Catherine Anpilogova is a senior student of the Center for Innovative Methods of Education “The Medicine of the Future” at the I.M.Setchenov First Moscow State Medical University. She conducts research work in close conjunction with V.A.Rakhmanov Department of Skin and Venereal Diseases. She has published more than 8 papers in reputed journals.

This clinical research was conducted at V.A. Rakhmanov Department of Skin and Venereal Diseases (the First Moscow State Medical University, Russia) and the Hematology Science Center (Moscow, Russia). We observed 8 patients with CTCL: 3 (37.5%) men and 5 (62.5%) women at the age of 50-56. The diagnoses were verified with histological, immunochistochemical and clonal hematological research methods. The duration of the disease ranged from 2 to 36 years. The patients had different stages of the CTCL: IA – 3 patients, IB – two patients, IIA – one patient, IIB – one patient. Before the treatment all the patients were fully examined; the contraindications for photochemotherapy were not revealed. The Hematology Science Center prescribed Reaferon (3 million units – 3 times per week). At the same time the photochemotherapy based on skin exposure with UV (wavelength 320-400 nm) in 2 hours after ammifurin intake (photosensitizer) was applied in our clinic. The initial dose of the irradiation depended on the phototype of the patient’s skin and was 0.5-1.0 J/cm2. Photochemotherapy was carried out 4 times a week with gradually increasing dose of 0.5-1.0 J/cm2 in every 2 sessions to a single dose of 8-10 J/cm2. The course of therapy consisted of 20-30 procedures. After the combined therapy we reached the clinical remission in 75% of cases. Theclinicalbehaviourwasimprovedin 25% of cases (reduction and cessation of itching, blanching and flattering of lesions). At IA-IIA stage of CTCL the treatment was noted to be more effective.

Ipsa Niyant Pandya has completed her MBBS at the age of 23 years from M.S.University and is pursuing her 2nd year MD in Dermatology from M.S.University. She has more than 5 publications under her name in pubmed indexed journal. She has also won the first prize for her case in Gujatat state IADVL (Indian Association of Dermatology,Venerology & Leprology) meet, September 2014.

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue often producing a type of verrucous dermatitis. It is most commonly caused by Fonseacaea pedrosoi and Cladosporium carrionii. It is prevalent all over the world but more cases are reported in tropical and subtropical countries. We present a case of a 60 year old male coming from a rural background who presented with multiple verrucous plaques and papules over left leg extending to thigh since 25 years along with enlarged non tender left inguinal lymph nodes. The lesions were associated with itching and pain. Differential diagnoses considered were tuberculosis verrucosa cutis, chromoblastomycosis, verrucous psoriasis and sporotrichosis. Mantoux test was negative. Potassium hydroxide mount showed hyaline septate fungal hyphae along with sclerotic bodies (medlar bodies) , suggestive of chromoblastomycosis. Fonsecaea pedrosoi was isolated in fungal culture. Punch biopsy from the lesions showed dermal nodular dense tuberculoid and suppurative granulomatous infiltrate. Clusters of thick walled brown coloured refractile yeast cells showing 'cluster of pennies' appearance was seen within some giant cells and also extracellularly , suggestive of chromoblastomycosis. As per the current literature, systemic itraconazole and terbinafine are the first line treatment for chromoblastomycosis. Since these drugs were not available in our hospital, the patient was given intravenous fluconazole 400mg twice a day for a month to which he responded well. Weekly cryotherapy with liquid nitrogen spray was started as a supportive treatment. The patient was discharged on oral fluconazole along 400 mg twice a day with oral terbinafine 250 mg once a day as a maintenance therapy. Dramatic response was seen within 3 months with residual pigmentation and scarring. We present this case due to rarity of reports showing intravenous fluconazole as a primary treatment in chromoblastomycosis.

Emily Tongdee has completed her B.S. degree in biology at the age of 20 years from the University of Florida and is currently a third year medical student in the class of 2017 at Florida International University Herbert Wertheim College of Medicine. She has co-authored a publication in breast cancer research in the Journal of Biological Chemistry and in dermatology in the Journal of Drugs in Dermatology. She is currently invested in publishing papers in dermatology. She is especially interested in pursuing a combined residency in internal medicine and dermatology.

Background: Wrong-site surgeries in dermatology are not uncommon due to difficulty finding the initial biopsy site. In fact, a survey of Mohs surgeons indicated that 14% of malpractice cases resulted from wrong-site surgery.1 The Mohs surgeon may be unable to determine the surgical site if the referring physician does not include detailed documentation, such as a photograph, diagram, or written description of the biopsy site including anatomical landmarks as reference.2 However, patients often return for Mohs surgery many weeks following the initial biopsy. By this time, the biopsy site has healed and become less visible to both patient and physician, making it difficult even with proper documentation. Patients themselves may have incorrect site recall, particularly if the biopsy was in a location not visible to the patient.2A study by Perri et al revealed that 31.4% of patients could not accurately identify their biopsy site.4 Despite these attempts to decrease wrong-site surgery, further techniques are exigent in confirming the surgical site. Objective: To investigate the utility of anesthetic blister induction at a suspected biopsy site to identify the location prior to Mohs surgery. Methods: A patient presented with a clearly identifiable neoplasm, which was biopsied and histologically diagnosed as a squamous cell carcinoma. Subsequently, the patient was scheduled for Mohs surgery. On presentation for the surgical procedure, the initial biopsy site was not clearly identifiable and delayed initiation of treatment. Upon injection of local anesthetic, blister formation was developed in the initial biopsy site, clearly depicting our surgical location.Our presented surgical case was confirmed with frozen sections upon Mohs surgery. Results:The biopsy site was easier to locate with the assistance of a blister that formed as a result of local anesthetic administration. Conclusions: This is a clear example of how a new technique of blister formation secondary to anesthetic injection can highlight what may be an obscure operative site. The bulla formation induced amongst the weakly adherent malignant keratinocytes allows operation site identification with higher degree of certainty.Through the use of many available means to confirm biopsy site location, dermatologists can prevent unneeded delay and damage to the patient. As various methods develop and provide assistance in Mohs surgery, we describe preoperative bulla formation as an additional or adjunctive tool to surgical site identification.

Chronic urticaria is defined as hives, typically occurring daily, for greater than 6 weeks duration. Autoimmunity is the most emphasized etiopathogenetic factor. Microchimerism is existence of an allogeneic DNA in a living creature. The most frequent sample is fetomaternal cell trafficking during pregnancy. Hematopoietic cell, solid organ transplantation and blood transfusion are iatrogenic causes. There are variable studies investigating the role of microchimerism on etiopathogenesis of autoimmune diseases. To our knowledge, no report has investigated the relationship between the microchimerism and chronic idiopathic urticaria (CIU). We aimed to investigate the possible role of microchimerism on the CIU as autoimmune skin disease. We analysed SRY gene as indicator of fetal microchimerism in our patient and healthy control grups. Patients were 31 women with chronic urticaria over 18 years old who had applied to our clinic between 2011–2014. Patients divided into two groups as group 1 with 16 patients having son and group 2 with 15 patients being nullipar or having daughter. Control women are also divided into two groups according to having or not having son as Group 3 (n=51) and Group 4 (n=52) respectively. A total of 31 patients, 8 of them (%25,8) and 4 of 103 control women (%3,9) showed SRY gene presence. The difference between patient and control group was statistically significant (p: < 0.01). As result of our study, microchimerism may be associated with the etiopathogenesis of chronic idiopathic urticaria. But we think there is a need for larger series of studies to support this hypothesis.

My name is Dr Feysel Alo Tello. I graduated from Addis Ababa university department of dermatology in 2013 as dermatologist after 3 years of resident ship program in ALERT and Black Lion Hospital. I completed my undergraduate study in an International University of Africa and worked in Shashemene Referral Hospital as a General practitioner for two years in different department of the hospital, I am currently working as a dermatologist in Bethel teaching General Hospital(private) and Ambo General Hospital(governmental) as well

Acquired lymphangioma circumscriptum is a superficial lymphatic dilatation caused by a wide range of scarring processes. Histologically indistinguishable from congenital lymphangioma circumscriptum and occurs in all age groups, in adults as a late sequel of surgery, radiation therapy and scrofluderma. Patients usually present with numerous translucent vesicles in a chronic lymph edematous area several years after the primary pathology. I present a 22 years old female patient with the diagnosis of acquired lymphangioma circumscriptum of vulva admitted to our hospital by internist with an impression of genital warts, she had had bilateral inguinal discharging wound that diagnosed as a case of scrofluderma eight months prior to her presentation and started on anti –TB therapy and healed with typical scrofluderma scars , the vulva lesions start to appear two months after initiation of anti TB therapy.