Dermoscopy on nevus comedonicus : a case report and review of the literature

Nevus comedonicus (NC) is a very rare, benign hamartoma characterised by the occurrence of dilated, comedo-like openings, typically on the face, neck, upper arms, chest or abdomen. In uncertain cases, histopathological examination confirms the diagnosis. The authors suggest dermoscopy as a rapid and useful method of initial diagnosis of nevus comedonicus based upon its distinctive dermoscopic features. The dermoscopy reveals numerous lightand dark-brown, circular or barrel-shaped, homogenous areas with prominent keratin plugs

Podstawowe triki w dermoskopii

Dermoskopia stanowi obecnie w rękach lekarza praktyka niezbędne narzędzie, dzięki któremu może on rozpoznać w szybki sposób większość schorzeń dermatologicznych — nie tylko z grupy zmian melanocytowych i niemelanocytowych, ale również dermatoz zapalnych, polekowych toksyczności skórnych, chorób autoimmunologicznych oraz infekcji pasożytniczych. W celu ustalenia trafnej diagnozy zaleca się przeprowadzanie dodatkowych pomocnych testów diagnostycznych w ocenie dermoskopowej umożliwiających szybkie podjęcie decyzji warunkującej dalsze postępowanie diagnostyczno-terapeutyczne. Dotychczas w dostępnej literaturze opisano podstawowe pomocnicze testy dermoskopowe, takie jak test plastra (tape stripping), test z atramentem (ink furrow test), test ze zdrapania (scrapping, scratching test), test świecenia czy też test z uciskiem naczyń. W pracy omówiono główne techniki trików dermoskopowych stanowiących dodatkowe narzędzie szybkiej diagnostyki uzupełniającej badanie dermoskopowe

The management of skin reactions during epidermal growth factor receptor inhibitors in patients with colorectal cancer

Receptor nabłonkowego czynnika wzrostu (EGFR) jest śródbłonową glikoproteiną wykazującą ekspresję w wielu komórkach pochodzenia nabłonkowego. Stosowanie inhibitorów EGFR wiąże się z występowaniem różnorodnych działań niepożądanych, w tym najczęstszych z nich, reakcji skórnych (tzw. toksyczności skórnej), pojawiających się u ponad połowy leczonych pacjentów — nasilenie jest często powodem redukcji dawki leku bądź nawet przerwania leczenia. Ze względu na istniejący związek między odpowiedzią na leczenie inhibitorami EGFR, wyrażoną przeżyciem wolnym od progresji lub całkowitym przeżyciem a reakcjami skórnymi, obecnie zaleca się raczej leczenie i łagodzenie reakcji skórnych niż redukcję dawek czy przerywanie terapii inhibitorami EGFR. Istnieją jedynie nieliczne dane pochodzące z badań klinicznych, stąd potrzeba zebrania i usystematyzowania informacji dotyczących praktycznego postępowania w przypadku wystąpienia skórnych działań niepożądanych. Zawarte w pracy informacje mogą być przydatne w codziennej praktyce klinicznej i ułatwić podejmowanie decyzji dotyczących zarówno zapobiegania, leczenia i łagodzenia zmian skórnych, jak i samego leczenia inhibitorami EGFR. Skuteczne leczenie objawów skórnych zapewnia odpowiednie dawkowanie leku oraz jakość życia chorego. Onkol. Prak. Klin. 2010; 6, 6: 318–332The epidermal growth factor receptor (EGFR) is a transmembrane glycoprotein expressed by a number of cell types of epithelial origin. The use of EGFR inhibitors is associated with various adverse effects, including the most common ones: skin reactions (the so-called skin toxicity) developing in over half of the treated patients. Their intensification is often the reason for drug dose reduction or even treatment discontinuance. In view of the existing relationship between the response to treatment with EGFR inhibitors, expressed as progression-free survival or overall survival, and the skin reactions, it is currently recommended to opt for managing and alleviating the skin reactions rather than for reducing the drug dose or discontinuing the therapy with EGFR inhibitors. There is available only a limited amount of data from clinical trials on this issue, hence the need to collate and systematise the information concerning the practical approach to adverse effects involving skin. The data contained in this publication may prove useful in everyday clinical practice and facilitate the decision-making as regards the prevention, treatment and alleviation of skin lesions, as well as the therapeutic approach with the use of EGFR inhibitors itself. An effective treatment of skin symptoms ensures appropriate drug dosage and adequate quality of life of the patient. Onkol. Prak. Klin. 2010; 6, 6: 318–33

Diagnostyka obrazowa złośliwej plamy soczewicowatej (lentigo maligna) w obrębie wolnego płatka małżowiny usznej

Bez streszczeni

Dermoscopic Features of Actinic Cheilitis and Other Common Inflammatory Cheilitis: A Multicentric Retrospective Observational Study by the International Dermoscopy Society

Background: Clinical differentiation between different cheilitis variants may be difficult. Application of mucoscopy, in addition to clinical background, could provide additional diagnostic clues facilitating initial patient management. Objectives: To determine mucoscopic clues differentiating actinic cheilitis from the main forms of inflammatory cheilitis, including eczematous cheilitis, discoid lupus erythematosus, and lichen planus of the lips. Methods: This was a retrospective, multicenter study being a part of an ongoing project "Mucoscopy - an upcoming tool for oral mucosal disorders" under the aegis of the International Dermoscopy Society. Cases included in the current study were collected via an online call published on the IDS website (www.dermoscopy-ids.org) between January 2019 and December 2020. Results: Whitish-red background was found in actinic cheilitis as well as in cheilitis due to discoid lupus erythematous and lichen planus. Polymorphous vessels were more likely to be seen in actinic cheilitis compared to other causes of cheilitis. White scales, ulceration, and blood spots predominated in actinic cheilitis and lichen planus, whereas yellowish scales typified eczematous and discoid lupus erythematous cheilitis. Radiating white lines although most common in lichen planus patients were also seen in actinic cheilitis. Conclusion: Despite differences in the frequency of mucoscopic structures, we have not found pathognomonic features allowing for differentiation between analyzed variants of cheilitis

How Can the EU Beating Cancer Plan Help in Tackling Lung Cancer, Colorectal Cancer, Breast Cancer and Melanoma?

Cancer is the second leading cause of mortality in EU countries, and the needs to tackle cancer are obvious. New scientific understanding, techniques and methodologies are opening up horizons for significant improvements in diagnosis and care. However, take-up is uneven, research needs and potential outstrip currently available resources, manifestly beneficial practices—such as population-level screening for lung cancer—are still not generalised, and the quality of life of patients and survivors is only beginning to be given attention it merits. This paper, mainly based on a series of multistakeholder expert workshops organised by the European Alliance for Personalised Medicine (EAPM), looks at some of those specifics in the interest of planning a way forward. Part of this exercise also involves taking account of the specific nature of Europe and its constituent countries, where the complexities of planning a way forward are redoubled by the wide variations in national and regional approaches to cancer, local epidemiology and the wide disparities in health systems. Despite all the differences between cancers and national and regional resources and approaches to cancer care, there is a common objective in pursuing broader and more equal access to the best available care for all European citizens

How Can the EU Beating Cancer Plan Help in Tackling Lung Cancer, Colorectal Cancer, Breast Cancer and Melanoma?

Cancer is the second leading cause of mortality in EU countries, and the needs to tackle cancer are obvious. New scientific understanding, techniques and methodologies are opening up horizons for significant improvements in diagnosis and care. However, take-up is uneven, research needs and potential outstrip currently available resources, manifestly beneficial practices—such as population-level screening for lung cancer—are still not generalised, and the quality of life of patients and survivors is only beginning to be given attention it merits. This paper, mainly based on a series of multistakeholder expert workshops organised by the European Alliance for Personalised Medicine (EAPM), looks at some of those specifics in the interest of planning a way forward. Part of this exercise also involves taking account of the specific nature of Europe and its constituent countries, where the complexities of planning a way forward are redoubled by the wide variations in national and regional approaches to cancer, local epidemiology and the wide disparities in health systems. Despite all the differences between cancers and national and regional resources and approaches to cancer care, there is a common objective in pursuing broader and more equal access to the best available care for all European citizens

Czerniaki skóry - zasady postępowania diagnostyczno-terapeutycznego

Excisional biopsy of suspicious melanomatous skin lesions likely to be diagnosed as early melanomas is crucial in establishing diagnosis and prognostic factors. Early diagnosis and surgical removal of cutaneous melanoma not only improves patients’ prognosis, but it is also associated with approximately 90% likelihood of cure. Next steps in the therapeutical management of cutaneous melanoma following excisional biopsy are radical scar excision with adequate margins and sentinel lymph node biopsy. Radical lymph node dissection is recommended in case of regional lymph node metastases. High-risk patients should be enrolled into prospective clinical trials on adjuvant therapy. The treatment of melanoma patients with distant metastases is of limited value. Long-term survival is confined to selected group of patients (metastases to extra-regional nodes, subcutaneous tissue and lungs). The benefits of immunotherapy/immunochemotherapy as compared to dacarbazine monotherapy have not been proven. Patients with metastatic disease should be treated within the frame of clinical trials.Dla rozpoznawania i ustalenia najważniejszych czynników rokowniczych podstawowe znaczenie ma biopsja wycinająca podejrzanych zmian barwnikowych skóry, które mogą być wczesnymi czerniakami. Wczesne rozpoznanie i chirurgiczne usunięcie czerniaka nie tylko poprawia rokowanie, ale daje szansę wyleczenia u około 90% chorych. Kolejne etapy postępowania terapeutycznego obejmują kwalifikację chorych do radykalnego wycięcia blizny po biopsji wycinającej z właściwymi marginesami oraz wykonania biopsji węzła wartowniczego. W przypadku przerzutów do regionalnych węzłów chłonnych postępowaniem z wyboru jest wykonanie radykalnej limfadenektomii. Zaleca się włączanie chorych na czerniaki skóry o wysokim ryzyku nawrotu do prospektywnych badań klinicznych nad leczeniem uzupełniającym. Leczenie chorych z przerzutami ma obecnie bardzo ograniczoną wartość. Długoletnie przeżycia dotyczą niewielu chorych (przerzuty w pozaregionalnych węzłach chłonnych, tkance podskórnej lub płucach). Nie udowodniono przewagi immunoterapii lub immunochemioterapii nad monoterapią z zastosowaniem dakarbazyny. U chorych w stadium uogólnienia najwłaściwsze jest stosowanie leczenia w ramach klinicznych badań

How Can the EU Beating Cancer Plan Help in Tackling Lung Cancer, Colorectal Cancer, Breast Cancer and Melanoma?

Cancer is the second leading cause of mortality in EU countries, and the needs to tackle cancer are obvious. New scientific understanding, techniques and methodologies are opening up horizons for significant improvements in diagnosis and care. However, take-up is uneven, research needs and potential outstrip currently available resources, manifestly beneficial practices—such as population-level screening for lung cancer—are still not generalised, and the quality of life of patients and survivors is only beginning to be given attention it merits. This paper, mainly based on a series of multistakeholder expert workshops organised by the European Alliance for Personalised Medicine (EAPM), looks at some of those specifics in the interest of planning a way forward. Part of this exercise also involves taking account of the specific nature of Europe and its constituent countries, where the complexities of planning a way forward are redoubled by the wide variations in national and regional approaches to cancer, local epidemiology and the wide disparities in health systems. Despite all the differences between cancers and national and regional resources and approaches to cancer care, there is a common objective in pursuing broader and more equal access to the best available care for all European citizens.publishedVersionPeer reviewe