Introduction: dermatoscopy is a non-invasive technique which allows us to explore and evaluate the structures of the epidermis, the dermo-epidermal junction and the papillary dermal layer in vivo. Cognition of the specific diagnostic patterns lead to a right clue and proper diagnosis suggestion. Dermatoscopy depends on the timely correct recognizing of dermatoscopic findings and features and is therefore terminated and limited by time input and by experience of a physician. Dermatoscopy gained a great role in general dermatology with its importance in early diagnostics of a malignant melanoma and has become a valuable tool for the diagnosis of a various infectious and inflammatory diseases, nail pigmentations, hair abnormalities and scalp disorders including ectoparasitic infestations, cutaneous/ mucosal infections, psoriasis. Patients and methods: investigations are provided by dermatoscopy equipment – Dermatoscope MoleMax II. Our study included 791 patients (490 women and 301 men), in which we recorded a total of 1670 lesions in the period from May 9, to May 13, 2011. Results: from the total number of lesions analyzed there were 944 melanocytic and 726 nonmelanocytic lesions. Within melanocytic lesions, histopathology confirmed 9 malignant melanomas. From nonmelanocytic lesions present were: seborrheic keratosis 307, actinic keratoses (precancerosis) 118, hemangiomas 77 and bacocelular skin cancer BCC 68. Discussion: dermatoscopy is a method of epiluminiscent microscopy that in the analysis of tumor skin changes has completely replaced the standard magnifying glass. Credibility of dermatoscopy is going from 70-90% and the dermatoscopy became an indispensable diagnostic tool in the analysis of tumor changes on the skin. Conclusion: the dermatoscopy is valuable tool in diagnostics of variety of skin disorders in the field of general dermatology.

Introduction: Basal and squamous cell carcinomas are often grouped together and referred to as non-melanoma skin cancer. Basal cell carcinoma is the most common form of skin cancer. Basal cell skin cancer occurs on the face,nose, scalp, ears, hands, shoulders and back. Squamous cell carcinoma is the second most common type of skin malignancy. They are most often found on the face especially lower lip. Material and methods: The retrospective study included all patients by whom BCC was diagnosed during the period from January 1996 till December 2000 in Dermatology Department Clinical Center University of Sarajevo. Results: Number of BCC was 188. Male 98, female 90. Localization of BCC on the body in percents: upper lip: 8%, neck: 5%, trunk: 4%, hands: 7%, face: 76%. Representation of BCC on face: cheeks: 51, nose: 47, temporal region: 18, forhead: 17, periocular region:7, upper lip: 3. All of the patients were x-rays treated and cured without any failure, with one incident of radiodermatitis and one apparation of recurrences. Discussion: The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is common. Conclusion: The choice of therapeutic method depend on size, location, clinical type of BCC, age, general condition and attitude of the patient. Therapeutic methods can be surgery excision, cryosurgery, electrosurgery, radiotherapy and local cytostatics. Radiotherapy is indicated when BCC localization is inconvenient for surgical excision and it gives great results.

UNLABELLED Atopic dermatitis (i.e) Atopic eczema is a long-lasting skin disease with known hereditary component. Blood tests, especially IgE antibodies whose levels are often high in AD, are helpful. The aim of this study was to investigate the correlation between the clinical symptoms and the level of the IgE antibodies in atopic dermatitis patients, depending on their age. METHODOLOGY A retrospective study was conducted for the period between 2005 and 2010 and included were all the patients (62) in whom the AD was diagnosed. The results showed that the IgE level was highest in the patient group from 16-25 years and also seen was the tendency of IgE decreasing level correlated to increasing patient age.

Primary skin melanoma and skin cancers have been more prevalent in the previous decades and therefore have become a very significant public health problem. Dermatologists of the Skin and Venereal Diseases Clinic of the University of Sarajevo Clinics Centre initiated the first public preventive action called "Days of Fighting Melanoma" in May 2008. The objective of the campaign was to provide free dermatological examinations to all volunteers and to inform, through the media, wider population on early signs and recognition of skin cancer and the importance of sun protection. The total of 325 citizens were examined clinically and with dermatoscope in the period between 5 and 31 May 2008. The examination also included histological diagnoses: 7 patients with confirmed melanoma, 30 with basal cell carcinoma and 2 with spinocellular carcinoma. The results suggested a need for the expansion of the campaign to other towns in our country in order to demonstrate the importance of early detection of the disease and treatment options.

Recent evidence suggests that the angiotensin converting enzyme (ACE) is present in skin. The real value of the determination of ACE activity as a clinical-biochemistry test for the diagnosis of psoriasis has not been attained. Serum and tissue ACE were measured in 60 patients with psoriasis, 20 patients with lichen planus, 20 patients with seborrhoic dermatitis and in 20 healthy individuals. The serum and tissue ACE activity was determined before and after therapy, using the spectrophotometric method and hippuryl-l-histidyl-l-leucine as a substrate. The results showed that serum ACE activity before therapy was significantly increased in both groups--patients with psoriasis (p < 0.001) and patients with lichen planus (p < 0.001) in comparison to healthy individuals. However, there were no significant differences in serum ACE activity among patients with seborrhoic dermatitis and healthy individuals. After therapy, serum ACE activity significantly decreased in both groups of patients with psoriasis and patients with lichen planus comparing it to the level found in the control group. The values in both were similar. The tissue ACE activity in altered skin was significantly increased only in the patients with psoriasis in comparison to uninvolved skin of these patients, as well as the skin of healthy individuals. After therapy, there were no significant differences in tissue ACE activity between the treated skin and the healthy skin. In conclusion, determination of tissue angiotensin converting enzyme activity can be used in the differential diagnostic of indistinct clinical forms of psoriasis.

In 15 years period (1989 - 2004) we have treated at our Clinic a total of 101 patients diagnosed with erythema nodosum which makes 2.9% of the total number of patients treated in this period. In order to explore correlation between dermatological and lung diseases we applied statistical analysis with respect to number, sex, age and irregularities occurring on the skin surface. Female patients dominated with 96 of them (95.6%) in the group, while only five patients were male (4.3%). This makes 22 : 1 scale in favor of female patients, as opposed to usual 5:1 ratio. Similar predominance (86%) was found in the study conducted by Mert and Gurkan (1.2). Average age of the patients was 41.6 years, which is slightly higher than the average of 18 and 34. The youngest patient was 17 and oldest 77.

Dermatoscopy, also known as dermoscopy, is a noninvasive, in vivo technique for the diagnosis of pigmented skin lesions. It improves the diagnostic accuracy for melanoma compared with examination with the unaided eye but only for experienced observers who have been specifically trained. In November 2007, for the first time, a dermatoscopy course took place in Sarajevo, Bosnia & Herzegovina. The interactive course covered all aspects of modern dermatoscopy and was well received by the participants.

Regardless of method used, dermoscopy improves diagnostic procedures for the pigmentation skin changes, but only for the experienced examiners. That is why the adequate training is of outmost importance. Dermoscopy is excellent method for detecting melanomas at the earliest stage. This technique is not used to monitor nerves, but to detect melanomas at early stage. Follow-up is not an indication for one suspicious lesion. That kind of lesions should be removed. In case of patient with many typical lesions, excision of this entire lesion is not feasible. Instead of that, we use follow-up with clinical imaging, as well as digital dermoscope imaging, which once again depend on patient’s priority, as well as doctors estimate and patient consent.

Tissue angiotensin-converting enzyme (ACE) was measured in 60 patients with psoriasis and in 20 healthy individuals. According to clinical forms of psoriasis, patients were further divided into three groups: psoriasis with solitary lesions (n=20), psoriasis with multiple disseminated lesions (n=20) and erythrodermic psoriasis (n=20). The tissue ACE activity was determined before and after therapy, by the spectrophotometric method using hippuryl-l-histidyl-l-leucine as a substrate. The enzyme activity is expressed in units: 1 U corresponds to 1 nmol of hippuric acid released by hydrolysis of hippuryl-l-histidyl-l-leucine per minute and 50 mg of the tissue. Before therapy, tissue ACE activity was significantly increased in patients with psoriasis (4,14+/-0,34; X+/-SEM) in comparison to healthy individuals (1,86+/-0,16). The greatest increase in tissue ACE activity was observed in patients with erythrodermic psoriasis (4,72+/-0,65), followed by those with multiple disseminated lesions (4,24+/-0,63) and solitary psoriatic lesions (3,47+/-0,48). After therapy, serum ACE activity was significantly decreased in all clinical forms of the disease. Determination of tissue ACE activity might be a good non-specific parameter for assessment therapeutic effects.

Background. Uremic pruritus is common complaint among dialysis patients. The prevalence of renal itching in patients on dialysis is approximately 30%, but its treatment is often ineffective. The etiology of uremic pruritus remains unclear. The aim of this study was to evaluate the prevalence and severity of pruritus, and to correlate its presence and intensity with relevant clinical and laboratory parameters. Methods. Seventy-seven patients on maintenance haemodialysis were enrolled in the study. The mean age of patients was 55,78 ± 14,11 and duration of dialysis was 5,27 ± 3,80 years. Itch intensity was scored as mild, moderate and severe. One interviewer surveyed seventy-seven patients over three-day period. Some clinical and laboratory parameters were evaluated (age, sex, duration of dialysis, etiology of chronic renal failure (CRF), hematocrit, calcium, phosphorus, parathyroid hormone (PTH), Kt/V, calcium & phosphorus product). Ten patients with refractory pruritus were treated with UVB irradiation for two months, three times weekly, two minutes per each treatment. Results. Forty-five of seventy seven patients experienced itching (58,44%). The intensity of itching was mild, moderate and severe, in 42,22%, 40,0%, 17,78% of patients, respectively. In 19 patients (42,22%) pruritus intensified during and after dialysis. There was no significant difference in the serum levels of calcium, phosphorus, PTH, hematocrit, albumin and duration of haemodialysis. However, there was a significant difference in value of Kt/V in patients with pruritus (p<0,01) which has been lower, as well as the product of Ca and P04 (p <0,05). Conclusions. Our study has shown that increasing the dose of dialysis (Kt/V) leads to an improvement in uremic pruritus. Also UVB irradiation of the body, 1-2 minutes twice a week in ten patients resulted in long-lasting remission of the pruritus.

Skin and subcutaneus diseases morbidity in outpatients setting is characterized by 5% rate of global structure diseases and health state population in the SR BiH and F BiH, then high rate of skin and subcutaneus diseases morbidity and constant decrease of level of morbidity (number of diseases in the 1000 inhabitants) from 59/1000 inhabitant in the 1981 to 51/1000 in the 1991, 43 in the 2001 and 38 in the 2005, (F BiH), what is caused by decline of the level of morbidity in the population age 20 and older--from 58 in the 1981 to 25 in the 2005. The highest level of morbidity is registrated in children of the age 0-6, then in school children and teenagers (15-19) i.e. school children aged 7-14 which have been separated from teenagers (15-19) who have lower level of morbidity. The lowest level of morbidity is registrated in the population aged 20-64,teenagers (15-19) and population older than 65. The category "Infections of the skin and subcutaneus tissue" (LOO-LO8) and "Urticaria and erythema" (L5O-L55) had a highest participation in the structure of global skin and subcutaneus diseases (LOO-L99) but also had the highest decrease in the participation and in the morbidity rate in that period. The category "The others skin and subcutaneus diseases" (LIO-LI4) L2O L45 L55 L99) is ranked third with the lowest participation and increase in the participation at the end of the period due to the decrease in the participation of the two categories mentioned above. Morbidity of this category remained the same (15/1000 inh. In the 1981, 2001, 2005), except for the rate (14/1000) in the 1991. At the end of the observation period (2005) the ranking had changed as it was explained, so that the category "The others skin and subcutaneus diseases" came first, category "Infection of the skin and subcutaneus tissue" second and category "Urticaria and erythema" came on third place.