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Actinic keratosis is a common skin condition that has the potential to develop into malignant neoplastic lesions. Factors that are known to increase the likelihood of developing actinic keratosis include older age, male gender, UV exposure, and immunosuppressive treatment. Understanding the pathogenesis and significance of actinic keratosis as an initial form of the neoplastic process associated with a sequence of lesions arising on photodamaged skin has led to the concept of field cancerization. The choice of the optimal therapeutic pathway depends on the number of actinic keratosis lesions and the degree of photodamage in the skin, as well as the advancement of skin lesions. The clinical presentation of skin lesions also allows monitoring of the patient’s condition over time and assessing response to treatment, and facilitates rational decisions regarding potential therapy adjustments. This article outlines the guidelines for the diagnosis and treatment of actinic keratosis in Poland and presents an evidence-based management regimen that incorporates the practical clinical experience of dermatology experts. The recommendations cover a range of topics including topical treatment options, cryosurgery, photodynamic therapy with a photosensitizing agent, and combination treatments.

Dermoscopic patterns of inflammatory dermatoses (inflammoscopy) have been extensively studied in the recent years, though data on patients with darker phototypes (IV-VI) are sparse. The aims of this systematic review were to summarize the current state of knowledge on inflammoscopy applied to skin of color and provide a standardized nomenclature of reported findings. Besides dermoscopic features, type of setting and magnification, number of cases, and histopathological correlation were analyzed. Eighty-five papers addressing 76 different dermatoses (25 papulosquamous dermatoses, 19 hyperpigmented dermatoses, seven hypopigmented dermatoses, four granulomatous dermatoses, two sclerotic dermatoses, five facial inflammatory dermatoses, and 14 miscellaneous conditions) for a total of 2073 instances were retrieved. Only one study showed a level of evidence of III (cross-sectional study), whereas 10 and 74 displayed a level of evidence of IV (case-control studies) and V (case-series and case-reports), respectively. Moreover, our analysis also highlighted that most of papers focalized on a limited number of dermatoses, with several conditions having only single dermoscopic descriptions. Additionally, few studies compared findings among phototypes belonging to the “skin of color” spectrum. Further studies designed according to a systematic approach and considering the above-mentioned issues are therefore needed.

Introduction: There is growing evidence of the potential uses of dermoscopy in diagnostics of demodicosis. No previous studies have analyzed dermoscopic features in patients with ocular demodicosis. Objectives: To evaluate the potential usefulness of videodermoscopy in diagnostics of ocular demodicosis. Methods: It was a single-center prospective observational study in which results of videodermoscopic examination of the eyelids were compared to the results of classic microscopic examination in patients with suspected ocular demodicosis and healthy volunteers. Results: Study group included 16 women and 15 men. In fifteen (48.4%) patients, microbiological examination of epilated eyelashes was positive. The results of forms filled by the patients concerning known subjective clinical symptoms of ocular demodicosis revealed no significant differences between the group with positive and negative results of microscopic examination. The presence of Demodex tails and madarosis observed during dermoscopic assessment correlated positively with positive results of microscopic examination. At least one Demodex tail was found in 86.7% (13/15) cases with positive results of microscopic examination. In the two remaining cases microscopic evaluation showed the presence of Demodex brevis. In 37.5% (6/16) of patients with negative results of microscopic examination, videodermoscopy showed the presence of Demodex tails. Conclusions: Videodermoscopy may facilitate the diagnostics of ocular demodicosis. Patients reporting clinical symptoms suggesting ocular demodicosis but negative results of videodermoscopic examination should be referred to classical microscopic examination to exclude the presence of Demodex brevis. In patients with negative microscopic examination results and symptoms suggesting ocular demodicosis, dermoscopy-guided microscopic re-evaluation could be considered.

Ocular demodecosis is a disease caused by Demodex folliculorum and Demodex brevis mites. Demodex folliculorum inhabits eyelash hair follicles, while Demodex brevis inhabits the meibomian glands and glands of Zeiss. The pathogenic role of Demodex mites is still under discussion. Numerous studies indicate that they are the etiological factor of many ailments of the protective apparatus of the eye and its anterior segment (e.g., blepharitis, tear film disorders, corneal lesions). Symptoms may include: decreased visual acuity, itching around the eyes, dry eyes or tearing, foreign body sensation, impaired contact lens tolerance, recurrent styes or chalazions. Currently, the most commonly used method of diagnosis of Demodex infestation is microscopic examination of epilated eyelashes. There are no uniform standards for the treatment of ocular demodecosis.

Mastocytosis is a heterogeneous group of diseases associated with excessive proliferation and accumulation of mast cells in different organs. Recent studies have demonstrated that patients suffering from mastocytosis face an increased risk of melanoma and non-melanoma skin cancer. The cause of this has not yet been clearly identified. In the literature, the potential influence of several factors has been suggested, including genetic background, the role of cytokines produced by mast cells, iatrogenic and hormonal factors. The article summarizes the current state of knowledge regarding the epidemiology, pathogenesis, diagnosis, and management of skin neoplasia in mastocytosis patients.

Abstract 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

Introduction: Frontal fibrosing alopecia (FFA) is a form of primary lymphocytic scarring alopecia characterized by a progressive recession of the fronto-temporal hairline. Although the clinical presentation of FFA is very typical, biopsy for histopathological examina­tion is still recommended to confirm the diagnosis. Currently, a growing number of skin and mucosal inflammatory diseases are diagnosed with modern noninvasive techniques such as dermoscopy without the necessity of a biopsy. Objectives: The International Dermoscopy Society (IDS) aimed to test the ability of its members to diagnose classic FFA through clinical and dermoscopic parameters and to compare acquired data to the largest cohort studies published since 1994. Methods: This is an observational, cross-sectional study describing patient demographics, clinical presentation and diagnostic tools used in a sample of FFA patients collected by IDS members. A literature search was then performed using Pubmed to review studies reporting more than 100 cases. Results: IDS members submitted 188 cases demonstrating a predominant female population (98.4%). In 71.8% of the cases, the clinical presentation and the trichoscopic findings allowed for the diagnosis. Out of 24 revised studies, 13 showed that clinical and trichoscopic features were decisive for the diagnosis in almost all cases. Conclusions: Demographic and clinical data of our cohort were mostly comparable to previous reported data on FFA. The relevant role of the clinical and trichoscopic features in diagnosing FFA was confirmed by our study and the reviewed literature. Trichoscopy could be considered a worldwide-acknowledged non-invasive technique for the diagnosis of FFA.

Dermoscopy is currently used as an auxiliary tool in general dermatology. Since some commercially available dermoscopes have built-in magnets, electromagnetic interference (EMI) may occur when examining cardiac implantable electronic devices (CIED) patients. The aim of the study was to create maps of electromagnetic fields defining a safe distance in terms of EMI. The study was performed in laboratory conditions using measuring equipment specially designed for this purpose. The following dermoscopes have been tested: Illuco IDS-1100, Visiomed Luminis, Visiomed Luminis 2, Heine NC2 with and without a contact plate, DermLite DL4, and DermLite Handyscope. Measurements were made for the following set of lift-off distances: 5, 10, 20, 30, 40, 50, and 150 mm. Each 2D scan consisted of 10-line scans shifted from each other by 10 mm. The strength of the magnetic field decreased with the distance from the faceplate. The distribution of the magnetic field differed depending on the position of the magnets. The highest magnetic field was recorded in the center of the Heine NC2 faceplate (up to 8 mT). In most cases, at a distance of 10 mm, the magnetic field strength was measured below 1 mT, with the exception of Heine NC2 and Heine NC2 with a contact plate. All tested dermoscopes generated a magnetic field of

Incidence of skin cancers is constantly increasing, what constitutes a significant epidemiologic problem of modern medicine. Basal cell carcinoma is the most common neoplasm affecting Caucasians. Histopathological examination is a gold standard that allows for diagnosing skin cancers. The presented recommendations discuss clinical and pathomorphological sub-types of basal cell carcinoma, their dermoscopic features, stage assessment, and methods for treatment as well as prevention of recurrence of this cancer. Surgical excision of the lesion is a basic and preferred therapeutic option. Other non-surgical options show lower treatment efficacy, and thus, should be considered in cases of cancers with low risk of recurrence, when a surgery is contraindicated or impossible.

The clinical, pathological and dermoscopic features, including recommended diagnostic procedures for cutaneous squamous cell carcinoma (SCC) and Merkel cell carcinoma (MCC) are presented. The therapeutic standard for both cancers is surgical removal. In the case of SCC Mohs microsurgery may be performed, with the intraoperative analysis of the completeness of excision. The recommendations also include non-surgical methods of treatment, including systemic therapies used in advanced forms of the disease. The aim of the recommendations is to provide help in choosing the optimal diagnostic and therapeutic options for individual patients with SCC or MCC. These recommendations take into consideration similar documents published by other scientific organizations and expert opinions of the authors.

Introduction . Subcutaneous fat necrosis of the newborn is a rare form of panniculitis observed predominantly in neonates within the first weeks of life. In most cases subcutaneous lesions resolve spontaneously without complications. Occasionally, however, dystrophic calcifications and subcutaneous atrophy are observed. Objective . Presenting a case of a child with subcutaneous fat necrosis of the newborn and the clinical spectrum of the disease. Case report . We present a male neonate affected by subcutaneous fat necrosis of the newborn complicated by dystrophic calcifications and subcutaneous atrophy. Conclusions . From the clinical point of view, the most important factor to consider is the possible coexistence of subcutaneous fat necrosis of the newborn with a range of metabolic complications. The incidence of local complications (including dystrophic calcifications and subcutaneous atrophy) is rare. Patient follow-up is essential to determine future aesthetic and functional effects of the disease, and management of possible complications.

Introduction . Scabies is a common skin infestation caused by the mite Sarcoptes scabiei. The occurrence of cases of atypical clinical appearance that pose diagnostic difficulties seems to be increasing in clinical practice. Objective . To present the utility of videodermoscopy for diagnosis of scabies in children and adults. Case report. Cases of three patients hospitalized in the Department of Dermatology in Gdansk are presented. In all these cases videodermoscopy examination allowed the diagnosis of scabies to be confirmed. Conclusions . Videodermoscopy is a non-invasive, simple and fast tool of high sensitivity and specificity helpful in the diagnosis of scabies.

Introduction . Lichen nitidus (LN) is a rare, chronic, inflammatory dermatosis usually affecting children and young adults. Nails involvement is very rare. Until now, 7 cases of LN with nail involvement have been described. Objective. To present a rare case of childhood lichen nitidus where trachyonychia was the main manifestation of the disease. Case report. A 7-year-old, Caucasian, previously healthy boy presented thumbnail longitudinal ridges, distal splitting and subungual hyperkeratosis for 7 months. Numerous mycological and bacteriological examinations were negative. Dermatological examination also revealed erythematous lesions on the proximal nail fold as well as small skin-pigmented papules on the thumb. Similar papules grouped into patches were also observed on the upper limbs, trunk and forehead. Treatment was not recommended. Conclusions . Lichen nitidus may rarely affect nails and should be considered as a possible cause of nail lesions in childhood.

Introduction. Basal cell carcinomas (BCCs) are the most common of all cancers in the Caucasians, and their incidence has been rising in younger populations. BCC usually occurs in sun-exposed body areas, most commonly on the head, neck and upper extremities. Experimental data have shown that the sonic hedgehog pathway may be involved in BCC development, but the mechanism by which activation of the hedgehog pathway leads to carcinogenesis is still not clear. Objective. The aim of the study was to assess the association between 331A/T polymorphism in the SHH gene and 385G/A polymorphism in the SMO gene and the development of basal cell carcinomas. Material and methods. The study group consisted of 142 Caucasians with histopathologically confirmed BCC and 142 healthy volunteers as a control group. All patients were diagnosed and treated in the Department of Dermatology and Venereology in Lodz. Polymorphisms in SHH and SMO genes were assessed by RFLP-PCR. Results. Associations between 331A/T polymorphism in the SHH gene and 385G/A polymorphism in the SMO gene and the development of basal cell carcinomas were found. Additionally, significant differences in genotype distribution of all examined polymorphisms between BCC patients and controls were detected. Conclusions . The sonic hedgehog pathway is implicated in the etiopathogenesis of basal cell carcinoma, the most common human cancer. A better understanding of the molecular background of this pathway might be useful for introduction of new therapeutic methods.

Introduction . Lichen spinulosus is a rare, benign dermatosis representing follicular keratotic disorders. It is characterized by follicular keratotic papules grouped into large patches. Symmetrical and often asymptomatic lesions affect the limbs, trunk, neck and very rarely the face. The etiopathogenesis of lichen spinulosus is unclear. The disease has been reported predominantly in children in the second decade of life, more frequently in boys. For the treatment keratolytics and emollients are mainly used. Topical corticosteroids, retinoids, tar preparations and vitamin D analogs are also useful. The disease has not been reported in Polish medical literature. Objective . Presentation of child with lichen spinulosus and review of the literature. Case report. An 8-year-old, generally healthy boy presented for a couple of years symmetrical, small spinous papules grouped into patches. Lesions affected the knee and shins. Hyperkeratotic lesions on the eyelids and nose were also observed. Histopathology showed dilated hair follicles with keratotic plugs and mild lymphocytic infiltration. According to clinical and histopathological features, the diagnosis of lichen spinulosus was established. The patient was treated with keratolytics and emollients with partial remission. Conclusions . Lichen spinulosus is a rare dermatosis which should be differentiated from other follicular keratotic disorders as well as nummular eczema, lichen planopilaris, frictional childhood eruptions, miliary pustular syphilis and psoriasis.

Introduction . Erythema dyschromicum perstans (EDP) or ashy dermatosis is a rare, benign acquired disease characterized by macular hyperpigmentations. The cause of EDP is unclear although some drugs, toxic agents and internal disorders have been associated with this dermatosis. Objective . Presentation of the first case of the association between EDP and Crohn disease treated with infliximab. Case report . We present a case of a 15-year-old boy with Crohn disease who was treated with infliximab. During the treatment asymptomatic, hyperpigmented macules on the trunk were observed. Based on clinical and histopathological features the diagnosis of erythema dyschromicum perstans was established. Conclusions . Erythema dyschromicum perstans may be associated with Crohn disease and infliximab.

Wprowadzenie: Nie jest znana epidemiologia guzów aparatu paznokciowego.Ze względu na często niespecyficzny obraz kliniczny diagnostykatych zmian może sprawiać trudności. Cel pracy: Ocena częstości występowania oraz spektrum guzów aparatupaznokciowego w populacji Polski Północnej. Materiał i metodyka: Spośród 1588 pacjentów diagnozowanychi leczonych w Klinice Dermatologii, Wenerologii i Alergologii GdańskiegoUniwersytetu Medycznego z powodu różnorodnych patologiiaparatu paznokciowego do badania włączono 129 osób z guzami. Wyniki: Guzy stanowiły około 8% patologii aparatu paznokciowego.Większość (92%) miała charakter łagodny. Najczęściej rozpoznawanozmiany melanocytowe (41%), guzy chrzęstno-kostne, włókniakioraz torbiele śluzowe. Najczęstszym nowotworem złośliwym byłczerniak. Wnioski: Guzy aparatu paznokciowego są obserwowane w populacjiPolski Północnej dość często. Większość z nich ma charakter łagodny.Diagnostyka zmian melanocytowych aparatu paznokciowego jest niezwykleistotna ze względu na ryzyko rozwoju czerniaka.

Wprowadzenie. Czerniak aparatu paznokciowego jest rzadkim typemczerniaka o złym rokowaniu. Ocenia się, że stanowi on około 1%wszystkich czerniaków skóry w populacji kaukaskiej.Cel pracy. Ocena częstości występowania tego nowotworu w populacjipółnocnej Polski oraz jego charakterystyka kliniczna i histopatologiczna. Materiał i metody: wśród 1588 pacjentów diagnozowanych i leczonychw Klinice Dermatologii, Wenerologii i Alergologii GdańskiegoUniwersytetu Medycznego z powodu różnorodnych patologii aparatupaznokciowego do badania włączono 8 chorych (5 kobiet i 3 mężczyzn,średnia wieku 59 lat) z czerniakiem aparatu paznokciowego.Wyniki: czerniak aparatu paznokciowego stanowił 0,504% wszystkichpatologii aparatu paznokciowego. Wszyscy pacjenci cechowali się IIIlub IV fototypem skóry. Guz był zlokalizowany w większości przypadkóww obrębie palucha lub kciuka. Najczęstszym typem histopatologicznymbyłczerniak akralny. Średni naciek nowotworu według Breslowawynosił 7,2 mm (zakres 2,5–18 mm). U 37,5% badanychobserwowano przeżycie ponad 20 miesięcy. Wnioski: czerniak aparatu paznokciowego w populacji północnej Polskiwystępuje rzadko, ale jest najczęstszym nowotworem złośliwymnarządu paznokciowego.Wbadanej populacji nowotwór rozpoznawanow zaawansowanych stadiach, co wiąże się ze złym rokowaniem.

Wprowadzenie: Nieczerniakowe nowotwory skóry są najczęstszyminowotworami złośliwymi w populacji kaukaskiej. Obserwuje się staływzrost zapadalności. Leczenie chirurgiczne jest najefektywniejsząmetodą terapii. Cel badań: Analiza pod względem epidemiologicznym, klinicznymi wyników leczenia chirurgicznego przypadków raków skóry leczonychw Gdańsku. Materiał i metodyka: Przeanalizowano 1406 chorych z 1849 ogniskamiraka (691 mężczyzn i 715 kobiet). Chorzy byli operowani w latach1998–2009. Nowotwory wycinano ze standardowym marginesemresekcji. Badanych analizowano pod względem wieku, płci, lokalizacjinowotworu, jego wielkości, marginesu resekcji oraz wznów. Wyniki: Obserwowano wzrost liczby osób operowanych z powodunowotworów skóry. Średni wiek badanych to 66 lat. Stosunek występowaniaraka podstawnokomórkowego do raka kolczystokomórkowegowynosił 9 : 1. Najczęstszym umiejscowieniem nowotworu byłaskóra twarzoczaszki. Nowotwory wysokiego ryzyka wznowy obserwowanow 1020 przypadkach. Odsetek wznów wynosił 3,7%, natomiastdla nowotworów wysokiego ryzyka 5,2%. Wnioski: W północnej Polsce wzrasta częstość występowania rakówskóry. Leczenie chirurgiczne powinno być złotym standardem w terapiiguzów wysokiego ryzyka.

Wprowadzenie: Dane z literatury wskazują na udział receptora dlawitaminy D (ang. vitamin D receptor – VDR) w rozwoju nowotwo równarządów wewnętrznych oraz raków skóry. W pojedynczychpracach analizowano rolę reduktazy metylenotetrahydrofolianowej(ang. methylenetetrahydrofolate reductase – MTHFR), której nieprawidłowaaktywność związana jest z indukcją kancerogenezy. Cel pracy: Ocena stężenia 25(OH)D oraz parathormonu w surowicyu pacjentów z rakiem podstawnokomórkowym (ang. basal cell carcinoma– BCC), a także analiza ekspresji VDR i MTHFR w bioptatach zezmian skórnych typu BCC. Materiał i metodyka: Badaniem objęto grupę 79 chorych z BCC oraz46 wolontariuszy stanowiących grupę kontrolną. U wszystkich badanychoznaczano stężenie witaminy D i parathormonu w surowicy,natomiast u 44 pacjentów z BCC oraz 30 wolontariuszy pobieranobiopsje skóry celem oznaczenia ekspresji VDR i MTHFR. Wyniki: Stężenie 25(OH)D było statystycznie istotnie wyższe w grupiekontrolnej niż u chorych na BCC (p = 0,0026), podczas gdy stężenieparathormonu w surowicy pacjentów z BCC było istotnie wyższew porównaniu z grupą kontrolną (p < 0,0001). U chorych na BCCwykazano istotnie wyższą ekspresję VDR niż w grupie kontrolnej(p < 0,001). Taką samą zależność obserwowano w odniesieniu do ekspresjiMTHFR, która była istotnie wyższa w bioptatach skóry pobranychze zmian typu BCC w porównaniu z grupą kontrolną (p < 0,01). Wnioski: Na podstawie wyników badań własnych nie można jednoznacznieokreślić roli VDR i MTHFR w rozwoju raków podstawnokomórkowychskóry, jakkolwiek wiele argumentów przemawia za ichistotnym udziałem w procesie kancerogenezy. Stąd też uzasadnionejest prowadzenie dalszych, kompleksowych i wieloośrodkowychbadań celem poznania złożonej etiopatogenezy BCC.

Wprowadzenie: W trzech kolejnych miesiącach 2009 roku badano177 pacjentów z nieczerniakowymi rakami skóry, którzy zgłosili sięw celu konsultacji, ustalenia postępowania i ewentualnego leczenia.Większość osób (131) zgłosiła się z powodu wznowy lub nowotworówniewyleczonych. Nowotwory były zlokalizowane w obrębie głowyi szyi, a 56,6% z nich znajdowało się w strefie zwiększonego ryzykawznowy i przerzutów. Cel pracy: Analiza przyczyn niepowodzenia pierwszego leczenianieczerniakowych nowotworów skóry. Wyniki: Niepowodzenie leczenia najczęściej dotyczyło raka podstawnokomórkowego.W tej grupie ponad 66% guzów wykazywałojedną lub więcej cech klinicznych ryzyka wznowy i w 11% obrazagresywności histopatologicznej. Ponad 29% wszystkich zmian leczono bez zweryfikowania histopatologicznego rozpoznania kli ni -cznego. Spośród osób ze wznowami lub niewyleczonymi rakami 75%było poddanych kriodestrukcji. W mniejszości byli pacjenci leczenichirurgicznie, w tym 52% było nowotworów nieradykalnie usuniętych. Wnioski: Niepowodzenia pierwszego postępowania powodująznaczne trudności w dalszym leczeniu chirurgicznym, wiążą sięz dylematami rekonstrukcyjnymi oraz niezbędną uzupełniającą radioterapią w przypadkach trudności uzyskania „czystości” onkologicznej.