Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society.

BACKGROUND: The dermoscopic features of classic patch stage mycosis fungoides (MF) have been described, but data on plaque and tumoral stage as well as rarer MF subtypes is limited. OBJECTIVE: To evaluate dermoscopic morphology and dermoscopic-pathological correlations of classic MF stages and investigate dermoscopic features of MF variants. METHODS: Patients with histopathologically confirmed lesions of classic MF (patch, plaque and tumoral stage) or folliculotropic, erythrodermic and poikilodermatous MF were included. Standardized evaluation of dermoscopic pictures of the included MF variants and comparative analysis and dermoscopic-pathological correlation assessment of different stages of classic MF were performed. RESULTS: A total of 118 instances were included (75 classic MF, 26 folliculotropic MF, 9 erythrodermic MF and 8 poikilodermatous MF). Linear/linear-curved vessels and white scales in the skin furrows were significantly associated with patch-stage MF, while clustered dotted vessels were related to plaque-stage MF and peripheral linear vessels with branches, ulceration and red globules separated by white lines to tumour-stage MF. Moreover, patchy white scales were significantly more common in patches and plaques compared to tumours, whereas focal bright white structureless areas were related to plaque and tumoral stage. Vessels histopathologically corresponded to dilated vascular structures in the dermis, orange structureless areas to either dermal hemosiderin (patch/plaque stage) or dense cellular infiltration (tumours), bright white lines/structureless areas to dermal fibrosis and ulceration to loss of epidermis. The main dermoscopic findings of folliculotropic MF were lack of hairs, dilated follicles and follicular plugs, while erythrodermic MF was mainly characterized by linear/dotted vessels, patchy white scales and focal orange structureless areas and poikilodermatous MF by focal white and brown structureless areas, white patchy scales and brown reticular lines. CONCLUSION: Dermoscopy may allow a more precise characterization of classic MF and reveal clues suggestive of the main MF variants.

Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta with fatal outcome.

Ulceronecrotic Mucha-Habermann disease is a severe, febrile form of pityriasis lichenoides et varioliformis acuta. The condition may sometimes have a fatal outcome, especially in elderly patients. In this paper, we are reporting on a 60-year-old male patient who suffered from the eruption of erythematous, haemorrhagic, ulceronecrotic papules accompanied by high temperature. Erosions and ulceronecrotic papules covered over 80% of his body. Three weeks after his admittance to our hospital, clinical signs resembling ileus together with the leucocytosis occurred. The patient was transferred to the department of internal medicine and later to the surgery department. The fulminant course of the disease could not be stopped, and the patient died of severe intestinal and colon gangrene caused by the massive thrombosis of superior mesenteric artery. Up to date, only 23 cases of this severe form of the disease have been reported, and even with the early recognition, fulminant course may lead to death.

The biomechanical aspect of testis hydrocele.

The liquid content of the hydrocele or watery hernia presses blood vessels of the testis. This pressure occurs in the accordance with hydrostatic and hydraulic laws. However, none of 223. 568 studies on the pressure in mammalian organisms registered worldwide has reported on the pressure values in case of testis hydrocele. Results obtained by observation of 20 patient with testis hydrocele suggested that the hydrostatic pressure of testis hydrocele always surpassed the pressure of blood vessels within the scrotum, proving that the pressure of a fluid as a mechanical factor plays an important role in the malfunction of spermatogenesis as well as in hypoxemic hypoxia of the testis.

Biomechanical aspect of supravesical urine derivation by Bricker's method.

The findings obtained by excretory urography in 15 patients of various age and occupation confirmed the study premise that in the upright position after the procedure of supravesical urine derivation as described by Bricker, the isolated segment of the ileum does not function as a conduit but forms a siphon-like receptaculum which, according to the laws of liquid mechanics, prevents or reduces the ascent of gases and bacteria into the upper urinary ducts. This also appears to be a logical explanation for a decreased incidence of infection of proximal urinary ducts in Bricker's method of supravesical urine derivation as compared to other mechanically comparable surgical procedures.

A biomechanical aspect of the lumbal approach to the kidney.

Functional differences between surgically attacked musculature of the lumbal region and intact musculature of the contralateral side were assessed in 71 patients by the method of Multic-Labar, Moire topography, electromyography and X-ray analysis of the thoraco-lumbar spine. The following conclusions were derived from the results obtained. In the intact musculature of the lumbal segment of the spine, sliding forces reached 200 kN in males an 170 kN in females aged >25 and <30 years. In younger and older age groups, the values were lower, assuming a form of the ascending and descending limb of a parabole, respectively. Upon healing, the lumbal musculature damaged by surgical resection showed decreased values of the pulling and sliding forces by 15 and 25 kN on an average, respectively, as definite values independent of age and sex. Kinematic alterations included myogenic geneses of a stationary form, with normal innervation, involving the whole damaged musculature. Summa summarum, results of analyses suggested the values of kinematic forces of pulling and sliding forces of the musculature damaged by surgical resection to be definitely significantly reduced, thus confirming the premise of the study.