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Background:Early recognition is the most important intervention to improve melanoma prognosis.Objective:To report the value of dermoscopy and digital dermoscopy in the clinical diagnosis of malignant melanoma (MM).Methods:Retrospective analysis of 99 consecutive primary MMs diagnosed between 2010 and 2013. The MMs were divided into 3 groups: 1) the MM was the reason for consultation (MMC), 2) the MM was detected during routine control of nevi (MMRC), and 3) the MM was detected due to changes observed during digital dermoscopy follow-up (MMDFU). Clinical, dermoscopic and histologic features were assessed.Results:A total of 99 MMs were diagnosed in 89 patients (55% male) with a mean age of 50.8 (18-93) years. Of all the MMs, 35 were the reason for patient consultation (MMC), 52 were detected during routine control of nevi (MMRC) and 12 were diagnosed due to changes observed with digital dermoscopy (MMDFU). On clinical examination, 74.2 % of MMC met the 4 ABCD criteria, while only 30.7 % of MMRC and 8.3 % of MMDFU. Most MMC were correctly classified as malignant according to dermoscopy, but 44.2% of MMRC and only 16.7% of MMDFU. 22.9% of MMC, 50% of MMRC and 58.3% of MMDFU were in situ. Mean Breslow thickness was significantly lower in the MMDFU group (0.52 mm) than in the MMRC and MMDFU groups (0.77 and 1.43 mm respectively).Conclusions:The use of dermoscopy and digital dermoscopy allows the detection of MMs in early stages, even in the absence of specific criteria for malignancy.

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Summary Peripheral blood T lymphocytes and T cell subsets were examined in fifteen patients with lichen planus prior to and for 4 months during treatment. The percentages of different T cell sub‐populations were defined by indirect immunofluorescence using monoclonal antibodies OKT3, OKT4 and OKT8. These are specific markers of total T cells, helper‐inducer T cells and suppressor‐cytotoxic T cells respectively. Decreased percentages of suppressor T cells and elevated helper suppressor ratios were observed before treatment and after 1 month of therapy. These changes had disappeared by the second month of treatment, by which time all the lesions had healed.

The immunofluorescence studies in 12 cases of bullous lichen planus (LP) are reviewed. The clinical and immunological findings suggest that there are two different forms of bullous LP: firstly, LP vesiculosus which is an acute form of classical LP, and, secondly, LP pemphigoides which is merely the association of LP and bullous pemphigoid.

The purpose of the present study was to examine the phenotype of cutaneous immunocompetent cells and to quantify Langerhans cells in Lichen planus by the use of monoclonal antibodies directed against T‐cell populations. Helper cells (OKT4+) and Suppressor/cytotoxic cells (OKT8+) were observed in all cutaneous infiltrates, and numerous Langerhans cells were identified by OKT6, BL6, and BL2 (HLA‐DR) in the epidermis and dermis. The quantification of Langerhans cells demonstrated that the number of dendritic cells in epidermis is greater in involved skin than in non‐involved skin. In recent lesions, Langerhans cells are more abundant than in older lesions. The results in peripheral blood indicated a T Helper/Suppressor imbalance with a decreased T‐Suppressor/cytotoxic subpopulation in patients with lichen planus diseases. In lichen planus, our results suggest an immunological reaction involving all the immunocompetent cell subpopulations with a first stage of information by Langerhans cells (OKT6+, BL6+, BL2+ (HLA‐DR)) and Helper cells (OKT4+), and second stage mediated by Suppressor/cytotoxic cells (OKT8+).