MULTIPLE MUSHROOM-LIKE GROWING CYLINDROMAS OF THE SCALP (TURBAN TUMOR) IN A PATIENT WITH BROOKE-SPIEGLER SYNDROME: UNIQUE MANIFESTATION IN A BULGARIAN PATIENT.

Cutaneous cylindromas are rare, slow-growing adnexal tumors commonly found on the capillitium or face. When located on the capillitium, they can cluster together, forming a headgear-like structure that gives the characteristic "turban" appearance. Brooke-Spiegler syndrome, an autosomal dominant condition, is typically benign, though malignant transformation can occur.

DERMATOFIBROSARCOMA PROTUBERANS: WIDE LOCAL EXCISION AS DERMATOSURGICAL APPROACH WITH FAVOURABLE FINAL OUTCOME-CASE PRESENTATION AND SHORT UPDATE ON THERAPEUTIC OPTIONS.

Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade cutaneous sarcoma typically found on the proximal extremities and the trunk, characterized by infiltrative growth and low risk of metastasis. High rates of local recurrence or relatively large tumor sizes can significantly complicate therapeutic management, particularly when 1) surgical intervention is not adequately performed and /or 2 access to newer medications is limited or their high cost imposes a financial burden on patients. We present the case of a 63-year-old male with a histologically confirmed dermatofibrosarcoma protuberans, measuring 6 cm in diameter, located on the right dorsal region, accompanied by several confluent multifocal nodules situated infralaterally to the primary formation.

EFFECTIVENESS AND TOLERABILITY OF APREMILAST IN TREATMENT OF A SAMPLE OF PATIENTS WITH PSORIASIS.

Aim: Current study was aimed to appraise the effectiveness and tolerability of apremilast in psoriasis patients at AL-Diwaniyah province, Iraq.

Materials And Methods: This prospective cross-sectional study conducted at Dermatology Unit/ AL-Diwaniyah Teaching Hospital/ Iraq, during the period from January to October 2023. A total of 125 patients, 90 males and 35 females, were enrolled in this study.

DERMATOLOGIC SURGERY: ROTATION ADVANCEMENT FLAP AS FIRST LINE TREATMENT FOR HIGH-RISK SQUAMOUS CELL CARCINOMAS OF THE PERIOCULAR/PERIORBITAL ZONE- PRESENTATION AND DISCUSSION ABOUT 2 NEW CASES.

Rotation advancement flaps are a challenge for dermatosurgery and in particular the severe clinical cases, mainly affecting skin tumors in the facial area or the so-called ˝high risk areas˝. The proximity of these areas to important vital structures (such as nerves and blood vessels) also determines the need for more precision when performing this type of manipulation. Teamwork and preoperative planning are crucial and provide a number of advantages in terms of the timely achievement of the therapeutic endpoints.

SHARK PEDICLE ISLAND FLAP FOR BASAL CELL CARCINOMA OF THE PERIALAR ZONE OF THE NOSE: PHOTOXICITY AND PHOTOCARCINOGENICITY MEDIATED BY POTENTIALLY NITROSAMINE CONTAMINATED DRUG INTAKE -A NEW EXPLANATION FOR THE SKIN CANCERS PATHOGENESIS?

Modern skin cancer pathogenesis includes new concepts such as nitroso photocarcinogenesis and nitroso-mediated photosensitivity. The above 2 new concepts are in all likelihood also modeled/determined by photocarcinogens known as nitrosamines and/or NDSRIs available as contaminants in many drugs worldwide. The phototoxicity of nitrosamines is a known nonspecific property of them, for which evidence exists as far back as 1972.

CLINICAL PREDICTORS OF BLASTOCYSTOSIS TREATMENT EFFICACY.

Improvement of methods and criteria for diagnostics of human blastocystosis and selection of drugs for etiotropic therapy remain urgent scientific tasks of the present day. Clinical manifestations of blastocystosis in humans are diverse, and in this regard, their influential role on the effectiveness of blastocystosis therapy cannot be excluded. To assess the predictor properties of clinical symptoms, we retrospectively analyzed them in 300 patients with blastocystosis in alternative groups: group A - with good therapeutic effect (n=162) and group B - with satisfactory effect (n=138).

Negative Pressure Level and Effects on Bacterial Growth Kinetics in an Wound Model.

Negative Pressure Wound Therapy (NPWT) has been widely adopted in wound healing strategies due to its multimodal mechanism of action. While NPWT's positive impression on wound healing is well-established, its effect on bacterial load reduction remains equivocal. This study investigates NPWT's efficacy in reducing bioburden using an porcine skin model, focusing on the impact of and .

(NDMA) METFORMIN AND (NTTP) SITAGLIPTIN INDUCED CUTANEOUS MELANOMAS: LINKS TO NITROSOGENESIS, NITROSO-PHOTOCARCINOGENESIS, ONCOPHARMACOGENESIS AND THE METABOLIC REPROGRAMMING.

Changing the vision, understanding, interpretation and analysis of certain data or scientific dilemmas is what is able to change the status quo and revitalize a mission, an impulse or important thoughts, thus creating the conditions for it to increase immensely the chances of bringing it to success. Or, following Albert Einstein's postulate: ˝We cannot solve our problems with the same thinking we used when we created them˝, we should think: ˝Where does the road to success start? How do we solve or neutralize a problem? ˝ And the answer is: ˝ By taking a consistent and systematic approach, analyzing each component! And we eliminate every possibility of negative influence.˝ These thoughts apply with full force to cancer rates in general, but also to melanoma rates in particular: the murderous tempo of globalization and modernization in medicine has not yet led to the desired decrease in these rates; on the contrary, they are rising headlong and remain largely unpredictable and difficult to regulate.

EDUCATION FROM DERMATOLOGISTS: THE SIMULTANEOUSLY DEVELOPMENT OF 16 KERATINOCYTIC CANCERS AFTER USE OF METFORMIN IN COMBINATION WITH LOSARTAN/ HYDROCHLOROTHIAZIDE, METOPROLOL AND NIFEDIPINE- IMPORTANT LINKS TO DRUG RELATED (PHOTO)-NITROSO-CARCINOGENESIS AND ONCOPHARMACOGENESIS.

Oncopharmacogenesis and Drug-Induced Skin cancer related Nitrosogenesis are newly introduced concepts in the medical literature that owe their genesis or presence to the carcinogens/ mutagens, also known as nitrosamines/NDSRIs, which are present in a heterogeneous class of drugs. The contribution to the origin of these 2 concepts is entirely due to 1) the functions and efficacy of FDA in terms of control and identification of these carcinogens, and 2) the establishment of clinicopathological correlations by the dermatologists, occurring during drug intake. According to recent FDA data, the concentration of NDMA in just one metformin tablet could be up to more than 5-fold increased.

PERIOCULAR HIGH RISK BCCS AFTER ADDITIONAL/PARALLEL INTAKE OF TORASEMIDE, MOXONIDINE AND MIRABEGRON: IMPORTANT LINKS TO SKIN CANCER RELATED (PHOTO-) NITROSOGENESIS IN THE CONTEXT OF PHARMACO-ONCOGENESIS.

The Nitrosogenesis of skin cancer is a modern newly introduced concept in medicine, mainly concerning melanoma, but also keratinocytic cancers such as basal cell carcinoma. The nitroso-contamination of more than 300 drugs worldwide and the permanent (relatively short-term) intake of mutagen-contaminated drugs could create serious prerequisites for the development of skin cancer. Retrospective but also prospective analyses following potentially contaminated polymedication with a heterogeneous type of nitrosamines in real patients are indicative of a causal connection rather than a sporadic association between 1) intake of a possibly nitrosamine-contaminated drug and 2) generation of keratinocytic skin cancer.

DRUG RELATED NITROSOGENESIS, PHOTOCARCINOGENESIS AND ONCOPHARMACOGENESIS OF NODULAR MELANOMA: A CASE RELATED ANALYSIS CONCERNING THE POLYCONTAMINATION OF THE POLYMEDICATION WITH VALSARTAN/HYDROCHLOROTHIAZIDE AND BISOPROLOL.

Despite the fact that the pathogenesis of cutaneous melanoma is shrouded in mystery, factors that have been neglected or unnoticed until now have come to the attention in recent years, and in all likelihood, they could also be pivotal. These factors, known as nitrosamines or NDSRIs, are characterized by high carcinogenic and mutagenic potency, and some of them have demonstrated these properties to human DNA as well. Unfortunately, these ingredients also turn up as contaminants in about 300 of the most widely distributed drugs worldwide.

POSTNATAL CARE AMONG POSTPARTUM WOMEN DURING HOSPITAL DISCHARGE.

The postpartum period is the most important part of the woman's health care, as serious and life-threatening complications can occur during this period. The purpose of this study was to gather information on women's perception regarding postnatal care. The study enrolled 100 postpartum women who attended all the postnatal services at the Obstetrics and Gynecology Clinic in Pristina, Kosovo.

MORPHEAFORM BCC OF ALA NASI: A SUCCESSFUL DERMATOSURGICAL APPROACH BY TRANSPOSITION FLAP FROM THE ADJACENT AREA. CONTAMINATION OF VENLAFAXINE, BISOPROLOL AND OLANZAPINE WITH NITROSAMINES/NDSRIS: THE MOST LIKELY CAUSE OF SKIN CANCER DEVELOPMENT AND PROGRESSION.

Two steps are able to lead to a significant decrease in the incidence of skin cancer overall and/or to its parallel and successful surgical treatment. The first step concerns its non-occurrence or less frequent clinical manifestation and is largely related to the modern concept known as prevention, but not the one mainly related to solar radiation, but: 1) informing patients about the possible contamination of certain drugs with carcinogens/nitrosamines/NDSRIs and 2) making clinicians aware of the modern concept of limited to completely eliminated intake of nitrosamines/NDSRIs in medications. The ineffectiveness of either of these entities could in all likelihood be seen as one of the major causes of the headline growth in the incidence of skin cancer and keratinocytic cancer in particular.

NANOPARTICLES AND COLORECTAL CANCER: CAN THE USE OF METAL NANOPARTICLE COMPOSITIONS AFFECT OXIDATIVE STRESS MARKERS AND COLON HISTOLOGICAL CHANGES UNDER DMH-INDUCED CARCINOGENESIS.

Colorectal cancer (CRC) - a significant global health challenge. Exploring biological markers of oxidative stress is crucial, as they can play an essential role in initiating the transition from an organ's "healthy state" to a "malignant injury." There is substantial promise in investigating the level of 8-isoprostane (8-isoPGF2α) as a novel and dependable marker of oxidative stress.

"THE DANGEROUS BRASSIERE" AND THE NEVUS ASSOCIATED POLYPOID MELANOMA: CONNECTION SEEMS PLAUSIBLE?

The development of cutaneous melanoma of the skin based on dysplastic nevus is not uncommon. The causes of the progression of nevi to melanomas are numerous and not well understood at present. Certain genetic and epigenetic factors have a major influence on this evolution.

SUBUNGUAL HEMATOMA OVERLAPPING WITH SUBUNGUAL LOCATED FOCAL MELANOCYTIC HYPERPLASIA: DERMATOSURGICAL APPROACH AS OPTIMAL TREATMENT CHOICE.

Subungual lesions present a serious challenge for clinicians. The following factors can cause certain problems in interpreting the data: 1) Changes in lesion morphology over time: It may indicate the presence of a malignant lesion (increased pigmentation over time and lack of distal growth) but may actually be a benign lesion (chronic persistent subungual hematoma). 2) Patient's medical history can be misleading or difficult to verify, especially in problematic patients, or those with mental health problems or communication disorders (e.

ADVERSE DRUG EVENTS: LICHEN PLANUS OF THE PENIS AFTER INTAKE OF NEBIVOLOL- FIRST REPORTED CASE IN THE WORLD LITERATURE.

The pathogenesis of lichen planus and lichenoid-type reactions remains shrouded in mystery to this day, precisely because of the inability to perform acute/specific tests for reproduction of a particular type of reaction (in this case lichenoid) in order to prove a causal relationship. Nevertheless, the concept of molecular mimicry/antigen mimicry as a possible important pathogenetic inducer for lichen planus and lichenoid-type reactions, is increasingly becoming a topic of discussion and remains more than relevant at present. Disturbances in the integrity of tissue homeostasis- in one form or another, in fact, become a powerful generator of cross-mediated immunity, possibly directed at tissue-localized structures/structural elements/proteins or amino acids.

CONGENITAL LYMPHANGIOMA OF THE FOOT MIMICKING MULTIPLE VIRAL WARTS: DERMATOSURGICAL APPROACH WITH SECONDARY WOUND HEALING AND FAVOURABLE FINAL OUTCOME.

The problems with lymphangiomas in general stem from the fact that on the one hand they most often show an atypical clinical picture, and on the other hand their localization does not always allow the desired complete surgical removal. Lymphangiomas are rare and benign tumors of the lymphatic vessels. In the higher percentage of cases, they are defined as congenital malformations.

CONGRESS REPORT OF THE 5TH NATIONAL CONGRESS OF THE BULGARIAN SOCIETY FOR DERMATOLOGIC SURGERY, SOFIA, 11TH MARCH 2023 WITH MAIN TOPICS: NITROSAMINES AS MOST POWERFUL TRIGGER FOR SKIN CANCER DEVELOPMENT AND PROGRESSION/PERSONALISED ONE STEP MELANOMA SURGERY AS POSSIBLE SKIN CANCER TREATMENT OPTION.

Deciphering the mutational pattern of skin tumours, remains a major challenge for clinicians and researchers. Over 80% of mutations in tumours are acquired, which in practice also means preventable. The surgical treatment of skin cancer and cancer in general is a worldwide, unsolved but at the same time not unsolvable problem.

NITROSOGENESIS OF SKIN (HUMAN) CANCER- THE HIDDEN TRUTH OF A NEVERENDING STORY: NITROSAMINE CONTAMINATION IN OLMESARTAN, VALSARTAN AND HCT AS MAIN RISK FACTOR FOR THE DEVELOPMENT OF KERATINOCYTE CANCER.

The pathogenesis of skin cancer remains shrouded in mystery. Nevertheless, a substantial amount of new data is now available to provide a logical explanation regarding the possible link between 1) the occurrence of single or multiple acquired/somatic mutations and 2) the generation and progression of skin cancer, as well as 3) the potential association of the above two facts with the availability of nitrosamines in drugs for hypertension, diabetes, gastritis, acne, tuberculosis, various other antibiotics, etc. The nitrosogenesis of skin cancer is slowly but surely being established as a significant concept that could not be ignored for longer periods of time.