Twenty nevi on the arms: a simple rule to identify patients younger than 50 years of age at higher risk for melanoma.

Patients with a high total nevus count (TNC) merit a total-body examination, but a simple strategy to identify these high-risk individuals is essentially missing. The aim of this study was to investigate the correlation between the number of melanocytic nevi on both arms and the TNC, and to evaluate patient variables that may have an effect on this association. In this multicenter, cross-sectional study, 2175 patients were examined and the mean number of arm nevi in relation to TNC was calculated. A mean value of fewer than 10 arm nevi was found in patients with TNC lower than 51 and a mean value of greater than 19 arm nevi was scored in patients with TNC greater than 50. These values remained unchanged after adjustment for various patient variables. In relation to TNC greater than 50, the presence of 20 or more arm nevi had specificity and negative predictive values of 95.2 and 89.6%, respectively. The sensitivity was 65.5% in patients younger than 50 years of age and 37.5% in the older age group. The number of arm nevi was significantly higher in individuals with a history of melanoma and in those with a melanoma detected during the study period. The presence of 20 or more nevi on the arms is an independent predictor of a high TNC and risk of melanoma. This sign thus represents a simple and rapid screening tool for either the primary care physician or the dermatologist to help identify high-risk patients.

[Evaluation of effect of local administration of desoximetasone and ditranol in psoriatic lesion byapplying 20 MHz ultrasound].

INTRODUCTION: This prospective study was aimed at examining the modification of ultrasound characteristics of psoriatic plaques during desoximetasone and dithranol treatment. MATERIAL AND METHODS: The examination included 50 patients with chronic plaque-type psoriasis to whom 0.25% desoximetasone and dithranol was applied on the psoriatic lesions in the period of 21 days. The changes were measured before and every 7 days after the beginning of therapy by the combined application of A- and B-mode echosonography. RESULTS. At the beginning of the examination, the average values of the enter echo were 0.67 +/- 0.53 mm; hypoehogen shadow 0.30 +/- 0.11 mm, and dermis thickness 3.03 +/- 1.05 mm. On the first check up, the average values of the enter echo were 0.45 +/- 0.29 mm; hypoechogen shadow 0.23 +/- 0.08 mm and dermis thickness 2.65 +/- 0.97 mm. On the second check up, the average values of the enter echo were 0.30 +/- 0.18 mm; hypoechogen shadow 0.21 +/- 0.18 mm, dermis thickness 2.18 +/- 0.82 mm. On the third check up, the average values of the enter echo were 0.24 +/- 0.17 mm; hypoechogen shadow 0.18 +/- 0.17 mm, and dermis thickness 1.8 +/- 0.69 mm. DISCUSSION. The evaluation of the ultrasonographic characteristics revealed a significant reduction in the values in the course of the examination. Statistically significant differences were found before, during, and at the end of the examination by recording the ultrasound parameters of the epidermis and dermis and by following their modification. CONCLUSION. Precise determination of ultrasound parameters of epidermis and dermis and the possibility of recording their modification in a shorter or longer time interval can be used for monitoring and assessment of therapy effect of a medication.

Nasal-type NK/T-cell lymphoma: a case report.

Extranodal NK/T-cell lymphoma represents less than 1% of all lymphomas, but is more common in Asia and South America. We present a 67-year-old female with a 10-month history of four reddish-blue firm and painful nodules in the parietal region of the head, ranging in size from 1 to 5 cm. Two nodules were taken for biopsy, which showed atypical lymphoid cells with angiocentric growth pattern. The immunophenotype of the tumor cells was CD45RO +, CD56 +, CD3 + (epsilon chain), CD20-, consistent with the diagnosis of NK/T-cell lymphoma. NK/T-cell lymphomas are rare and the optimal treatment has not been clearly established.

[Bacteriological finding in the urethra in men with and without non-gonococcal urethritis].

BACKGROUND/AIM: Non-gonococcal urethritis (NGU) is a very common sexually transmitted disease. The etiology of the disease is complex and not completely solved. The aim of this study was to determine the bacteriological finding in the urethra in men with and without non-gonococcal urethritis. METHODS: The study group comprised 200 men with symptoms of urethritis. The control group consisted of 60 men without symptoms of urethritis. The diagnosis of nongonococcal infection was made by finding of an increased number of polymorphonuclear leukocytes (> or = 5) under the microscope in a sample of Gram-stain of urethral smear (x 1 000) and without evidence of Neisseria. gonorrhoeae in specimens (negative direct microscopy and cell culture). Bacteriological examination included: direct microscopy with the Gram-stained and methylblue-stained smears of urethral discharges, and cultivation of specimens under the aerobic/unaerobic conditions. In addition to standard bacterial examination and performinig direct imunofluorescence test to detect Chlamydia trachomatis (bioMerieux, France), urethral smears were also examined for the presence of Ureaplasma urealyticum and Mycoplasma hominis by commercially available Mycofast Evolution 2 test (International Microbio, France). The finding of mycoplasmas > or = 10(4) CCU/ml was positive. The data were statistically analyzed using Pearson chi2 and Student t test. RESULTS: C. trachomatis was predominant bacterial species found in urethra in men with nongonococcal urethritis. It was isolated alone and/or mixed with mycoplasmas and/or other bacteria in 86 (43.0%) of examinees. There was statistically significant difference in finding of C. trachomatis between the study group and the control group (p < 0.001). U. urealyticum was found in men with NGU: 30.2% were with C. trachomatis and 36.0% were without C. trachomatis (p > 0.05). In 16 (8.0%) men with NGU, C. trachomatis was isolated alone, while in 13.0% examinees it occurred with U. urealyticum. Staphylococcus saprophyticus was isolated in one subject with NGU, alone. Streptococcus agalactiae was found in 1.5% of men with urethritis. Anaerobic bacteria were found in 38 (19.0%) subjects with NGU and in 7 (11.7%) subjects from the control group. CONCLUSION: C. trachomatis was predominant bacterial species found in urethra in men with nongonococcal urthretitis. Mixed infections were frequent.

Immunophenotyping of amelanotic melanoma. A case report.

Amelanotic malignant melanoma (AMM) is a subtype of cutaneous melanoma with little or no pigment upon visual inspection. The lack of pigmentation is the reason for late diagnosis of lesions and a poor prognosis. We report a case of a 55-year-old female with an AMM diagnosed by immunophenotyping. Monoclonal antibodies S-100, HMB-45, and antibodies to cytokeratin were used. Our patient underwent a wide local excision (a 2 cm wide margin) 2 years ago. So far there are no signs of a recurrence. In doubtful cases, immunophenotyping with monoclonal antibodies HMB-45 and S-100 is important for confirming the correct diagnosis of AMM.

Dermoscopy of melanoma.

Early detection of malignant melanoma is one of the greatest challenges for dermatologists. Dermoscopy is an in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented lesions of the skin. We report a 85-year-old man with a pigmented skin lesion in left mandibular region. Dermoscopy revealed evident characteristics of malignant melanoma. The total score was 7 points according to the 7- point checklist. Pathohistological examination confirmed diagnosis of melanoma.