1-3% of human population is affected by psoriasis. Nail disorders are reported in 10-80% of patients with psoriasis. Nail deformations vary according to their degree of severity but are mainly represented by pitting, Beau's lines, hyperkeratosis, onycholysis, leuconychia or oil drops. Onychomycosis is a fungal infection of the nails, caused by dermatophytes, yeast and moulds. In this study, 228 patients with psoriasis aged between 18 and 72 were examined (48 - from Plovdiv, Bulgaria; 145 - from Pleven, Bulgaria and 35 - from Thessaloniki, Greece); 145 of them were male and 83 of them were female. The examination of the nail material was performed via direct microscopy with 20% KOH and nail samples plated out on Sabouraud agar methodology. The severity of the nail disorders was determined according to the Nail Psoriasis Severity Index (NAPSI). Positive mycological cultures were obtained from 62% of the patients with psoriasis (52%- Plovdiv, Bulgaria; 70%- Pleven, Bulgaria and 43%- Thessaloniki, Greece). In 67% of the cases, the infection was caused by dermatophytes, in 24% by yeast, in 6% by moulds and in 3% by a combination of causes. All patients with psoriasis were identified with high levels of NAPSI, whereas the ones with isolated Candida had even higher levels. Seventeen percentage of the patients have been treated with methotrexate, 6% have been diagnosed with diabetes and 22% have been reported with onychomycosis and tinea pedis within the family. An increased prevalence of onychomycosis among the patients with psoriasis was found. Dystrophic nails in psoriasis patients are more predisposed to fungal infections. The mycological examination of all psoriasis patients with nail deformations is considered obligatory because of the great number of psoriasis patients diagnosed with onychomycosis.

Photosensitivity reactions are recognized as unwanted adverse effects of an array of commonly administered topical or systemic medications, including nonsteroidal antiinflammatory agents, antifungals, and antimicrobials. When a drug induces photosensitivity, exogenous molecules in the skin absorb normally harmless doses of visible and UV light, leading to an acute inflammatory response. In phototoxic reactions, the damage to tissues is direct; in photoallergic reactions, it is immunologically mediated. In vitro and in vivo assay systems can assist in predicting or confirming drug photosensitivity. The incidence of photosensitivity reactions may be too low to be detected in clinical studies and may become recognized only in the postmarketing stage of drug development. Some drugs have been withdrawn because of photosensitivity effects that appeared after general release. Photosensitivity reactions have been studied for a number of topical antimicrobials and for the sulfonamides, griseofulvin, the tetracyclines, and the quinolones. Incidence and intensity of drug phototoxicity can vary widely among the different compounds of a given class of antimicrobials. When phototoxic effects are relatively low in incidence, mild, reversible, and clinically manageable, the benefits of an antimicrobial drug may well outweigh the potential for adverse photosensitivity effects.

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The initial histology was re-examined. S100 was negative on the pigment-containing cells. These were actually a dense collection of melanin-laden macrophages (melanophages). The term TM is used to describe this phenomenon.Although regression is a well-known histological and clinical feature of malignant melanoma, complete regression is rare. The exact incidence is unknown. Some cases of metastatic melanoma with an unknown primary are likely to be due to spontaneous complete regression of the primary melanoma. Several histological patterns of complete regression have been described including florid lichenoid inflammation, complete regression with residual benign naevoid component, and TM. 5 TM or nodular melanosis refers to the presence of a dense aggregate of melanophages. It is a rare histological finding; a search of the world literature revealed only a few reports of TM and of these only one was as a result of completely regressed melanoma. 6 It can also be seen with other cutaneous lesions including heavily pigmented naevi, pigmented basal cell carcinomas, and other pigmented epithelial neoplasms. 7 TM therefore poses a diagnostic challenge for histopathologists, although completely regressed melanoma obviously needs to be included as a differential diagnosis.In summary, we present a patient exhibiting the rare histological picture of TM replacing a regressed malignant melanoma. As TM is so rare it can easily be misinterpreted, for example as a heavily pigmented benign naevus. Clinicopathological correlation in this case, with regional lymph node and disseminated metastases, made a diagnosis of regressed melanoma fairly straightforward, but the isolated finding of TM can rarely occur with other cutaneous tumours.

Oral condyloma acuminatum is a papillomatous lesion that is transmitted most often sexually and associated with the human papilloma virus (HPV). This report describes a case of a 30-year-old woman with multiple oral condylomata acuminata, located on the lateral edges and on the dorsum of the tongue. The incisional biopsy showed histological features compatible with those of condyloma acuminatum. E6 viral oncogene of HPV types 6, 11, 16, and 33 was identified by means of polymerase chain reaction (PCR). The lesions were removed by radiodissecation and treated topically with trichloroacetic acid (80% and 40%) and interferon-alpha-2a. No recurrence was evident 8 months after the treatment. We report this case not only for the simultaneous presence of low-and highrisk HPV types in one patient and the rarity of the condition, but also for the good res-ponse to the combined surgical and medical treatment that we observed.