Clinical, Dermoscopic, and Histological Characteristics of Melanoma Patients According to the Age Groups: A Retrospective Observational Study.

BACKGROUND: Although the role of melanoma risk factors is well documented, their correlation with patients' age is less frequently analyzed. METHOD: The analysis was performed among 189 melanoma patients in different age groups, including <30 years, 31-60 years, and >60 years, to investigate the risk factors, topography, and coexistence of morphological features of 209 melanomas (dermoscopic and histopathological). RESULTS: Among the youngest age group, no correlation with the presence of estimated risk factors was found. The most common dermoscopic pattern was spitzoid and multicomponent asymmetric. The group of middle-aged patients was the most diverse in terms of the occurrence of risk factors, solar lentiginosis, dermoscopic patterns, topography, histological subtypes, and invasiveness of melanomas. The oldest group characterized a strong correlation between solar lentiginosis, NMSC comorbidity, the prevalence of facial melanomas, the dermoscopic pattern of melanoma arising on chronic sun-damaged skin, and regression. CONCLUSION: The findings regarding the presence of age-specific features in melanoma patients, especially in the youngest and middle-aged groups, might be helpful for clinicians and to target secondary prevention efforts.

Dermoscopy of Small Diameter Melanomas with the Diagnostic Feasibility of Selected Algorithms-A Clinical Retrospective Multicenter Study.

OBJECTIVE: The aim of the study was to verify two hypotheses. The first concerned the possibility of diagnostic dermoscopic differentiation between cutaneous melanomas of the histopathological category in situ (pTis) and thin melanomas (pT1a) in terms of their diameter. The second assessed the diagnostic feasibility of two dermoscopic algorithms aiming to detect ≤ 5.0 mm-sized melanomas histopathologically confirmed as pTis and pT1a. METHODS: Dermoscopic images of consecutive cases of histopathologically confirmed melanomas were evaluated by three independent investigators for the presence of the predefined criteria. The melanomas were subdivided according to their diameter into small melanomas, so-called micromelanomas (microM)-sized ≤ 5.0 mm and >5.0 mm, according to published definitions of small melanocytic lesions. The Triage Amalgamated Dermoscopic Algorithm (TADA) and the revisited 7-point checklist of dermoscopy (7-point) algorithm were chosen for the diagnostic feasibility. Odds ratios and corresponding 95% confidence limits (CL) were calculated using the logistic regression adjusted for age for the melanoma-specific dermoscopic structures, the dermoscopic patterns and the diagnostic feasibility of the 7-point checklist and TADA algorithms. The p-values of the results were corrected using the Bonferroni method. RESULTS: In total, 106 patients with 109 melanomas, 50 sized ≤ 5.0 mm and 59 exceeding the diameter of 5.0 mm, were retrospectively analyzed. The prevalent general pattern of microM was the spitzoid one (48% vs. 11.86%, p = 0.0013). Furthermore, 40% of microM vs. 6.78% melanomas sized > 5.0 mm (p = 0.0023) did not present melanoma-specific patterns. The asymmetric multicomponent pattern was present in 64.41% melanomas sized > 5.0 mm and in 26.00% microM (p = 0.0034). The asymmetry of structures or colors was detected in 56% microM vs. 89.83% (p = 0.0020) and 56% microM and 94.92% (p = 0.000034) melanoma sized > 5.0 mm, respectively. The differences in frequency of the detected dermoscopic structures specific to melanomas revealed that microM are almost deprived of negative networks (p = 0.04), shiny white structures (p = 0.0027) and regression features (p = 0.00003). Neither prominent skin markings nor angulated lines were found in the entire study group. Out of the vascular structures, microM presented only dotted (32%) or polymorphous (28%) vessels, although more rarely than melanomas sized > 5.0 mm (66.1% p = 0.017 and 49% p > 0.05, respectively). The diagnostic feasibility revealed a score ≥ 3 of the 7-point algorithm (indicative for malignancy) in 60% microM and 98.31% melanomas sized > 5.0 mm (p = 0.000006). The TADA algorithm revealed melanoma-specific patterns in 64% microM and 96.61% > 5.0 mm-sized melanomas (p = 0.00006) and melanoma-specific structures in 72% and 91.53% (p > 0.05), respectively. CONCLUSION: In the dermoscopy, 40% of micromelanomas histopathologically staged as pTis and pT1a did not reveal melanoma-specific patterns. Among the general melanocytic patterns, the spitzoid one was the most frequently found in melanomas sized ≤ 5.0 mm. The 7-point checklist and TADA dermoscopic algorithms were helpful in the identification of the majority of melanomas sized ≤ 5.0 mm.

[Prevalence of antibodies against Anaplasma phagocytophilum, Babesia microti i Borrelia burgdorferi in adults in North-Eastern Poland]. / Wystepowanie przeciwcial przeciw Anaplasma phagocytophilum, Babesia microti i Borrelia burgdorferi u doroslych z pólnocno-wschodnich rejonów Polski.

THE AIM: of the study was to evaluate the seroprevalance of antibodies against Anaplasma phagocytophilum and Babesia Microti in healthy north-eastern Poland, adult population. MATERIAL AND METHODS: The study was conducted in a group of 142 healthy adults (mean age 19-22), bitten by ticks within last 2 years. The control group consisted of 50 adults from central Poland (nonendemic area). The antibody levels for A. phagocytophilum (IgG/Ap-Ab) and B. microti (IgM/Bm-Ab) were evaluated in two series of samples from the same persons (interval 5-6 months) by immunoenzymatic tests (Borrelia Biomedica, Austria), immunofluorescence test (Human Granulotic Ehrlichiosis IFA IgG and Babesia microti IFA IgG from MRL Diagnostics). RESULTS: Positive results for A. phagocytophilum were defined as titres > or =1:256 and for B. microti > or =1:64 and B. burgdorferi > or = 11 BBU/ml. Positive results for IgG B. burgdorferi during the first collection were revealed in 16% (n=24/142) of individuals from endemic area and in 4% (n=2/50) of the control group, which was statistically relevant (p<0,05). IgG A. phagocytophilum antibodies were present in 3,5% (n=5/142) of individuals from the endemic area, but for IgG B. microti antibodies (IgG/Bm-Ab) no positive results were found. No IgG antibodies against A. phagocytophilum and B.microti, were found in individuals from non-endemic area. During the second collection, in individuals from the endemic area, the antibodies against B. burgdorferi were found in 9,8% (n=14/142), IgG A. phagocytophilum antibodies (IgG/Ap-Ab) in 4,9% (n=7/142) and against B. microti (IgG/ Bm-Ab) in 1,4% (n=2/142). The antibodies against B. Burgdorferi were found in 2% (n=1/150) of the control group during the second collection, and no IgG against A. phagocytophilum and B. microti were found. CONCLUSION: [corrected] Evaluating the seroprevalance of the studied antibodies in both collections, a conclusion was drawn that there was no significant increase of antibodies levels directly after the highest exposition to tick bites. None of individuals showed 4-fold antibody level increase between the first and second collection. The seroconversion for IgG/Bm-Ab antibodies was present in 1,4% (n=2/142) of individuals, in those 2 cases a 2-fold antibodies level increase was observed. As far as IgG/Ap-Ab antibodies are concerned the seroconversion was observed in 2,1% (n-3/142), but only one case shown a 3-fold antibodies level increase. No seroconversion of B. burgdorferi antibodies were found in the second collection.

[Total and specific IgE and immediate skin tests in the prognosis of atopic dermatitis]. / Calkowite i swoiste IgE oraz natychmiastowe testy skórne w rokowaniu atopowego zapalenia skóry.

The possibility of forecasting of atopic dermatitis (AD) course is limited. The aim of the study was to determine the prognostic usefulness of determination of total and specific IgE concentrations and the results of immediate skin tests in AD patients. The study included 480 adult patients with AD. Immediate skin tests with extracts of 18 aeroallergens and 10 food allergens were performed by PRICK method. Total IgE concentration and concentration of specific IgE (sIgE) against 13 aeroallergens and 12 food allergens were determined by the FAST method. For the assessment of the degree of pathologic process intensity the occurrence was determined of selected AD features according to Hanifin and Rajka exerting direct effect on the severity of the disease, urticaria, extensive cutaneous lesions and remission of the disease. The results were subjected to statistical analysis. In patients in whom total IgE concentration was significantly increased and/or hypersensitivity was found to aeroallergens, coexistence of atopic diseases of the airways, ectodermal defect, urticaria and extensive skin lesions was more frequently observed. Extensive skin lesions were also more frequent in patients with hypersensitivity to food allergens. The studies performed demonstrated that the diagnostic tests discussed are useful for prognostication of AD course. The presence of SIgE, positive results of immediate skin tests and high total IgE concentration prognosticate a more severe course of the disease.