WAO-ARIA consensus on chronic cough - Part II: Phenotypes and mechanisms of abnormal cough presentation - .

Background: Chronic cough can be triggered by respiratory and non-respiratory tract illnesses originating mainly from the upper and lower airways, and the GI tract (ie, reflux). Recent findings suggest it can also be a prominent feature in obstructive sleep apnea (OSA), laryngeal hyperresponsiveness, and COVID-19. The classification of chronic cough is constantly updated but lacks clear definition.

In-vivo diagnostic test allergens in Europe: A call to action and proposal for recovery plan-An EAACI position paper.

Diagnostic allergens are defined as medicinal products in the EU. Marketing authorization by national authorities is necessary; however, diagnostic allergens are not homogeneously regulated in different EU member states. Allergen manufacturers argue with increasing costs forcing them to continuously reduce the diagnostic allergen portfolios offered to allergists.

Acanthosis Nigricans - A Two-Sided Coin: Consider Metabolic Syndrome and Malignancies!

Background: Acanthosis nigricans (AN) is acquired hyperpigmentation of the intertriginous body regions. Histologically, AN is characterised by a thickened stratum corneum and a variable amount of acanthosis. Although benign and rarely symptomatic, AN may be a red flag for underlying pathologies.

Ultraviolet A-1 in Dermatological Diseases.

The exposure to ultraviolet radiations and visible light, or phototherapy, is a well-known therapeutic tool available for the treatment of many dermatological disorders. The continuos medical and technological progresses, of the last 50 years, have involved the field of phototherapy, which evolved from UVA and PUVA in its various forms, to the development of narrowband UVB (NB-UVB) and NB-UVB micro-focused phototherapies. Further advances in technology have now permitted the introduction of a new device emitting UVA-1 radiations.

Psychoneurocutaneous medicine: past, present and future.

Psychoneurocutaneous medicine is an important and rapidly growing field. It is an integrative science created to address the interaction between the mind, nervous system and skin. Four major fields are involved: psychiatry, psychology, neurology and dermatology.

Contact dermatitis: a historical perspective.

Contact dermatitis is a common skin condition that can have a considerable impact on patient quality of life and function. Historically, contact dermatitis has played a significant role in the evolution of dermatology as the understanding of a relationship between environmental exposure and specific skin disease became more widely accepted. Reports about this relationship can be found throughout the history of humanity, thousands of years ago.

Vitiligo: successful combination treatment based on oral low dose cytokines and different topical treatments.

The current treatments for Vitiligo are not completely satisfactory in terms of clinical, aesthetic and compliance results for patients. Recently, combination therapies had been introduced with positive results. In this paper the combination between systemic oral treatment with Low Dose Cytokines in association with other topical treatments was evaluated.

Non-healing facial lesions: cutaneous old world leishmaniasis in dresden.

Cutaneous leishmaniasis is a common vector-borne disease world-wide but not in Central Europe. The typical clinical manifestation is an enlarging papule on the site of infection. Vectors are sandflies and reservoirs may be wild animals like rodents, dogs or even humans.

Nonsyndromic aplasia cutis congenita: a case report.

Aplasia cutis congenita (ACC) is a rare disorder, which is defined by the localized, or less commonly widespread absence of skin involving the epidermis, dermis and subcutaneous tissue with an incidence of 1/10.000 newborns. The underlying bone and dura mater can be also affected, and muscle and bone involvement occur in approximately 20 to 30% of the cases.

Giant congenital melanocytic nevus localized in the axillary area: serial excisions as optimal treatment option.

Congenital melanocytic nevi are relatively rare lesions (1-6%). Their size and location can cause cosmetic and functional disorders of varying degrees of severity, but in addition they can also undergo transformation to malignant melanoma. Different types of treatments have been described as being effective for these lesions, the choice of the most appropriate method depending on the size and the location of the nevi as well as the patient’s age.

Intralymphatic histiocytosis overlying hip implantation treated with pentoxifilline.

Intralymphatic histiocytosis (IH) is a rare condition that presents with livedoid, erythematous to violaceous patches and plaques near affected joints most commonly in patients with rheumatoid arthritis and in at least 8 reports overlying metal implants. We report the case of a 58 year-old Caucasian woman who developed an indurated violaceous reticulated plaque overlying her right hip after placement of a metal hip implant 6 years prior for treatment of osteoarthritis. Histopathology revealed a proliferation of D2-40-positive dilated lymphatic spaces in the dermis and intralymphatic proliferation of CD68-positive histiocytes.

Heel melanoma: the final result of wrong diagnostic and therapeutic approach in another bulgarian patient. First documented case from the board of the “adcrstr-association for dermatohistopathologic control, reevaluation and subsequent therapeutic recomme.

Difficulties with frequent misdiagnoses and incorrectly defined tumor thicknesses applied to the same histopathological preparation occurring among Bulgarian patients, has led to the creation of national and/or international associations or boards for control in problematic circumstances, particularly for patients with melanocytic and non melanocytic cutaneous tumors. Once again we report a problematic case of a patient with acral lentiginous melanomа, localized in the heel area of the right foot, in an otherwise healthy 69-year old woman. A pigmented lesion gradually developed in her heel area, where the patient had been previously treated several times with invasive therapeutic methods (cryosurgery, shave curettage) due to misdiagnosis as a verrucous lesion or as a viral wart in the absence of any prior histopathology report.

Dysplastic nevi, melanoma and pregnancy- where is the relationship?

Dysplastic nevus is a precursor and a risk factor for the development of malignant melanoma, which explains the scientific interest in this field. Its etiology includes various of endogenous and exogenous factors, as we are considering the influence of hormonal status on the possible malignancy of congenital nevi in particular. The occurrence of some typical melanocytic lesions such as chloasma during pregnancy, where the hormone effect is demonstrated, as well as the more frequent changes of the dysplastic nevi namely within the pregnancy, leads to the idea for the endocrine dependence of the malignant transformation of some melanocytic lesions.

Basal cell carcinoma or not Basal cell carcinoma? That is the question!

Basal cell carcinoma is the most frequent malignant tumor in mankind. Although diagnosis often is based on clinical signs confirmed by histopathology, there are simulators of this tumor and there are basal cell carcinomas with misleading clinical appearance. Here we present 4 samples that illustrate the challenge in diagnostics.

“Melanoma imitators”- how to prevent the aggressive approach?

Melanoma imitators could be lesions of different genres; vascular, infectious (granulomatous) and non-melanocytic tumors in addition to various skin artifacts. Their early recognition is essential for the subsequent and sometimes invasive diagnostic and therapeutic approach by the clinician. This paper focuses on several unique cases involving patients with clinical signs of advanced stage melanoma that actually had either benign lesions or circumstances where surgical excision could be avoided.

Melanoma of the heel – a case series of a rare melanoma subtype.

Melanoma of the heel is a rare subtype of the disease, which shows some variations of its incidence in different geographic areas as well as atypical clinical manifestations, resembling numerous other dermatologic conditions, which often leads to misdiagnosis at the early stages of the disease. We present a case series of four patients with malignant melanoma of the heel, with delay of diagnosis due to their atypical presentation, which is illustrated by tumor thickness, Clark level (VI and V), and tumor stage. All of the reported cases are from our own files and demonstrate the challenges with melanoma of the heel, with the aim to emphasize the necessity to biopsy all lesions with unknown significance to avoid the delay in diagnosis and prevent wrong subsequential treatments.

Are microscopic satellites in melanoma indicative of lymphovascular invasion? A preliminary case study.

Microscopic satellites (microsatellites) in primary melanoma are defined as one or more discontinuous nests of neoplastic melanocytes measuring more than 0.05 mm in diameter that are clearly separated by normal dermis (i.e.

Desmoplastic malignant melanoma associated with pigmented ocular tumor: second documented problematic case from the board of “adcrstr-association for dermatohistopathologic control, re-evaluation and subsequent therapeutic recommendations”.

Malignant melanoma is the most malignant skin tumor, whose incidence is rising gradually. It usually occurs in pre-existing lesions in photo-exposed areas of the skin, and, despite its occurrence across a broad age range, its appearance prevails among the elderly. It has a tendency to metastasize rapidly.

Treating skin diseases according to the low dose medicine principles. Data and hypotheses.

Cytokines, hormones and growth factors, also defined with the collective name of “signaling molecules” are key regulating agents of physiological (and also pathological) functions according to the principles of Psycho-Neuro-Endocrine-Immunology (P.N.E.

Psycho-neuro-endocrine-immunology and low dose cytokines therapy: principles and evidences for an innovative medical approach in acute and chronic inflammatory diseases.

The development of the Psycho-Neuro-Endocrine-Immunology (P.N.E.

Sarcoid type reaction: medical hypotheses.

Sarcoid-type reactions could not always be clearly distinct from the independent disease sarcoidosis. Particular attention should be paid to paraneoplastic type of sarcoid reaction which until recent literature was characterized as 1) sarcoidosis associated with tumor disease or 2) sarcoidosis classified and presented as paraneoplastic disease. The analogy between sarcoidosis and paraneoplastic type of sarcoid reaction are the pure epithelioid cell granulomas.