Acta Dermatovenerologica Alpina Pannonica et Adriatica最新文献

Although basal cell carcinoma is the most common form of skin cancer, the superficial subtype is rarely seen on the upper eyelid. We report the case of a 71-year-old woman with a 4-year history of upper eyelid pruritus, initially diagnosed as blepharitis and unsuccessfully treated with various medications, including topical and systemic corticosteroids, topical immunomodulators, and antihistamines. The unusual presentation, location, histologic subtype, and persistent pruritus posed a significant diagnostic challenge in this case.

Kallikrein proteases (KPs) are vital enzymes involved in the formation of dermatosomes and are regulated by the body's internal inhibitors. Maintaining a balance between KPs and their inhibitors is essential for promoting a healthy scalp. The scalp specifically contains two KPs: human kallikrein (hK) 5 and hK7, which are encoded by their respective genes. In addition, the serine protease inhibitor Kazal-type 5 (SPINK5) gene encodes the lympho-epithelial Kazal-type‒related inhibitor (LEKTI), which effectively inhibits both hK5 and hK7. The normal desquamation process relies on the availability and activity of hK5 and hK7, along with their regulation by LEKTI. When LEKTI levels are insufficient, it results in abnormal desquamation characterized by the overactivity of hK5 and hK7. Consequently, KPs, particularly hK5 and hK7, present promising targets for novel treatments aimed at reducing flake formation associated with dandruff. KP inhibitors are crucial components in targeting these proteases. In this review, literature on KPs, dandruff, and their inhibitors was analyzed to elucidate the roles of KPs in dandruff pathogenesis and to evaluate the therapeutic potential of KP inhibitor-based approaches for managing this condition.

Psoriasis is a common chronic inflammatory skin disorder that primarily affects the skin, nails, and joints. Beyond its cutaneous manifestations, psoriasis is associated with several systemic comorbidities. Various factors can trigger or exacerbate psoriasis, including stress, infections, medications, and vaccinations. This article reports what is, to the best of the author's knowledge, the first known case of acute exacerbation of plaque-type psoriasis, presenting as guttate psoriasis (GP), following herpes zoster vaccination. A 52-year-old male with a history of longstanding plaque-type psoriasis developed a sudden flare of GP lesions 2 weeks after receiving the recombinant herpes zoster vaccine. Physicians should be vigilant for potential triggers of psoriasis exacerbation, with the recombinant herpes zoster vaccine being among them.

Co-occurrence of blisters in patients with lichen sclerosus (LS) can raise the question of whether they represent a bullous variant of LS or a concomitant autoimmune disorder. We report a rare case of bullous pemphigoid (BP) occurring on previous LS lesions. To the best of our knowledge, this is also the first BP180-negative case reported in literature. Here, we propose alternative mechanisms, independent of BP autoantibodies, that may lead to development of BP on skin affected by LS. In addition, we provide a literature review that explores the underlying pathophysiology and offers practical treatment insights, equipping clinicians with valuable guidance for similar complex cases.

Angiosarcoma (AS) is a rare and aggressive soft tissue sarcoma originating from endothelial cells, with cutaneous manifestations often seen in the head and neck region. Despite its rarity, AS poses significant diagnostic challenges due to its variable presentation and ability to mimic other dermatological conditions. We report the case of an 87-year-old female that presented with a 4-month history of an asymptomatic nodule on her neck, which rapidly progressed into an indurated plaque spreading to her face, chest, and scalp. Initially misdiagnosed as cellulitis and dermatitis, the lesion was unresponsive to antibiotics and steroids. Imaging showed extensive infiltration in the neck, precluding surgical resection. This case underscores the diagnostic difficulty of AS, which can be mistaken for benign skin conditions. Despite a multidisciplinary approach, the prognosis for AS remains poor, with a 5-year survival rate of approximately 35%. Treatment options include surgery, radiation, chemotherapy, and immunotherapy tailored to the patient's condition and tumor characteristics.

Shigellae can be transmitted through sexual contact, especially among gay, bisexual, and other men who have sex with men (gbMSM). The dynamics and factors contributing to sexual transmission of shigellosis are not yet fully understood. Shigella spp. are intestinal pathogens with a low infectious dose, making them more likely to spread through sexual contact. Asymptomatic carriage may also contribute to its transmission through sexual activity. Recommendations for prevention of sexual transmission of shigellosis include less risky sexual behavior, the use of protective measures, thorough cleaning of sex toys, and good personal hygiene. If a partner has diarrhea, it is recommended to avoid sexual contact during and for at least 1 to 2 weeks after the symptoms have resolved, and to refrain from oral-anal contact for 4 to 6 weeks. Globally, the burden of shigellosis is highest in low- and middle-income countries, particularly among young children. In high-income countries, international travelers and gbMSM are considered the main risk groups for shigellosis. Raising awareness about the possible sexual transmission of shigellosis among at-risk groups is necessary. Increasing awareness among clinicians about the potential for sexual transmission of shigellosis is vital to ensure appropriate counseling and patient management.

This review evaluates the risks and benefits of botulinum toxin (BTX) therapy for treating bromhidrosis. A search was conducted across six databases, including clinical trials comparing BTX therapy with BTX-free controls. The analyzed outcomes included pooled adverse events (AEs), treatment success, ≥ 50% overall improvement, and recurrence rates. Subgroup and sensitivity analyses were performed. Fourteen trials involving 1,293 participants were eligible. The BTX group experienced significantly fewer AEs than controls (relative risk [RR], 95% confidence interval [CI]: 0.33 [0.20-0.54]). Subgroup analysis indicated that the AE reduction was significant only when compared to small skin incision procedures. Overall, BTX did not show significant treatment success (RR [95% CI]: 1.06 [0.85-1.34]) or ≥ 50% improvement (RR [95% CI]: 0.98 [0.93-1.03]). However, BTX demonstrated superior treatment success compared to electrocauterization (RR [95% CI]: 1.45 [1.15-1.83]) and ethanol injection (RR [95% CI]: 2.27 [1.49-3.45]). Against placebos, BTX significantly reduced odor intensity (mean difference [95% CI]: 1.39 [-2.63 to -0.16]). Nevertheless, the recurrence rate was significantly higher in the BTX group (RR [95% CI]: 3.80 [1.06-13.67]). Notably, most studies (n = 9) were of low quality. In conclusion, although BTX is safe, it is not effective for the treatment of bromhidrosis.

Introduction: Hidradenitis suppurativa (HS) is a chronic skin disease marked by recurrent abscesses, sinus tracts, and scarring, often accompanied by systemic symptoms. Diagnosed clinically, HS affects around 0.4% of people in western populations, but standardized treatment options are limited, leading to inconsistent outcomes. This study retrospectively analyzes 15 years of HS cases in southeastern Europe to better understand regional characteristics and treatment responses.

Methods: This is a retrospective, cross-sectional study encompassing 103 HS patients hospitalized from 2007 to 2022 at a university dermatology and venereology clinic.

Results: Women were younger than men at onset of HS (19 vs. 28 years old) and at first hospitalization (31 vs. 39 years old). Men were most often diagnosed as Hurley stage III at hospital admission (50.8%), whereas women predominantly had Hurley stage II (57.5%, p = 0.032). Trunk involvement was more prevalent in women (62.5% vs. 41.3%, p = 0.036) and the back of the neck in men (30.2% vs. 7.5%, p = 0.006). Obesity was the most commonly found concurrent disease (35.9%) overall, and a history of acne was the most frequent dermatological comorbidity (29.1%). HS patients had a fivefold increase in their chance of having psoriasis. The most commonly employed systemic treatments were oral antibiotics: rifampicin with clindamycin (62.1%) followed by tetracyclines (42.7%).

Conclusions: HS patients had a fivefold higher likelihood of having psoriasis. Female patients were less likely to experience severe disease presentations. Although metabolic syndrome and its components were relatively common, they showed no correlation with disease severity. Treatment approaches for HS varied notably between males and females.

This review assesses Poland's activities in preventing and managing human papillomavirus (HPV)-related diseases, summarizing information from the 2023 HPV Prevention and Control Board meeting. Progress in primary, secondary, and tertiary prevention identifies opportunities to strengthen control of cervical cancer. Poland's national HPV vaccination program, launched in June 2023, initially achieved suboptimal coverage. In contrast, regional initiatives such as the Wrocław immunization program, which has operated for over a decade, demonstrate highly relevant context-specific best practices, including the use of a "train the trainers" model to effectively share information among stakeholders and mitigate crisis. Improved vaccination rates require not only ease of access to vaccines, as the COVID-19 vaccination program has demonstrated, but also addressing parental concerns about vaccine safety and effectiveness. Moreover, innovative strategies-such as integration of adolescent vaccination with cervical screening among women 30 to 45 years old-may have the potential to increase uptake and accelerate elimination in the country. For secondary prevention, Poland is well placed to switch to HPV-based screening, having a centralized registry, validated tests, and standardized colposcopy. The results of a study of the "HPV testing In Polish POpulation" (HIPPO) cervical cancer screening program confirm the superiority of HPV testing over cytology; however, current opportunistic screening poses challenges concerning completeness and equity in data. Expanding organized screening programs and midwife-led services will increase access and help build confidence in public-sector health systems. Tertiary prevention is in line with updated European guidelines. In early-stage cervical cancer, there has been an increase in the use of less invasive surgical approaches, and immunotherapies, such as pembrolizumab, hold promise in locally advanced disease. Initial data suggest that HPV vaccination may help reduce the incidence of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) after excisional treatments, but more data are needed. Poland's coordinated approach shows significant improvements while also highlighting the need for continued innovation, quality control, and public engagement to improve the prevention and treatment of HPV-related conditions.

Primary cutaneous CD4-positive small or medium T-cell lymphoproliferative disorder (PCSM-LPD) is characterized by a slow-growing and asymptomatic solitary plaque or tumor, usually involving the head, neck, or upper extremities. The diagnosis is established based on clinical presentation, histopathological features including pleomorphic morphology and CD4-positive immunophenotype of neoplastic T lymphocytes, and molecular analysis showing clonally rearranged T-cell receptor (TCR) genes. Plaques typical of mycosis fungoides are essentially absent. Treatment options include surgical excision, radiotherapy, and topical or intralesional steroids. Because the disease is indolent, aggressive diagnostic tests and systemic treatments are not recommended. We present a case of PCSM-LPD in a previously healthy young man that spontaneously regressed after a biopsy.