[Dr.Anisimova]

Sporadic congenital leukonychia with koilonychia[Ссылки доступны только зарегистрированным пользователям ]
Leukonychia totalis (LT) is a rare condition with autosomal dominant inheritance.1 Hereditary LT has often been reported in conjunction with other dermatoses, including nail features.2–6 To our knowledge, few cases of sporadic LT with koilonychia have been reported.7,8
A 22-year-oldman was referred to the Department of Dermatology at St. Mary’s Hospital for white concave nails since birth (Figs*1 and 2). He had never complained of any pain or decreased sensation in his nails or digits. He was a student without any notable medical history or trauma to his nails or digits, and was otherwise healthy. This condition was not changed by temperature, activity, or stress. The nail color was uniformly white on the fingernails and on the toenails except for some linear streaks on the right great toenail. All the nails were concave with everted edges (so-called “spoon nails”) and smooth surfaces. There was no family history of leukonychia or koilonychia. A complete chemistry profile including iron profile, complete blood count with differential, and urinalysis were unremarkable.
Leukonychia refers to whitening of the nail plate and can be classified according to the distribution of white coloring or the pattern of nail involvement. This condition can be temporary or permanent depending on its etiology.9
True leukonychia occurs in response to a structural abnormality of the nail plate and the nail matrix. Normally, the nail plate consists of cornified cells, but in leukonychia a defect occurs in the keratinization of cells so that immature, large nucleated cells are present. The keratohyaline-containing cells reflect light and prevent the visualization of the pink vascular bed. The cells produce an appearance that is milky, chalky, bluish, ivory or porcelain white in color, and the opacity of the whiteness varies. When the nails are faintly opaque, transverse streaks are seen.3,10
True leukonychia can be separated into total and subtotal or partial forms, and the latter can occur in a punctate, striate or distal manner. Koilonychia is commonly found in the nails of normal children, but usually disappears spontaneously. All the fingernails may be involved and, less frequently, the toenails. Proliferation of connective tissue and sometimes increased vascular flow causes the fingernails to lift up. The depressed distal portion of the affected toenails may reflect distal connective tissue anoxia and atrophy.

Idiopathic acquired persistent true partial to total leukonychia
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Congenital onychogryphosis: Leaning tower nail
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Онко/новообразования
Smoking Raises Risk Of Squamous Cell Carcinoma Of The Skin In Women
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"Cigarette smoking is more strongly associated with SCC than BCC, particularly
among women."

Surgical margins for melanoma in situ
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Conclusion
The frequently recommended 5-mm margin for melanoma is inadequate. Standard surgical excision of melanoma in situ should include 9 mm of normal-appearing skin, similar to that recommended for early invasive melanoma.

Epidemiologic aspects of seborrheic keratoses
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Lentigines, laser, and melanoma: A case series and discussion
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Clinicopathological evaluation of nonmelanoma skin cancer
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Adjuvant Therapy: Melanoma
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Системные,склеро,люпус-...
Impact of Smoking in Cutaneous Lupus Erythematosus
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Conclusions* Current smokers with lupus erythematosus had worse disease, had worse quality of life, and were more often treated with a combination of hydroxychloroquine and quinacrine than were nonsmokers. Never and past smokers showed greater improvement when treated with antimalarial agents plus at least 1 additional immunomodulator. Current smokers had greater improvement when treated with antimalarial drugs only.

Response to Antimalarial Agents in Cutaneous Lupus Erythematosus
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Conclusions* The use of quinacrine with hydroxychloroquine is associated with response in patients for whom hydroxychloroquine monotherapy fails. Further reduction in disease activity can be associated with continuation of treatment with antimalarial agents.

Genital lichen sclerosus common in morphea patients[Ссылки доступны только зарегистрированным пользователям ]
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Conclusions* Genital LS is significantly more frequent in patients with morphea than in unaffected individuals. Forty-five percent of patients with plaque morphea have associated LS. Complete clinical examination, including careful inspection of genital mucosa, should therefore be mandatory in patients with morphea because genital LS bears a risk of evolution into squamous cell carcinoma and thus needs treatment with topical corticosteroids.

Some Topical Therapies Effectively Treat Lichen Sclerosus
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