Reflectance confocal microscopy (RCM), a new non-invasive imaging technique has proven to be a useful tool for detection of basal cell carcinoma in vivo.

Objective: To non-invasively assess efficacy of cryotherapy for sBCCs by cytomorphologic analysis using RCM.

Methods: We examined 10 histologically proven sBCCs located on the trunk of 5 consecutive patients with a mean age of 84.6 years. A-769662 in vitro SBCCs were frozen twice using a spray

nitrogen cryoprobe. RCM imaging was performed in each sBCC before cryotherapy and after 5 and 24 h to monitor resulting tissue injury. Distinct cytomorphologic characteristics were determined by three observers allowing non-invasive evaluation of therapeutic efficacy of treatment immediately after cryotherapy.

Tumour clearance was assessed by RCM imaging 3 months LDN-193189 mw after therapy followed by histopathologic examination.

Results: Characteristic RCM-features of BCC were present in all lesions before cryotherapy. Five hours after cryotherapy, all 10 sBCCs showed small bright round to polygonal structures at basal layer and black round to oval areas of varying size with such bright structures floating therein, correlating to cell necrosis and incipient blistering. Eight sBCCs showed also cell necrosis in upper dermis. After 24 h all sBCCs showed necrotic cells beneath collagen bundles. Tumour clearance on check details later histopathologic examination was only proven in those lesions showing

damage to the upper dermis after 5 h with RCM.

Conclusion: Early cell necrosis within upper dermal structures seems to correlate with ablation of overlying turnout tissue. When it is not produced by cryotherapy, a second treatment should be considered. (c) 2008 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.”
“Purpose of reviewEosinophilic granulomatosis with polyangiitis (EGPA) (Churg-Strauss syndrome) is a peculiar hybrid condition of a systemic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and a hypereosinophilic disorder with frequent lung involvement that occurs in people with asthma. This review focuses on areas of evidence or persistent uncertainty in the classification, epidemiology, clinical presentation, diagnosis, prognosis and management of EGPA and attempts to identify clues to the mechanisms in the development or course of the disease.Recent findingsThe 2013 revision of the EGPA definition formally placed the disease in the subset of ANCA-associated vasculitides. Recently published large case series underlined that the presence of ANCAs, found in 30-40% of EGPA, determines distinct but partly overlapping disease expression and the major detrimental effect of heart involvement on survival. There is some evidence that asthma in EGPA resembles a nonallergic eosinophilic asthma phenotype.