Adam Borzęcki

Bio: Adam Borzęcki is an academic researcher. The author has contributed to research in topics: Dermatology & Basal cell carcinoma. The author has an hindex of 3, co-authored 16 publications receiving 36 citations.

Darier–White disease treated with fractional CO2 laser in two cases

Abstract: Darier-White disease is one of the most common genodermatoses. The most typical clinical symptoms such as diffuse hyperkeratotic papulae usually appear during puberty or early adulthood in seborrhoeic area. It is connected with substantial deterioration of the quality of life due to aesthetic defect. Although there exist many therapeutic options, the disease still causes considerable therapeutic difficulties. Treatment with fractional CO2 laser seems to be a promising therapeutic method. In this paper, we present two cases of patients with Darier's disease who have been treated with a fractional CO2 laser with very good clinical outcome.

High-frequency ultrasound in the diagnosis of selected non-melanoma skin nodular lesions.

Abstract: Introduction Ultrasonographic examination is commonly used in an outpatient setting, possibly due to its low cost, low risk for patients and the possibility to obtain real time images. Typically used heads have the frequency ranging from 7.5 to 12 MHz. Higher frequencies ensure higher resolution, yet they are limited by the penetration depth - reaching from several to several tens of millimetres into the skin. High-frequency ultrasonography (HFUS) appears to be a promising method for the detection and differential diagnostics of selected nodular skin lesions. Aim The study aimed at a comparison of the data obtained by using HFUS, histopathological and dermatoscopic images of selected skin lesions to determine their common features. Material and methods Nodular lesions classified as potentially malignant were subjected to clinical, dermatoscopic and high-frequency ultrasonographic examinations. Then the patients were referred for surgical removal with histopathological assessment. Results A total of 54 nodular lesions were examined, out of which 34 were diagnosed as non-melanoma. The most common lesions were melanocytic naevi dermatofibroma, nodular basal cell carcinoma and pyogenic granuloma. Other examined lesions included blue naevus, seborrheic wart, xanthogranuloma juvenile and Spits naevus. In all lesions except Spitz naevus, HFUS images corresponded at least with dermatoscopic or histopathology images. Conclusions HFUS can be used as a supporting diagnostic tool ensuring better pre-operative proceedings. HFUS is a non-invasive, easy and inexpensive screening method for the determination of different skin cancers as it provides valuable information allowing to determine the cutting margins and lesion shape.

Skin melanoma imaging using ultrasonography: a literature review.

Abstract: Melanoma is one of the most unpredictable tumours, as regards both morphology and the course of disease. It may have different clinical forms making it very difficult to diagnose. Therefore, it often surprises even the most experienced dermatologists. Despite numerous attempts, no efficient treatment of advanced stages have been elaborated, and early detection and removal of a skin lesion currently constitutes the most efficient treatment method. Diagnostics uses different types of dermoscopic techniques characterised by considerable sensitivity and specificity in detecting melanoma at an early developmental stage. A continuous development of medical technologies leads to improving many methods of skin lesion imaging. Ultrasonography is one of these methods, enabling evaluation of the thickness of melanoma in vivo with high precision. Change thickness is the decisive factor influencing 5-year survival. The paper evaluates the usefulness of high-frequency ultrasonography (HFUS) in pre-operative melanoma imaging on the basis of literature review. Additionally, the use, role and placement of HFUS in skin melanoma diagnostics is determined.

Melanoma and other malignant skin cancers in psoriatic patients treated with phototherapy. Role of the p16 protein in psoriasis.

Abstract: Recently, the potential risk of malignant skin cancer development in psoriatic patients has been highlighted. It seems that some pathogenetic factors in psoriasis could predispose to a malignant transformation. So far, the relationship between the therapeutic schemes in psoriasis and possible neoplastic transformation has not been clearly explained. The phototherapy is considered a very effective therapeutic method in psoriasis, however, the pathogenesis of some malignancies is associated with the exposure to UV radiation. One of the defence mechanisms that protect the cells from damaging and mutagenic factors, such as UV radiation, seems to be the p16 protein. Moreover, in recent years, the altered expression of the p16 protein in the diseases not related to malignant transformation, including psoriasis, has been observed. The new hypothesis suggesting a participation of the p16 protein in psoriatic plaque formation has appeared.

Evaluation of the clinical usefulness of high-frequency ultrasonography in pre-operative evaluation of cutaneous melanoma - a prospective study.

Abstract: Introduction There are many papers in the available literature on the pre-operative evaluation of malignant melanoma (MM) using a 20 MHz probe. In many Western European countries, this examination is standard in the diagnosis of such lesions in terms of the resection margin. However, few papers describe and compare the results of melanoma thickness measurements using 20 and 50 MHz frequency probes. Aim The aim of the study was to evaluate the thickness of melanoma using 20 and 50 MHz probes. In addition, the obtained values were evaluated in comparison to the thickness values obtained in the histopathological examination. Material and methods Melanoma malignum was confirmed histopathologically in 19 out of 72 patients. Then only those 19 patients were enrolled in the study. Results A correlation was demonstrated between the thickness of the melanoma measured with the 20 and 50 MHz probes, expressed in mm, and the thickness obtained in the histopathological examination expressed in millimeters (Breslow's scale). It was 0.759 (p < 0.001) and 0.734 (p < 0.001), respectively. The average thickness of melanomas obtained in ultrasound examination was identical for both probes and was 0.74 mm. Conclusions It seems that both types of probes can be used to assess melanoma thickness. The demonstrated correlation of high-frequency ultrasonography (HFUS) thickness with Breslow's scale indicates that the HFUS evaluation can be used in determination of melanoma resection margins as a repeatable, painless, non-invasive test.

Neoplasms with Follicular Differentiation

Abstract: If you wish to order, or require further information regarding the titles reviewed here, please write or telephone the BMJ Bookshop, PO Box 295, London WC1H 9TE. Tel: 071 383 6244. Fax: 071 383 6662. Books are supplied post free in the UK and for British Forces Posted Overseas addresses. Overseas customers should add 15% for postage and packing. Payment can be made by cheque in sterling drawn on a UK bank, or by credit card (MasterCard, VISA, or American Express) stating card number, expiry date, and your full name.

Lichen Planus and Lichenoid Disorders

Abstract: Lichen is a rather common chronic inflammatory, immune-mediated disease which affects the skin and the mucous membranes; it occurs in Caucasian and in pigmented skin populations without ethnic predilection. The clinical manifestations represent a non-specific mucocutaneous reactive pattern, precipitating after diverse irritating factors and environmental conditions. It seems that individuals with heavily pigmented or black skin are predisposed to develop a lichenoid response after chronic irritation.

High-frequency ultrasound in clinical dermatology: a review.

Abstract: Ultrasound was first introduced in clinical dermatology in 1979. Since that time, ultrasound technology has continued to develop along with its popularity and utility. Today, high-frequency ultrasound (HFUS), or ultrasound using a frequency of at least 10 megahertz (MHz), allows for high-resolution imaging of the skin from the stratum corneum to the deep fascia. This non-invasive and easy-to-interpret tool allows physicians to assess skin findings in real-time, enabling enhanced diagnostic, management, and surgical capabilities. In this review, we discuss how HFUS fits into the landscape of skin imaging. We provide a brief history of its introduction to dermatology, explain key principles of ultrasonography, and review its use in characterizing normal skin, common neoplasms of the skin, dermatologic diseases and cosmetic dermatology. As frequency advancements in ultrasonography continue, the broad applications of this imaging modality will continue to grow. HFUS is a fast, safe and readily available tool that can aid in diagnosing, monitoring and treating dermatologic conditions by providing more objective assessment measures.

The risk of skin cancer in psoriasis patients treated with UVB therapy.

Abstract: Phototherapy is an effective and widely used treatment for generalised plaque psoriasis. Despite the mutagenic effects of UVB this type of therapy is still assumed to be a safe treatment option. We have performed a cross sectional study to assess the risk of skin cancer in the cohort of psoriasis patients treated with UVB. A total of 162 white patients (116 men and 46 women, mean ± standard deviation age 56.0 ± 13.5 years) were included in the study. All patients have previously been treated with UVB at least 100 times in the last 5 years. Eight patients (4.9%, 0.95 CI: 2.2-9.5%) out of the 162 included in the study had histopathologically verified skin cancer. We found that the risk of skin cancer in psoriasis patients treated with UVB correlated with the number of treatments (controlling for age) but not with the type of UVB lamp. How-ever, the overall risk of malignancy in the UVB-treated patients was not greater than in the general population.

Granuloma faciale: a rare disease from a dermoscopy perspective

Abstract: The granuloma faciale is a rare and benign skin disease of unknown etiology, characterized by chronic leukocitoclastic vasculitis. It is characterized by skin lesions predominantly facial whose course is chronic and slowly progressive. The diagnosis is based on clinical features, histopathology and, more recently, in dermoscopy. We describe the case of a male patient, 40 years old, with a sarcoid lesion on the malar site, whose histopathological examination revealed a mixed inflammatory infiltrate with presence of Grenz zone. Dermoscopy revealed a pink background with white striations. The definitive diagnosis is made by histopathologic evaluation, and dermatoscopy can be helpful. It is known to be resistant to therapy, oral medications, intralesional and surgical procedures are options.