Acta Dermatovenerologica Alpina Pannonica et Adriatica最新文献

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.

Introduction: Disease progression, drug resistance mutations, and treatment strategies may vary by HIV-1 subtype. This study determined HIV-1 subtypes circulating in Slovenia, a Central European country with an HIV-1 epidemic driven by men who have sex with men, focusing on molecular epidemiology of non-B subtypes.

Methods: A total of 367 HIV-1 sequences were included. Subtype was assigned by employing eight different HIV subtyping tools coupled with maximum likelihood phylogenetic analyses.

Results: The subtyping tools COMET, jpHMM, and REGA 3.0 exhibited the best performance on the dataset studied. Phylogenetic analyses showed a 14.7% prevalence of non-B subtypes, with subtype A detected most frequently (4.9%), followed by CRF02_AG (2.4%), subtype C (1.1%), subtypes D, G, and CRF01_AE (0.8% each), and subtypes F and CRF22_01A1 (0.3% each). A subtype could not be assigned to 12 sequences (3.3%), indicating potential unique recombinant forms. Non-B subtypes were significantly associated with a heterosexual route of transmission and infection acquired in Eastern Europe, Africa, or Asia.

Conclusion: In a country where subtype B is predominant, non-B subtypes were observed in one out of seven patients, a non-negligible proportion, which underlines the importance of systematic surveillance of HIV subtype diversity and the corresponding molecular epidemiology.

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by the L1, L2, and L3 serotypes of Chlamydia trachomatis (CT). It primarily affects regional lymph nodes. Although it is not endemic in Europe and North America, recent reports indicate an increasing prevalence among men who have sex with men, with proctocolitis as the most frequently reported symptom. We report the case of a homosexual male that presented to our department with a nodular lesion on the shaft of the penis and tender, enlarged inguinal lymph nodes. Throat, urethral, and rectal swabs were collected for CT testing using real-time polymerase chain reaction. The urethral swab was positive for CT, whereas the throat and rectal swabs were negative. Subsequent testing detected the presence of LGV DNA. The patient was treated with a prolonged course of doxycycline. After 6 weeks, the urethral swab for CT returned a negative result. The patient reported complete remission 7 weeks after the start of treatment.

Introduction: Psoriasis vulgaris is an immune-mediated inflammatory disease influenced by genetic and immunologic factors, including micronutrient deficiencies. The HLA-Cw6 gene and zinc level have been separately studied in psoriasis patients, yielding inconsistent findings. A descriptive study regarding HLA-Cw6 allele expression, zinc levels, and their direct correlation in Indonesia is lacking.

Methods: This prospective case-control study involved 33 psoriasis patients and 33 age- and sex-matched control patients at the dermatology clinic affiliated with Hasanuddin University in South Sulawesi in 2021. Cases were classified into mild, moderate, and severe psoriasis according to Psoriasis Area and Severity Index (PASI) score. An EDTA tube was used to take a 5 ml blood sample, followed by analysis for PCR of the HLA-Cw6 allele and a colorimetric assay to measure zinc level. Statistical analysis was performed to determine the association between HLA-Cw6 and zinc level and psoriasis disease severity.

Results: Among the 33 psoriatic patients enrolled in this study, three (9.1%) of the cases were classified as mild psoriasis, 10 (30.3%) were classified as moderate psoriasis, and 20 (60.6%) were classified as severe psoriasis. The HLA-Cw6 allele was detected in 93.9% of psoriasis cases and in 3% of control patients (p < 0.001). The HLA-Cw6 allele was detected consecutively in 66.7%, 90.0%, and 100% of mild, moderate, and severe psoriasis patients, respectively. Zinc levels were lower in psoriasis patients compared to controls (16.85 ± 3.55 vs. 13.74 ± 3.78 μmol/l). Severe psoriasis patients exhibited the lowest average zinc level (14.76 ± 1.40 μmol/l, 15.48 ± 4.20 μmol/l, and 12.72 ± 3.56 μmol/l in mild, moderate, and severe patients, respectively). The mean zinc level in HLA-Cw6-positive patients was 13.68 μmol/l, and 14.6 μmol/l in HLA-Cw6-negative patients (p = 0.495).

Conclusions: The study revealed the presence of HLA-Cw6 allele expression and decreased serum zinc levels in psoriasis patients compared to controls. Both factors demonstrated associations with psoriasis disease severity.

Introduction: Plaque psoriasis and celiac disease are multisystemic diseases. The association of psoriasis and enteropathy with histological changes similar to celiac disease has already been described, and it has also been found that a gluten-free diet improves psoriatic changes. This study assesses the relationship between celiac disease antibodies and psoriasis.

Methods: The study included 112 participants: 60 with psoriasis in a test group and 52 healthy subjects in a control group. Within the psoriasis group, participants were further divided into two subgroups: one consisting of patients with both psoriasis and psoriatic arthritis (n = 17) and another comprising patients with psoriasis alone (n = 43). After informed consent was obtained, the Dermatology Life Quality Index (DLQI) score and Psoriasis Area and Severity Index (PASI) score were evaluated. Laboratory tests included assessment of anti-deaminated gliadin peptide antibodies (DGP), anti-gliadin antibodies (AGA), and anti-tissue transglutaminase antibodies (tTG).

Results: Immunoglobulin G (IgG) and immunoglobulin A (IgA) DGP antibodies were detected more frequently and at higher serum concentrations in patients with psoriasis compared to healthy controls (p = 0.03, p = 0.04, respectively). Similarly, elevated levels of IgG-tTG antibodies (p = 0.003) and IgA-DGP antibodies (p = 0.02) were observed in the same test group.

Conclusions: A relationship between positivity to celiac disease antibodies and psoriasis, particularly with regard to AGA, has been identified. Further studies are required to elucidate the nature, pathophysiology, and significance of these findings.

Introduction: Acne occurring in adults over the age of 25 years is known as acne tarda or adult acne. Three types of adult acne are recognized: persistent, late-onset, and recurrent acne. Most studies do not compare the characteristics between the three variants. In addition, little is known about adult acne in males. This study describes the epidemiological factors of adult acne and investigates certain triggering factors by sex and different types of adult acne.

Methods: A multicenter, prospective, descriptive study was conducted. Patients with adult acne and an acne-free control group were compared regarding medical history, family history, smoking and drinking habits, and dietary factors. In addition, triggering and prognostic factors were investigated by sex and three different types of acne: persistent, late-onset, and recurrent acne.

Results: The participants included 944 (88.56%) female and 122 (11.44%) male patients with adult acne, and 709 (73.85%) female and 251 (26.15%) male control patients. The consumption of crackers, chocolate, and pasta was significantly more common in the acne group than in the control group (p = 0.017, 0.002, and 0.040, respectively). Male patients with adult acne had a significantly longer disease duration than female patients with adult acne (p = 0.024). The most common type of acne was recurrent acne, followed by persistent and late-onset acne. Among patients with persistent acne, 14.5% had polycystic ovary syndrome (PCOS), whereas 12.2% of patients with recurrent acne and 11.1% of patients with late-onset acne had PCOS. Severe acne was more common in the persistent acne type (28.13%). The cheek (59.90%) was the most common involvement area, and stress (55.23%) was the most common triggering factor regardless of sex.

Conclusions: Although adult female and male patents with adult acne share similar triggering factors, the involvement areas can differ, which may indicate the additional hormonal etiology of female adult acne. Further epidemiological studies on adult acne in both sexes may illuminate the pathogenesis of the disease, thus making possible the development of new treatment strategies.

Tinea genitalis is a relatively new entity of dermatophyte infection, observed mainly in young adults. By definition, it is localized on the mons pubis and on the labia in women, and on the penile shaft in men. It has been described as a "lifestyle disease" and potentially sexually transmitted disease. We report the case of a 35-year-old patient, an immigrant woman, with tinea genitalis profunda, presenting with painful deep infiltrative papules and plaques, purulent inflammation, and signs of secondary impetiginization. Concomitantly, tinea corporis, tinea faciei, tinea colli, and tinea capitis were diagnosed. Her skin lesions developed over an approximately 2-month period. The zoophilic dermatophyte Trichophyton mentagrophytes was cultivated from the pubogenital lesions, as well as Escherichia coli and Klebsiella pneumoniae. The patient was treated systemically with terbinafine, antibiotics, and short-term corticosteroid, and topically with antimycotic and antibiotic cream. During almost 3 weeks of hospitalization, satisfactory improvement was achieved. A literature review with new clinical and epidemiological observations is presented for this rare type of tinea, which poses a diagnostic and treatment challenge.