Merkel Cell Carcinoma: Case Report

Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine carcinoma of the skin. Although it is 40 times less common than malignant melanoma, its mortality is much higher compared to melanoma. From 1986 to 2001 there was rapidly increasing incidence in reported cases of MCC, with a tripling in the rate over this 15-year period. The vast majority of MCC presents on sun-exposed skin. The head and neck area is the most common site of tumor occurrence. We present 70-year old female patient with painless red-colored nodule, size 2x2x2 cm on the dorsal side of mid left forearm. The surgical excision with negative margins was performed, and pathohistological analysis confirmed Merkel cell carcinoma. Sentinel lymph node biopsy was negative. In conclusion, as MCC is a very aggressive rare skin carcinoma with lethal outcome, it should be mandatory to perform biopsies of any suspected skin lesion

Liječenje običnih bradavica u narodnoj medicini

Common warts (verrucae vulgares) are the most common complaint in routine dermatological practice. Warts can be painful on pressure and are often an aesthetic problem, but they are not a major threat to the person’s general health. Treatment options are symptomatic and do not eradicate the causative agent. Dermatological surgery procedures such as cryotherapy, electrocauterization and excochleation can be painful, with common recurrences. These are the most important reasons for revival of the treatment procedures and remedies based on traditional medicine. Traditional medicine is still commonly practiced as a form of self-healing. This paper presents the most commonly used wart remedies of plant, animal and mineral origin, along with various magic practices. We emphasize that this paper is written from the viewpoint of physicians, practitioners of dermatology, not as a study in the history or culture. The main objective of the study was to explore various substances and methods people use as home remedies for warts. We performed a case study survey among the general population by interviewing 147 adult participants using a simple preliminary questionnaire inquiring about preferred treatment and knowledge about common warts.Obične bradavice su najčešći problem u rutinskoj dermatološkoj praksi. One nisu značajna zdravstvena poteškoća niti utječu na opće zdravstveno stanje, ali mogu biti bolne, naročito na pritisak i mogu biti estetski problem. Liječenje je simptomatsko i njime se ne utječe na eliminaciju uzročnika. Dermatokirurški postupci kao što su krioterapija, elektrokauterizacija i ekskohleacija su bolni, a recidivi česti. Ovo su najvažniji razlozi zbog kojih se u svrhu samoliječenja oživljavaju prakse iz narodne medicine. Ovaj rad predstavlja najčešće korištene pripravke biljnog, životinjskog i mineralnog podrijetla zajedno s različitim magijskim postupcima. Naglašavamo da je ovaj rad učinjen sa stajališta liječnika, dermatologa praktičara, a ne povjesničara ili etnologa. Glavni cilj studije bio je istražiti tvari i metode koje su ljudi koristili za samoliječenje bradavica. Proveli smo istraživanje anketiranjem 147 odraslih ispitanika iz opće populacije koristeći jednostavan upitnik o osnovnoj informiranosti o bradavicama i izboru liječenja

Cryoglobulinemic vasculitis as a manifestation of paraneoplastic syndrome – a case report

Krioglobulinemija predstavlja prisutnost cirkulirajućih krioglobulina u serumu koji mogu dovesti do organskih oštećenja te sistemskog odgovora karakteriziranog umorom, artralgijama, purpurom, neuropatijom i glomerulonefritisom. Bolest uglavnom zahvaća male i srednje krvne žile i uzrokuje vaskulitis zbog stvaranja imunokompleksa koja sadrže krioglobuline. Miješane krioglobulinemije (tip I. i II.) najčešće su povezane s infekcijama, naročito hepatitisom C (HCV), ali se mogu javljati u sklopu limfoproliferativnih bolesti te autoimunih bolesti. Prikazali smo 75-godišnjeg bolesnika s akrocijanozom i nekrozom distalnih falangi 2. i 4. prsta lijeve šake te purpuroznim promjenama donjih ekstremiteta. Od 2001. bolesnik je liječen po hematologu zbog non-Hodgkinova limfoma želuca (MALT), a od 2002. godine kontrolira se zbog primarnog Sjogrenova sindroma. Učinjenom opsežnom obradom nađena je krioglobulinemija tip II., ali bez dokaza HCV-infekcije ili relapsa limfoproliferativne bolesti. Naknadnom obradom dokazan je slabo diferencirani adenokarcinom prostate i započeto liječenje antiandrogenom. Oko godinu dana nakon pojave simptoma akrocijanoze i digitalne nekroze kontrolnom endoskopskom obradom dokazan je i adenokarcinom želuca, bez tumorskih presadnica, te je provedeno kirurško liječenje. Međutim, postoperativno se razvija kliničko pogoršanje uz pojavu novih digitalnih nekroza na rukama te ubrzo dolazi do smrtnog ishoda pod slikom višesustavnog organskog zatajenja. Povezanost krioglobulinemije i solidnih tumora rijetko je opisana u literaturi, stoga je od izuzetnog značenja detaljna dijagnostička obrada radi što ranijeg otkrivanja osnovne bolesti.Cryoglobulinemia refers to the presence of circulating cryoglobulins in the serum which may lead to organ damage and systemic response characterized by fatigue, arthralgias, purpura, glomerulonephritis and neuropathy. Th e disease mainly aff ects small and medium-sized blood vessels and causes vasculitis due to cryoglobulin-containing immune complexes. Mixed cryoglobulinemia (type I and II) are most oft en associated with infections, especially hepatitis C virus (HCV), but may occur as part of lymphoproliferative and autoimmune diseases. We present a 75 -yearold male patient with acrocyanosis and digital necrosis of the left hand and purpura of the lower extremities. Since 2001 the patient was treated for Non- Hodgkin’s lymphoma of the stomach (MALT) and since 2002 for Sjogren’s syndrome. Extensive diagnostic procedures revealed cryoglobulinemia type II, but without evidence of HCV infection or relapse of lymphoproliferative disorder. Furthermore, poorly diff erentiated prostate adenocarcinoma was diagnosed and antiandrogen treatment was initiated. One year aft er the onset of symptoms acrocyanosis and digital necrosis, gastric adenocarcinoma was diagnosed, without metastatic disease, and surgical treatment was performed. However, postoperatively recurrence of new digital necrosis of the hands occurred along with clinical deterioration and multiple organ failure leading to lethal outcome. Association of cryoglobulinemia and solid tumors is rarely described in the literature, so it is very important to perform comprehensive diagnostic evaluation and detect potential underlying disease as soon as possible