Relative Importance of Traditional Risk Factors for Malignant Melanoma in the Czech Population.

AIM: The Czech Republic is one of the leading European countries in incident cases of malignant melanoma (MM), which is on the rise. The study objective was to assess the strength of associations between MM and the known generally accepted risk factors for MM in the population of the Czech Republic. METHODS: The study was designed as a case-control study where cases were incident cases of MM detected at the Department of Dermatology and Venereology of the Bulovka Hospital. Controls were selected from cancer-free patients admitted to departments other than Dermatology and Venereology. Validated questionnaires were used to collect demographic, epidemiological, and clinical data. RESULTS: The binary logistic model shows the main risk factors for MM: male, female (OR=0.292, 95% CI=0.175-0.486), a changed mole (OR=6.371, 95% CI=3.774-10.756), a history of skin cancer (OR=95.704, 95% CI=37.241-10.756), and sunbeds use (OR=3.594, 95% CI=1.288-10.028). Using sunscreen products was considered as a protective factor against MM (OR=0.253, 95% CI=0.137-0.466). CONCLUSION: The primary and secondary prevention increasingly emerges as a public health priority in the effort to reverse the negative trend in cases of MM and mortality from this disease in the Czech Republic. A prerequisite for an effective secondary prevention through screening is, among others, the identification of the population groups at highest risk for MM.

Significantly higher incidence of skin cancer than other malignancies in patients after heart transplantation. A retrospective cohort study in the Czech Republic.

AIMS: To perform the first study in Czech Republic on heart transplant recipients (HTRs), compare the risks for different types of cancer and provide comprehensive analysis of skin cancer and other types of cancer morbidity from which we would be able to derive an evidence-based skin cancer surveillance program. MATERIALS AND METHODS: A retrospective cohort study was performed to determine and compare standardized morbidity ratio (SMR) of different types of cancer developed after heart transplantation. We analysed data obtained from medical documentation of 603 HTRs transplanted between 1993 and 2010. RESULTS: 191 incident cases of malignancy occurred in123 HTRs (20.4%). According to expectations, nonmelanoma skin cancer was the most frequent type of malignancy (119 cases) with SMR 7.6 (P < 0.001), followed by lung cancer with SMR 2.7 (P < 0.001). SMR for melanoma was 2.5, P = 0.129. Other types of cancer in HTRs (prostate and kidney cancer) were less frequent (SMR 2.06, P = 0.038 and SMR 2.03, P = 0.122). CONCLUSION: The risk of malignancy development is significantly higher for HTRs compared to the general population. Squamous cell carcinoma of the skin is the most frequent type of cancer followed by basal cell carcinoma. These findings emphasise the importance of regular skin cancer screening in HTRs.

Dermatitis toxica faciei after boric acid.

An adverse toxic reaction to the topical application of a 2% boric acid solution is described in a 2-year-old girl. Topical boric acid is licensed for use in children above the age of 10 in the Czech Republic. However, it can be bought over the counter and it is very often used in younger children. Due to its fast absorption and slow elimination, there is a high risk of systemic side effects. On the other hand, topical side effects are not reported in the present literature.

First case of pachyonychia congenita in the Czech Republic.

Pachyonychia congenita (PC) is a rare autosomal dominant skin disorder characterized predominantly by hypertrophic nail dystrophy, oral leukokeratosis, and painful palmoplantar keratoderma. It is associated with a mutation in one of five keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17. The International PC Research Registry (IPCRR) confirms that as of January 2014 there have been 547 cases of PC genetically confirmed. It is estimated that there are between 2000 and 10,000 cases of PC in the world. However, the exact prevalence of PC is not yet established. We report a case of PC-K6a, p.Arg164Pro, in a 40-year-old man. Initially he was diagnosed with onychomycosis and was treated with systemic antifungals. This is the first genetically confirmed case of PC in the Czech Republic.