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Background: Idiopathic inflammatory myopathies (IIM) are a rare heterogeneous group of diseases characterised by chronic skeletal muscle inflammation, but other organs are also frequently involved. IMM represent a diagnostic challenge and a multidisciplinary approach is important to ensure successful diagnosis and adequate follow-up of these patients. Objective: To describe the general functioning of our multidisciplinary myositis clinic, highlighting the benefits of multidisciplinary team management in patients with confirmed or suspected IIM and to characterise our clinical experience. Methods: Description of the organization of a dedicated multidisciplinary myositis outpatient clinic, supported by IMM specific electronic assessment tools and protocols based on our Portuguese Register - Reuma.pt. In addition, an overview of our activity between 2017 and 2022 is provided. Results: An IIM multidisciplinary care clinic, based on a close collaboration between Rheumatologists, Dermatologists and Physiatrist is detailed in this paper. One hundred and eighty-five patients were assessed in our myositis clinic; 138 (75%) of those were female, with a median age of 58 [45– 70] years. At the last appointment, 130 patients had a confirmed IIM diagnosis, and the mean disease duration was 4 [2– 6] years. The most frequent diagnosis was dermatomyositis (n = 34, 26.2%), followed by antisynthetase syndrome (n = 27, 20.8%) and clinically amyopathic/paucimyopathic dermatomyositis (n = 18, 13.8%). Twenty-four patients (18.5%) were on monotherapy and 94 (72.3%) were on combination therapy. Conclusion: A multidisciplinary approach is important to ensure the correct diagnosis and follow-up of these patients. A myositis clinic, with a standardised practice at a tertiary hospital level, contributes to a standardization of care and opens research opportunities. [ABSTRACT FROM AUTHOR]

Targeted therapy and immunotherapy have markedly improved prognosis of advanced melanoma patients. With expanded use of these drugs, a range of cutaneous adverse events has emerged. Although the vast majority of adverse events are low-grade, they many cause significant morbidity and can affect patients' quality of life. Early diagnosis and prompt intervention may prevent unnecessary discontinuation of life-saving anticancer therapies. In this article, we review the cutaneous adverse events of small molecules and monoclonal antibodies used for the therapy of melanoma and discuss their pathophysiology and recommendations for prevention and management of these adverse events. [ABSTRACT FROM AUTHOR]

The clinical diagnosis of dermatomyositis can be difficult and challenging. In the right clinical setting and with the use of the recently described myositis specific antibodies, an earlier diagnosis can be made and therapeutic approaches promptly started, minimizing the risk of disease progression. We herein present a case of a patient with mechanic's hands and a previously documented drug eruption to hydroxychloroquine. Although these clinical findings are not pathognomonic of dermatomyositis, in the right clinical scenario, they are precious diagnostic tools. [ABSTRACT FROM AUTHOR]

Reflectance confocal microscopy (RCM) is a noninvasive real-time imaging technique that has been widely used for the diagnosis of skin cancer. More recently, it has been reported as a useful tool for the diagnosis and management of several inflammatory and infectious skin disorders. This article provides an overview of the current available applications of RCM use in cutaneous infections and infestations. PubMed was used to search the following terms in various combinations: reflectance confocal microscopy, skin, hair, nail, infection, parasitosis, mycosis, virus, bacteria. All papers were accordingly reviewed. In most cutaneous infections or infestations, the main alterations are found in the epidermis and upper dermis, where the accuracy of confocal microscopy is nearly similar to that of histopathology. The high resolution of this technique allows the visualization of most skin parasites, fungi, and a few bacteria. Although viruses cannot be identified because of their small size, viral cytopathic effects can be observed on kératinocytes. In addition, RCM can be used to monitor the response to treatment, thereby reducing unnecessary treatments. [ABSTRACT FROM AUTHOR]

Most patients have typical features of infective panniculitis, with suppurative granulomas within the lobule and a neutrophilic infiltrate.2 Requena et al described a series of 13 patients with cutaneous mucormycosis in which histopathologic features mimicked pancreatic panniculitis and gouty panniculitis.3 As in the cases reported, we observed a lobular, calcifying panniculitis with ghost adipocytes that are the hallmark of pancreatic panniculitis. CONCLUSION Cutaneous mucormycosis is an emerging fungal infection that must be considered in the differential diagnosis of a calcifying panniculitis, particularly in immunocompromised patients. Cutaneous mucormycosis is a serious infection, with a high overall mortality.2 The diagnosis of cutaneous mucormycosis is challenging and a high clinical awareness may improve the prognosis, as early diagnosis and prompt management are crucial to prevent fatal outcome. [Extracted from the article]

Non-sexually transmitted urethritis are rare and may be caused by uropathogens in the context of urinary tract manipulation or anatomical abnormalities. We present a case of Pseudomonas urethritis in a 71-year-old man who had undergone prior cystectomy and cutaneous urinary diversion. This case illustrates the importance of considering and investigating less frequent causes of urethritis, ensuring that correct treatment is given, in order to avoid possible complications. [ABSTRACT FROM AUTHOR]

Quercus cerris is an important species in the forests of Kosovo with a potential high economic value, although there is little information on the stem quality for the saw-milling industry. This study brings data on wood properties, particularly on heartwood, sapwood and bark development within Q. cerris trees grown in two sites in Kosovo, where mature trees were felled, and discs taken at different stem height levels. The average radial growth rate was 1.21 and 1.76 mm yr-1 for both sites. Heartwood decreased from the tree base upwards with a proportion of 53% and 43% until 5 m of height in the two sites. The radial width of sapwood was higher at the stem base (on average 44 mm) and afterwards approximately constant at 32 mm. The taper was low at an average 3.3 mm m-1 between 3.3 and 7.3 m of height. Bark represented on average 16.4% of the total stem cross-section and contained a substantial proportion of rhytidome (51% of the total bark area proportion at stem base and 41% at 9.3 m). Q. cerris in Kosovo showed good potential as a timber species for the supply of stem wood to the saw-milling industry, allowing good yields of heartwood-only sawn wood components. The bark should also be considered for complementary valorization. [ABSTRACT FROM AUTHOR]

Diabetes is a serious, chronic disease with a rising prevalence worldwide. Its complications are a major cause of morbidity and mortality and contribute substantially to health care costs. In this article the authors review the most common and sensitive skin manifestations that can be present on patients with diabetes and prediabetes. The prompt recognition of these frequently underestimated entities is extremely important as it may trigger not only an adequate metabolic evaluation but also a timely referral and appropriate treatment, minimizing the secondary effects of long-term diabetes and improving the prognosis of diabetic patients.

A 24-day-old female newborn presented with multiple annular erythematous plaques with a targetoid shape, on the forehead, neck and upper trunk, that had begun ten days earlier. She had been diagnosed with citrullinemia type 1 in the first week of life and arginine supplementation was initiated. Her personal and family history was otherwise unremarkable. Laboratory tests showed high levels of anti-La/SSB and anti-Ro/SSA in both mother and baby. The patient was diagnosed with Neonatal lupus erythematosus on the basis of the clinical, histopathological and laboratorial findings. Neonatal lupus is a rare immune-mediated disease that results from transplacental transfer of maternal IgG antinuclear antibodies. The disease can affect different organs, mainly the skin and heart. Although the skin lesions are usually characteristic, they pose a diagnostic challenge in the absence of maternal history.