BIOIMPEDANCE ANALYSIS IN THE DIAGNOSIS OF SKIN CONDITION

The number of visits and calls to doctors with dermatological diseases is growing rapidly every year and every year the number of cases with malignant skin tumors increases catastrophically. In medical practice, the diagnosis of any skin disease occurs by a doctor in several stages: history taking, visual examination with percussion and palpation, referral to the laboratory, if it is really necessary, for additional examination and diseases differentiation. The last stage is the most expensive due to the duration of the analysis process time, and with malignant neoplasms - this is a very critical factor because it affects the effectiveness of the further treatment and survival chance. In addition, without the conclusion of the laboratory and tests to provide recommendations for specialized treatment is almost impossible, because the doctor being in the dark and should act more at random, not at instructions with accurate information and diagnosis. Given this, there is a need for diagnostic tools that will allow dermatologists to quickly and by hand differentiate pathological conditions. The aim of this work is to find significant differences in the values of capacity and impedance of healthy tissues and tissues with cancers of varying severity, lesions, and dislocations. The founded differences can be used to predict and diagnose malignancies and cancer of the upper layers of the skin. Based on the results of experiments, an impedance analyzer of the state of biological tissue is proposed for use, the structural scheme and principle of operation of which is illustrated in the work. The results of this study can serve as a key factor and starting point in the future expansion of the tools of dermatological offices, in order to improve the efficiency of rapid diagnosis and identification of dermatological diseases, without waiting for the results of histological examinations.

Cryodestruction of recurrent malignant skin tumors of different localizations in polyclinics

Introduction. Skin cancer is one of the most common types of malignant neoplasms in Russia. Radiation therapy, surgical intervention, and combined treatment are usually used for skin cancer. Unfortunately, the above methods are not always successful. The reason for the incomplete effect of surgical treatment may be insufficient radicalism of the intervention due to the doctor's desire to cause the least trauma to the surrounding healthy tissues in order to obtain a good cosmetic result. Selective destruction of tumor tissue in cryogenic exposure with minimal damage to surrounding healthy tissues is accompanied by a hemostatic effect, which is especially important in the treatment of both primary and recurrent decaying tumor ulcers. Aim — to evaluate the effectiveness of cryodestruction as the method of choice in the outpatient treatment of recurrent skin cancer. Materials and methods. The study was controlled, non-randomized. The criterion for inclusion in the study was the establishment of the diagnosis of recurrent skin cancer at the application and subsequent treatment in the outpatient clinic of the State Budgetary Institution "Oncologic Dispensary" in Novocherkassk from 2016 to 2020. A total of 532 patients were studied. Patients were planned to undergo tumor cryodestruction with several freeze-thaw cycles, lasting 2-5 minutes. Results. The results of the study indicate high efficiency of cryodestruction. Complete recovery in the treatment of recurrent skin cancer was observed in 446 (83.4%) patients. Repeated cryodestruction was performed in 86 (16.6%) patients, who experienced continued growth and recurrence after cryodestruction within 1 to 18 months. Subsequently, 38 of 86 patients (7.2%) did not experience continuation of growth and new recurrences. Discussion. Based on the literature data and our treatment results it was determined that cryodestruction is the most acceptable and simple method of treatment for this category of patients. Conclusion. In the presence of limited recurrences of skin cancer of various localizations, cryogenic exposure is effective (in 90.6% of the outcome — recovery) in patients of different sex and age, regardless of the location and prevalence of the tumor process and is the method of choice of treatment in an outpatient setting.

Localization on the palmar face of the hand of a Darier-Ferrand dermatofiborosarcoma. About a case

Darier-Ferrand dermatofibrosarcoma is a rare but not exceptional malignant mesenchymal skin tumor, representing 0.1 % of malignant skin tumors. It is characterized by high recurrence, slow growth and low metastatic potential. Although several clinical cases of an unusual variant of Darier-Ferrand dermatofibrosarcoma have been reported in the literature, localization on the palmar face of the hand is not common. We report a case of Darier and Ferrand dermatofibrosarcoma at the level of the fourth commissure of the palm of the left hand in a 43- year-old young Malagasy adult treated by a large surgical excision with a healthy margin of two centimeters associated with adjuvant chemotherapy with Imatinib.

Cutaneous Squamous Cell Carcinoma with Mucinous Metaplasia in Dogs

Background: Squamous cell carcinoma (SCC) is one of the most common malignant skin tumors in domestic animals. Histologically, they are characterized by a proliferation of neoplastic keratinocytes with varied keratin production. Some SCCs have peculiar histological characteristics that permit them to be classified into uncommon to rare histological subtypes, reported in animals and humans. However, according to the authors' knowledge, the mucin-producing subtype described in humans has not yet been reported in animals. In this study, we report the occurrence of two mucin-producing SCCs in dogs, a histological presentation similar to that seen in cutaneous SCCs with mucinous metaplasia in humans.Cases: Two dogs, a 5-year-old Yorkshire female and a 17-year-old Dachshund male, had a skin nodule near the tail and on the right eyelid. The nodules varied from 1 to 5 cm in diameter, were firm and covered with skin and hair. The cut surface was firm and white. Histological findings were compatible with squamous cell carcinoma, characterized by a neoplastic proliferation of keratinocytes originating in the epidermis and infiltrating the dermis. The keratinocytes were arranged in islands and occasional anastomosed cords, supported by a fibrous stroma. The formation of pearls varied from moderate to sparse. The nuclear and cellular pleomorphism was accentuated in case two and moderate in case one. Mitosis figures ranged from two to five in a high magnification field. Within the neoplasm, there were large vacuolated neoplastic cells with slightly fibrillar intracytoplasmic basophilic content. This content has been rarely observed in an extracellular medium. The presence of mucin was confirmed by positive Alcian Blue (AA) staining. In immunohistochemistry (IHC), tumor cells showed strong immunostaining for pancitokeratin, and in areas with marked mucin deposition, immunostaining was predominantly moderate to weak. No tumor cells were immunostained for CD34 and Blc-2 antibodies. Compared to AA and Harris' hematoxylin, it was possible to demonstrate the presence of mucin in the cytoplasm of neoplastic keratinocytes using IHC. No vascular or lymphatic invasion by neoplastic cells was observed. The average cell proliferation index assessed by counting the nucleolar argyrophilic organizing regions (AgNOR) was 3.4 in case 1 and 4.5 in case 2.Discussion: Although the SCC routinely does not present a diagnostic challenge in veterinary practice, the histological presentation of the reported cases does not fit the current classification available in veterinary medicine. The histological presentation observed in these two dogs is similar to that described for cutaneous SCCs with mucinous metaplasia in humans, and so far not described in animals. The observation of intracytoplasmic mucin in humans is an essential finding for the diagnosis of SCC with mucin metaplasia. In the present cases, we observed a slightly basophilic amorphous substance in the cytoplasm of proliferated neoplastic keratinocytes, which stained strongly in blue when applied the Alcian Blue (AA) histochemical technique. This observation became more evident when using IHC counterstained with AA and Harris hematoxylin. In the histological analysis, the absence of an adenoid growth pattern or glandular formation amid neoplastic proliferation ruled out the possibility of a mucinous adenocarcinoma or a mucoepidermoid carcinoma. In addition, we could rule out a follicular neoplasia, including keratinizing infundibular acanthoma due to the absence of a central pore and the absence of immunostaining for CD34 and Bcl-2. These immunohistochemical findings, together with histological findings, reinforce the diagnosis of SCC with mucinous metaplasia in our dogs.

Xeroderma Pigmentosum in Children: Report of 4 Cases

: Xeroderma pigmentosum (XP) is a rare genetic disorder inherited in an autosomal recessive pattern. Patients with XP are extremely sensitive to ultraviolet (UV) radiation that leads to defective DNA repair. People with XP often suffer from problems in the eyes, face, neck, and other areas of the body, frequently exposed to sunlight. It is characterized by photosensitivity, dry skin, pigmentary changes of the skin, premature skin aging, and a considerable increase in incidence rates of malignant skin tumors. There is no cure for XP. In this article, we have described four patients from two families, three of whom had malignant skin tumors.

Dramatic invasion of the orbit by periocular cutaneous squamous cell carcinoma

The periocular skin is susceptible to numerous benign and malignant neoplasms. Malignant skin tumors of the periocular area are very particular; they can present differently, are rapidly aggressive and pose a real therapeutic challenge. Aggressive forms occur mostly in immunocompromised individuals. A complete destruction of the orbit is rare and the initial seat is most often the eyelid. We report the case of an immunocompetent 70-year-old patient with destruction of the entire orbital region including the eyeball secondary to the extension of squamous cell carcinoma of the internal canthus.

Comparative analysis of the effectiveness of «Chaos and Clues», «Triage Amalgamated Dermoscopic Algorithm» dermatoscopic algorithms and BLINСK techniques in the diagnosis of melanoma and other skin cancers depending on previous dermatoscopy experience

Aim.Comparison of the results of the use of dermatoscopic algorithms Chaos and Clues, Triage Amalgamated Dermoscopic Algorithm (TADA) and BLINCK technique in the diagnosis of melanoma and other malignant skin tumors depending on the presence of previous dermatoscopy experience. Materials and methods.Algorithms were tested on 85 patients with 85 skin formations who visited the polyclinic of Kursk Regional Clinical Oncology Clinic in 20172019. The average age of the patients was 54.8 years old. Dermatoscopy was performed by the non-polarized dermatoscope HEINE mini 3000, photo documentation by the Canon PowerShot SX540 HS camera. Immersion medium ethyl alcohol (conc. 70%). Patients were carefully examined physiologically and clinically. A clinical and epiluminescence pattern of all neoplasms was obtained, their morphological examination was performed. For the research 2 groups of 3 participants were formed based on the criterion of previous dermatoscopy experience. Each algorithm was evaluated by objective (sensitivity, specificity) and subjective (speed, convenience) criteria. The dermatoscopic results obtained by the techniques used were compared to the histological findings. Results. Using algorithms by a group having previous dermatoscopy experience, the following results were obtained: in the method Chaos and Clues sensitivity 93.753.3%, specificity 77.44.6%, speed 3 points, convenience 3 points. TADA sensitivity 96.82.2%, specificity 79.24.8%, speed 4 points, convenience 5 points. BLINCK sensitivity 96.82.2% specificity 77.44.6%, speed 4 points, convenience 5 points. In the group with no previous dermatoscopy experience, the results were as follows: in the Chaos and Clues algorithm, sensitivity 93.753.3%, specificity 62.35.7%, speed 3 points, convenience 3 points. TADA sensitivity 84.44.6%, specificity 64.25.8%, speed 4 points, convenience 5 points; BLINCK sensitivity 80.64.4%, specificity 77.44.6%, speed 5 points, convenience 4 points. Thus, these algorithms can be used in the diagnosis of malignant skin neoplasms. At the same time, individuals with no experience of dermatoscopy are encouraged to use the Chaos and Clues algorithm. In a group having experience in dermatoscopy, both the TADA and the BLINCK technique can be used equally.

Epidermodysplasia Verruciformis: A Case Report

Epidermodysplasia verruciformis (EDV) is a rare, inherited disorder that is characterized by an increased susceptibility to infection with specific human papilloma viruses (HPV) and a greater propensity for developing malignant skin tumors. A 26 years old Nepalese male patient presented with complaints of multiple asymptomatic raised warty lesions on bilateral hands and multiple light colored flat to raised lesions present over the neck, trunk, bilateral extremities sparing the face and genitals.A skin biopsy was performed which revealed hyperkeratosis, focal parakeratosis, acanthosis, keratinocytes were swollen and irregularly shaped, had abundant basophilic cytoplasm and contained numerous round basophilic keratohyaline granules. Nuclei were large, round and empty with marginal distribution of chromatin, some were pyknotic. Epidermodysplasiaverruciformis is a rare inherited disorder spread by HPV. It is characterized by hypopigmented or hyperpigmented macular lesions, pityriasis versicolor-like lesions and an early tendency to develop skin malignancies. The management of EDV includes early diagnosis, sun protection, life-long observation for the malignant transformation and therapeutic modalities like acitretin, imiquimod, topical retinoids, cryotherapy, etc.