We describe the rapid growth of a Reed nevus followed by its slow involution and present dermoscopic follow-up images. The child was monitored for 10 years (from age 3 to 13 years) by digital dermoscopy. The Reed nevus completely lost its typical dermoscopic arrangement (starburst pattern) with involution and distinct changes in dermoscopic pattern.

Objectives: Collision tumours are rare situations characterised by the coincidence of two different skin neoplasms in the same lesion. Methods: We have analyzed 41 collision skin tumours from one department in the clinical-dermoscopic-histopathologic correlations. Results: We present 41 collisions tumours. The mean age of our patients was 67.9 years, the mean diameter of the lesion was 11.6 mm. The most frequent locations were trunk (27 lesions) and head/neck (11 lesions). The collisions were classified as benign/benign (13 cases), benign/malignant (25 cases) and malignant/malignant (3 cases). The most frequent participants were seborrheic keratosis (24 cases), malignant melanoma (17 cases), melanocytic nevus (14 cases), basal cell carcinoma (12 cases) and heamangioma (10 cases). Thirty cases were of “dominant/minor” type and 11 cases of “half to half” type. Malignant tumours were a part of 28 collisions; these lesions were larger, patients were older and the malignant part was dominant in most cases. More than half of the collisions were unexpected by the initial clinical examination. Six collisions were missed by the initial histopathological examination. Conclusions: Collision tumours can be missed by clinical or even histopathological examination. Dermoscopy is very helpful in the recognizing of difficult cases and cooperating with the histopathologist.

ZusammenfassungZieleDie Lentigo maligna ist ein bei älteren Patienten häufig auftretendes malignes Carcinoma in situ mit einem geringen invasiven Progressionsrisiko. Da ein chirurgisches Vorgehen schwierig sein kann oder vom Patienten abgelehnt wird, besteht ein Bedarf an nichtoperativen Therapieoptionen wie beispielsweise eine Laserbehandlung.Patienten und MethodenWir berichten über 17 Patienten, die wegen einer histopathologisch gesicherten Lentigo maligna mit einem 2940 nm Er:YAG‐Laser (Erbium‐dotierter Yttrium‐Aluminium‐Granat‐Laser) behandelt wurden. Die Ablation der Läsionen schloss einen Sicherheitsabstand von 5 mm ein und wurde unter Lokalanästhesie mit überlappenden Laserspots (3,5 mm), einer Energiedichte von 6,5 J/cm2 und einer Wiederholungsrate von 5 Hz durchgeführt. Trat im abladierten Bereich während der nachfolgenden drei Monate eine klinisch erkennbare Pigmentierung auf, wurde die Läsion erneut behandelt. Bei allen Patienten erfolgte eine Nachkontrolle auf residuale oder rezidivierende Tumoren.ErgebnisseWir konnten bei allen 17 Patienten klinische Tumorfreiheit erreichen. Während der Nachsorge traten drei Rezidive auf (9, 30 und 36 Monate nach der Laserbehandlung). Alle Patienten waren mit dem Behandlungsverlauf und dem kosmetischen Ergebnis zufrieden. Die mittlere Dauer der Nachkontrolle betrug 28 Monate.SchlussfolgerungenDie Laserablation ist eine interessante alternative Therapieoption bei Lentigo maligna. Sie kann in ausgewählten Fällen eingesetzt werden, bei denen ein chirurgisches Vorgehen kontraindiziert oder schwierig ist oder vom Patienten abgelehnt wird.

OBJECTIVES:Lentigo maligna is a common in situ malignancy in elderly patients, with a low risk of progression to an invasive tumor. Surgical treatment may be complicated or refused. Non-surgical treatment options (such as lasers) may therefore be needed. PATIENTS AND METHODS:We report on 17 patients treated with a 2940-nm Er:YAG (erbium-doped yttrium aluminum) laser for histopathologically confirmed lentigo maligna. The lesions were ablated with a 5 mm margin of adjacent skin under local anesthesia with a 3.5 mm overlapping spot, energy density of 6.5 J/cm2 and a repetition rate of 5 Hz. If clinically visible pigmentation was seen in the ablated area during the following three months, the lesion was re-treated. All patients were followed up for residual or recurrent tumors. RESULTS:We achieved clinical clearance in all 17 patients. There were three recurrences during the follow-up period (9, 30 and 36 months after laser therapy). All patients were satisfied with the treatment course and cosmetic outcome. The mean follow-up duration was 28 months. CONCLUSIONS:Laser ablation is an interesting alternative method for treatment of lentigo maligna. It can be used for selected cases where surgery is contraindicated, complicated or declined by the patient.

WHAT IS KNOWN AND OBJECTIVE:Drug-induced lupus erythematosus occurs with some drugs and resolves with their withdrawal. Anti-TNF therapies have been found to be associated with a lupus-like syndrome, which is clinically distinct from classical drug-induced as well as idiopathic lupus erythematosus.CASE DESCRIPTION:We describe a case of a patient with severe psoriasis, who developed muscle pain with paraesthesia accompanied by ANA titres elevation with adalimumab treatment. The condition resolved after adalimumab cessation, and the patient was started on ustekinumab with good results.WHAT IS NEW AND CONCLUSION:Ustekinumab might be a useful treatment option for patients with a history of TNF-induced lupus-like syndrome.

DERMOSCOPIC APPEARANCE The original dermoscopic examination clearly suggests seborrheic keratosis with pseudofollicular openings and horny pseudocysts (Fig 2, A). The two follow-up images beautifully capture the regression of the previous lesion (see Fig 2, B and C ). The diagnosis of seborrheic keratosis is still easily recognizable in the second image. Based on the last image with granular gray pigmentation, the exclusion of lentigo maligna is almost impossible; no dermoscopic structures typical for seborrheic keratosis are visible at this time.

Uvod:Lecbu nižsich T kategorii tumorů penisu pomoci dřive standardni parcialni amputace penisu je možne oznacil za nadbytecně radikalni a v dnesni době můžeme využit celou řadu jiných meně radikalnich přesto dostatecně efektivnich metodik. Ve clanku je podan přehled soucasných možnosti.Přehled:Idealni metodou je excize ohranicene leze, což je vsak zřidka kdy možne. Na ploche leze typu PelN (penilni intraepitelialni neoplazie) ci karcinom in situ lze užit lokalni lecbu (5-fluorouracil, imiquimod, fotodynamicka lecba - senzibilizator aminolevulinat). Alternativou je tepelna destrukce pomoci CO2, Nd: YAG ci Er: YAG laseru. Metody lze nahradit technicky narocnějsim operacnim výkonem - resurfacing s dermoepidermalnim stěpem. Casto zmiňovana Mohsova metoda (postupna excize za opětovne peroperacni kontroly patologem) se v praxi přilis neujala. U nadorů pokrocilejsich, nereagujicich na předchozi metody lecby ci u mužů davajicich přednost rychlemu radikalnimu řeseni ci nemajici možnost nasledne peclive dispenzarizace je urcena glansektomie. Jako urcitou alternativu s horsimi výsledky lze mužům odmitajicim operaci nabidnout brachyradioterapii.Zavěr:Soucasne penis setřici možnosti lecby nam umožňuji zahajit lecbu již ve stadiu PelN a plně zachovat penis. Neexistuji jasna doporuceni k výběru te ktere metody, natož doporuceni sekvenci lecby při selhani prvni volby. Volba lecby tak zavisi na dostupnosti metodiky a preferenci lekaře a pacienta. Jako v jiných oblastech onkourologie plati zasada týmove spoluprace (zde zejmena patolog, dermatovenerolog, urolog) a koncentrace problematiky do specializovaných center.

Background Atopic dermatitis (AD) is a common chronic inflammatory skin disease. Malassezia, the predominant skin microbiota fungus, is considered to exacerbate AD, especially in a subset of patients with head and neck type AD (HNAD). In the present study, the relationship between AD and sensitization to Malassezia antigens was investigated. Methods We assessed 173 patients with AD. The severity of eczema was determined with Eczema Area and Severity Index (EASI); the type of AD, namely, head and neck type, was reported as well. The total serum IgE and specific IgE to Malassezia were determined and correlated with clinical picture of AD, sex, age, and the EASI. Results Total IgE was elevated in 77.7% of patients. Specific IgE to Malassezia was positive (≥0.35 kU/L) in 49.1% of patients. Men were significantly more often sensitized to Malassezia antigen (58% of men vs 42% of women; P value, 0.04). Concurrently, 58% of patients with HNAD versus 42% non-HNAD patients had higher levels of specific IgE to Malassezia, this difference being nearly significant (P value, 0.06). Patients with atopy were also more frequently sensitized to Malassezia. No significant relationship between EASI and the level of total IgE or specific IgE to Malassezia was observed. Conclusions In our population, IgE-mediated sensitization was found in up to 49% of all patients with AD, most common in men and in head and neck type.

BACKGROUND:Atopic dermatitis (AD) is a common chronic inflammatory skin disease. Malassezia, the predominant skin microbiota fungus, is considered to exacerbate AD, especially in a subset of patients with head and neck type AD (HNAD). In the present study, the relationship between AD and sensitization to Malassezia antigens was investigated.METHODS:We assessed 173 patients with AD. The severity of eczema was determined with Eczema Area and Severity Index (EASI); the type of AD, namely, head and neck type, was reported as well. The total serum IgE and specific IgE to Malassezia were determined and correlated with clinical picture of AD, sex, age, and the EASI.RESULTS:Total IgE was elevated in 77.7% of patients. Specific IgE to Malassezia was positive (≥0.35 kU/L) in 49.1% of patients. Men were significantly more often sensitized to Malassezia antigen (58% of men vs 42% of women; P value, 0.04). Concurrently, 58% of patients with HNAD versus 42% non-HNAD patients had higher levels of specific IgE to Malassezia, this difference being nearly significant (P value, 0.06). Patients with atopy were also more frequently sensitized to Malassezia. No significant relationship between EASI and the level of total IgE or specific IgE to Malassezia was observed.CONCLUSIONS:In our population, IgE-mediated sensitization was found in up to 49% of all patients with AD, most common in men and in head and neck type.

Anogenital granulomatosis (AGG) is a rare chronic inflammatory disorder of unknown aetiology. It presents clinically with swelling of the genital or anoperineal area, with histopathological findings of noncaseating giant cell granulomas. Some cases of AGG are associated with underlying systemic disease, mainly Crohn disease. We report two patients with AGG. The first was a young man with ulcerative colitiis treated with infliximab, which also alleviated the developing symptoms of AGG. The second was a young woman who was otherwise healthy. After the introduction of complex decongestive therapy, the oedema was considerably reduced in both patients.

Malignant melanoma is one of the most malignant tumours. If it is diagnosed in the early stage, the prognosis is quite good. Timely diagnosis is essential as well as early surgical removal of the tumour in a specialized centre. The aim of the article is to highlight the difficult diagnosis and differential diagnosis of malignant melanoma. The authors describe a rare case of malignant melanoma in an eleven-year-old girl, a neglected finding of malignant melanoma in a young man, the difficult differential diagnosis of malignant melanoma and a case of malignant melanoma arising from a congenital naevus.The incidence of malignant melanoma is increasing worldwide, and it is therefore necessary to bear this diagnosis in mind when performing clinical examination of patients and discovering suspected lesions.

Conflict of interest: none declared. A 69‐year‐old white man presented with a 30‐year history of a solitary, asymptomatic lesion on his right palm. The lesion had gradually increased in size over the years, but did not cause the patient any discomfort. His medical history included recurrent otitis since childhood, nonspecific hepatitis at the age of 7 years, and treated prostatic hyperplasia. Five years previously, the patient had undergone systemic treatment with antimycotics for onychomycosis involving his toenails; this treatment had no effect on the palmar patch. On physical examination, a well‐circumscribed, rounded, slightly depressed erythematous patch, 25 × 8 mm in size, was seen on the thenar eminence of the patient's right palm. (Fig. 1). A biopsy lesion was taken from the margin of the lesion for further examination. ... On histopathologic examination of the biopsy specimen, a sharp difference in the thickness of the uninvolved and involved skin was noted. In the central part, the stratum corneum (SC) was thinner, and consisted of compact orthokeratosis above a zone of parakeratosis. There was mild hypogranulosis beneath the parakeratosis. The lesional part of the skin also showed dilated capillaries in the papillary dermis (Fig. 2a,b).

International Journal of DermatologyVolume 52, Issue 12 p. 1620-1621 Correspondence Shiitake dermatitis: a distinctive clinical entity Jan Ricar MD, Jan Ricar MD Department of Dermatology and Venereology, Charles University, Medical School and Teaching Hospital Pilsen, Pilsen, Czech Republic E-mail: ricarj@fnplzen.czSearch for more papers by this authorKarel Pizinger MD, PhD, Karel Pizinger MD, PhD Department of Dermatology and Venereology, Charles University, Medical School and Teaching Hospital Pilsen, Pilsen, Czech Republic E-mail: ricarj@fnplzen.czSearch for more papers by this authorPetra Cetkovska MD, PhD, Petra Cetkovska MD, PhD Department of Dermatology and Venereology, Charles University, Medical School and Teaching Hospital Pilsen, Pilsen, Czech Republic E-mail: ricarj@fnplzen.czSearch for more papers by this author Jan Ricar MD, Jan Ricar MD Department of Dermatology and Venereology, Charles University, Medical School and Teaching Hospital Pilsen, Pilsen, Czech Republic E-mail: ricarj@fnplzen.czSearch for more papers by this authorKarel Pizinger MD, PhD, Karel Pizinger MD, PhD Department of Dermatology and Venereology, Charles University, Medical School and Teaching Hospital Pilsen, Pilsen, Czech Republic E-mail: ricarj@fnplzen.czSearch for more papers by this authorPetra Cetkovska MD, PhD, Petra Cetkovska MD, PhD Department of Dermatology and Venereology, Charles University, Medical School and Teaching Hospital Pilsen, Pilsen, Czech Republic E-mail: ricarj@fnplzen.czSearch for more papers by this author First published: 24 September 2012 https://doi.org/10.1111/j.1365-4632.2011.05410.xCitations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume52, Issue12December 2013Pages 1620-1621 RelatedInformation