Glatiramer acetate, given as a 40 mg subcutaneous injection thrice weekly, was recently approved by the FDA based on data suggesting better compliance and a more favorable side effect profile compared to lower dose, daily dosing. The most commonly reported adverse events are transient injection site reactions involving redness and pain at the site; however, more pronounced panniculitis and lipoatrophy have also been reported. Here, we present the case of a 51-year-old female treated with higher dose glatiramer acetate who presented with a cutaneous injection site reaction consistent with Nicolau syndrome. The excised specimen revealed typical glatiramer acetate-associated panniculitis, alongside subcutaneous sclerosis. This case shows the spectrum of cutaneous complications possible with glatiramer acetate injections, the finding of sclerosis being relatively infrequently reported. Given the relatively short duration of trials leading to FDA approval of thrice weekly dosing of glatiramer acetate, clinicians should perform careful clinical and histopathological evaluation and reporting of patients who experience injection site reactions.

yielded two distinct groups with miRNA expression patterns corresponding to final RNU pathology (p[0.029). Validation of these miRNAs revealed upregulation of miR-21-5p in invasive tumors (p[0.026) and downregulation of four miRNAs (miR-141-3b, miR-26b-5p, miR-29c-3p, let-7b-5p) in HG tumors (p<0.05). Using miR-141-3p and miR-29c-3p in combination as a predictive model for grade resulted in a sensitivity and specificity of 89.3% and 62.5% respectively, with an area under the curve of 0.812.CONCLUSIONS: We present distinct miRNA expression profiles of UTUC biopsies that are associated with HG, invasive tumors compared to LG, non-invasive lesions. We further highlight validated UTUC miRNAs that show a statistically significant correlation with tumor invasion and grade.