Background:Trichoscopy is a newly developed method of hair image analysis, based on videodermoscopy of hair and scalp.Objective:The aim of the study was to establish normal values and set the standard for trichoscopy in female population. Patients and methods:A total of 60 healthy females with no symptoms of hair or scalp diseases in anamnesis, upon clinical examination and in classic hair diagnostic techniques were included into the study. Mean age of these females was 36.5 (19-64) years. Trichoscopy was performed with the use of Fotofinder II. In all patients trichoscopy was performed in four locations (frontal area, occipital area, left and right temporal area). Hair and perifollicular area were evaluated. Measurements were performed with the application of the MoleAnalyzer software.Results:Mean hair thickness was 0.061mm±0.008mm in frontal area vs. 0.057mm±0.007mm in occiput (p<0,001) and vs. 0.058mm±0.008mm in left temporal area and 0.059mm±0.008mm in right temporal area (p>0.005). The percentage of thin hairs (below 0.03mm) was 5%±4.3 in frontal area vs. 5.5%±4.8 in occiput vs. 6.4%±5.7 in right temporal area. The highest proportion of single-hair pilosebaceous units was observed in the temporal areas (29.1±16.2 vs. 23.2±13.5 in frontal and 18.4±12.1 in occipital areas; p<0.005). Based on study results, the norms for parameters measured in trichoscopy were assessed: mean hair thickness bigger than 0,053mm in frontal area and bigger than 0,050mm in others; percentage of thin hairs should be less than 10% in frontal and occipital area and less than 13% in temporal areas. The percentage of pilosebaceous units with single hair should be less than 35% in frontal area, 30% in occiput and 40% in temporal areas. Yellow dots were seen sporadically and they shouldn't be in a higher number than 3 in 4 fields of vision with 70-fold magnification in frontal area and only 1 in others. Perifollicular discoloration should be lower than 25% for frontal area, lower than 15% in occiput and 20% for temporal areas.Conclusion:A standard procedure to perform trichoscopy (hair and scalp videodermoscopy) for diagnostic purposes was developed. Norms of measurable parameters were established for the population of adult whitefemales.

Background:Erythema multiforme is a cutaneous reaction that has only rarely been described in varicella zoster virus infection.Main observations:We describe a 76-year old immunocompetent male patient with thoracic herpes zoster. While treated with oral brivudin he developed a widespread cutaneous erythema multiforme. The lesions completely cleared with two weeks with systemic corticosteroids.Conclusion:Varicella zoster infections are possible triggers of erythema multiforme and this is the oldestpatient reported with such an association. Brivudin itself has not been reported to induce erythema multiforme and is an unlikely cause of disease in our patient.

Background:Angiosarcoma is a malignant tumor of the blood vessels' endothelial lining. The tumor is very aggressive and tends to recur locally and metastasize to distant organs. Commonly, it is associated with different risk factors like lymphoedema, prior radiotherapy but rarely, it may also be associated with chronic venous ulceration.Main observation:We present a patient with a chronic venous ulceration who developed angiosarcoma of the ulcerated leg with good outcome after treatment.Conclusion:It is very important to follow patients with chronic wounds and recognize changes which may be life threatening. In addition to squamous cell carcinoma (Marjolin's tumor), which is most common, angiosarcoma can develop within a venous ulcer.

Background:Malignant histiocytosis is a rare neoplasm composed of abnormal histiocytes typically affecting the liver, spleen, lymph nodes, and bone marrow. This entity has been rarely documented involving the skin and has never been reported confined to the skin.Main observations:A 74-year-old white man presented to the dermatology clinic with complaints of a non-healing ulcerated lesion on his cheek of several months duration. Histopathological examination revealed a poorly circumscribed neoplasm consisting of pleomorphic epithelioid cells with abundant foamy cytoplasm. Immunohistochemistry was positive for CD-43, CD-68, and lysozyme, but negative for CD-3, CD-20, CD-30, CD-34, SMA, CD-1a or S-100. The prominent CD-68 and lysozyme staining along with the histological features, the clinical presentation of erythematous nodules with diffuse erythematous plaques, and absence of bone marrow findings, led to the diagnosis of malignant histiocytosis confined to the skin.Conclusion:Malignant histiocytosis involving the skin is rare. The presence of large pleomorphic epithelioid cells with foamy cytoplasm, with or without engulfed erythrocytes should alert the dermatopathologist to the possibilityofmalignanthistiocytosis.Appropriatimmunohistochemical evaluation, including CD-43, CD-68, CD-1a, S-100, and lysozyme, should be completed to confirm the diagnosis.

Background:Secondary erythromelalgia can occur due to various underlying medical disorders or drug toxicity.Main observations:A 75-year old male developed acute secondary erythromelalgia following the onset of rosuvastatin use and associated myopathy. The illness was reversible after discontinuation of the pharmacological agent.Conclusion:Secondary erythromelalgia may occur after rosuvastatin use, but this and other dermatological toxicities are rare.