We sometimes encounter a patient who has both cutaneous malignant melanoma and another malignancy. Malignant melanoma is likely to metastasize to lung, liver, bone, and brain. Therefore, when we see a lesion in a visceral organ in a melanoma patient, we need to differentiate whether the lesion is metastatic melanoma or not. Herein we report two cases of melanoma examined with video-assisted thoracic surgical (VATS) lung biopsy for the diagnosis of multiple lung lesion, because the clinical course and imaging findings suggested a low possibility of metastasic melanoma. VATS biopsy revealed one patient to have metastatic melanoma and the other to have primary lung cancer. Therefore, we could stage these patients correctly and choose appropriate treatments. VATS lung biopsy is considered to be helpful in diagnosing solitary or multiple lung lesions in patients with melanoma when it is difficult to differentiate whether the lesion is metastatic melanoma or not.
Haemophilus influenzae is an important cause of community-associated pneumonia, but it rarely contributes to skin infections such as cellulitis, because gram-positive cocci account for a large portion of these diseases. We report a severe case of a 70-year-old, previously healthy man with cellulitis caused by community-associated BLNAR (beta-lactamase nonproducing ampicillin-resistant Haemophilus influenzae) and followed by sepsis. He received cephotaxime sodium, but persistent fever continued. Additional oral administration of levoflocacin was very effective, and his symptoms improved. In the treatment of severe cellulitis cases like ours, intra-venous blood culture can be useful to confirm the causative bacteria.
To evaluate the hydration effect of combination bathing and moisturizing regimens, we applied moisturizers after bathing every day and quantified cutaneous hydration status for 2 weeks in eight healthy volunteers. Hirudoid (Heparinoid)® soft, Vaseline, and Pastaron (Urea)® soft were applied at 2 mg/cm2 to their forearms 1 minute and 1 hour after bathing for 2 weeks. We measured the cutaneous hydration before and after the study almost every other day. There were no significant differences between the application of each moisturizer at 1 minute and 1 hour after bathing. These moisturizers provide hydration benefits by continuoususe. In conclusion, to be effective, patients should apply moisturizers every day at any time they prefer.