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to explain the oft-debated question why some thin M behave aggressively because they possess an early tumorigenic VGP inside them (11). Moreover, any diagnostic report should be also accompanied by further well-known microstaging attributes, such as Clark level, mitotic count, lymphovascular invasion, perineural infiltration, ulceration, satellitosis, tumor infiltrating lymphocytes, and, if available, sentinel lymph node status (12,13). In conclusion, we believe that a renewed histogenetic approach to M diagnosis deserves wide scientific dissemination in order to achieve better clinical management of individual cases in the era of personalized medicine.Giant molluscum contagiosum (MC) is a peculiar variant of the disease with the presence of multiple or single lesions larger than 5 mm. In contrast to typical molluscum contagiosum, dermoscopic features of giant lesions have been poorly described, and none of the reports included multiple giant lesions in an immunocompromised patient. We present a patient with acquired immunodeficiency syndrome diagnosed with multiple giant molluscum contagiosum along with the dermoscopic features of this entity. We examined a 40-year-old patient who had been diagnosed with acquired immunodeficiency syndrome (AIDS) two months earlier. The disease defining AIDS was cerebral toxoplasmosis (initially presenting as a brain tumor several months earlier). Laboratory investigation showed a decreased CD4 cell count of 11 cells/mm3 and HIV viral load of 252 472 copies/mL. The patient was referred to the Department of Dermatology due to multiple flesh-colored, asymptomatic nodules with superficial telangiectasia that had been observed t MC. The observed dermoscopically large yellowish globules seem to correspond with the crypts and the surrounding white structures with the areas of lobulated, endophytic epidermal hyperplasia. The presence of vascular structures in dermoscopy corresponds with the blood vessels tightly surrounding inverted hyperplastic epidermal lobules (Figure 2, b). Dermoscopic features od giant MC are different than those observed in small lesions. Interestingly, the dermoscopic appearance of smaller lesions observed in our patient seemed to be similar to MC eruptions described in immunocompetent patients (1). 4-Deoxyuridine In case of clinical suspicion giant MC coexisting with smaller lesions, dermoscopic assessment of the latter may serve as a clue to diagnosis.Targetoid hemosiderotic hemangioma is an acquired vascular malformation of unknown origin. We report the case of a 31-year-old man with a recurrent and spontaneous regressive targetoid hemosiderotic hemangioma. Diagnosis relied on clinical and histological findings. Physical examination revealed presence of an approximately 2 cm targetoid lesion located on the left arm, and associated with pain after pressure. No trigger agent (trauma, insect sting) was reported. Dermoscopy showed a group of red lacunae centrally, encircled by an intermediate yellow circular homogenous area and a red violaceous homogenous ring in the periphery. The histopathological examination and the immunohistochemical staining of the lesion were characteristic for a hemangioma-like proliferation of vessels in the upper part of the dermis, similar to a targetoid hemosiderotic angioma. We also review epidemiological, clinical, and histopathological findings in 6 similar cases presented in the literature. Spontaneous regression and recurrence have rarely been described in this type of skin lesion.Gout represents a metabolic disorder with systemic echo, in which needle-like crystals of monosodium urate are deposited in various tissular structures. Crystals accumulation in the connective tissue (tophi) represents the late, chronic stage of this disease, usually emerging after an average of 10 years after disease onset. Herein we report three cases of patients aged 70, 33, and 53 who presented with painful subcutaneous nodules located on various body areas. All of them had hyperuricemia. Several conditions had to be investigated in order to establish the etiology of uric acid metabolism alterations. Laboratory and pathology findings established the diagnosis of gout, with tophi as the first symptom of the disease. Following patient education, diet and lifestyle changes, and medication, the outcome in all patients was favorable, with alleviation of the symptoms. Tophaceous gout as a first presentation of this disease is currently uncommon, but dermatologist should be aware of this rare finding for proper management of such cases and to prevent the resultant significant functional and quality of life impairment if not recognized early.Were the women that were compulsorily committed to closed venereology wards in the Soviet Occupation Zone (SOZ) and German Democratic Republic (GDR) prostitutes and sexually promiscuous individuals? 1,241 patient records of the closed venereology ward in Leipzig-Thonberg were researched in the Leipzig Municipal Archive and evaluated using the historical-critical method. Two periods were investigated June 1946 to February 1961 (the period of validity of the Orders of the Soviet Military Administration in Germany - SMAG) and March 1961 to August 1990 (period of validity of the GDR regulation).During the two periods of investigation, 3% of the women compulsorily committed to the closed venereology ward Leipzig-Thonberg were prostitutes. 9% of women were compulsorily committed as sexually promiscuous individuals during the first period of investigation, and 13% during the second period. During the first period, mainly adult women with a venereal disease were compulsorily committed. These women were treated for gonorrhea or syphilis. In contrast, the majority of compulsorily committed individuals during the second period were underage girls without a venereal disease. In conclusions 1) Whereas mostly prostitutes and sexually promiscuous individuals were compulsorily committed to venereology wards in the Federal Republic of Germany (FRG), the proportion of prostitutes and sexually promiscuous individuals in Leipzig-Thonberg was very small. 2) In the 1950s, mostly adult women with venereal diseases were compulsorily committed in the FRG and GDR. 3) A comparison with the closed venereology facility in Berlin-Buch (GDR) shows a similar age distribution among compulsorily committed women in the 1970s and a general decline of venereal diseases.The body of literature supporting the use of Mohs micrographic surgery (MMS) in tumors outside the main indications (basal cell carcinoma, squamous cell carcinoma, dermatofibrosacroma protuberans, lentigo maligna) is constantly growing, but it is still based on case reports, case series, or at best institutional case series that focus on a single malignancy. link2 Our aim in this review was to assess use of MMS in an array of rare tumors outside the usual indications. A review was performed using the MEDLINE database and the search engine ClinicalKey®. We reviewed the use of MMS on atypical fibroxanthoma (AFX)/malignant fibrous histiocytoma, microcystic adnexal carcinoma, extramammary Paget's disease, Merkel cell carcinoma, pocrine/eccrine carcinoma/porocarcinoma, trichilemmal carcinoma, leiomyosarcoma, and angiosarcoma. Mohs micrographic surgery appears to be scarcely used in these tumors due to their low incidence. It is mainly performed for tumors in the H-zone of the face, and can be performed safely. The overall recurrence rate is lower compared with simple or wide local excision. MMS should be used in a more generalized fashion for these tumors.The aim of this study was to determine distribution of the Candida (C.) species in onychomycosis and analyses in vitro susceptibility to fluconazole and itraconazole. In recent years, cases of onychomycosis in Lithuania caused by Candida have increased significantly. In the period between 2009 and 2016, a total of 8149 clinical cases (outpatients and inpatients) were investigated at the Vilnius University Hospital Santaros Clinics (VUH SC). Candida yeasts were identified using VITEK 2 (BioMerieux, France) and IVD Maldi biotyper 2.3 (Bruker Daltonik GmbH, Germany), automated systems for identification of yeasts. The antifungal susceptibility to the Candida species were determined by disc diffusion. Candida spp. were the most frequently isolated pathogens in onychomycosis during the investigation period. The main species in onychomycosis were C. albicans (38.6%), followed by C. krusei (33.7%), C. tropicalis (11.1%), C. parapsilosis (7.9%), and other Candida (8.7%). The different antifungal susceptibility patterns among Candida species confirm the need to perform antifungal susceptibility in vitro testing of yeasts from patients with onychomycosis.Atopic dermatitis (AD) is a common chronic and relapsing, non-contagious inflammatory skin disorder, characterized by skin barrier impairment and baseline immune irregularities. The literature on the relationship between AD and cutaneous delayed-type hypersensitivity is inconclusive. There is an ongoing debate whether contact sensibility (CS) is found more or less often among patients with AD. Aim of the study was to evaluate the incidence of contact sensitivity (positive patch test reactions) in patients with and without AD. We patch tested a total of 2143 patients (563 men and 1580 women). There were 226 patients with history of AD; 61 (27%) men and 165 (73%) women. The patient group without AD consisted of 1917 patients, 502 (26%) male and 1415 (74%) female patients, who were referred to our Department with clinical suspicion of allergic contact dermatitis (ACD). A patch test was performed with the baseline series, and readings were performed on days D2, D3, and D7. Among patients with AD, 109 (48.2%) had a positive patch test reaction to at least one allergen, whereas 1094 (57.1%) patients with no history of AD had a positive patch test reaction. link3 The most common positive allergens in patients with AD were nickel (II) sulfate (13.3%), thimerosal (12.4%), cobalt (II) chloride (11.5%), methylisothiazolinone (MI) (8.4%), fragrance mix I (6.6%), potassium dichromate (5.3%), methyldibromo glutaronitrile (4.0%), and carba mix (4.0%). The results of our study agree with previous findings that there is no significant difference in prevalence of CS between the atopic and nonatopic populations.In October 2020, highly pathogenic avian influenza A(H5N8) viruses were detected in 2 dead swans in Inner Mongolia, China. Genetic analysis showed that the H5N8 isolates belong to clade 2.3.4.4b and that the isolates cluster with the H5N8 viruses isolated in Eurasia in the fall of 2020.Over the last decade, chronic critically ill (CCI) has emerged as an epidemic in intensive care unit (ICU) survivors worldwide. Advances in ICU technology and implementation of care bundles has significantly decreased early deaths of critically ill patients, and have allowed them to survive previously lethal multiple organ failure (MOF). However, more and more survivors leave persistent low grade organ dysfunctions, depend on continues organ support, need to stay in ICU, and become CCI patients. These patients experience a persistent immune dysregulation with persistent inflammation, immunosuppression, and catabolic syndrome. Therefore, malnutrition is an important feature of patients with CCI, and nutritional support is a crucial part of their treatment. The main strategies of nutritional support are as follows providing sufficient calories and proteins with appropriate anabolic agents to promote anabolic metabolism, using immunomodulators to improve immune suppression and inflammatory responses, and supplementing micronutrients to enhance metabolic support.