High-frequency ultrasonography (HF-USG) is a relatively new imaging method that allows the evaluation in a non-invasive manner of the skin layers and skin appendages. It is a diagnostic tool with increasing usefulness in numerous dermatological pathologies. High reproducibility, non-invasiveness and short diagnostic time make this method an increasingly used tool in dermatological practice. The subepidermal low-echogenic band is a relatively newly described parameter that seems to be a marker not only of intrinsic and extrinsic skin aging, but also of inflammatory processes taking place at the skin level. This systematic review aims to evaluate the role that SLEB has in the diagnosis and monitoring of the treatment of some inflammatory and non-inflammatory dermatological conditions, as well as its utility as a disease marker.

The interrelations and sequencing of interleukins are complex (inter)actions where each interleukin can stimulate the secretion of its preceding interleukin. In this paper, we attempt to summarize the currently known roles of IL-4, IL-13, IL-31, and IL-33 from a multi-disciplinary perspective. In order to conduct a comprehensive review of the current literature, a search was conducted using PubMed, Google Scholar, Medscape, UpToDate, and Key Elsevier for keywords. The results were compiled from case reports, case series, letters, and literature review papers, and analyzed by a panel of multi-disciplinary specialist physicians for relevance. Based on 173 results, we compiled the following review of interleukin signaling and its clinical significance across a multitude of medical specialties. Interleukins are at the bed rock of a multitude of pathologies across different organ systems and understanding their role will likely lead to novel treatments and better outcomes for our patients. New interleukins are being described, and the role of this inflammatory cascade is still coming to light. We hope this multi-discipline review on the role interleukins play in current pathology assists in this scope.

Psoriasis vulgaris is a polygenic, immunomediated dermatological condition, characterized pathophysiologically by abnormal proliferation of the epidermis and immune response disorders, evidenced by the presence of a dermal inflammatory infiltrate accompanied by exocytosis. The prevalence of this disease is continuously increasing, and the significant impact on quality of life is determined by both the severity of the skin manifestations and the associated comorbidities, which underlines the importance of early diagnosis. Among the imaging methods useful in the diagnosis and monitoring of psoriasis vulgaris are dermatoscopy and high-frequency cutaneous ultrasonography (HFUS). Dermatoscopy is a valuable complementary imaging tool in assessing the therapeutic response in patients with psoriasis vulgaris. Although clinical lesions may show partial or complete remission, the persistence of the specific vascular architecture—characterized by dilated and branched capillaries—suggests the maintenance of disease activity and justifies the need for continued treatment. HFUS allows the identification of characteristic changes in psoriatic plaques, such as homogeneous thickening of the epidermis, visible as a hyperechoic band, the presence of a hypoechoic subepidermal band, and thickening of the dermis. Evaluation with 20 MHz probes can significantly contribute to monitoring therapeutic efficacy, since the first observable changes under topical and/or systemic treatment include a reduction in the thickness of the epidermis, dermis, and hypoechoic subepidermal band. The integration of dermatoscopy and HFUS within the clinical evaluation allows for a complex and precise approach to the management of patients with psoriasis vulgaris, facilitating objective monitoring of disease progression and appropriate adjustment of therapy.

Desmoplastic melanoma accounts for 5% of all cases of melanoma, but its diagnosis can be difficult due to its frequent clinical presentation with amelanotic lesions. Histologically, spindled melanocytes surrounded by a collagenous stroma are observed. Compared with other types of melanoma, the desmoplastic types presents greater local aggression, and is more prone to local recurrence, but has a lower risk of lymph node metastasis. Early detection, accurate staging, and proper surgical management are the main factors associated with higher survival rates in melanoma patients. Reflectance confocal microscopy (RCM) has proven to be a valuable imaging tool in the diagnosis of skin neoplasms, being useful for orientating practitioners towards the diagnosis of melanoma and indicating the necessity of performing a diagnostic biopsy. We present the case of 52-year-old woman, who presented to the dermatology department with an irregular, dark-colored plaque in the right deltoid region. Dermoscopy showed asymmetry with an atypical network and some areas of regression. RCM revealed pagetoid cells in the upper epidermis, cell atypia, non-edged papillae, dermal inflammation, and nucleated cells in the dermis, which are highly suggestive of melanoma. A biopsy was also performed. A histopathology exam confirmed the diagnosis of superficially spreading melanoma with a desmoplastic component, and revealed a Breslow index of 0.9 mm, Clark level IV, an absence of mitoses, angiolymphatic invasion and regression, and complete excision. The CT and PET-CT scans were negative. A biopsy of the axillary sentinel lymph node was conducted, with a negative result obtained, establishing the IB stage of the disease. The patient will remain under follow-up to look for a recurrence or a new primary melanoma.

Introduction: Graves’ disease (GD) is an autoimmune disorder affecting the thyroid gland, leading to systemic manifestations such as hyperthyroidism, Graves’ orbitopathy, and pretibial myxedema. Contrary to previous beliefs that hyperthyroidism protects against thyroid cancer, recent studies reveal an increased incidence of thyroid malignancies in GD patients, particularly differentiated thyroid carcinomas and, in rare cases, medullary thyroid carcinoma (MTC). Case series: This case series presents three female GD patients diagnosed with MTC, highlighting the complexities of diagnosis and management. All patients exhibited thyroid nodules with suspicious ultrasonographic features, elevated plasma calcitonin levels, and required total thyroidectomy. Histological examination confirmed MTC. Discussion: These cases underscore the importance of routine calcitonin screening in GD patients with thyroid nodules to facilitate early detection and improve prognosis. Our findings suggest that while the coexistence of GD and MTC is likely incidental, vigilant monitoring and comprehensive evaluation are crucial for timely intervention. Conclusions: This study advocates for integrating calcitonin testing into the standard diagnostic protocol for GD patients presenting with thyroid abnormalities.

Background and Objectives: This study aimed to identify the risk factors of primary cutaneous melanomas associated with microsatellites, satellites, and in-transit metastases. Materials and Methods: We performed a retrospective study on patients diagnosed with invasive primary cutaneous melanomas in two pathology departments. The cases were distributed into two groups, comparing the clinical–pathological features of cases that presented microsatellites, satellites, and in-transit metastases with cases that did not present microsatellites, satellites, and in-transit metastases. Results: From the total number of primary invasive cutaneous melanomas diagnosed (n = 204), 22% presented microsatellites, satellites, and in-transit metastases (n = 46). The presence of microsatellites, satellites, and in-transit metastases was strongly correlated with a Breslow index > 4 mm, a Clark level of IV or V, and a pT3 or pT4 pathological stage (p < 0.0001). Those cases were also associated with lymphovascular invasion (p = 0.0013), ulceration of the primary melanoma (p = 0.0037), and an increased mitotic rate (p = 0.0078). The presence of microsatellites, satellites, and in-transit metastases is associated with higher rates of lymph node metastases (p = 0.0006) and recurrence (p = 0.0282). Conclusions: The most important risk factors associated with microsatellites, satellites, and in-transit metastases are represented by a Breslow index > 4 mm, a Clark level of IV or V, and an advanced pathological stage.