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Introduction . Dermatomyositis is a rare systemic disease of connective tissue characterized by inflammation of the muscles and the skin. Malignant melanoma is a cancer that begins in melanocytes in the skin, mucosa of the rectum, intestine, oral cavity, external genitalia or in the eyeball. Objective . Presentation of a patient with dermatomyositis as a possible paraneoplastic syndrome of malignant melanoma. Case report . We present a case of a 56-year-old woman who was referred to us due to erythematous skin lesions on the limbs, face, neck and upper chest. The patient also complained of progressive muscle pain and weakness of the shoulder and pelvic girdle as well as of dysphagia. The patient had a small ulcerative lesion on the right foot that was removed. Histopathological evaluation revealed malignant melanoma cells, which were also present in the sentinel lymph node. Conclusions. Screening in dermatomyositis patients should also be focused on melanoma, especially in cases with negative antibodies.

Background. Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients. Methods. This prospective study was undertaken to assess the feasibility of autogenous arteriovenous fistula creation in 71 obese patients (BMI 34.6 ± 7.8). We performed a two-stage procedure, in which radio-cephalic fistula formation was followed by subcutaneous transposition of the venous component for safe and easy puncture. Results. Fistulas suitable for puncture, having blood flows of 799 ± 285 ml/min, and sufficient to perform adequate haemodialysis (Kt/V 1.24) were achieved in 85% of the patients. Primary patency rates were 65% and 59% at 6 and 12 months, respectively, and secondary patency rates were 83% both at 6 and 12 months. Conclusions. Obesity does not prevent successful autogenous arteriovenous fistula formation, and may protect forearm venous vessels from the iatrogenic damage that occurs before the onset of haemodialysis therapy. [ABSTRACT FROM AUTHOR]