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Dolenc-Voljc M.,University of Ljubljana | Zgavec B.,University of Ljubljana | Vizjak A.,University of Ljubljana | Tenyi V.,Celje General and Teaching Hospital | Luzar B.,University of Ljubljana
Acta Dermatovenerologica Alpina, Pannonica et Adriatica | Year: 2013

Figurate erythema can appear in a wide spectrum of dermatological diseases. Rarely, it can present as an atypical manifestation of bullous pemphigoid. Among eosinophilic dermatoses, figurate erythema may appear in Wells syndrome, which has been occasionally reported in association with Toxocara infection. We present the case of an older female patient diagnosed with bullous pemphigoid, who presented with an unusual combination of blisters and figurate erythema outside the area of blister formation. In addition, high blood eosinophilia associated with lymph node and bone marrow eosinophilia was diagnosed and was causally related to Toxocara canis infection. The patient was treated with dapsone for bullous pemphigoid and with albendazole for toxocariosis, with complete regression of all skin lesions and blood eosinophilia. This paper discusses the possible etiopathogenesis of figurate erythema in our patient and summarizes previous clinical and histological findings in bullous pemphigoid and eosinophilic dermatoses presenting with figurate erythema lesions.

Kovacic D.,Celje General and Teaching Hospital | Glavnik N.,Celje General and Teaching Hospital | Marinsek M.,Celje General and Teaching Hospital | Zagozen P.,Celje General and Teaching Hospital | And 4 more authors.
Journal of Cardiac Failure | Year: 2012

Background: Hydrogen sulfide (H 2S) has emerged as a third gaseous transmitter in mammals. In animal models of heart failure, treatment with an H 2S donor can protect the heart against adverse remodeling and attenuate cardiac dysfunction. The aim was to determine total plasma sulfide in patients with congestive heart failure. Methods and Results: Total plasma sulfide was determined in 57 patients on admission to an outpatient clinic or cardiology department. Total plasma sulfide concentrations in these patients was lower compared with a control group (5.32 [2.22, 8.00] μM vs. 8.5 [6.00, 14.00] μM; P =.05). Total plasma sulfide decreased significantly across the New York Heart Association (NYHA) functional classes (II, 5.84 [4.33, 8.00] μM vs. III, 4.67 [4.00, 7.17] μM vs. IV, 2.67 [2.22, 4.31] μM; P =.001). The total plasma sulfide negatively correlated with pro-BNP (R 2 cubic, 0.692; P =.001) and pulmonary artery systolic pressure (R 2 cubic, 0.569; P =.001). The receiver operating characteristic analysis of the area under the curve for total plasma sulfide as a predictor of mortality was 0.904 (95% CI, 0.822-0.987; P =.001), and of rehospitalization was 0.779 (95% CI, 0.650-0.908; P =.001). Total plasma sulfide was a univariate predictor of mortality (odds ratio, 0.245; 95% CI, 0.108-0.555; P =.001). Conclusion: Total plasma sulfide is negatively related to severity of congestive heart failure: it is lowest in NYHA Class IV and in patients with high pro-BNP and high pulmonary artery pressure. Low total plasma sulfide predicts a higher mortality rate. © 2012 Elsevier Inc. All rights reserved.

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