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​DERMATOLOGICAL DIAGNOSIS

​Dermatological diagnosis represents a very important segment of expert analysis and an unavoidable step on the way to successful healing. It is a set of special diagnostic techniques used in dermatology to facilitate the establishment of an accurate diagnosis, and at the same time - but not least - to reduce the number of invasive diagnostic methods for certain skin conditions (biopsy, X-ray imaging).

Dermatological diagnostics allows us to make an accurate diagnosis based on the exclusion of differential diagnostic images. Our clinic is special in that we provide a unified one-stop service.

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​DERMOSCOPY

Dermoscopy is a skin examination with a digital device that analyzes the image of changes in the skin with the help of a special video device - a dermatoscope. It is an examination performed exclusively by a dermatologist, which allows for a detailed analysis of changes in the skin. The color, size, border and presence of pigment structures, blood vessels and other formations are determined, which should clarify the nature of the skin change. Dermoscopy is particularly important in the early detection of melanoma and in distinguishing malignant from benign skin changes.

 

DERMOMAPPING

This diagnostic method, which is also performed exclusively by a dermatologist, serves to create a map of changes in the skin. That map represents a basic, initial picture of the quality of the skin. Only pigmentary changes can be noted on it, and blood-vascular or some other changes can also be established. During the following annual systematic examinations, which at our clinic we certainly advise patients, we compare the new condition with a map and in this way we see what changes in the body, what changes have occurred and whether we need to act preventively somewhere, remove something or do something else. treatment.

 

SCINOCOSPIA

Skinoscopy is a videomicroscopic skin examination technique. It is used for diagnostic purposes, with the aim of analyzing the color, structure, keratin formations, vascular component and the entire structure of changes, even when it is not about potential skin tumors.

It is particularly important in the diagnosis of basal cell carcinoma, squamous cell carcinoma, dermatofibroma, seborrheic keratosis, in the detection of scabies and pubic lice, in the examination of warts, and in the determination of margins during surgical or laser excision (removal) of changes.

 

CAPILLAROSCOPY

Capillaroscopy is a videomicroscopic method of examining small blood vessels - capillaries of the skin at the edge, ie. on the nail region screen and on the nail region itself. It is used as an auxiliary method in the early detection of systemic diseases of the connective tissue, as well as control of the treatment of systemic diseases of the connective tissue. The examination is performed without accompanying pain and any discomfort.

TRICHOSCOPY

It is a videomicroscope technique for examining the scalp as a whole or its parts. As a diagnostic technique, it is used in the diagnosis of disorders of the hair structure and diseases of the scalp itself. Trichoscopy without a contact medium is intended to examine the structure of the hair itself, and trichoscopy with the application of a contact medium is used to examine the structures of the scalp skin (such as blood vessels, pigment structures or areas without the presence of hair).

Trichoscopic examination provides a large number of answers when it comes to the disease of the structure of the hair and scalp, and thanks to it, the number of invasive methods in the diagnosis of the same (biopsy) is significantly reduced.

This technique is important in the diagnosis of psoriasis, seborrheic dermatitis, fungal infection of the scalp, androgenetic alopecia, lichen planopilaris, frontal fibrosing alopecia, other scarring alopecias, follicultis, chronic lupus.

MICROSCOPIC EXAMINATION OF HAIR

Examination of the hair by light microscopy is an important clinical method of diagnosing various disorders that affect the characteristics of the hair.

Disorders of hair growth and structure can be observed as primary diseases of the skin adnexa or as secondary involvement of the hair and scalp during the development of other dermatoses. Disturbances in the structure and functional capacity of hair can also be part of various genodermatoses and syndromes.

ULTRASOUND OF THE SKIN

Our clinic is the only one in the area that performs skin examination with high-resolution ultrasound. It is a diagnostic procedure that enables a detailed analysis of the skin layers, changes within the skin and determining the relationship to the surrounding structures. The examination is simple, painless, completely harmless and does not expose the body to radiation.

Ultrasound examination shows the boundaries of tumor tissue, subcutaneous lymph nodes, ulcers, cystic changes inside the skin, foreign bodies in the skin and skin tumors - lipomas, fibromas, atheroma.

COLOR DOPPLER OF BLOOD VESSELS OF THE LOWER EXTREMITIES AND BLOOD VASCULAR MALFORMATIONS

Color Doppler of leg blood vessels is an ultrasound diagnostic method that examines arterial and venous blood vessels.

This examination is indicated for patients who have changes on the skin of the lower extremities, which are associated with impaired circulation (crush, chronic hypostasis dermatitis, purupa pigmentosa, skin sclerosis and varicose blood vessels, thrombosis, diabetic foot).

Color Doppler of blood vessels is especially necessary when patients are being prepared for laser interventions of vascular malformations such as port wine spots (PWS), angiomas, angifibromas and arteriovenous alforms.

By examining the leg veins with color doppler, it is possible to determine the state of the superficial and deep venous vessels, as well as the associated perforators, both in assessing the function of the valves and in assessing the morphology of the walls.

With this method, the potential for thrombosis of superficial or deep venous vessels can be established, as well as dilated veins (varicose veins) can be diagnosed, that is, it can be assessed whether the percentage

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SKIN BIOPSY

It is a procedure of taking a piece of skin, which is performed under local anesthesia in order to establish an accurate diagnosis of the disease.

The skin is first anesthetized with different local anesthetics, which are determined according to the needs of each patient individually. Then a very small segment of diseased skin tissue is taken in the form of a 4mm cylinder or ellipsoidal slice. Such a sample is then sent to a dermatopathologist for histopathological or immunopathological analysis to perform a detailed microscopic examination of the sample.

ALLERGOLOGY TESTING FOR CONTACT ALLERGENS

The test used to diagnose a contact allergy is called an epicutaneous or patch test. It is carried out by gluing the test of diagnostic substances into the chambers, thus fixing it to the surface of the skin. Standardized test contact allergens are used, but individual epicutaneous test allergens are also made according to anamnestic data. The chambers are fixed on the skin of the back or upper arms (on areas not exposed to the sun), and readings are taken after 48 or 72 hours. The test results are interpreted as indicators of a late allergic reaction.

ALLERGOLOGY TESTING FOR INHALER AND NUTRITIONAL ALLERGENS

Prick test is a superficial puncture test, which is performed on the skin of the forearm or back using a drop of test allergen, which is a possible cause of allergy. At least 3 days before the "prick test", the use of oral or injectable antiallergic drugs (antihistamines - except cetirizine, hydroxyzine, clemastine, loratadine, cyproheptadine) or some other drugs that can affect the test results should be stopped: thus, tricyclic antidepressants should be stopped for 6 days , tetracyclines, phenothiazines, H2 receptor blockers for 1 day, and local corticosteroid ointments and creams for 15 days before the test. The skin reactivity results are read 20 minutes after the test is applied. Testing is not performed in the acute phase of the disease or acute exacerbation of a chronic disease.

At our clinic, testing is performed on the following panels of allergens:

Inhalation allergens: Dermatophagoides pt., hair, grass pollen, weed pollen, tree pollen, birch, eska, artemisia, ambrosia, alternaria, cladosporium, and a number of rare and regionally present allergens

 

Nutritional allergens: egg, milk, flour, cereal, peanut, tuna, hake, fish, apple, chocolate, kiwi, banana, lemon, peanut, chicken and a number of individual allergens

 

Preservatives: acetyl-salicylic acid, Na-benzoate, K-metabisulfite, glutaraldehyde, citric acid, Na-glutamate, tartrazine

 

DETERMINATION OF SKIN TYPE

The most important parameters of the skin, which determine the skin type, are:

  • hydration

  • fat (sebum)

  • capillary network (erythema)

  • pigmentation (melanin),

These parameters are key data for determining and recommending the basic preparations that the patient will use for skin care.

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