Acta dermatovenerologica Croatica : ADC最新文献

{"title":"Impact of the COVID-19 Pandemic on Adult Patients with Atopic Dermatitis.","authors":"Weronika Zysk,&nbsp;Magdalena Trzeciak","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a chronic, inflammatory, itchy dermatosis with periods of remissions and exacerbations. Social isolation and lockdown measures may cause increased stress which in turn may affect the skin condition of patients with AD. We aimed to investigate the impact of the COVID-19 pandemic on the course of AD and the mental health of adult patients with AD. The study was based on an anonymous online questionnaire. A total of 91 adult patients with AD participated in this survey. The study population consisted of 77 (84.6%) female and 14 (15.4%) male patients. The average age of patients was 28.3 years. Fifty-four respondents out of 91 (59.3%) noticed a worsening in the course of AD. Patients with worsened AD most often indicated exacerbating itching of the skin (92.6% of 54). Only 54 (59.3%) patients continued treatment as directed by the attending physician. Of those that did not, 13 (14.3%) took or applied fewer medications and 24 (26.4%) stopped taking or applying medications altogether. Of all respondents, 60 (65.9%) believed that their mental health had deteriorated and 11 (12.1%) patients developed suicidal thoughts during the COVID-19 pandemic. The results indicate that the COVID-19 pandemic had a negative impact on the course of AD among adult patients. Forced life changes, increased stress, and poor adherence to treatment may have been contributing factors. Increased stress may have also worsened the mental health of patients with AD, which in turn may have exacerbated AD.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ashy Dermatosis in a Two-year-old Child: A Case Report and Mini-review.","authors":"Shumpei Kamano,&nbsp;Eri Hotta,&nbsp;Sachiko Goto,&nbsp;Mizuho Inagawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ashy dermatosis, or erythema dyschromicum perstans, is characterized by acquired grey patches distributed on the face, neck, trunk, and extremities with an unknown pathophysiology. Herein, we report a case of ashy dermatosis in a two-year-old child, possibly caused by an infection, with eventual improvement within two years, absent any treatment. To our knowledge, this is the second report of ashy dermatosis in a patient under the age of three years, and the first under the age of two years that was followed-up in the English-language literature from 2000 to 2021. Although the eruptions showed eventual improvement without any treatment in our case, all cases do not improve spontaneously. Further research is necessary to differentiate cases that eventually improve from resistant ones and determine treatment options for resistant cases.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"32-35"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brodalumab Seems to Recover Its Therapeutic Efficacy After a Relatively Short \"Washout\" Period with Anti-TNF Agents: A Successful Pattern for Double-switch Therapy.","authors":"Eleftheria Tampouratzi,&nbsp;Konstantinos Sfaelos,&nbsp;Kyriakos Talaiporou,&nbsp;Τheodora Douvali,&nbsp;John Katsantonis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Psoriasis is a lifelong disease with a chronic relapsing course, and treatment agent switching is a common and accepted practice in cases of primary or secondary inadequate response. Patients with prior biologic treatment failure or loss of response are a subset of individuals who most likely have more severe disease with a greater impact on quality of life. Additionally, switching between multiple biologics is associated with clinical consequences (e.g. development of anti-drug antibodies), which may limit efficacy of subsequent biologic therapies (1,2). Adalimumab and brodalumab were both shown to be highly specific and efficient while sparing the cumulative toxicity observed in conventional anti-psoriatic drugs use. An observational study on 5 patients suffering from severe plaque psoriasis provided a successful pattern on double-switching of the aforementioned biologic agents. Therapy was initiated with brodalumab, and after secondary failure or occurrence of arthritic comorbidities, a short washout period with adalimumab followed without striking results. Re-administered brodalumab showed retrieval of initial therapeutic efficacy on both skin and joints. Patients provided written informed consent. Five Caucasian patients (mean age 53.2 years), with severe plaque psoriasis (mean baseline Psoriasis Area and Severity Index (PASI) score 18.58) and seriously affected Dermatology Life Quality Index (DLQI) (median score 19.3) underwent brodalumab treatment with excellent response. However, a secondary loss of efficacy occurred within an average period of 23 months, with intense arthritic implication in three patients. A switch to adalimumab followed, which lasted 4.2 months on average. Due to inadequate response, treatment with brodalumab was resumed (Figure 1). Resumption of treatment with brodalumab, after a rather short ''washout'' period with adalimumab, led to immediate remission of psoriasis, reducing median PASI and DLQI scores to 1.84 and 2.3 respectively, while still maintaining this effectiveness for an average of 8.8 months (follow-up timepoint). The clinical course over time for patient 2 is presented from the start of brodalumab treatment to the first and second relapse before completing and maintaining treatment with this biologic agent (Figure 2). Interestingly, at the same time, comorbidities in 3 of 5 patients with the axial psoriatic arthritis type that had arisen earlier subsided with remarkable clinical amelioration. Switch therapy in patients with severe psoriasis is a common clinical practice, due to the chronic and unpredictable course of the disease, both in nonresponsive or relapsing cases, and few studies have assessed the efficacy of a second line biologic treatment in this population. A real-life, multicenter, prospective study in Italy supported the switch from anti-IL 17 to adalimumab or ustekinumab as a safe and effective therapeutic strategy, but there was a gap for patients with loss of efficacy after failure ","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"48-50"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Primary Apocrine Carcinoma of the Frontal Region: Clinical Presentation, Histopathological Features, and Surgical Treatment.","authors":"Dragana Petrović Popović, Marijan Novaković, Milan Stojičić, Dimitrije Brašanac, Mirjana Petrović-Elbaz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Primary cutaneous apocrine carcinoma (PCAC), a subtype of sweat gland carcinoma, is an extremely rare malignant neoplasm. Distinguishing an apocrine carcinoma from a breast carcinoma metastasis is difficult even for a pathologist. Most arise in regions of high apocrine gland density like the axilla, and rarely on the scalp and eyelid, but they can occur elsewhere on the skin. Primary cutaneous apocrine carcinoma of the scalp is a rare malignancy most often reported in the literature as case reports or small case series. The giant form of primary cutaneous apocrine carcinoma in the frontal region has not been described in the literature, to the best of our knowledge. There are no established protocols for treatment of primary cutaneous apocrine carcinoma. We report a case of a giant primary cutaneous apocrine carcinoma localized in the frontal region. A definitive diagnosis of a primary cutaneous apocrine carcinoma was established by biopsy with microscopic and immunohistochemical analysis. Wide surgical excision and reconstruction with large local transposition flap and split thickness skin grafts for secondary defect were our therapy of choice. Primary cutaneous apocrine carcinoma is a very rare malignancy, and the giant form has not yet been described. Surgical treatment provided the patient with tumor-free status as well as satisfactory aesthetical appearance and quality of life.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatitis Artefacta: A Practical Guide for Diagnosis and Management.","authors":"Julio Torales,&nbsp;Karina Malvido,&nbsp;María Alejandra Vázquez,&nbsp;Iván Barrios,&nbsp;José Almirón-Santacruz,&nbsp;Rodrigo Navarro,&nbsp;Marcelo O'higgins,&nbsp;Gabriel Casas,&nbsp;João Mauricio Castaldelli-Maia,&nbsp;Antonio Ventriglio,&nbsp;Israel González-Urbieta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dermatitis artefacta (DA) is a psycho-dermatologic condition based on patients' behavioral patterns, characterized by an intentional production of cutaneous lesions on their own skin. The clinical presentation can be highly variable. Patients with DA seldom seek psychological support or psychiatric consultation. More often, they seek help from their primary care physician or dermatologist. This review article aims to provide a practical guide for the diagnosis and management of AD and affected patients. A broad literature search was performed using the PubMed and Google Scholar electronic online databases, using key words \"dermatitis artefacta\", \"diagnosis\", \"management\", and \"psychodermatology\". The search was limited to English and Spanish language articles and was supplemented with themed books and book chapters. DA can occur in a variety of clinical presentations, and physicians should suspect DA in patients with a history of psychiatric disorders or extensive use of healthcare services. The ultimate goal of DA treatment may be a proper referral to mental health services. However, the prognosis is poor even when successful mental health referrals are achieved, with low recovery rates. A useful approach may include the suggestion that a mental health provider can help with the anxiety and the distress generated by the lesions: in this case in this case it will be crucial to discuss this with the mental health provider after obtaining informed consent from the patient. Considering the difficulty in promoting patients' adherence to treatment, the ideal setting for DA treatment is a psycho-dermatologic clinic, where both dermatologic and psychological interventions can be seamlessly integrated.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"17-23"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand, Foot, and Mouth Disease in Children: Clinical Characteristics of an Outbreak in Novi Sad, Serbia.","authors":"Sonja Prćić,&nbsp;Aleksandra Matić,&nbsp;Milan Matić,&nbsp;Anica Radulović,&nbsp;Zorica Gajinov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hand, foot, and mouth disease (HFMD) is a relatively common mild viral infection that usually affects young children, mainly occurring during the late spring, early summer, and fall months. It is most commonly caused by members of the human enterovirus (HEV) genus. Recently, HFMD has received renewed attention because of evidence that this disease could have clinical, epidemiological, and etiological characteristics different from those initially associated with it. HFMD may be associated with neurologic or cardiopulmonary complications and can, rarely, lead to death. Our study was a retrospective analysis on 83 children (<18 years of age) who were clinically diagnosed with HFMD at the Department of Dermatology of the Institute for Child and Youth Health Care of Vojvodina, in a single, tertiary-care university hospital in Novi Sad, Vojvodina province, Serbia, for the time period from January 2016 to December 2017. During the study period, HFMD was diagnosed in 83 children. Our results suggest that the outbreak of HFMD occurred in younger children (average age 3.10 years), who seem to be the most susceptible age group for HFMD infection. Taking into account that the diagnosis of HFMD is usually clinical, we believe that it is important for health professionals to be well-informed about the clinical features and the course of the disease. Good personal hygiene and the implementation of a surveillance system can help stop the spread of the disease and prevent outbreaks.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"24-28"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmental Erythema Multiforme: An Unusual Drug Reaction to Anastrozole.","authors":"Sanja Poduje,&nbsp;Luka Vujević,&nbsp;Nika Filipović,&nbsp;Majda Vučić,&nbsp;Marija Buljan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Erythema multiforme (EM) is an immune-mediated, mucocutaneous hypersensitivity syndrome that can occur as a result of various medications, including a wide range of antineoplastic and hormonal drugs. Anastrozole, a nonselective aromatase inhibitor used in breast cancer management has been associated with different cutaneous side effects, of which EM is rarely seen and usually in a minor or major form with typical target lesions. This is a short report of a patient who developed a rare cutaneous side effect after the use of aromatase inhibitor anastrozole - segmental erythema multiforme in cancer-affected area. Cutaneous adverse effects limited to cancer-affected breast are extremely rare but should be considered in everyday dermatological practice. We find this case instructive not only because of the rarity of the segmental EM, but also because, contrary to classical teaching, drug eruption due to anastrozole occurred months, not days after the initiation of therapy.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"29-31"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41243000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Atopic Dermatitis and Corticophobia on the Quality of Family Life.","authors":"Oksana Kotarski,&nbsp;Marija Pečnjak,&nbsp;Mario Blekić,&nbsp;Ivana Bukvić,&nbsp;Blaženka Kljaić Bukvić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of the study was to investigate the impact of atopic dermatitis (AD) in children and corticophobia on the quality of family life. Children with AD and their parents were included in a cross-sectional study. The severity of AD was self-assessed using the Patient Oriented-Scoring of Atopic Dermatitis (PO-SCORAD) index, and the severity of corticophobia using the Topical Corticosteroid Phobia (TOPICOP) score, and the general impact of AD on family quality of life using the Family Dermatology Life Quality Index (FDLQI). We included 330 parents, mostly mothers (99.4%) and children with a median age of 3 years (interquartile range, IQR 1.5-5.0 years). The median values of the PO SCORAD index and TOPICOP score were: 19.1 (IQR 13.6-24.1) and 58.3 (IQR 41.7-72.2), respectively. The median FDQLI score was 12 (IQR 7-16). The influence of independent variables such as parental age, child's age, child's gender, family history of allergies, place of residence, parental education, associated allergic disease in the child, PO SCORAD, and the TOPICOP score on the FDLQI was analysed. The significant models were the age of the parents (protective factor), the PO SCORAD index, and the TOPICOP score, which together accounted for 26.1% of the variability of FDLQI. Concusion of the study is that AD in children, its severity, and the parent's fear of chronic corticosteroid treatment impair the quality of family life.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"31 1","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41243001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of CD8+ T-Cells and their Cytokines in the Pathogenesis of Psoriasis.","authors":"Iva Volarić, Marijana Vičić, Larisa Prpić-Massari","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The important role of CD8+ T-cells in the pathogenesis of psoriasis is well-determined. However, besides type 1 cytokines that were formerly known, it was recently found that these cells secrete type 17 and type 22 cytokines. The majority of IL-17A+CD8+ T-cells in the blood belong to a subset of innate T-cells named mucosa-associated invariant T-cells (MAIT). However, the majority of IL-17A+CD8+ T-cells in psoriatic epidermis are conventional T-cells and are up-regulated in psoriasis. In contrast to Th17 cells that secrete only IL-17, Tc17 cells secrete IFN-ϒ, TNF-α, CCL20, IL-22, and granzyme B as well. The key cytokine is IL-17A, which promotes keratinocyte hyperproliferation and stimulates them to produce other proinflammatory cytokines. These activities initiate and propagate the inflammation and architectural changes in the skin that clinically manifest as psoriatic lesions. However, a relatively novel cell subtype named Tc22 has been discovered in psoriasis that could secrete IL-22 in the absence of IL-17 and IFN-gamma. IL-22 stimulates proliferation and de-differentiation of keratinocytes, subsequently leading to epidermal acanthosis. As the understanding of the pathogenesis of psoriasis increases, the new selective therapies may offer an optimal balance between increased clinical benefit and reduced risk of side-effects.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"27 3","pages":"159-162"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Behavior Changes in Cutaneous Melanoma Survivors.","authors":"Mirjam Rogl Butina, Igor Švab, Barbara Perić, Igor Bartenjev","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aim of this study was to investigate changes in health behavior of melanoma survivors with emphasis on safe sun behavior (SSB) and skin self-examination (SSE). We also identified factors with significant impact on SSE improvement. We performed a cross-sectional (epidemiological) survey based on a structured questionnaire. 150 patients from three medical institutions were invited and 144 patients responded. Statistical analysis was performed with SPSS version 23.0, with the level of significance set to 0.05. After being diagnosed with cutaneous melanoma, patients significantly improved preventive health behavior: 68.1% showed improvement in SSE, and 91.5% of patients improved SSB. There was statistically significant (P<0.001) improvement in the frequency of skin examination, examination of poorly visible areas (between the toes, genitals), and obtaining help in examination. Use of melanoma images remained scarce. Results for SSB were even better, and statistically significant improvement was recorded in all areas: using higher UV protection filters, wearing sunglasses, headgear, long sleeves, and trousers, and especially in staying in deep shade during hours of heavy UV radiation. The only factor with a positive influence on expected improvement in SSE was female gender. On the other hand, there were two factors that had a negative impact on SSE: patients with melanoma stage 1 and patients who had already self-examined themselves before their melanoma diagnosis. Preventive health behavior improved significantly after diagnosis of cutaneous melanoma. Patients markedly improved SSB and substantially enhanced SSE. We believe that it is reasonable to improve SSE further, encouraging patients by increasing their feeling of self-efficacy.</p>","PeriodicalId":94367,"journal":{"name":"Acta dermatovenerologica Croatica : ADC","volume":"27 2","pages":"67-74"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}