Search

Basosquamous carcinoma (BSC) is a rare non-melanoma skin cancer that shares the characteristic features of both basal and squamous cell carcinomas (BCC, SCC). Our research enables better characterization of BSC in comparison to high-risk subtypes of BCC and SCC. Paper includes a retrospective analysis of BSC cases regarding sex, age, number of tumors and anatomical distribution in comparison to BCC and SCC evaluating the differences and defining the implications. Histologically confirmed carcinomas recorded between 1999 and 2019 were studied. 181 diagnosed BSC cases were identified, making this study the largest cohorts of BSC patients reported worldwide. Most cases were reported on head and neck. Analysis of facial anatomic distribution shows that most commonly affected sites were the nose (43%) and the cheek (25%). The age at excision of metatypical BCC was higher than those of low-risk BCC (P P = 0.20). We revisited that the concept of BSC is the most similar to high-risk subtypes of BCC. Patients with diagnosed BSC have higher risk of second nonmelanoma skin cancer. Therefore, the frequency of follow-up examination should be adjusted to the individual risk of another skin cancer.

Non-melanoma skin cancers (NMSCs) are the most common malignancies diagnosed in Caucasian populations. Basal cell carcinoma (BCC) is the most frequent skin cancer, followed by squamous cell carcinoma (SCC). Unfortunately, most European cancer registries do not record individual types of NMSC. To evaluate the incidence of primary BCCs and SCCs regarding age, sex, tumour site and tumour subtype to determine trends in epidemiology of both cancers. Retrospective analysis of BCCs and SCCs diagnosed and treated across seven sites in Poland from 1999 to 2019. We recorded 13,913 NMSCs occurring in 10,083 patients. BCC represented 85.2% of all cases. SCC patients were older than BCC patients (77.1 ± 11.3 years vs. 70.1 ± 12.3 years, p 0.01). The nodular subtype was the most common subtype of BCC, followed by the superficial and infiltrative subtypes. The superficial BCC subtype was more common on photoprotected areas (p 0.01), whereas the nodular BCC subtype occurred on the face (p 0.01). The high-risk SCC subtypes were more common on face compared to low-risk SCC subtypes (p 0.01). BCC and SCC are common malignancies developing at various ages and anatomical sites. These data underline the need for better registration policies regarding NMSC in order to improve prevention and treatment strategies for these tumours.

Purpose Analysis of human gait as well as diagnosis of human locomotion organ should always be conducted with velocity of gait equal to Preferred Walking Speed (PWS). The literature review shows that the PWS value is not the same in real and virtual environment. The aim of this study was to determine PWS values in both environments and to specify values of parameters used in equations enabling PWS calculations on the basis of lower limb length. Methods Research-related tests involved 40 subjects walking on the treadmill and wearing HMD goggles. The spatial scenery made participants feel like during a walk in the park. The tests included measurements of displacements of the COP, allowing for the calculation of the Lyapunov exponent and Floquet Multiplier. Both coefficients were used to identify stability at various gait velocities. Results The analysis revealed that the PWS in relation to gait on the treadmill with VR was lower than the PWS without VR. The final stage of research involved the determination of new values of coefficients of the formula enabling the identification of the velocity of comfort of gait in VR. Conclusions Obtained results proved that PWS in real and virtual environment are different. The lower values were obtained for measurements in VR. On the basis of these results, value of the "a" coefficient, used in PWS calculations on the basis of lower limb length, was re-determined. The new value makes it possible to assess PWS for gait conducted on treadmill in virtual environment, what can be very important in gait evaluation.

Biologics seem to offer a promising nonsurgical approach in hidradenitis suppurativa (HS), especially in disease with highly pronounced inflammation. Recent studies revealed increased expression of a broad range of cytokines in lesional HS skin, including interleukin (IL)-17.This study was undertaken to determine IL-17 serum levels in this group of patients.Our study was conducted on a group of 86 patients between 16 and 72 years of age with HS. A total of 86 matched healthy volunteers constituted the control group. Enzyme-linked immunosorbent assay kits were used to quantify IL-17 serum concentration.The mean IL-17 serum level of patients with HS was 3.68 ± 2.08 pg/mL, which was significantly elevated (P .0001) compared with that found in healthy volunteers (2.5 ± 1.11 pg/mL). Moreover, there was a tendency toward higher serum concentrations of IL-17 in patients with more advanced disease (P = .005). Disease duration; patient sex, age, and body mass index; and smoking habits were not determining factors for IL-17 serum concentration.Hospital-based study population was a limitation, as was a lack of posttreatment assessment.In light of our findings and literature on increased expression of IL-17 in HS lesions, evaluating the clinical effectiveness of using anti-IL-17 agents in the treatment of patients with HS is justified.

Indexing methods are very popular in terms of determining the degree of disability associated with motor dysfunctions. Currently, indexing methods dedicated to the upper limbs are not very popular, probably due to difficulties in their interpretation. This work presents the calculation algorithm of new SDDI index and the attempt is made to determine the level of physical dysfunction along with description of its kind, based on the interpretation of the calculation results of SDDI and PULMI indices.23 healthy people (10 women and 13 men), which constituted a reference group, and a group of 3 people with mobility impairments participated in the tests. In order to examine possibilities of the utilization of the SDDI index the participants had to repetitively perform two selected rehabilitation movements of upper extremities. During the tests the kinematic value was registered using inertial motion analysis system MVN BIOMECH.The results of the test were collected in waveforms of 9 anatomical angles in 4 joints of upper extremities. Then, SDDI and PULMI indices were calculated for each person with mobility impairments. Next, the analysis was performed to check which abnormalities in upper extremity motion can influence the value of both indexes and interpretation of those indexes was shown.Joint analysis of the both indices provides information on whether the patient has correctly performed the set sequence of movement and enables the determination of possible irregularities in the performance of movement given.

The aim of the study was to examine the influence of different types of virtual sceneries and frequencies of movement of visual disturbances on stabilometric values as well as whether individual sceneries and changing frequency can minimize effect of adaptation of tested person to applied disturbances.There were 23 healthy participants. A person has been standing on a Zebris stabilometric platform. Virtual 3D environment was displayed by means of HMD Oculus Rift system. An open (a meadow) and closed (a room) sceneries were used. The sceneries moved along the sagittal axis and rotated around horizontal axis. The measurement lasted 30 seconds and in the middle of it frequency of translational movement was changed from 0.7 Hz to 1.4 Hz or from 1.4 Hz to 0.7 Hz.The data were reported as medians of COP velocity and ellipse area. Visual disturbances caused the increase of these values in comparison with the tests conducted with open eyes. Results divided into periods (the first and the second 15 seconds) showed that in the first half of the test values were higher compared to the second half. The comparison of values obtained for open and closed scenery showed that higher values were recorded for open scenery.The comparison of both types of sceneries on the basis of COP velocity and ellipse area showed that open scenery had a greater impact on the measured stabilometric values. It was found out as well that people got accustomed to the applied disturbances, but this effect was lower in the open scenery.

The aim of the research was to formulate a new index enabling assessment of the overall pathology of the upper limb movement. It defines the difference between the pathological movement and a normal movement pattern.Methodology of determining the index is based on a mathematical algorithm for calculating the Gait Deviation Index which is based on advanced methods of image comparison. To calculate the ULMDI index, one must divide the analyzed movement into cycles appropriate to the nature of the movement (similarly in gait it is the gait cycle) and then determine kinematic quantities (courses of joint angles).A group of 23 healthy people (10 women: k1-k10 and 13 men: m1-m13) as the reference group and a group of 3 persons with mobility impairments (p1-p3) took part in the research. Time values of the angles of the joints on both upper limbs were registered and then ULMDI indexes were calculated.It has been shown that the developed ULMDI index allows to detect the deviations from the accepted norm in the performance of movements. The results showed that both the description of the motor dysfunction of examined person based on the diagnosis of the physician, a detailed analysis of kinematic waveforms received during the tests and the calculated values provide a coherent picture of the state of a human movement. The index analysis is less time-consuming for the doctor, and the comparison of the results at various stages of therapy gives an objective picture of the rehabilitation progress.

Metallothionein-3 (MT-3) has been shown to be expressed in several malignancies and to have an impact on patients’ survival in breast and urinary bladder cancer cases. However, its expression has not been determined in normal skin or in its malignant lesions. MT-3 expression was studied using immunohistochemistry in 17 cases of normal skin, 18 of actinic keratosis (AK), 39 of squamous cell carcinoma (SCC), and 23 of basal cell carcinoma (BCC). Low MT-3 expression was observed in normal skin epidermis with faint or no expression in the epidermis basal layer. Significantly higher MT-3 expression was noted in AK (P = 0.007) and SCC (P

SummaryBackground The management of hidradenitis suppurativa (HS) is still challenging, and new treatment methods are necessary. Acitretin seems to be a promising agent in HS management; however, literature data are limited. Objectives To investigate the clinical efficacy of acitretin monotherapy in 17 patients with long-standing and recalcitrant HS. Simultaneously, an assessment of quality of life was carried out. Methods The study was conducted with a group of 17 patients with HS. Patients were treated with acitretin for up to 9 months and examined at baseline, after 1 month, and then every 3 months from baseline. The clinical extent of disease severity was measured with the HS Severity Index (HSSI), Hurley scoring system, Physician's Global Assessment and Dermatology Life Quality Index (DLQI). Results Nine patients (53%) finished the whole 9 months of acitretin treatment. The mean acitretin dose was 0·56 ± 0·08 mg kg−1 daily. A significant improvement of clinical manifestation (HSSI, DLQI) was observed after only 1 month of therapy, and further improvement was recorded during the next few months. Overall, eight subjects (47%) fulfilled the criteria for response (HSSI ≥ 50% reduction from baseline). The dropout rate was 47%, due mostly to drug ineffectiveness and adverse events. Discontinuation of treatment resulted in deterioration or relapse of HS 2–8 months after acitretin cessation, in all but one patient. Conclusions HS treatment with acitretin seems to be a promising method of disease management. However, due to the high daily dosage, its usage may be limited.

Defining the influence of parameters of visual disorders on ability of balancing turns out to be an important process in effective diagnostics. Current diagnostic methods relating mainly to determination of the coefficient of BRUTM (Balance Rehabilitation Unit Trade Mark) depend on lots of tests carried out in a disturbed environment created by Virtual Reality Technology. The aim of this study is to determine the effect of the frequency of visual disturbances on stabilographic values in the virtual reality environment.The study was carried out involving one research group in Virtual Cave. There were induced visual disturbances with different frequencies and with the change of frequency during measuring the position of the center of pressure (COP) in the test. Before each test the reference test was performed. All tests were performed with disorders in two different sceneries: closed and open scenery. All measurements were carried out on an immobile Zebris platform which enables determination of feet pressure distribution. From the measured values of the position of the COP Short Time Fourier Transform (STFT) was calculated.The results of calculation are shown in graphs. Their analysis showed that changing the parameters of disorder frequency in world created using Virtual Reality Technology affects stabilographic parameters. The intensity of these changes is also affected by applied research scenery.Conditions have been set out to carry out similar studies in order to obtain reliable results. The study is the first step in a project to develop a system for diagnosis and rehabilitation of human movement using Virtual Reality Technology.

OBJECTIVE To describe our own surgical techniques of wound closure in pubic and armpit areas in the treatment of hidradenitis suppurativa (HS) and to analyze surgical procedures performed with regard to complications, tolerance, and factors influencing recurrence rate. METHODS Between 1999 and 2009, 118 operations were performed on 57 patients with HS. Surgical procedures included local excision of involved tissue and different methods of wound closure, including those of our own design such as the “star-like” technique and “pubic flaps.” Treatment tolerance was evaluated 3 months after surgery, and efficacy was evaluated after 24 months. RESULTS Forty-four (77.2%) patients showed good tolerance of the operation and during the postoperative period, whereas only one individual (1.8%) reported unsatisfactory tolerance. Of all patients, 51 (89.5%) expressed willingness to undergo additional surgery in the event of lesion recurrence. During the 2-year follow-up period, complete recovery was observed in 34 (59.7%) patients, partial recovery in 18 (31.6%), and no improvement in five (8.8%). Factors influencing recurrence rate were number of skin areas affected by HS lesions and disease duration. CONCLUSION Surgical treatment of HS is effective and well tolerated. In selected cases, our own techniques of surgical wound closure accelerated healing and improved results. The authors have indicated no significant interest with commercial supporters.

Hidradenitis suppurativa is a recurrent, debilitating suppurative skin disease. The symptoms are much more than just physical, but studies of its impact on patients’ psychological state and related quality of life are very limited. The current study was conducted with a group of 54 patients, aged 16–65 years, who had an active, but stable, course of hidradenitis suppurativa. The aim of the study was to determine the influence of hidradenitis suppurativa on a broad spectrum of psychophysical factors. Assessment was carried out using several questionnaires, which revealed the following mean scores: Dermatology Life Quality Index (DLQI) (12.67 ± 7.7), Beck Depression Inventory-Short Form (BDI-SF) (5.87 ± 4.68), Evers et al. “6-Item Scale” (3.87 ± 3.65), EQ-5D (0.66 ± 0.23 (health index) and 56.78 ± 18.84 (VAS)), Functional Assessment of Chronic Illness Therapy – Fatigue scale (FACIT-F) (32.06 ± 11.01) and Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) (56.44 ± 15.17%). The results highlight the important impact of hidradenitis suppurativa on a wide spectrum of psychophysical aspects and impairment of related quality of life among patients. Our findings indicate that advancement of the disease seems to be the most important factor negatively influencing patients’ well-being (p < 0.01). It is noteworthy that an anogenital location appears to impair the hidradenitis suppurativa patients’ quality of life most of all (p < 0.05), but the occurrence of lesions on uncovered skin plays a crucial role in the stigmatization level (p < 0.05). Key words: hidradenitis suppurativa; acne inversa; quality of life; DLQI; BDI; EQ-5D; FACIT-F; QLES-Q-SF.

Purulent infection of the neck is a serious condition, which can occur at any age and regardless of any factors. It often leads to the serious complications, including death. A case report. The authors present a case of a 56-year-old patient who reported to the emergency department because of the severe neck pain, fever and progressive weakness. Physical examination revealed an extensive inflammation involving skin and subcutaneous tissue surrounding suboccipital area and neck. Palpation of the thyroid gland showed tumor of the left lobe. Due to deteriorating condition, it was decided to admit the patient to the hospital, along with urgent surgery. It was necessary to perform a repeated removal of the necrotic tissues of the nuchal area. Diabetes mellitus type II was diagnosed during hospitalisation. Long and laborious extensive wound care enabled to perform a skin graft and full recovery. The patient was discharged in good general and local condition in the 11th week of the hospitalization.

Background Basal cell carcinoma (BCC) is the most common skin malignancy. Eyelids constitute a special location of BCC because of the proximity of the eyeball. Objective This study was undertaken to evaluate the incidence of BCC located on the eyelids, to examine the clinical and histologic types of BCCs in this location, and to present some reconstructive techniques used in the treatment of BCC in palpebral region. Methods There were 330 patients with BCC retrospectively included in the study. The comparison was performed between clinical and histologic features of BCCs located on eyelids and in other locations. Results and Conclusions Approximately 16% of all tumors were located on the eyelids. The majority of tumors were situated on the lower eyelid. Noduloulcerative clinical type was observed in 96.3% of tumors. This type was significantly more frequently found on eyelids than on trunk and extremities (p

Background Mutations in nucleotide excision repair (NER) genes are the cause of xeroderma pigmentosum, a genetic syndrome with proneness to basal cell carcinoma (BCC) of the skin. Single nucleotide polymorphisms (SNPs) may affect the effectiveness of DNA repair and hence influence individual susceptibility to a variety of neoplasms. The aim of this study was to find associations between SNPs in selected NER genes and sporadic BCC development. Materials and methods The study group consisted of 100 patients with histopathologically confirmed BCCs and the control group of 100 elderly individuals with no personal history of any cancer. DNA isolated from peripheral blood lymphocytes was genotyped for seven SNPs in five different NER genes. Statistical analyses for associations were performed. Results A weak association between XPD exon 6 silent C/A polymorphism and BCC development risk was found when comparing single polymorphisms between the two groups. When considering sex and SNPs, men with the A-allele in XPC intron 11 C/A have been found to have a decreased risk of BCC. Conclusions There is no consistency in association studies between SNPs and BCC susceptibility. SNPs in NER genes seem to have an insignificant influence on the risk of developing BCC of the skin.

Background: Hidradenitis suppurativa (HS) is nowadays regarded as a systemic disease associated with metabolic syndrome. Some recent studies have also demonstrated an increased cardiovascular risk in patients with HS. Circulating endothelial progenitor cells (EPCs) play an integral role in the regulation and protection of the endothelium and in the maintenance of vascular homeostasis. Objective: This study was undertaken to determine the possible alterations in the number of EPCs in patients with HS compared to controls. Methods: The number of EPCs, identified as CD133+/KDR+ cells, was determined with flow cytometry in the peripheral blood of 25 HS patients and 31 controls. Results: The number of EPCs was significantly reduced in HS sufferers compared with controls (p < 0.0001). The mean number of EPCs was assessed as 191.3 ± 118.5/ml and 672.4 ± 343.0/ml for patients and controls, respectively. Conclusion: A decreased number of EPCs among HS sufferers may contribute to endothelial malfunction resulting in increased cardiovascular risk in this group of patients.

The renin-angiotensin system (RAS) is known mainly as a regulator of cardiovascular homeostasis. However, it has also been shown to mediate processes such as proliferation, apoptosis, angiogenesis, and carcinogenesis. Nonmelanoma skin cancers (NMSC) - including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) - are among the most common cancers. The aim of the present study was to determine the immunohistochemical expression of angiotensin-converting enzyme (ACE), angiotensin-converting enzyme 2 (ACE2), and Ki-67 antigen in archival samples of normal skin, actinic keratosis, and malignant skin lesions. Cytoplasmic-nuclear ACE immunoreactivity was observed in 99% of examined cases of both normal skin and cancers. Significantly higher ACE immunoreactivity occurred in normal skin, as compared with BCC and SCC (p < 0.01, p < 0.0001, respectively). Additionally, ACE immunoreactivity was also significantly higher in BCC, compared with SCC (p < 0.05). ACE2 immunoreactivity was noted in basal epidermal layers and in sebaceous gland cells in normal skin, though not in NMSC. These novel observations suggest that ACE and skin RAS may be involved in the pathogenesis of malignant skin lesions.

Basal cell carcinoma (BCC) of the skin is considered to be the most common malignancy in people of European ancestry. It is often not clinically aggressive and has been regarded as genetically stable. However, histopathologic subtypes of BCC differ in their ability to invade surrounding tissues and recur. The aim of this work was to present a comprehensive study of chromosomal imbalances of cutaneous BCC and to correlate the findings with their histopathologic and clinical features. In all, 101 tumor samples were classified according to the current microscopic classification of BCC and then analyzed by comparative genomic hybridization (CGH). Over 60% of BCC were found to carry chromosomal imbalances - partial or whole chromosome gains and losses. Different subtypes of BCC presented common chromosomal alterations. No single chromosomal imbalance was found to be characteristic of a particular subtype of BCC, although the frequency of some chromosomal changes differed from one group to the other. The significance of chromosome 2 gains as a phenomenon that does not coexist with the losses in 9q is discussed.

Hidradenitis suppurativa (HS) is a recurrent, debilitating suppurative skin disease. Nowadays the major challenge is the choice of optimal treatment. Many conservative therapies seem to have only a supportive character and do not prevent progression of the disease. Early surgical intervention with complete excision of the involved areas is still considered to be the most efficient therapy, but anti-tumour necrosis factor (TNF)-alpha agents may offer a possible non-surgical treatment. The aim of this study was to determine the serum concentration of TNF-alpha and its probable alterations during the disease process in patients with HS. Analysis of TNF-alpha serum concentration in 54 individuals with HS revealed significantly higher levels than in the sera of healthy controls (p = 0.006). To the best of our knowledge, this is the first report of increased TNF-alpha serum concentration in patients with HS.

Hidradenitis suppurativa (HS) is a recurrent, debilitating suppurative skin disease. The major challenge is the choice of optimal treatment. Assessment of treatment effectiveness is currently associated with clinical observations of disease activity based on Hurley's or Sartorius' grading system. Detailed examination of patients with HS and evaluation of disease severity is frequently time-consuming and undoubtedly subjective. With regard to these factors, there is a need for laboratory findings that will help resolve the problem. The aim of this study was to determine the usefulness of soluble interleukin-2 receptor (sIL-2R) serum concentration as a marker of HS clinical staging and comparative analysis with the commonly conducted laboratory measurements, including white blood cell count, C-reactive protein and erythrocyte sedimentation rate. The statistical analysis of all these laboratory parameters conducted within a group of 54 individuals with HS revealed that sIL-2R serum level seems to be the most sensitive measurement for evaluation of disease stage. Moreover, the existence of strong dependences between sIL-2R serum concentration and Hurley's HS grading system were demonstrated. In conclusion, we believe that sIL-2R serum level could be used as a valuable marker for disease staging in patients with HS.

Tumescent local anesthesia is based upon the infusion of large volumes of neutralized anesthetic solutions, mainly lidocaine, at very low concentrations. This results in the paralysis of sensory nerve endings and minute nerve twigs, leading to a reduction in pain. The aim of this study was to assess the safety of lidocaine application in tumescent local anesthesia on different regions of patient's bodies. Measures of safety included the analysis of lidocaine concentrations and its pharmacokinetic parameters. In total, 48 patients were infused with tumescent anesthesia in the hypogastrium, buttocks and thighs, axillae, breasts, trunk, and face and neck areas. Lidocaine was infused in doses ranging from 5.2-40 mg/kg b.w., and in concentrations of 0.05% (hypogastrium, buttocks, thighs) or 0.1-0.15% (axillae, breasts, trunk, face, neck), using a total amount of 300-3200 mg. As the peak lidocaine concentration did not exceed 5 microg/ml (commonly known as the toxic threshold), the results of our study indicate that the doses used (not exceeding 40 mg/kg b.w.) are completely safe for patients undergoing tumescent anesthesia in different body areas. The observation of statistically significant correlations between both the dose and the total amount of lidocaine administered and its peak plasma concentration, together with the lack of correlations between the dose and the amount and the time taken to reach peak concentration, allows the safety of each anesthetic dose to be predicted. An analysis of the heterogeneous dynamics of lidocaine plasma concentration changes in tumescent anesthesia in different body areas indicates that both the rates and the degrees of absorption and elimination depend on the area of infiltration; this is in turn related to the vascularization of any given area. The study of lidocaine concentration and pharmacokinetic parameters also showed that there may potentially be a higher risk of a large anesthetic concentration developing within a short period of time during anesthesia of the upper parts of the body. During tumescent anesthesia, significantly higher plasma concentrations of lidocaine were observed in the face and neck than in the hypogastrium, buttocks and thighs, axillae, breast and trunk 0.5 to 4 h after its infusion. This indicates the need for carefully conducted patient observations immediately after infiltration into the aforementioned areas.

SRY-related HMG box protein 18 (SOX18) is a transcription factor involved in a range of physiological processes, including differentiation of endothelial cells during new vessel formation. Numerous studies are being conducted to determine its role in carcinogenesis.Thirty-five cases of squamous cell carcinoma (SCC), 61 cases of basal cell carcinoma (BCC), 15 cases of actinic keratosis (AK) and 15 normal skin (NS) cases were examined in the study. Expression of SOX18 was investigated with immunohistochemistry and light optic microscopy. The obtained results were subjected to statistical analysis including available clinicopathological data.Nuclear expression of SOX18 was shown in vascular endothelial cells, basal layer cells of NS epidermis, as well as in AK, BCC and SCC cancer cells. Expression of SOX18 in SCC, BCC and AK cells was significantly higher than in NS (p0.01, p0.001 and p0.01, respectively). Additionally, higher expression of SOX18 in BCC than in SCC cells (p0.001) was observed.SOX18 may play a role in the development of BCC and SCC. Further studies with the use of additional markers tested at the mRNA and protein level are necessary for better explanation of SOX18 function in cancer transformation.