A b s t r a c tSkin aging has become an area of increasing research interest in dermatovenerology. Changes in the skin associated with aging can be detected by high -frequency 20 MHz ultrasonography, which is a useful diagnostic technique allowing reliable imaging of cutaneous and superficial subcutaneous structures.Skin thickness is considered an objective parameter providing assessment of the influence of endogenous or exogenous factors, such as ultraviolet (UV) or infrared (IR) rays. Except for the changes in the skin thickness, there are also specific structural changes in the dermis of older subjects -subepidermal low echogenic band (SLEB) -that is a manifestation of photoaging severity. The main aim of this study was to identify and characterize the specific ultrasonographic changes of the cutaneous structure related to age and degree of photo exposure (the presence and measurement of SLEB).

A patient with primary malignant melanoma localized to the right gluteal region is described. Four years later and after intercurrent influenza, disseminated metastases of malignant melanoma to the skin occurred. After a further 6 months melanodermia developed and lasted until the death of the patient (6 months later). Autopsy revealed melanosis of the visceral organs. Histology taken from internal organs using S-100 protein and HMB-45 melanoma methods confirmed metastases of malignant melanoma to the skin, oral cavity, palatal tonsils, nasal and nasopharyngeal mucosae, lungs, myocardium and brain. The authors discuss the mechanism of melanosis--a rare sign in patients with metastasizing malignant melanoma.

No abstract

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking carcinoma and puerperal or non-puerperal mastitis. The primary purpose of this prospectively performed case control study was to compare clinical and imaging signs of IGM with the reference group of nonspecific, non-puerperal mastitis (NM) to identify the most typical clinical and imaging signs essential for a correct differential diagnosis. The secondary purpose was to present a new approach to non-invasive treatment. Thirty-nine women with histologically proven IGM and twenty-six patients with nonspecific mastitis underwent clinical examination, breast ultrasound (US), mammography (MG) and MRI examination. The most typical signs were selected for each group and method; followed by a statistical evaluation. The effectivity of colchicine, vitamin E and ribwort plantain tincture in treatment was assessed by clinical examination and imaging. Typical clinical signs of IGM included unilateral acute onset of breast edema, redness, palpable masses, missing fever, lymphadenopathy, no response to antibiotics or surgical interventions. Ultrasound revealed: "finger-like" structures (100%), ductectasias (76.9%), abscesses (76.9%) and lymphadenopathy (15.4%), while in MRI skin and tissue edema (100%), multicentric lesions (100%), abscesses (76.9%), ring enhancement (84.6%), lymphadenopathy (15.4%) and small enhancing lymph nodes (38.5%) were observed. Among the clinical signs, fistulas, hypoechoic mass, ductectasias and diffusion weighted images (DWI) restriction were significantly more frequent in patients with IGM than in those with NM. Treatment effectivity yielded 100% with a complete response between 6-19 months, depending on the disease extent. Targeted questions together with imaging can speed up selection for proper treatment with colchicine, vitamin E and local treatment. Long lasting use of antibiotics and repeated surgical interventions should be avoided.

Malignant melanoma is an oncological disease characterized by etiologic heterogeneity and it has increasing incidence and mortality in the Slovak Republic. While it is treated surgically in combination with chemotherapy, targeted therapy, and immunotherapy, malignant melanomas can ulcerate and are susceptible to infections. These are highly aggressive cancers with metastasis, and recent studies have shown the presence of mutations in RAC1, PPP6C and STK19 genes in melanoma patients. Mutations in these genes are driver mutations; important in oncogenesis and providing selective advantage to tumor cells. The aim of our study is to establish a method to detect driver mutations in formalin-fixed, paraffin embedded (FFPE) tissue DNA. We applied Sanger sequencing to detect driver somatic mutations in RAC1, PPP6C, STK19 and BRAF genes in patients with malignant melanoma. Confirmation of BRAF V600E mutation was obtained by allele-specific PCR. The BRAF V600E mutation was present in 15 of 113 patients (13.2%) and the driver mutation in 7 of 113 patients (6.2 %). Our results demonstrate that Sanger sequencing analysis detects mutations in FFPE clinical samples. The identification of these somatic driver mutations in samples with verified malignant melanomas enabled development of a molecular classification of melanomas, and our study provides evidence of diversity of novel driver mutations implicated in malignant melanoma pathogenesis. These findings could have very important implications for targeted therapy.

The authors present new cases of malignant melanoma seen at the Skin Cancer Clinic of the University Hospital in Martin in the year 2017. There have been 112 new cases of malignant melanoma, 66 in men and 46 in women, diagnosed in 2017. We have recorded a occurence of two melanomas in one person in 3 patients, two men and one women. One patient had metastatic melanoma found in lymph nodes without corresponding skin lesions. The most common tumor body localisation in both men and women was on the back (51 melanomas, 45 %). In women, the most common localisation was upper extremities (13 melanomas, 29 %), followed by lower extremities and the back at the same rate (11 melanomas, 24 %). In men, the most common localisation was on the back (40 melanomas, 60 %). Histologically, the most common type was superficial spreading malignant melanoma (50 melanomas), the second most common was non specific type of malignant melanoma (19 melanomas). The majority of cases were low risk lesions with histological Breslow thickness in the range from 0,1 mm to 1 mm (47 melanomas). High risk lesions with histological Breslow thickness more than 4 mm were the second most common type (24 melanomas).

A b s t r a c t Nodular amelanotic melanoma has been always a great challenge in dermatology. Because of lack of melanin pigment, tumors are diagnosed usually in advanced stage. Amelanotic melanoma can mimic basal cell carcinoma. Knowledge of typical dermoscopic structures helps to establish diagnosis and to plan surgery with appropriate safety margins. In amelanotic melanoma we can see typical vessels, white streaks or milky red globules on pink-reddish background. Vessels are typically thin and polymorphous in thick amelanotic melanoma. We had a case when vessels were polymorphous but thick. It can be confusing with nodular basal cell carcinoma where vessels are typically thick and arborizing. Nodular basal cell carcinoma is the most common form of basal cell carcinoma. Dermoscopy is a valuable tool for the diagnosis of basal cell carcinoma. Typical dermoscopic structures are arborizing vessels, possible sites of ulceration and/or pigmentation. We describe a case report of patient with typical dermoscopic structures seen in nodular basal cell carcinoma.

High-frequency skin ultrasonography using Dermascan C, manufactured by Cortex Technology, is an important part of modern diagnostic procedure of various skin diseases. It has been used in dermatology since 1979, when it was first used for the measurement of cutaneous thickness. Ultrasonography is a universal, painless, low-risk and non-invasive procedure that can easily be performed and repeated. It provides real-time visual information about the processes in the skin. This technique has grown to become frequent imaging method in dermatology. Skin ultrasonography is usually applied in the assessment of skin tumours, inflammatory or fibrosing skin diseases. The main application of ultrasonography in dermatovenerology is a preoperative thickness measurement of malignant melanoma. There is an excellent correlation between ultrasonographic and histological measurements of melanomas thickness. Moreover, information about the lesion quality and the inner structure can be obtained. In this article authors present the possibility of using high-frequency 20 MHz ultrasonography in dermatovenerology.