Acta Dermatovenerologica Alpina Pannonica et Adriatica最新文献

Skin warts are ubiquitous, self-limiting, benign neoplasms caused by human papillomaviruses (HPV). Several studies have investigated the prevalence and diversity of HPV types in the three main types of skin warts: common, plantar, and flat warts. Using different methodological approaches and diverse populations, several HPV types were detected in skin warts, but often the etiological link remained unconfirmed. This review addresses recently improved multiple strategies for investigating the presence of HPVs in skin warts, covering proper sampling techniques for HPV testing, choice of molecular method(s) for HPV detection, and assignment of the etiological causality of the tested skin wart to a causative HPV type using cellular viral load estimation. These novel approaches provide useful insight into the range of HPV types causing skin warts and support a refined understanding of their etiology. In addition, we conducted a literature review of the main studies examining HPV prevalence and genotype distribution in common warts, plantar warts, and flat warts. Finally, HPV type-specific histopathological patterns in skin warts are briefly discussed.

Introduction: Atopic dermatitis (AD) and psoriasis (PS) are skin diseases that have a significant impact on the quality of life. The correct application of corticosteroids in topical treatment is highly effective and safe for patients. Excessive and irrational fear of these drugs based on incorrect information is increasingly observed at dermatological clinics.

Methods: To assess the extent of corticophobia, we conducted a single-center cross-sectional survey using the TOPICOP© questionnaire.

Results: The study included 57 patients (56% female) with AD and 58 patients (60% female) with PS. The combined TOPICOP© score averaged around 44, showing no significant difference between the two skin conditions. However, consistently higher scores were observed among female participants compared to males.

Conclusions: The prevalence of corticophobia was comparable to that reported in other similar studies and was higher among female patients, which replicates previous findings. Patients with AD, who were younger on average than patients with PS, often relied on friends, acquaintances, family members, and the internet as their main information sources. Providing correct and reliable information to patients is crucial for ensuring treatment adherence.

Introduction: Psoriasis is a prevalent, complex, immune-mediated illness. There is some evidence in the literature supporting the involvement of the Wnt signaling pathway in psoriasis. No previous studies have focused on the association between the Wnt signaling pathway and vitamin D receptor (VDR) expression in psoriasis. This study investigates the expression of VDR and mediators of the canonical (β-catenin) and non-canonical (Wnt5a) Wnt signaling pathway in psoriatic lesional skin biopsy specimens compared to controls.

Methods: A cross-sectional study conducted on skin punch biopsy specimens from 42 psoriasis patients were stained with VDR, β-catenin, and Wnt5a and compared with 42 control biopsies. Patients' demographics, clinical data, and serum vitamin D levels were recorded.

Results: VDR showed nuclear localization with significant downregulation in the psoriasis specimens compared to controls. β-catenin (membranous) and Wnt5a (cytoplasmic) showed significant upregulation in the psoriasis specimens. When the expressions of VDR, β-catenin, and Wnt5a were compared based on disease severity, no differences were found between mild, moderate, and severe subgroups of the disease. Late-onset psoriasis patients had lower VDR and Wnt5a histoscores compared to the early-onset group. A trend toward a positive correlation was observed between the histoscores of VDR and Wnt5a.

Conclusion: Our findings confirm the significance of VDR signaling in the pathophysiology of psoriasis and strengthen the relationship between this disease and the Wnt signaling pathway. There was evidence that there is an association between VDR status and Wnt5a expression.

Trichotillomania, defined as the compulsive pulling out of one's hair, is a psychocutaneous condition associated with functional impairment and decreased quality of life. The pathophysiology of trichotillomania is poorly understood and likely multifactorial, involving alterations in both neural activity and cognitive function. Behavioral treatment options for trichotillomania are limited and are often only modestly effective. Moreover, there are no medications currently approved by the U.S. Food and Drug Administration for its treatment. The gaps in knowledge regarding the neurological underpinnings and behavioral markers of trichotillomania and effective treatment options for it highlight the importance of ongoing research in this field. For this narrative review, PubMed was searched to identify articles related to trichotillomania published until July 2023. Recent advances in research on trichotillomania pathophysiology, diagnosis, clinical associations, and treatment are presented, with particular focus on how this condition uniquely spans the disciplines of both psychiatry and dermatology.

The emergence of de novo or recurrent cutaneous eruptions in individuals with hematological diseases presents a challenge when determining whether they indicate secondary dissemination or an unrelated diagnosis. Eosinophilic eruption of hematoproliferative disease is a rare nonspecific manifestation accompanying lymphoproliferative disorders, including chronic lymphocytic leukemia (CLL). We present the case of a 70-year-old man with CLL in remission (previously treated with two 6-month cycles of fludarabine-cyclophosphamide plus rituximab, 2 and 5 years earlier) with an acute, disseminated polymorphic skin eruption. Skin biopsies from two sites (bulla and infiltrated nodule) were taken for histopathological examination. The pathologist reported giant spongiform vesicle formation with eosinophils with dermal and hypodermal inflammatory infiltrate composed of lymphocytes (predominantly T cells, fewer B cells) and eosinophils. Secondary neoplasm dissemination and sarcoidosis were excluded by means of immunohistochemistry. A diagnosis of eosinophilic eruption of hematoproliferative disease in the CLL patient post-chemotherapy and without active disease was established. Two weeks after skin remission, the patient worsened with enlarged lymph nodes and a leukocyte count of 291 × 10^9/l. CLL relapse was confirmed. Leukocytapheresis was performed and ibrutinib 140 mg three times daily was prescribed. Our case underscores the importance of recognizing this relatively common but underreported eosinophilic eruption associated with hematoproliferative diseases.

This review article focuses on cutaneous manifestations in schoolchildren and adolescents 6 to 18 years old connected with various aspects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, including personal protective equipment (PPE), SARS-CoV-2 infection, and the SARS-CoV-2 vaccine. The use of PPE has been associated with mask-related acne due to microbiome dysbiosis and disruption of skin homeostasis, leading to the emergence of new acne or exacerbation of preexisting acne. Chilblain-like lesions, erythema multiforme-like eruptions, and cutaneous manifestations of multisystem inflammatory syndrome related to SARS-CoV-2 are the most commonly described skin manifestations of SARS-CoV-2 infection. The proposed mechanisms involve either the direct interaction of the virus with the skin through cutaneous receptor angiotensin-converting enzyme 2 in the epidermal basal layer or hyperactive immune responses. The impact of SARS-CoV-2 infection has also been described on adnexa, including hair changes such as alopecia areata and telogen effluvium, as well as nail changes presenting as onychomadesis and periungual desquamation. Cutaneous adverse effects of the SARS-CoV-2 vaccine have been described in case reports and differ from those in adults. Therefore, there is a need for increased awareness regarding the most prevalent cutaneous manifestations associated with COVID-19 in children because they tend to be mild or nonspecific in nature.

Patients receiving immune checkpoint inhibitors (ICIs) commonly experience cutaneous immune-related adverse events (irAEs). We present two cases, a 51-year-old female and a 70-year-old male, that were undergoing treatment with pembrolizumab for metastatic melanoma and developed scaly, erythematous papules on their skin. Following skin biopsies, histological analysis confirmed the diagnosis of lichen planus. In the first patient, acitretin at a dosage of 25 mg/day was administered for 6 months, resulting in complete resolution of lichen lesions. Imaging scans showed no signs of melanoma. The second patient was treated with topical betamethasone dipropionate ointment for several weeks, which led to a favorable therapeutic response. During follow-up, a thoracic CT scan showed several micronodular lesions in the right lung, whereas brain and abdomen CT scans showed no signs of the disease. Lichen planus is not a commonly reported irAE in patients treated with ICIs. This report underscores the importance of conducting skin biopsies in patients receiving ICI therapy and highlights the potential prognostic importance of skin irAEs in patients with melanoma receiving such treatment.

Introduction: Anogenital warts (AGWs) are proliferative lesions mainly presenting in the anal, genital, and perianal regions. They are one of the most prevalent sexually transmitted infections globally.

Methods: The study included patients that presented at the Dermatology Clinic of Health Sciences, University Elaziğ, Fethi Sekin City Hospital between January 2019 and December 2022 and were diagnosed with AGWs. Patients that presented with this diagnosis and were screened for other sexually transmitted infections (HBsAg, anti-HBs, anti-HCV, anti-HIV, VDRL, and TPHA) were identified. Epidemiological and demographic patient data and the results of serological tests for other sexually transmitted infections in the last 4 years were analyzed. The patient data and examination results were collected retrospectively based on the hospital automated patient records.

Results: AGW incidence was significantly higher in males. The mean patient age was 32, and the mean female patient age was lower than that of males. It was observed that the number of patients that were followed up with an AGW diagnosis increased significantly during the last 4 years (p < 0.05). The study detected 2.2% HBsAg, 0.6% TPHA, 0.3% VDRL, 0.5% anti-HCV, and 56.5% anti-HBs positivity. No anti-HIV-positive patients were identified. None of the patients had more than one sexually transmitted infection on serology testing.

Conclusions: Although the serological findings were higher when compared to certain studies and quite low when compared to others, it would be beneficial to evaluate all patients with AGWs for other sexually transmitted infections.

Introduction: Keloids are pathologic conditions characterized by fibroblast hyper-proliferation and excess collagen deposition. Enalapril, one of the angiotensin-converting enzyme inhibitors, has recently been highlighted as a new therapeutic modality in treating keloids. This study evaluates the effectiveness of intralesional injection of enalapril versus triamcinolone acetonide (TAA) in keloids.

Methods: Forty patients with multiple keloids were enrolled in our study. Enalapril and TAA were injected intralesionally in one session per month for three sessions. The clinical outcomes were assessed via the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS).

Results: In both groups, according to VSS and POSAS, there was a high statistically significant difference (p-value ≤ 0.01) before treatment, at the end of each session, and 3 months after treatment. There was no significant difference between both groups regarding degree of improvement. Patients treated with TAA developed more significant complications than those in the enalapril group (p-value < 0.05).

Conclusions: Both enalapril and TAA had the same clinical effect. Enalapril could be a safe alternative to steroids in the treatment of keloid and hypertrophic scars. Further studies on enalapril are needed on a large sample of patients with further focus on the mechanism of this innovative drug.

Introduction: Monkeypox virus (MPXV), typically endemic in West and Central Africa, has raised global concern due to the recent outbreak in several non-endemic countries with human-to-human transmission. Here we present a comprehensive analysis of MPXV genomes from Slovenia.

Methods: Two real-time polymerase chain reaction (RT-PCR) assays for Orthopoxvirus (OPV) and MPXV genes were used for laboratory confirmation of mpox. Complete MPXV genomic sequences were obtained using nanopore long reads and Illumina technology. Phylogenetic analyses compared the Slovenian MPXV sequences with the global sequences.

Results: A total of 49 laboratory-confirmed mpox cases were diagnosed in Slovenia in 2022, mainly affecting males under 40. In 48 cases, a complete genome sequence was obtained and phylogenetic analysis revealed five distinct lineages (B.1, B.1.14, B.1.2, B.1.3, and A.2.1), with B.1 and B.1.3 dominating, suggesting multiple introductions into Slovenia. Genome analysis revealed significant divergence from the reference MPXV-M5312_HM12_Rivers.

Conclusions: The genetic diversity observed in the Slovenian MPXV sequences sheds light on the complex dynamics of the 2022 mpox outbreak and highlights the need for further research to understand the impact of mutations on MPXV functional characteristics and their role in the evolution and diversification of current lineages.