Spatial substantiation of linear parameters of biopsy in histological examination of pigmented skin neoplasms in children

Usually the lower part of melanocyte nevi is at a depth of not more than 1–2 mm or more, which is typical for congenital nevi, as well as for large pigmented tumors that protrude significantly above the skin surface and have a pronounced intradermal part. Incomplete removal of pigmented nevi occurs during their superficial removal with insufficient capture of healthy tissues. When excision of pigmented nevi by acute method means in the vast majority of cases of incomplete removal can be avoided, and primarily because the suturing of the edges of the postoperative wound requires much deeper excision of tissues. Рurpose – to increase the effectiveness of surgical treatment of pigmented skin tumors in children by using a mathematical model. Materials and methods. The study was conducted on the basis of the oncohematology department of Vinnytsia Regional Children’s Clinical Hospital, a mathematical model for calculating the parameters of operational access was conducted on the Microsoft Excel platform. Results. Using the proposed mathematical model, the following parameters of the operating material were calculated: the area of the resection edges of the operating material; the area of the base of the operating material; the total area of morphological examination of the surface of the surgical material; determining the difference in the volume of surgical material to be histologically examined by different methods of its collection. In all cases, the tumor for three-dimensional histological examination was excised in the form of an ellipse with a safety zone (healthy tissue around the tumor). The surgical direction of the incision was formed with an inclination to the surface of the skin towards the tumor with the formation of an acute angle with it, while the upper part of the dermis was cut less than its lower part. This approach to the formation of the profile of the surgical wound improves the conditions for further reconstructive wound defect closure. Conclusions. Comparative mathematical calculation according to the proposed spatial geometric model of the biopsy in the form of a truncated elliptical cone convincingly shows an increase in the useful volume of surgical material in the planned histological examination compared with the cylindrical elliptical configuration of the biopsy due to involvement in the field of microscopic structures «residual structures» (processes) corresponding to melanocyte nevi, under the guise of which the development of the initial stages of melanoma may occur. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: children, melanocyte nevi, operative accesses.

Physiological changes of the skin during pregnancy

The appearance of skin changes during pregnancy is inevitable and physiologically determined. This period is characterized by hormonal, immunological and metabolic changes and associated physiological changes in the skin. These include pigmentation (linea nigra, melasma, pseudoacanthosis, growth and appearance of pigmented nevi), changes in connective tissue (striae distensae, skin tags), blood vessels (stellate hemangiomas, erythema of the palms, vasodilatation, edema, cutis marmorata) and skin appendages (increased sebaceous and eccrine glands activity, reduced hair loss and increased hair density, onychodystrophy). It is important to inform women about possible changes, to recognize them in time to reduce the impact of their appearance on the health and course of pregnancy, as well as to avoid unnecessary tests and interventions.

Robotic intelligence in the organization of pre-medical diagnostics of the risk of tumor diseases

Based on the creation of a robotic complex, the analysis of clinical observations of 1053 patients was carried out, by means of a survey with illustrations, in which 106 (30.4 4.6%) later revealed a malignant process. In 53 patients with microscopy of pigmented nevi, other tumors and precancerous changes in visual localization, oral cavity, in which 13 (72.2% 1.1) had melanoma and other tumors. In 75 patients, based on the survey, a urease breath test was required, on the basis of which, if it was present for more than 10 units, FGS was performed, while in 12 cases, peptic ulcer in the acute stage or scarring, chronic gastritis with metaplasia zones, and in 4 (11.7 0.9), stomach cancer was detected. The survey was conducted with the participation of clinical residents and students on Open days and at the request of patients after 3 advertising exhibitions

Tick infestation masquerading as a nodule in the eye lid

Introduction: Ticks are ectoparasites which can lead to various blood borne diseases. Tick bite may resemble pigmented nevi, mole or nodule resulting a diagnostic dilemma. Tick bite in eye lid is rare and this case report describes tick bite in lower eye lid mimicking a traumatized pigmented nodule where the tick was identified only on magnification and was successfully removed mechanically. Case: A 61-year-old man presented to the eye out patient department with a sudden and painful black pigmented lesion on the right lower lid for four days. The tick was manually removed with forceps. Conclusion: This case report explains the need for a high index of suspicion as tick bite in sudden or recent onset pigmented lesions especially in endemic areas.

Dermatoscopy in the diagnosis of pigmented nevi

The high incidence of melanoma and unsatisfactory results of its treatment in some cases make the issue of timely diagnostics of pre-melanoma skin pathology, in particular the identification of pre-melanoma pigmented nevi, of great importance and can be used for choice an adequate tactics of treatment. The purpose of the study was to evaluate the informativeness of dermatoscopy in cases of patients with pigmented nevi of skin as a part of melanoma prevention. 168 patients with pigmented nevi were screened. All nevi were photographed with a digital camera SONY Cyber-Shot DSC-H3, first in normal mode with the capture of the localization zone of the tumor and its surrounding tissues, and then in macro mode (“Zoom 10”). To confirm the clinical diagnosis, additional characteristics of the pigment formation on the skin, the manual immersion dermatoscopy, was used using the contact non-polarized HEINE mini 3000 LED dermatoscope. Evaluation of images was carried out using the diagnostic algorithm ABCD and ABCD-E. Our findings suggest that the clinical diagnostic algorithm used by us for detecting signs of the activation of a pigmented nevi is highly informative — the sensitivity is 97.6 %. Performing immersion dermatoscopy allows to increase the informativeness of the clinical and instrumental examination at the preoperative stage up to 98.2 %, which is comparable with the data obtained at the stage of urgent cytological examination: the method sensitivityis 98.2 %.

Clinical and cytogenetic features of 516 patients with suspected Turner syndrome – a single-center experience

Background: Clinical suspicion of Turner syndrome (TS) may be challenging. Short stature and absent puberty are not mandatory and the dysmorphic picture is widely variable. The aim of the study was to describe a representative sample of patients with suspected TS in a single center and to verify which set of features may help discriminate those with TS. Methods: This was a retrospective study of patients with suspected TS evaluated between 1989 and 2012 with the same clinical and cytogenetic protocols. Data regarding reason for referral, age and height at diagnosis, birth data, pubertal features and dysmorphisms were analyzed. Results: TS was diagnosed in 36% of 516 patients; structural chromosome anomalies predominated (42%). Short stature was the main reason for referral of patients with and without TS. The mean age of patients at first visit, with TS or without TS was similar (11.89 and 11.35 years, respectively), however, infants and adolescents predominated in the TS group. The mean full-term birth weight was lower in patients with TS as well as height at diagnosis, but normal height z-score was found in 17% of patients. Spontaneous puberty occurred in 30% of TS patients aged 13 years or more, but most had pubertal delay. Residual lymphedema, webbed neck, cubitus valgus, hyperconvex nails, shield chest, abnormal nipples, pigmented nevi, short fourth metacarpal and shorter height were the best discriminators for girls with TS. Conclusions: Though short stature, pubertal delay and typical stigmata should prompt investigation of TS, lack of one of these features should not exclude this hypothesis. Dysmorphisms other than those considered “typical” should be sought on physical examination.