In this study, we investigated the cardiovascular risk factors as well as ectonucleotidase activities in lymphocytes of metabolic syndrome (MetS) patients before and after an exercise intervention. 20 MetS patients, who performed regular concurrent exercise training for 30 weeks, 3 times/week, were studied. Anthropometric, biochemical, inflammatory and hepatic parameters and hydrolysis of adenine nucleotides and nucleoside in lymphocytes were collected from patients before and after 15 and 30 weeks of the exercise intervention as well as from participants of the control group. An increase in the hydrolysis of ATP and ADP, and a decrease in adenosine deamination in lymphocytes of MetS patients before the exercise intervention were observed (P<0.001). However, these alterations were reversed by exercise training after 30 weeks of intervention. Additionally, exercise training reduced the inflammatory and hepatic markers to baseline levels after 30 weeks of exercise. Our results clearly indicated alteration in ectonucleotidase enzymes in lymphocytes in the MetS, whereas regular exercise training had a protective effect on the enzymatic alterations and on inflammatory and hepatic parameters, especially if it is performed regularly and for a long period.

Vulvar skin diseases represent a heterogeneous group of skin diseases which display infectious, inflam- matory or malignant nature. The authors conducted a review of epidemiological, etiopathogenic, clínicopathological, therapeutic and prognostic aspects of five vulvar inflammatory skin diseases, namely lichen sclerosus, eczema, psoriasis, lichen planus and Zoon’s vulvitis. Except for the Zoon’s vulvitis, vulvar inflammatory skin diseases are more common in women compared to their counterparts in males. Their etiopathogenic features remain unknown. Itching and pain are the most common complaints. Extra-genital lesions may be present. The diagnosis of psoriasis and eczema is usually clinical and the definitive diagnosis of lichen sclerosus, Zoon’s vulvitis and lichen planus is primarily histological. Althou- gh mostly treated by dermatologists, vulvar inflammatory skin diseases may require a multidisciplinary approach which includes gynecology, urology, pediatrics, psychology and psychiatry. Superpotent or potent topical corticosteroids are the primarily therapeutic approaches, followed by topical calcineurin inhibitors. The risk of malignancy is present in lichen sclerosus and lichen planus, requiring periodic examination. KEYWORDS – Vulvar Diseases; Skin Diseases; Vulvar Lichen Sclerosus; Psoriasis; Lichen Planus; Vulvitis.

Background: Ultrasound and colour Doppler are adjuvant techniques widely used in clinical settings in obstetrics, cardiology, and others. Its use in dermatology is more incipient although it presents potential for clinical use namely in dermo-oncology. Objective: This study explores the usefulness of the combination of cutaneous ultrasound with Doppler after digital dermatoscopy in distinguishing between most common benign and malignant skin lesions, focusing on the importance of different vascular patterns. To streamline the diagnostic process, we propose a combined imaging workflow that integrates dermoscopic findings with vascular and structural data obtained via Doppler ultrasound. Methods: In total, 42 benign and malignant skin tumours were analysed in a population of 42 patients using a Fotofinder digital dermatoscopy device and a GE ultrasound machine with a high-frequency probe (20 MHz). Doppler was applied to assess lesion vascularization and identify distinct blood flow patterns. Results: Cutaneous ultrasound revealed that malignant lesions often exhibited intense and disorganized vascularization, while benign lesions displayed more ordered and peripheral blood flow patterns. In all of our cases, ultrasound with Doppler imaging clarified the uncertainties raised by dermatoscopy. Conclusions: The use of Doppler cutaneous ultrasound after digital dermatoscopy proved to be a valuable tool to aid the diagnosis in dermatology, as it improved the differential diagnosis between benign and malignant lesions, contributing to the establishment of the final diagnosis in the studied cases.

Background/Objectives: Actinic keratosis (AK) is the key precursor of invasive cutaneous squamous cell carcinoma (cSCC). Rising incidence, ageing populations, and limited dermatologists’ availability, particularly in rural and underserved regions, underscore the need for more inclusive care pathways. As in other common diseases such as diabetes or hypertension, general practitioners (GPs) could play a pivotal role in improving access, early recognition, and management of AK, provided that systemic barriers are addressed. Methods: This article synthesises current evidence and expert insights from a European multi-country advisory process, focusing on Italy, France, Germany, Spain, Portugal, the Netherlands, and Greece. The advisory board comprised dermatologists selected based on their clinical expertise and national representativeness, and consensus was reached through structured discussion and iterative review of background materials. Results/Conclusions: The study outlines unmet needs, barriers, and enablers for GPs’ involvement and proposes a structured strategy supported by consensus recommendations. It offers a pragmatic model for improving AK care through stronger collaboration between primary care and dermatology. Greater GPs’ involvement may support earlier recognition, better triage, improved access to care, and more efficient use of specialist services, while ensuring that complex or high-risk lesions remain under dermatologists’ oversight. This may help optimise AK care pathways across Europe.