Diagnosis, tratament and follow-up of patients with melanoma during COVID-19 pandemic is quite challenging. These patients are often immunocompromised, but, on the other hand, management of this malignant skin cancer should not be delayed. It is necessary to diagnose and stage the melanoma as soon as possible, in an attempt to provide a better prognosis. There are few data regarding the treatament of melanoma during COVID-19 pandemia. However, the general recommandations suggest testing all cancer patients prior administration of the therapy. The European Society for Medical Oncology (ESMO) provided guidelines regarding therapy of this skin cancer during COVID-19 pandemic. Every patient is different, and it is always important to evaluate the risks and benefits.

Bart syndrome is a genetic disorder that is characterized by the association of congenital localized absence of the skin (aplasia cutis), blister formation (epidermolysis bullosa), dystrophic nails and lesions of the mouth mucosa. The association of this diseases is considered a variant of aplasia cutis congenita (ACC) with epidermolysis bullosa (EB). The inheritance pattern of Bart’s syndrome seems to be autosomal dominant. Aplasia cutis congenita (ACC) is a group of heterogeneous diseases representing failure of the skin to fully develop. Frieden created a classification system for ACC consisting of nine groups based on the number and location of the lesions and the presence or absence of associated malformations. In this report, we present a rare case of Bart syndrome in a newborn female baby with aplasia cutis in the lower extremities associated with lesions of epidermolysis bullosa on the face and on the hand fingers first, then located also on the thighs, and dystrophic nails.

Cutaneous melanoma is a malignant tumor that develops from melanocytes found in the basal layer of the epidermis. Even though it is not the most common type of skin cancer, it is the most aggressive one with an increasing incidence worldwide. The risk factors inherited in the appearance of melanoma are sun exposure together with severe sunburns in childhood and adolescence, high number of moles and genetic factors. We present the case of a 66 years old women with numerous skin sunburns in the past years who refer to our clinic for three pigmented skin lesions, with asymmetrical edges, elevated to the cutaneous plane, with a diameter of 2 cm for the largest one and chromatic dysmorphism, located on the posterior thorax. The dermoscopic examination was suggestive for cutaneous melanoma. We performed the surgical excision of all three cutaneous tumors and the histopathologic examination was performed. The diagnosis of all three lesions was of melanoma. A CT examination was made together with sentinel node biopsy. The aim of this paper is to present a rare case of simultaneous three skin melanomas and the treatment alternatives of this patient after clinical and paraclinical investigations.

Sarcoidosis is a multisystemic granulomatous disease, with unknown etiology, characterized histopathologically by the development in the affected organs of some „empty” (non-caseous) granulomas. Cutaneous lesions can sometimes be the fi rst localization of the disease. We present the case of a patient with known sarcoidosis and autoimmune thyroiditis, who developed a rash spread on the trunk and limbs, for which she was treated with dermatocorticoids and antihistamines, but without significant improvement. A skin biopsy was performed with histopathological examination, which revealed: at the dermal level, lympho-histiocytic infiltrates with nodular distribution, forming several granulomas, without areas of necrosis of caseification, including frequent cells with epithelioid appearance, suggestive for the diagnosis of cutaneous sarcoidosis. The patient underwent systemic cortisone therapy and hydroxychloroquine, with favorable outcome. The challenge of diagnosing this pathology is to differentiate it from a number of conditions, including: ring granuloma, cutaneous Crohn’s disease, lipoid necrosis, lupus vulgaris. To establish the diagnosis of certainty, it is necessary to correlate the clinical data with the result of the histopathological examination.