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Clear cell acanthoma represent a benign solitary epidermal tumor of the clear glycogen containing epithelial cells, which is quite common in dermatologic practice. The etiology of this tumor formation is not known exactly at the moment. Clinically, the lesion appears as a single reddish papule or papule-nodule and the characteristic of this lesion is represented by a peripheral scaling collarette. Although solitary lesions represent the most common form of presentation of the acanthoma with clear cells, less than thirtieth cases of multiple clear cell acanthoma, from two up to four hundred lesions, have been described in the medical literature to date. The diagnosis based on clinical features frequently needs to be supported using a dermoscopy exam and, in most cases, a histopathology exam is required. The treatment consists is complete removal (standard surgical excision, cryotherapy, electrofulguration alone, carbon dioxide laser or shave removal or curettage followed by electrofulguration). For the cases with multiple lesions, cryotherapy, or topical 5- fluorouracil are preferred. We present the case of a 62-year-old male patient, presented to our Dermatology Department for multiple asymptomatic rounded papules and multiple exophytic nodular tumor formations (approximate fifteen), on the lower extremities, which had occurred approximately two years previously and gradually increased in number.

Obesity correlates with a higher risk of fractures in some sites as vertebras, upper arm, and legs. This is a narrative mini-review focused on several key points that link obesity with osteoporosis. Waist circumference may a better predictor of fractures than body mass index (BMI) in obese females. Even obese menopausal women have an extra source of estrogens in fat tissue this actually is not enough to offer a complete protection against osteoporotic fractures. Low levels of testosterone in males induce a higher risk of fall dependent or independent of sarcopenia (which is more evident in elderly). High BMI is correlated with vitamin D deficiency. Obesity is a contributor to muscle damage and decline due to fat accumulation and inefficient fuel utilisation by the muscle, namely sarcopenic obesity, regardless the age. Associated type 2 diabetes mellitus involves bone damage and fracture risk due to glycated proteins of the matrix, the changes of adipokines, increased cortical porosity, high risk of fall because of blood pressure and glycaemia anomalies, visual disturbances, renal and peripheral nerves diabetes-associated conditions etc. The fracture risk is also augmented via fat derived cytokines and chronic inflammation. Even it seems logical that the weight correction though bariatric surgery reduces the fracture risk in obesity, actually data from longitudinal studies pointed that, despite the procedure is life saving, it does not actually protect against osteoporosis which is regarded as a potential long-term complication. A high fracture burden in obesity should increase the level of awareness for practitioners of different medical areas due to multiple levels of complications and to the epidemiological impact of obesity.

Psoriasis is a chronic, immune-mediated inflammatory disease that significantly affects a patient's quality of life. Several systemic complications can influence disease progression and response to treatment. Biological therapy is considered the most effective therapeutic option in treating moderate to severe forms of psoriasis. The success of therapy may depend on its persistence, also known as drug survival. The dermatologist needs to be aware of comorbidities and factors that influence the persistence or discontinuation of biological treatment to make appropriate treatment decisions. We have identified several studies on the persistence of biologic therapy or drug survival in patients with psoriasis and summarized some of the most important issues known to date. In several recently published studies, the survival of ustekinumab is better than TNF‐α inhibitors but lower than ixekizumab. Notably, the studies were performed on a limited number of patients and follow-up time. Moreover, secukinumab appears to have a shorter drug survival than other biological agents, especially in patients with biological experience. A real indicator of therapeutic success could be a high quality of life. Female gender and obesity have been consistently highlighted among the predictors of treatment discontinuation, while psoriatic arthritis could be a predictor of persistence and maintenance of biological therapy. We are currently aiming to improve the therapy for patients treated with biological agents to reduce the pressure on the national public health system.

Breast cancer remains a significant health concern, with predictions indicating a rise in global incidence. While the
primary focus is on oncological radicality, the aesthetic and psychological impacts of surgical interventions, such as radical
mastectomy, cannot be ignored. This study, conducted over 8 years, aimed to identify factors that can prevent unnecessary
lymphadenectomy. The research analyzed various parameters, including age, BMI, tumor size, and immunohistochemistry, to
determine their correlation with axillary lymph node invasion. The results highlighted the importance of tumor size and estrogen
receptor status in predicting axillary lymph node metastasis. The study underscores the value of sentinel lymph node biopsy in
early breast cancer treatment, emphasizing its benefits over complete axillary lymph node dissection.

"Melanoma outcome seems different between females and males, with a potential protective role of estrogen (E) through estrogen receptors (ER) expression into the tumor. In the study of ERs, both alfa (ERα) and beta (ERβ) is a well-known endocrine elements in non-melanoma tumors, like mammary and endometrial cancer. Immunohistochemistry (IHC) assessment of melanoma concerning ERs represents a path to explore the tumor profile to provide useful information concerning the prognostic and potential adjuvant treatment. Currently, this is not a routine practice, nor a mandatory step for deciding the medical therapy. Typically, IHCs are based on usual kits for mammary tumors regarding ERs configuration. Prior/concomitant use of oral contraceptives and hormonal replacement therapy is not correlated with a better prognostic in melanoma; neither have they represented a contraindication for survivors of melanoma; a subset of tumors might present a higher ER expression which is potentially targeted by the hormone-based treatment as SERMs (Selective Estrogen Receptors Modulator), for instance, tamoxifen. Experimental studies on melanoma cell lines confirmed the anti-tumor activity of ERβ which might function as a prognostic marker. G-protein-coupled estrogen receptors in melanocytes and keratinocytes might be involved, too. Additional crosstalk of TGF-β (Transforming Growth Factor β), respective IGF1 (Insulin-like Growth Factor), and ERα expression are involved in tumorigenic pathways. Recent preclinical studies showed the potential benefits of diarylpropionitrile, a selective agonist of ERβ; pyrazole derivates 21-23 can block ERs. Murine melanoma models showed the interference of anti-estrogenic medication (like molecule fulvestrant) to enhance immune checkpoint blockade, a modern approach to solid cancers. The proliferation of melanoma might be partially explained by ERs; whether this is generally applicable or there is a subgroup of tumors particularly related to E status is still debatable. The subject of E status in melanoma is far from clear at this point and further studies are necessary concerning this particular issue to implement it as a practical approach in the daily management of a disease that still has a very severe prognostic nowadays "

"Boosted by the COVID-19 pandemic, the adoption of technology has shifted people's lifestyles, impacting social interactions and leading to an increase in the use of telemedicine, including teledermatology (TD). Social media platforms facilitate communication between patients and physicians, between primary care physicians and specialists, and between dermatologists. The study aimed to assess the attitudes, views, and usage of dermatologists regarding TD consultations. A cross-sectional study was performed with the use of an anonymous, web-based questionnaire intended to be completed by dermatologists. A total number of 73 physicians, both resident and board-certified dermatologists completed the survey. Almost everyone (98.6%) used some form of teledermatology, the most frequently used platforms being WhatsApp, followed by classical telephone calls/messages, email, and other forms of TD. TD is considered to be especially useful in communicating with peer colleagues (94.4%), with physicians of other specialties (90.0%), with family doctors (72.9%) and with patients (69.9%). Since TD can facilitate the treatment-related follow-up of adverse effects, while also being useful in the triage of patients, its use will likely increase in the future. The main concerns were related to the accuracy of the diagnosis through TD, a less developed doctor-patient relationship, a less informative consultation, an increased workload as well and a diminished financial reimbursement. Dermatologists currently use TD in addition to the classical consultations of patients, as well as to communicate with family physicians and peer colleagues to better manage complex cases. Furthermore, TD proves to be an important tool in the education of young dermatologists."