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Placek W.,Katedra i Klinika Dermatologii | Wolska H.,Przychodnia Specjalistyczna High Med
Przeglad Dermatologiczny | Year: 2016

Rosacea is a common dermatosis more prevalent in females, significantly impairing quality of life. Currently erythematous, papulo-pustular and phymatous subtypes are distinguished, which do not necessarily represent consecutive stages. Recent findings indicate in the pathogenesis of rosacea the role of the impaired innate immune system and vascular abnormalities. Additionally, the role of genetic and infectious factors is suggested. The therapy of rosacea is directed not only against inflammatory changes but also anti-parasitic. In topical treatment the most commonly used are metronidazole and azelaic acid. Other drugs are topical antibiotics, antiparasitic agents such as ivermectin and preparations directly influencing erythema. In more severe cases tetracyclines or macrolides are used, and in the most severe cases, isotretinoine. As ultraviolet light is a recognized trigger for rosacea, regular sunscreen use is necessary. Also, proper diet is indicated. Presently in the treatment of rosacea more and more techniques using different lights are employed.

Jakubowicz O.,Katedra i Klinika Dermatologii | Zaba R.,Katedra i Klinika Dermatologii | Czarnecka-Operacz M.,Katedra i Klinika Dermatologii
Postepy Dermatologii i Alergologii | Year: 2010

Herpes viruses, that is HSV (Herpes simplex virus) type 1 and 2 and also VZV (Varicella-zoster virus), are among the most common human pathogens whose genome consists of DNA. So far over 100 species of herpes viruses have been identified, of which at least 8 cause human infections. Several antiviral medications are available on the Polish pharmaceutical market. However, the most difficult problem is related to the group of immunocompromised patients with herpes virus infections, due to the severe course of the viral infection and frequent resistance to the available antiviral medications. This paper is a review of available updated knowledge concerning selected medications, their antiviral mechanism of action and potential adverse effects. Moreover, therapeutic schemes for infections caused by HSV-1, HSV-2 and VZV viruses as well as in immunocompetent and immunocompromised patients have been presented.

Since its approval by the US Food and Drug Administration (FDA) in 1982, isotretinoin has been considered a breakthrough treatment against severe forms of acne. Systemic isotretinoin remains the most efficacious treatment for severe acne as well as many cases of more moderate disease that are unresponsive to other treatment modalities. Regardless of presence for approximately three decades on the market, there is still the question: which dosage? Moreover, isotretinoin is the only drug producing long-term remission, as well influencing scarring tendency. The current manuscript outlines the most appropriate dosage regimens for achieving the excellent efficacy, describes how to optimize treatment, reviews the recommended guidelines for treatment and monitoring, and summarizes interactions and adverse effects linked to oral isotretinoin usage. Copyright © 2011 Cornetis.

Lewicka-Potocka Z.,Studenckie Kolo Naukowe Przy Katedrze i Klinice Dermatologii | Szczerkowska-Dobosz A.,Katedra i Klinika Dermatologii
Przeglad Dermatologiczny | Year: 2016

Introduction. Pitted keratolysis (PK) is a mild infectious skin disorder caused by Corynebacterium spp., Kytococcus sedentarius or Dermatophilus congolensis. These bacteria produce enzymes that digest keratin, causing superficial lesions in the plantar surface. The disease is predominantly observed in young men. Objective. Pitted keratolysis despite the characteristic presentation of skin lesions is often misdiagnosed. In this article we aimed to remind readers of its clinical aspects and treatment by presenting a typical PK case. Case report. A 35-year-old man was admitted to the dermatological clinic due to skin lesions on both soles. In the physical examination we found multiple crateriform pits, associated with hyperhidrosis and malodour diagnosed as PK. Remission of lesions was observed after treatment with oral erythromycin. Conclusions. The differential diagnosis of plantar skin lesions should include PK. Due to typical clinical manifestation the diagnosis is based on physical examination.

Obtulowicz A.,Katedra i Klinika Dermatologii | Antoszczyk G.,Katedra i Klinika Dermatologii
Postepy Dermatologii i Alergologii | Year: 2010

In recent years great interest in phototherapy as an effective method for treatment of skin diseases has been observed. The biological effect of UV depends on the dose and the wavelength as well as patients' sensitivity to UV. Recently particular interest is more focused on narrow-band UVB (311-313 nm), which is considered safe and effective treatment for a variety of skin diseases. In the article the immunomodulatory and immunosuppressive mechanism of UVB 311 nm is described. The benefits and complications typical for this method are presented.

Syndromes involving premature aging provide outstanding models for a better understanding of both skin senescence and of the aging process in general. Based on the molecular pathomechanisms several main subsets of such disorders can be distinguished: progeroid syndromes with dysfunction of proteins forming the nuclear envelope (Hutchinson-Gilford syndrome, Werner syndrome, lipodystrophy), syndromes involving dysfunction of the nucleotide excision/repair DNA system (xeroderma pigmentosum, Cockayne syndrome), dysfunctions of helicases - enzymes of replication and transcription (Werner, Rothmund-Thomson, Bloom syndromes and ataxia telangiectasia), mutations of genes encoding proteins of extracellular matrix (variants of Ehlers-Danlos, and cutis laxa syndromes), mutations of the genes encoding telomerase complex (dyskeratosis congenita), and a syndrome with chromosomal aberrations (Down syndrome). Recent advances in basic research have raised new hopes regarding targeted therapies with progeria and aging.

Reszke R.,Katedra i Klinika Dermatologii | Szepietowski J.,Katedra i Klinika Dermatologii
Przeglad Dermatologiczny | Year: 2016

Azelaic acid (AZA) is a naturally occurring substance produced by Malassezia furfur which exerts various effects on the skin. Azelaic acid has antibacterial, anti-inflammatory, keratolytic, comedolytic, sebostatic and tyrosinase-inhibiting properties. Topical application of AZA as 20% cream or 15% gel is a well-established therapeutic method in various common dermatoses, mainly acne vulgaris, rosacea and disorders associated with hyperpigmentation. Azelaic acid is used as a component of chemical peels as well. The paper summarizes the most relevant issues concerning AZA application in dermatological treatment based on current knowledge.

Reich A.,Katedra I Klinika Dermatologii
Przeglad Dermatologiczny | Year: 2012

Introduction. Generalized pustular psoriasis is one of the most severe, potentially life-threatening forms of psoriasis. Drugs, infections and pregnancy are usually the trigger. Objective. The aim of the study was to present a case of intertriginous pustular psoriasis. Case report. A 28-year-old woman, suffering from common psoriasis since the age of 7 years, developed, during the puerperium, annular lesions of pustular psoriasis with characteristic, marginal scaling. The lesions were localized in the axillae, groins and in the breast folds, spreading at the periphery with evident central clearing. No general symptoms were present and the patient only complained of moderate skin burning. She was treated with cyclosporin and 0.1% methylprednisolone aceponate cream. Skin lesions cleared completely in one month. Conclusions. Intertriginous pustular psoriasis seems to be a distinct subtype of generalized pustular psoriasis.

Due to graft preserving immunosuppressive therapy, renal transplant recipients are predisposed to the development of a variety of skin infections and skin cancers. The aim of the study was to compare prevalence frequency of infective skin changes among patients after kidney transplantation and the dialyzed population. Clinical dermatological examination was performed in 486 patients after renal transplantation. The group consisted of 296 men (60.9%) and 190 women (30.1%), of mean age 46.1+/-13.1 (18-74 years) with median time after transplantation of 74.3+/-52.1 months. Most of the patients (80.7%) before transplantation were treated by maintenance hemodialysis. The most frequent immunosuppression regiments were combination of cyclosporine A (CsA) with mycofenolate mofetil (MMF) and steroids (GKS)-207 patients (42.5%); tacrolimus (TAC) with MMF and GKS-102 (20.9%) and CsA with azathiopine and GKS-53 patients (10.9%). The group of 112 dialyzed patients consisted of: 57 males (50.9%) and 55 females (49.1%), aged 57.4+/-15.4 years without history of immunosuppressive therapy and were on maintenance dialysis for 63.2+/-74.0 months. Most of this group (77.7%) was on maintenance hemodialysis, while the remaining 22.3% on peritoneal dialysis. The obtained results were analyzed based on t-Student's, Mann-Whitney's, chi-square and Fisher tests. It was shown that infective skin changes were significantly more frequent in the group of patients after kidney transplantation as compared with the dialyzed population. They were observed in 53.9% and 9.8% of the studied populations, respectively (p<0.0001). In the studied group after kidney transplantation the most frequent were viral changes (38.9%). Fungal infection was observed in 25.9% of these patients, while bacterial in 1.2% of this study group. In the dialyzed population fungal infections were diagnosed in 8.9%, while viral in 3.6% of patients. No bacterial changes were observed in this group. Acne was observed in 16.5% of patients after kidney transplantation. 1. In the group of patients after kidney transplantation receiving immunosuppressive therapy viral, fungal and bacterial infective skin changes were significantly more frequent as compared with the dialyzed patients. 2. The most frequent skin changes observed in patients after kidney transplantation were viral warts.

Infective skin changes are frequent complications in patients after kidney transplantation receiving immunosuppressive therapy. The aim of the study was to evaluate factors influencing on frequency and type of skin infections of bacterial and fungal origin in patients after kidney transplantation. The study was performed in 486 patients, 296 male (60.9%) and 190 female (39.1%) aged 46.1 +/- 13.1 years (18-74 years) 74.3 +/- 52.1 months after kidney transplantation remain mainly on triple immunosupresive therapy. Type, size and localization of skin changes revealed during dermatological evaluation were described according age, sex, and applied immunosuppression. The obtained results were analyzed based on t-Student's, Mann-Whitney's, chi-square and Fisher tests. It was shown that fungal infective skin changes in patients after kidney transplantation are more frequent in older population (48.4 +/- 11.8 vs. 45.2 +/- 13.4 years; p < 0.017). The significant differences concern interdigitale mycoses 49.7 +/- 11.1 vs. 45.4 +/- 13.3 years; p < 0.009, nail mycoses 51.5 +/- 10.4 vs. 45.5 +/- 13.2 years; p < 0,004 and foot mycoses 51.8 +/- 10.7 vs. 45.5 +/- 13.2 years; p < 0.0005. In male more frequent as compare with female were also fungal infections (30.7% vs. 18.4%; p < 0.002) including pityriasis versicolor 37.0% vs. 9.5%; p < 0.016 and interdigitale mycoses 18.6% vs. 9.0%; p < 0.004. Conclusions: Infective skin changes frequency in patients after kidney transplantation on immunosuppressive therapy depends on advanced age, male sex, and applied immunosuppressive therapy.

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