Acta Dermatovenerologica Alpina Pannonica et Adriatica最新文献

Introduction: Scalp seborrheic dermatitis (SSD) is a prevalent and chronic dermatological condition. Although various mechanisms have been proposed, its precise etiology and exacerbating factors remain unclear. This study aimed to identify the factors influencing clinical severity in individuals with SSD; to assess the associations between severity and variables such as gender, age at disease onset, treatment history, and the presence of comorbid systemic or dermatological conditions; and to determine potential triggering factors.

Methods: A total of 198 adult patients diagnosed with SSD were included in this retrospective study. Collected data included demographic characteristics, smoking and alcohol use, Fitzpatrick skin type, age at disease onset, duration of the most recent flare, frequency of hair washing, and the season during which the patient presented. Clinical severity of SSD was assessed by a dermatologist. In addition, the presence of systemic and dermatological comorbidities, as well as patient-reported triggering factors, was documented.

Results: A statistically significant difference in SSD severity was observed between sexes, with higher severity noted in male patients (p = 0.006). No significant associations were found between SSD severity and age, Fitzpatrick skin type, smoking or alcohol use, season of presentation/flare up, or the presence of systemic diseases. However, SSD severity differed significantly based on the presence of onychomycosis (p = 0.001).

Conclusions: The significant association between the frequency of onychomycosis and the severity of SSD highlights a potential link involving shared immunologic, microbial, and skin barrier dysfunctions underlying both conditions.

Cutaneous tuberculosis (TBC) is rather rare and has diverse clinical presentations relative to host immunity and the number of bacilli present in the tissue. A group of cutaneous lesions called tuberculids represent a strong, delayed-type hypersensitivity reaction to mycobacteria. Among them, erythema induratum of Bazin (EIB) typically presents as tender erythematous nodules that ulcerate and are usually confined to the posterior aspects of the calves. Paradoxical reactions (PRs) to appropriate treatment involving the skin have mostly been described in the setting of miliary tuberculosis. These PRs are encountered in infectious and inflammatory diseases during the institution of appropriate treatment representing a worsening or relapse of disease under treatment or unmasking of subclinical disease. This case report describes a patient with EIB developing a necrotic PR shortly after initiation of antituberculosis therapy. The skin lesions cleared with a topical corticosteroid treatment and continued antituberculosis therapy. It is important to recognize cutaneous PR in the setting of treated cutaneous TBC and to reassure patients about the excellent outcome that can be achieved with continuation of treatment.

A case of furuncular myiasis caused by the larva of Dermatobia hominis is described, involving the ankle region of a 35-year-old woman that had returned from a vacation in Colombia. After removal of the larva from the skin, the lesion healed in 2 weeks. Due to an increasing rate of intercontinental travel, dermatologists in Slovenia may need to consider Dermatobia myiasis in the differential diagnosis of furuncular lesions in patients with a relevant travel history.

Bacterial enteric pathogens can be transmitted through sexual contact, with gay, bisexual, and other men who have sex with men (gbMSM) being particularly at risk. The factors and dynamics involved in sexual transmission of bacterial enteric pathogens remain incompletely understood. Intestinal pathogens with a low infectious dose, particularly Shigella spp., followed by Campylobacter spp., which has a relatively higher infectious dose, are more likely to spread through sexual contact. Asymptomatic carriers of bacterial enteric pathogens may play a role in transmission through sexual activity. Recommendations for prevention of sexual transmission of bacterial enteric pathogens include engaging in less risky sexual behavior, minimizing oral-anal contact during sexual activity, maintaining good personal hygiene, and using protective measures such as cleaning sex toys. If a partner has diarrhea, it is recommended to avoid sexual contact during active illness and for at least 1 to 2 weeks after the symptoms have resolved. In addition, oral-anal contact should be avoided for 4 to 6 weeks following resolution of symptoms. Increasing awareness of the possible sexual transmission of bacterial enteric pathogens among at-risk groups is essential for encouraging behavioral changes. Similarly, raising awareness among clinicians that care for at-risk groups is essential for providing appropriate counseling and improving patient management.

Introduction: Melasma is a common hypermelanosis presenting as dark patches on sun-exposed skin. Its treatment remains challenging due to slow response, especially in chronic cases. This study compares the efficacy of 5% cysteamine with ectoine cream versus 4% hydroquinone with ectoine cream in treating melasma.

Methods: A double-blind randomized controlled trial was conducted from January to March 2024 across three centers in Indonesia: Dr. Moewardi Hospital (Surakarta), Gatot Soebroto Army Hospital (Jakarta), and Dr. Saiful Anwar Hospital (Malang). Participants were randomly assigned to Group A (5% cysteamine + ectoine) or Group B (4% hydroquinone + ectoine). Efficacy was evaluated using the modified Melasma Area and Severity Index (mMASI) and the JANUS-I skin analyzer. Quality of life was assessed using Melasma Quality of Life Scale (MELASQoL) and Dermatology Life Quality Index (DLQI) questionnaires.

Results: Both groups demonstrated reduced mMASI and JANUS-I scores, with slightly greater improvement in Group A, although the difference was not statistically significant (p > 0.05). Quality of living also improved in both groups, with no significant difference between them (p > 0.05).

Conclusions: Both treatment regimens effectively improved melasma pigmentation and QoL. Either 5% cysteamine with ectoine or 4% hydroquinone with ectoine can be considered viable treatment options for melasma.

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.

Introduction: Androgenetic alopecia (AGA) is a common hair loss condition characterized by follicular miniaturization. Vascular endothelial growth factor (VEGF) plays a key role in promoting angiogenesis and supporting hair follicle growth. Oral minoxidil has been suggested to upregulate VEGF levels, enhancing hair regrowth.

Methods: This prospective study included 50 participants divided into two groups: oral minoxidil (1 mg/day; n = 25) and control (n = 25). Serum VEGF levels were measured at baseline and after 12 weeks of treatment. Hair growth parameters, including hair count, diameter, shedding, and pull test results, were assessed systematically.

Results: Baseline VEGF levels were similar between groups (p = 0.1873). Post-treatment, VEGF levels increased significantly in the minoxidil group (217.88 ± 22.65 pg/ml vs. 142.81 ± 23.14 pg/ml in the control, p < 0.0001). Hair count and diameter improved significantly (p < 0.0001 and p = 0.0040, respectively), with reductions in shedding and pull test results (p < 0.0001). Positive correlations were observed between VEGF and hair count (r = 0.9965), whereas shedding showed negative correlations (r = -0.5374).

Conclusions: Oral minoxidil significantly enhances VEGF levels, promoting hair growth and reducing shedding. VEGF serves as a promising biomarker for assessing treatment effectiveness and understanding the angiogenic mechanisms involved in AGA.

Introduction: Melanoma can affect individuals of all ages, and its incidence is increasing among younger populations. Dermoscopy units are highly effective in reducing the number of benign lesions excised in high-risk patients. The aim of this study was to determine the occurrence of melanoma following dermoscopic examinations, the reasons for patient visits, the presence of social inequalities, and the characteristics of confirmed melanoma, including size and localization.

Methods: We conducted a retrospective descriptive study of patients examined at the Dermoscopy Unit of the Department of Dermatology at Nikšić General Hospital in Nikšić, Montenegro, from 2017 to 2022 using manual dermoscopy examination.

Results: The study comprised 125 patients (74 male and 51 female). The main reasons for dermoscopic examinations were a personal history of atypical nevi and the presence of more than 100 melanocytic nevi. The mean thickness of melanoma in patients younger than 45 years was 0.96 mm, in patients 46 to 65 years old it was 1.08 mm, and in patients over 66 it was 1.38 mm. A statistically significant difference in melanoma localization was observed between sexes: in male patients melanoma occurred significantly more often on the trunk, whereas in female patients it was more frequent on the lower legs.

Conclusions: Dermoscopy enhances diagnostic accuracy for skin lesions, benefiting both dermatologists and primary care providers. Effective melanoma prevention strategies include practicing sun protection, performing monthly self-examinations for new or changing moles and birthmarks, and attending regular medical checkups.

Multisystem inflammatory syndrome (MIS), also known as a Kawasaki-like illness, is a rare condition linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It presents with systemic inflammation and organ dysfunction, and it shares several clinical features with Kawasaki disease (KD). This case report describes an 8-year-old girl that developed symptoms suggestive of MIS or KD several weeks after a COVID-19 infection. She experienced a high fever lasting 4 days, followed by the appearance of itchy, erythematous patches on her legs, which later spread to her trunk and face. The inflammatory symptoms resolved spontaneously in less than 2 months without any lasting effects.

Introduction: Plantar warts caused by human papillomavirus (HPV) are often resistant to standard treatments, significantly affecting patients' quality of life. Pulsed dye laser (PDL) therapy has emerged as a promising alternative for refractory cases.

Methods: Four patients (three males, one female; ages 15 to 45) with recalcitrant plantar warts unresponsive to cryotherapy, curettage, and topical agents were treated with PDL. Each underwent three sessions spaced 3 weeks apart, using a fluence of 13.50 J/cm² and a pulse duration of 1.5 ms. Outcomes assessed included lesion resolution, recurrence rates, and adverse effects.

Results: All patients achieved complete wart resolution after three PDL sessions. By the second session, vascular coagulation was evident, leading to significant lesion reduction. No adverse effects such as scarring or pigmentation changes were reported, and no recurrences were observed during a 3-month follow-up.

Conclusions: Among laser therapies, PDL demonstrates excellent outcomes with minimal adverse effects in treating refractory plantar warts. Further studies are warranted to validate these findings in larger populations.