Acta Dermatovenerologica Croatica最新文献

The term "maskne" has been coined during the ongoing COVID-19 pandemic, designating acne associated with prolonged protective mask-wearing. Maskne is a variant of acne mechanica caused by mask-induced mechanical injury (pressure, friction, and rubbing) and occlusion. The additional factors influencing the onset of maskne include genetics, environmental factors, duration of mask-wearing, the type of mask, and previous facial skin disease. The prevalence of maskne is increasing since masks are the most commonly used personal protective equipment in the general population. Furthermore, wearing masks in public tends to become the "new normal" even in the post-pandemic period. Hence, the problem of maskne could become even more significant. This review aims to provide a comprehensive view of current knowledge on prevalence, pathogenesis, prevention, and treatment of maskne.

A male infant was born by spontaneous delivery on February 7, 2020, with a gestational age of 40 weeks and a birth weight of 4.1 kg. After birth, the infant presented with appearance of skin loss on the bilateral lower limbs, feet, left wrist, face, and lips. Large areas of skin defects, erosion, and exudation were noted on the extensor side of the bilateral lower limbs and feet, and some skin loss with a small amount of exudation was observed on the left wrist, face, and lips, which was accompanied by dorsal hyperextension of the right foot and oral mucosal ulceration (Figure 1). Because the parents refused invasive examinations (skin biopsy, i.e., transmission electron microscopy and immunofluorescence examination (1)) and the child was hospitalized in a period during which the strictest prevention and control measures for novel coronavirus pneumonia were enacted, the hospital canceled the invasive examinations; therefore, skin biopsy was not performed. The infant's parents were healthy and nonconsanguineous. They reported that neither of them had skin defects at birth. They also denied nail dystrophy or complete absence of the nail and a history of recurrent oral herpes or ulcers, and no other family members had such symptoms. The mother had multiple scheduled prenatal examinations during the pregnancy, and the sick infant delivered via natural birth was her first child. She did not have a history of previous miscarriage and underwent a thyroid function test and ultrasound B-mode examinations, which did not show obvious abnormalities. Ultrasound B-mode examination in the second trimester suggested bilateral renal sinus separation and excessive dorsiflexion of both feet of the fetus. A nuchal translucency (NT) scan, a noninvasive prenatal DNA test, and an oral glucose tolerance test (OGTT) showed no significant abnormalities. Ultrasound B-mode findings indicated that the infant had congenital dysplasia, suggesting that he may have a genetic disease. In a subsequent genetic test, compound heterozygous variations of c.C2005T (the nucleotide at position 2005 in the coding region was mutated from C to T) and c.G7922A (the nucleotide at position 7922 in the coding region was mutated from G to A) were detected in the child's collagen type VII alpha 1 chain (COL7A1) gene, and the mutations were from the child's parents' genes (Table 1). The COL7A1 gene is a well-established causative gene for autosomal recessive dystrophic epidermolysis bullosa. Based on these results, COL7A1 gene mutations may have been the cause of the disease in the child; thus, the child was definitively diagnosed with autosomal recessive dystrophic epidermolysis bullosa. CASE REPORT After admission, the child received aggressive nutritional support. For treatment, cefmetazole was given for anti-infection, aseptic dressings were applied on the body surface with skin defects, iodophor disinfection was carried out, recombinant human epidermal growth factor gel and chlortetracy

Fecal calprotectin (FCP) is a biomarker of intestinal inflammation and has recently been proposed as a diagnostic biomarker of food allergy (FA) in children. The aim of this study was to compare FCP level in infants and children under 4 years old with 1) atopic dermatitis (AD) with food allergy (FA) and 2) children with AD and without FA with the results in healthy controls. In total, 46 infants and children (mean age 14 months ± 12) diagnosed with AD were divided into two groups: G1, children with atopic AD with FA (n=28) and G2, children with AD without FA (n=18). The control group (G3) was made up of healthy children of the same age (n=18). The median FCP was significantly higher in G1 compared with G2 (G1: median 154, IQR 416 µg/g vs G2: median 41.3, IQR 59 µg/g; P=0.0096). The median FCP in children with AD and FA was significantly higher before elimination diet in comparison with FCP after 3 months of elimination diet (median 154, IQR 416 µg/g vs median 35, IQR 23 µg/g; P=0.0039). The level of FCP was significantly positively correlated with the SCORAD score (r=0.5544, P=0.0022). Our study showed a significant difference in level of FCP in patients with AD without FA compared with patients with AD and FA. We also found a positive correlation of FCP with SCORAD score, a biomarker of AD severity. New studies are needed to investigate the role of FCP as a biomarker of FA in children with AD.

Scarlet fever typically presents with distinctive erythematous papular rash following pharyngitis. Atypical forms may develop, making the diagnosis difficult. We present the case of a girl with fever, and unusual vesicular skin eruption (miliaria scarlatinosa) preceded by a skin infection, without mucosal changes. Leukocyte count, C-reactive protein, and antistreptolysin O-titer were elevated. Bacteriological swabs of the skin injury revealed Streptococcus pyogenes. Histopathology was compatible with scarlet fever exanthema. Intramuscular penicillin and topical wound care induced complete remission. It is of great importance to be aware of uncommon clinical presentations of scarlet fever in order to establish a timely diagnosis and prevent potential complications.

L-17 inhibitors belong to the group of the most effective and highly safe biological preparations intended for the treatment of psoriasis, and in the case of secukinumab and ixekizumab, also for the treatment of some immune-mediated inflammatory diseases of the joints. Despite initial expectations, they did not prove to be effective for the treatment of non-specific bowel inflammations (IBD). On the contrary, IBD worsening was reported in some cases where IL-17 inhibitors were used, and registration studies were terminated for this indication. In clinical studies, extensive meta-analyses of IL-17 inhibitor use for psoriasis and joint inflammation indications generally did not demonstrate any statistically significant increase in the risk of de-novo IBD with this type of treatment. Data from real-time practice are mostly similar. The literature describes individual cases with an obvious relation of de novo IBD development subsequent to treatment with IL-17 inhibitors in registered indications. The activation of latent, thus far clinically asymptomatic bowel inflammation is usually expected. Therefore, a careful review of medical history focused on bowel problems in personal and family history is necessary before starting therapy with IL-17 inhibitors. We present a similar experience with de novo onset of ulcerative colitis in two patients treated for psoriasis with ixekizumab, with associated psoriatic arthritis in one case.

Acne is an inflammatory disease of the pilo-sebaceous unit, which mainly affects young adolescents. The pathogenesis is multifactorial, as a combination of genetic predisposition, hormonal production, hyper-seborrhea, inflammation and overgrowth of C. acnes. Moreover, diet-induced hyperinsulinemia can lead to sebocyte stimulation, androgen production, and thus acne lesions. Pharmacological therapeutic approaches are varied and include topical and systemic antibiotics and, in severe cases, systemic retinoids, with several side-effects. However, increasing evidence has shown that adequate vitamin supplementation, use of probiotics, and proper nutrition with low carbohydrates and fats intake, can significantly contribute to the patient's clinical improvement. In this review, we describe the role of probiotics, vitamins, alimentation, antioxidants, UV exposure, and plants in acne disease.

Non-melanoma skin cancer (NMSC) is the most common neoplasm. The characteristics of this disease (location in aesthetically sensitive areas, the appearance of successive tumors during follow-up, and high rates of survival) are such that the concept of health-related quality of life (HRQoL) is of particular importance. The aim of the present study was to describe and analyses patient quality of life following diagnosis with cervicofacial NMSC. A descriptive cross-sectional study was conducted on patients with cervicofacial NMSC, confirmed by skin biopsy. In each case, when the definitive diagnosis of NMSC was established, the patient completed the Skin Cancer Index questionnaire and demographic data, health status, and sun exposure habits were recorded. The study population was composed of 220 patients with histologically confirmed cervicofacial NMSC. The mean score obtained for the Skin Cancer Index questionnaire was 54.1 (SD 21.9), in which the social-aesthetic component had a mean score of 76.7 (SD 26.2), while the emotional component had a mean score of 23 (SD 25.1). Male patients, those with secondary or higher education, and those who had no history of anxiety or depression had significantly higher mean scores for HRQoL. This study demonstrated that the diagnosis of cervicofacial NMSC significantly impacts HRQoL and that certain population groups (women, persons with only primary or no education qualifications, and those a history of anxiety or depression) are more susceptible. The questionnaire scores obtained were lower than those reported in previous studies on this topic and reflect a particularly strong impact on emotional aspects of patient quality of life.

Infantile hemangiomas with minimal or arrested growth (IH-MAGs) are a subtype of infantile hemangiomas (IHs), characterized by absent or minimal (equal or less than 25% of the total IH surface area) proliferation. They are less conspicuous than classical IHs, but can also be complicated by ulceration or can be misdiagnosed as capillary malformations. The literature on IH-MAGs is scarce, but with increasing interest in the literature. We investigated the clinical and epidemiological characteristics of IH-MAGs in a retrospective series of cases found in a regional tertiary-care pediatric clinic during a 7-year period. Eleven infants with 14 IH-MAGs were included in the analysis. There were 7 girls and 4 boys. Unlike the majority of other authors, we have found 7 premature and 4 full-term infants in our case series. Most of the IH-MAGs were classified as focal (78.57%), were present at birth (72.72%), and were located on the lower body, below the waist line (71.42%). In almost all infants, erythematous background as well as vasoconstricted patches and/or halos were present, while fine or coarse telangiectasias were observed mainly in full-term infants. A subtle proliferative component was observed in only one case on follow-ups. There were no ulcerations. The therapy - topical and oral beta-blocker - was introduced in two cases of IH-MAGs in the face region. Clinical characteristics of IH-MAGs in our case series were similar to those found in other studies on this subject. However, we found a significantly higher percentage of premature infants with IH-MAGs than in any available reference.

The puffy foot syndrome, a novel clinical entity, describes the complication of secondary lymphedema with chronic progression in the feet, a finding that has often been overlooked in the non-tropical setting. While previously well described in the upper extremities, this complication has not been fully explored in the lower extremities. However, given increasing rates of diabetes mellitus, obesity, and a myriad of other possible etiologies in the United States, it is important to understand this entity and its non-viral, non-parasitic causes in non-tropical regions. This review delineates common illustrative properties of this syndrome observed in clinical practice as well as long-term complications, including Ruocco's immunocompromised cutaneous district, that are often overlooked. Furthermore, a novel method of staging is suggested for this condition, reflective of increasing risk of complication, infection, and malignancy. We also highlight the increased need for improved detection and recognition of this condition to avoid possibly deleterious outcomes.

Psoriasis and hidradenitis suppurativa are two common dermatological diseases that affect physical, social, and psychological aspects of the patients' lives. The aim of this study was to compare quality of life, depression, anxiety, self-esteem, and loneliness in patients with psoriasis and hidradenitis suppurativa. One hundred and eight patients with psoriasis, 113 patients with hidradenitis suppurativa and 116 healthy controls were included in the study. The quality of life, depression, anxiety, and loneliness of the patients as well as their self-esteem were assessed using the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), the UCLA loneliness Scale (UCLA-Version 3) and the Rosenberg's Self-esteem Scale (RSES), respectively. Patients with psoriasis (12.77±4.43) reported a higher mean impairment in DLQI than patients with hidradenitis suppurativa (11.10±6.53, P=0.028), in the univariate comparisons. Patients with psoriasis presented statistically significantly higher levels of anxiety and depression than both patients with hidradenitis suppurativa and healthy controls, while patients with hidradenitis suppurativa also had higher anxiety and depression compared with healthy controls. Patients with psoriasis (46.31±6.36) reported statistically significantly higher loneliness than both patients with hidradenitis suppurativa (43.18±7.40) and controls (40.42±4.41), while the patients with hidradenitis suppurativa also presented higher loneliness in comparison with controls. Lower levels of self-esteem were found in patients with psoriasis (15.08±3.11) compared with both patients with hidradenitis suppurativa (18.89±1.69) and controls (20.25±2.60), while patients with hidradenitis suppurativa also had lower self-esteem than controls. Significant levels of depression, anxiety, and impaired quality of life were strongly associated with disease severity. When patients with mild disease were compared, those with psoriasis presented with both higher levers of loneliness and lower scores for quality of life. Although both psoriasis and hidradenitis suppurativa are associated with impaired quality of life and psychological aspects, significantly worse scores were recorded in patients with psoriasis.