEM) and circular dichroism (CD). In addition, amount of the insulin with a beta-sheet structure was reduced after FEL irradiation, as evidenced by thioflavin T (ThT) assay. An ELISA experiment revealed reduced adhesion of FEL-irradiated insulin amyloid to native insulin. In mice, FEL-irradiated insulin amyloid formed sparse nodules in subcutaneous tissues compared to those formed by non-irradiated amyloid. These results suggest a potential for application of FEL to insulin amyloid, provided that direct irradiation of FEL to insulin amyloid in mouse skin leads to improved blood glucose levels in future.

Severe combined immunodeficiency (SCID) comprises a group of life-threatening inborn errors of immunity (IEI) characterized by profound T-cell deficiency, frequently accompanied by impaired B cell and natural killer (NK) cell function. X-linked SCID (X-SCID), caused by pathogenic variants in IL2RG, accounts for approximately 30% of all SCID cases.

Malignant peripheral nerve sheath tumor (MPNST) represents a life-threatening complication of neurofibromatosis type 1 (NF1). This report describes a male patient with NF1 and concomitant MPNST treated at our institution. A 55-year-old male first presented with multiple, skin-colored neoplasms distributed across his body over the course of three decades, without any identifiable predisposing factors. Two years before presentation, a firm subcutaneous nodule appeared on his left back, causing intermittent mild discomfort, leading to a diagnosis of multiple neurofibromas. Despite participation in a clinical trial, the lesion on his left back progressively enlarged, and associated pain intensified. A multidisciplinary team subsequently recommended resection of the dorsal mass via Mohs surgery under general anesthesia. Postoperative histopathological analysis confirmed NF1 with concurrent MPNST. No adjuvant targeted therapy was administered, and no recurrence was observed during the six-month follow-up. This case highlights the coexistence of NF1 and MPNST, aiming to enhance clinical awareness of the malignant transformation risks in NF1, thereby promoting earlier diagnosis and minimizing the potential for misdiagnosis and delayed intervention.

BackgroundSubcutaneous fat necrosis (SCFN) of the newborn is a rare panniculitis. It is characterized by erythematous, indurated nodules or plaques involving the back, buttocks, or extremities. Although the lesions usually resolve spontaneously, SCFN can be complicated by hypercalcemia. This complication may lead to significant morbidity and mortality. This review summarizes the risk factors, timing, and complications of hypercalcemia in SCFN.MethodThis review followed the PRISMA 2020 statement (Registration ID: CRD420251145895). A systematic search was conducted in PubMed, Scopus, ScienceDirect, EBSCO, and ProQuest for studies published between 2015 and 2025. Case reports, case series, observational studies, and reviews reporting SCFN with calcium data were included. Data on risk factors, timing of onset, and complications were synthesized narratively.ResultsThirty-one studies were included. The most common reported maternal risk factors were gestational diabetes mellitus (GDM) (7/30) and hypertension or preeclampsia (5/30). Perinatal hypoxia, especially asphyxia (30/35), was the predominant neonatal factor. SCFN lesions typically appeared within the first 3 weeks of life (wks of life), while hypercalcemia developed within 8 wks of life. Nephrocalcinosis (NC) was the most common complication (18/28).ConclusionSCFN is a systemic condition with a substantial risk of delayed or persistent hypercalcemia. This review highlights the delayed onset of hypercalcemia, which may occur weeks after skin lesion development. These findings emphasize the need for extended monitoring, including serial calcium assessment and renal imaging, to prevent overlooked complications and improve neonatal outcomes.