[Recurrent acral lentigous melanoma successfully treated with Mohs' micrographic surgery. Case report and review of the literature]. / Recidív acralis lentiginosus melanoma sikeres eltávolítása Mohs-féle mikrográfikus sebészi technikával. Esetismertetés és irodalmi áttekintés.

Mohs' micrographic surgery is an approach to selected skin cancer removal that aims to achieve the best prospect of total tumor excision simultaneously with maximal functional and cosmetic preservation. The advantage of the technique is that 100% of the surgical margin of the specimen, including the periphery and deep surface, can be examined intraoperatively by horizontally oriented frozen sections. This method offers cure rates significantly higher than conventional excision or other modalities. Mohs' micrographic surgery is the method of choice for removal of large, recurrent or incompletely excised skin cancers or for tumors located in functional and aesthetic relevant anatomic regions. The authors present a case of a 75-year-old man with a second time recurrent plantar invasive malignant melanoma successfully treated with Mohs' micrographic surgery technique and an immediate reconstruction using split-thickness skin graft.

Protein kinase C isoenzymes differentially regulate the differentiation-dependent expression of adhesion molecules in human epidermal keratinocytes.

Epidermal expression of adhesion molecules such as desmogleins (Dsg) and cadherins is strongly affected by the differentiation status of keratinocytes. We have previously shown that certain protein kinase C (PKC) isoforms differentially alter the growth and differentiation of human epidermal HaCaT keratinocytes. In this paper, using recombinant overexpression and RNA interference, we define the specific roles of the different PKC isoenzymes in modulation of expression of adhesion molecules in HaCaT keratinocytes. The level of Dsg1, a marker of differentiating keratinocytes, was antagonistically regulated by two Ca-independent 'novel' nPKC isoforms; i.e. it increased by the differentiation-promoting nPKCdelta and decreased by the growth-promoting nPKCepsilon. The expression of Dsg3 (highly expressed in proliferating epidermal layers) was conversely regulated by these isoenzymes, and was also inhibited by the differentiation inducer Ca-dependent 'conventional' cPKCalpha. Finally, the expression of P-cadherin (a marker of proliferating keratinocytes) was regulated by all of the examined PKCs, also in an antagonistic manner (inhibited by cPKCalpha/nPKCdelta and stimulated by cPKCbeta/nPKCepsilon). Collectively, the presented results strongly argue for the marked, differential, and in some instances antagonistic roles of individual Ca-dependent and Ca-independent PKC isoforms in the regulation of expression of adhesion molecules of desmosomes and adherent junctions in human epidermal keratinocytes.

[Report on erythroderma and scabies infection in connection with two cases of scabies norvegica]. / Az erythrodermáról és rühatkafertozésrol scabies norvegica két esete kapcsán.

Erythroderma is an inflammation of almost the whole surface of the skin, characterized by erythema, skin infiltration and desquamation. Despite the etiological factors, the generalized inflammation of a large body surface can lead to a life-threatening condition in itself. Parasite infection lies rarely in the background of erythroderma. The Sarcoptes scabiei var. hominis belonging to the mite family is the cause of scabies disease. While the prevalence of "classic" scabies is high world-wide, the more severe and more dangerous form - scabies norvegica - is only seldom observed. Diagnosis and treatment is highly important from an epidemiological aspect. The authors discuss the differential diagnostic problems and epidemiological significance of scabies infection and erythroderma using two cases.

Immunohistochemical examination of P-cadherin in bullous and acantholytic skin diseases.

Autoimmune blistering diseases (pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, dermatitis herpetiformis) and certain genodermatoses with acantholysis (Darier-disease, Hailey-Hailey disease) have different aetiological factors, but all result in bulla formation and/or in acantholysis. Cadherins are Ca++-dependent cell-cell adhesion molecules which play an important role in the cellular connection between normal cells. P-cadherin is involved in the selective adhesion of epidermal cells, and is expressed only on the surfaces of the two basal layers. We examined the expression of P-cadherin in some autoimmune bullous skin diseases and Darier's disease using immunohistochemistry and found P-cadherin to be strongly upregulated. We believe the upregulation is compensatory to the primary pathophysiological events in the various bullous dermatoses.