Дерматоскопические аспекты диагностики кожных метастазов рака молочной железы

Introduction. Skin metastases are the result of skin infiltration caused by the proliferation of cells of remotely located malignant tumors occurring with a frequency of 0.6–10.4 % in various oncological processes. They may be a sign of progressive neoplasm or a manifestation of newly diagnosed cancer. Due to a high variability of clinical manifestations leading to misdiagnoses, a limited number of articles describe clinical and dermatoscopic signs of solid tumors metastatic nodes. Aim: to analyze the clinical and dermatoscopic features of skin metastases from breast cancer.Materials and methods. A female patient has complaints of slight pain and itching in the lesions area on the scalp. According to her medical history, a right mastectomy was performed for right breast cancer in 2012, followed by hormone therapy willfully discontinued by the patient. Given the uncommon localization limited with the scalp, the differential diagnosis was made with a spectrum between a cylindroma, multiple basal cell cancer and metastatic carcinoma. A biopsy was carried out to confirm the diagnosis. Results and examination. The pathological skin process revealed itself through multiple nodes up to 2 cm in diameter, pinkish in color, dense, painless on palpation, poorly demarcated. Dermatoscopically: polymorphic vessels on an erythematous background, chrysalis-like structures. Breast cancer metastases were verified by histological and immunohistochemical examination.Conclusion. Skin metastases may be the first sign of cancer recurrence. Dermatoscopy can facilitate differenting them from other skin diseases. Density and diameter of pathological vessels are prognostically significant. Ifdetected lesions do not fit the standard pattern of skin neoplasms, histological verification of the diagnosis is recommended to be carried out.Введение. Кожные метастазы являются результатом инфильтрации кожи за счет пролиферации клеток отдаленно расположенных злокачественных опухолей, встречающихся с частотой 0,6–10,4 % при различных онкологических процессах. Они могут быть признаком прогрессирующего новообразования или являться проявлением впервые диагностированного рака. Ограниченное количество статей включают в себя описание клинических и дерматоскопических признаков метастатических узлов солидных опухолей. Это связано с большой вариабельностью клинических проявлений, приводящей к диагностическим ошибкам.Цель исследования: разобрать клинические и дерматоскопические особенности кожных метастазов рака молочной железы.Материалы и методы. Пациентка с жалобами на незначительные болевые ощущения и зуд в области образований на коже волосистой части головы. Из анамнеза: в 2012 году по поводу рака правой молочной железы была выполнена мастэктомия справа с последующей гормональной терапией, которую пациентка самовольно прекратила. Учитывая нехарактерную локализацию, ограниченную волосистой частью головы, проводился дифференциальный диагноз между цилиндромой, множественным базальноклеточным раком и метастазами карциномы. С целью уточнения диагноза была выполнена биопсия.Результаты и обследование. Патологический кожный процесс был представлен множественными узлами до 2 см в диаметре, розоватого цвета, плотными, безболезненными при пальпации, без четких границ. Дерматоскопически: полиморфные сосуды на эритематозном фоне, структуры по типу хризолит. По данным гистологического и иммуногистохимического исследований были верифицированы метастазы рака молочной железы.Заключение. Кожные метастазы могут быть первым признаком рецидива злокачественной опухоли. Дерматоскопия может облегчить их дифференциальную диагностику с другими заболеваниями кожи. Прогностически значимы плотность и диаметр патологических сосудов. При выявлении образований, не укладывающихся в стандартную клиническую картину новообразований кожи, целесообразно выполнение гистологической верификации диагноза

Naftifine hydrochloride (NH) in the treatment of pityriasis versicolor

Introduction & objectives: The purpose of this study was to demonstrate the efficacy comparability of 1% NH lotion vs. of 1% NH cream (exoderil, Sandoz) in the treatment of pityriasis versicolor. Material & methods. 71 patients with pityriasis versicolor were randomly allocated either to receive NH lotion once daily (NH lotion group (п = 35, 38.6 years (95% CI [33,7, 43.5]) or NH cream once daily (NH cream group (п = 36, 40.8 years (95% CI [36,6, 45.0]) for 14 days. Mycological evaluations (microscopy and culture) were performed at weeks 2 and 3, inflammation symptoms evaluations were scored at day 3, weeks 2 and 3 after start of the therapy. Overall cure rates assessment included results of mycological, clinical outcomes and safety evaluation. Results. There was no difference between groups in mycological cure rates (94% vs 92%) and inflammation regression (97% vs 97%). Overall cure rate was 91% and 92% of patients in NH lotion and NH cream groups respectively (p = 0,97). Conclusion. 1% NH lotion and 1% NH cream are effective in the treatment of pityriasis versicolor

Rare evidence of follicular lichen planus that arise in the process of its evolution

Case study of the patient with a follicular lichen planus long-flowing form was presented. In the process of its evolution there formed a focal atrophy of the smooth skin. This atypical form clinical features data is provided

IMBALANCE OF IL -1β И IL -1RA CYTOKINES IN BLOOD SERUM AND BRONCHOALVEOLAR LAVAGE IN COPD PATIENTS

Abstract. The aim of present study was to determine levels of IL-1β and its inhibitor, IL-1ra in blood serum and bronchoalveolar lavage fluid (BALF) of 20 patients with COPD, depending on severity of their disease, activity of inflammatory process, bacterial and viral complication. Methods. Twenty male patients with COPD (stage 2 to 4) were examined. It was shown that all the patients with COPD displayed high levels of IL-1β, both in the area of inflammation, and in blood serum. The latter index was dependent on the severity of disease and activity of inflammatory process. In BALF, the contents of IL-1β in all the patients under study was significantly exceeded the normal levels of this cytokine even at the earliest stages of evolving COPD. concentration in serum was depended at stage of disease and activity of inflammatory procces. There were no differences in IL-1β concentrations in BALF of 2 - 4 stage COPD patients. IL-1ra levels in the patients’ serum were within normal levels, and tended to increase in BAL, thus causing imbalanced IL-1ra/IL-1β ratio both in the inflammatory area, as well as systemically. The maximal detection of respiratory pathogens did significantly correlate with decreased IL-1ra/ IL-1β ratio, thus confirming the data on infectious agents as a pathogenetic component in COPD