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Introduction. Melanoma is a malignant tumour that develops from melanocytes and in most cases affects the skin. Although melanomas are usually highly pigmented, they can also be amelanotic. In the structure of mortality from skin cancers, melanoma takes the leading place with a rate of 90%. Even small tumours can metastasise. Under such conditions, early diagnosis is of paramount importance, as its main task is to detect and eliminate the primary lesion before it becomes deeply invasive. However, naked eye examination is limited to a sensitivity of about 75%, and is more effective when the tumour size is more than 5 mm. Among the additional examination methods, dermoscopy has become widespread. The technique has been introduced into the world dermatological practice for a long time and is actively used in Ukraine, demonstrating high efficiency at a relatively low cost of equipment. Materials and methods. Statistical data on 901 cases of newly diagnosed skin melanoma in the Ivano-Frankivsk region were obtained from the bulletins of the National Cancer Registry of Ukraine for the period 2012-2022. Results and discussion. There has been a gradual decline in the number of undetermined melanoma cases according to the TNM classification. The indicator has changed by more than 50 percentage points, with the lowest values at the turn of 2017-2018, and a subsequent increase of 10 percentage points until 2022. The number of reported cases of skin melanoma where the primary tumour distribution corresponds to the TI-TII category has increased, with a peak value of 92.7% as of 2017.  However, in the period 2019-2022, the trend changed dramatically. Since 2019, cases of skin melanoma diagnosed in the state of spread, which corresponds to category TIII, have prevailed – 51.1%, while cases of TI-TII accounted for 32.2% The global COVID pandemic that began in 2019 led to negative trends, contributed to the isolation of patients, and complicated their access to specialists.

Lymphomatoid papulosis is a rare skin disease. The incidence averages 1.5 cases per 1 million population. It is the most common in adults around the age of 40. It was previously considered as paraneoplastic dermatosis, but recent studies have confirmed that lymphomatoid papulosis is a primary CD30 + T-lymphoma of the skin. Despite the aggressive morphological features, it is benign. The disease is characterized by a tendency to spontaneous regression. Typically, skin lesions last 3-12 weeks, although in some severe cases they may last longer. Skin lesions may disappear or recur over decades. Patients require observation because a second lymphoproliferative disease develops in 10-40% of patients.           A case of lymphomatoid papulosis in a patient with diffuse astrocytoma is presented. The patient was treated with systemic retinoids. The results of differential diagnosis and additional research methods, including dermoscopy, are given. Although the use of dermoscopy was not crucial, the results of the research showed microscopic visual differences between the elements of the rash, depending on the stage of the disease. The picture was mostly typical, however, spots formed by the areas of central erythema on the background of light brown areas, with a predominance of the reticular vessels pattern were also noted in addition to the rash elements on the hairy skull. Clarification of this feature requires further study.           The purpose of our report is to draw the attention of dermatologists and family doctors to cases of rare dermatoses. The rareness of the disease, lack of knowledge on the clinical findings lead to diagnostic errors, “inadequate treatment”.

Nevus Spitz is a benign melanocytic proliferation, first described in 1948 by Sophie Spitz as a childhood melanoma. Initially, it was described as an erythematous papule or node, but further studies of the Spitz nevus proved that in 71-92% cases it is a pigmented formation. This pigmentation is often quite intense due to the rapid growth of the formation, which leads to the need for differential diagnosis with skin melanoma. After all, dermatoscopy can be used for this purpose and, when applying this research method, typically a pattern of an exploding star formed by streaks of linear pigmentation and symmetrically located pigment globules placed in the peripheral zone can be revealed. In case of non-pigmented Spitz nevus, spot vessels and reticular depigmentation are visualized. Both pigmented and non-pigmented forms of Spitz nevus in the process of evolution can regress partially or completely. Several clinical cases of different types of spitzoids, both typical and atypical, based on the non-clinical, dermatoscopic and histological diversity of the Spitz nevi, have been demonstrated in the article. Their macroscopic and dermatoscopic features as well as probable signs of dynamic changes are indicated in order to facilitate their recognition by other specialists.