Vesna Milicic

Actinic reticuloid presented as facies leonine

Kyriakos P. Kyriakis, MD, MPH Koumanoudi str 52 Athens 11474 Greece E-mail: fountou@otenet.gr References 1 Yeatman JM, Kilkenny M, Marks R. The prevalence of seborrhoeic keratoses in an Australian population: does exposure ton sunlight play a part in their frequency? Br J Dermatol 1997; 137: 411–414. 2 Rothman KJ. Stratified analysis. In: Modern Epidemiology. Boston, MA: Little Brown, 1986: 177–239. 3 Memon AA, Bothwell J, Tomenson J, Friedman PS. Prevalence of solar damage, keratosis and skin cancer in an English population. Br J Dermatol 1995; 132: 646.

Laparoscopic Splenectomy in the Treatment of Hematological Diseases of the Spleen

Abstract Methods of surgical treatment of hematological diseases of the spleen have changed significantly in the past decade. The introduction of laparoscopic and minimally invasiveprocedures as standard for solving a significant number of conditions in abdominal surgery, has led surgeons toincreasingly use laparoscopic surgery of the spleen. However, some unique anatomical characteristics of the spleen can lead to limitation in the application of laparoscopy. In this study, we investigated the application of laparoscopic splenectomy in the treatment of haematological disorders of the spleen, intraoperative and postoperative characteristics, the presentation ofoperational technique and the evaluation of the success of this procedure. In the treatment of benign hematological diseases, the effectiveness and efficiency of laparoscopy has been proven. The speculation of medical professionals is that laparoscopic splenectomy is an equal, if not the superior way of treating benign hematological diseases of the spleen in relation to the open procedure, and that there is a chance that laparoscopy might completely replace the classical surgery in most of it’s indications.

Generalized Pustular Psoriasis in Association with Squamous Cell Carcinoma of the Hypopharynx

Abstract Pustular psoriasis is an uncommon form of psoriasis consisting of widespread pustules on an erythematous background. Very rarely pustular psoriasis represent a paraneoplastic dermatosis. In this report we describe a case of generalized pustular psoriasis (GPP) associated with advanced, inoperable, metastatic squamous cell carcinoma of the hypopharynx. We suggest that physicians should be alert for the worsening of existing psoriasis or formation of novel psoriasiform eruptions and should undertake clinical evaluation of possible neoplastic disease.

Atrophoderma of Pasini and Pierini associated with extramedullary plasmacytoma.

A 34-year-old man presented with a 3-month history of well-defined, symmetrical lesions localized in his axillae and on both sides of the trunk. His medical and family history was unremarkable. He had initially been treated by his general practitioner with 40 mg/day of prednisolone for 7 days, with tapering of the dose during the following 2 weeks. As there was no improvement, the patient was referred to us for further examination and treatment. On physical examination, asymptomatic, hyperpigmented, nonindurated, slightly depressed plaques with distinct, abrupt margins were seen on the patient’s skin (Fig. 1a,b). Histopathological examination showed a normal epidermis, a mild mononuclear perivascular infiltrate and homogenization of collagen fibres with unaffected adnexal structures in the dermis (Fig. 2a). The collagen fibres stained blue with Masson trichrome staining (Fig. 2b). Laboratory investigations showed that erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated. Complete blood count, biochemical analysis and urine analysis were within the normal range. Serological examination for Borrelia burgdorferi and virological analyses (hepatitis C and B virus, human immunodeficiency virus) were negative. Chest radiography and abdominal ultrasonography did not reveal any abnormalities. A diagnosis of atrophoderma of Pasini and Pierini (APP) was made, and the patient was treated with oral doxycycline 200 mg/day for 14 days and local potent corticosteroid ointment, but there was no clinical improvement. Three months later, the patient developed dyspepsia. Gastroduodenoscopy did not show any abnormalities, but suspected retroperitoneal lymphadenopathy was observed with abdominal ultrasonography and confirmed with computed tomography scanning. Enlarged lymphatic nodes (diameter 57 mm) were present in the retroperitoneum (Fig. 2c). A laparotomy of the retroperitoneal lymph nodes and affected part of colon was performed. A diagnosis of extramedullary plasmacytoma (EMP) was postulated based on the clinical (painless, firm and solitary tumour formation, 100 mm in diameter in epigastrium), histopathological (tissue biopsy showed presence of plasma cells) and immunohistochemical

Generalized eruptive xanthomas associated with diabetic dyslipidemia

A 39-year-old, obese male, (body mass index 41.3 kg/m2) presented to the Department of Dermatology with generalized, diffuse, pruritic skin lesions. According to the patient, the first skin lesions had begun to appear a few years before, on the extensor side of the elbows and shoulders. Two months before dermatological examination, new skin lesions appeared in crops on the trunk and extremities, with a tendency to generalization. Physical examination showed small, generalized, pruritic, yellowish [...]