Tomaz Lunder

Ljubljana University Medical Centre, Lubliano, Ljubljana, Slovenia

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Publications (8)11.33 Total impact

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    ABSTRACT: Lichen planus (LP) is a common mucocutaneous disease of unknown aetiology with various geographical prevalence, may be related to some serious disorders such as squamous cell carcinoma and often remains underdiagnosed. The aim of this retrospective study was to thoroughly determine localization and clinical characteristics of LP lesions in a cohort of 173 Slovenian patients in association to the presence of accompanying symptoms and history of potential stressful events. Isolated cutaneous lesions of LP were found in 56.6% and isolated oral LP in 3.5% of patients. Thirty-four percent presented orocutaneous LP, whereas genitocutaneous LP was noted in 1.2%, orogenito-cutaneous LP in 4% and orogenital LP in 0.5% of patients. Underlying stressful events were noted in 36 out of 137 (26.3%) patients. Despite obviously visible localization of the lesions various medical specialists should be familiar with LP and thoroughly examine the complete skin, as well as oral, genital and anal mucosa in each LP patient to avoid a delay in diagnosing this disease and possibly disclose a much serious underlying condition. Psychological support should be offered, if needed.
    Collegium antropologicum 03/2011; 35(1):15-20. · 0.61 Impact Factor
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    ABSTRACT: Skin around venous leg ulcers (VLUs) is often inflamed and prone to contact sensitization. Expression of tight-junction components (ZO-1, occludin, and claudins 1 and 4) was studied by immunofluorescence in inflamed and noninflamed lower leg skin (both uncovered skin and skin occluded under hydrocolloid dressings) in patients with VLUs. No major differences were found in the expression of occludin and claudin-4. ZO-1 protein had stronger and more wide-ranging expression in the inflamed epidermis. Expression of claudin-1 was lost from the basal layer of the inflamed skin and skin under the hydrocolloid dressing. The skin on the lower legs affected by VLU may have altered expression of ZO-1 and claudin-1, similar to that seen in psoriatic plaques.
    Clinical and Experimental Dermatology 10/2009; 34(8):e949-52. · 1.33 Impact Factor
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    ABSTRACT: The association between hepatitis C virus (HCV) infection and lichen planus (LP) is a subject of controversy. Prevalence studies of HCV infection in LP patients in various countries reveal diverse results. The Slovenian population is rather homogenous with specific geographic and epidemiological characteristics. Lack of data or contradictory results from neighboring countries urged the need for a case-controlled study in our LP patients. The retrospective study was performed on 173 LP patients. Control group included 218 patients with dermatological diseases other than LP. Anti-HCV antibodies were found in 2/173 patients (1.2%) with LP and in 0/218 controls. No statistically significant difference was found between the study and control group regarding anti-HCV antibody prevalence (P = 0.195; estimated OR 6.4, 95% CI 0.3-134.0) and risk factors for HCV infection. Based on our results, anti-HCV antibody testing is not necessarily required in LP patients with no risk factors for HCV infection in this geographic region.
    International journal of dermatology 01/2009; 47(12):1250-6. · 1.18 Impact Factor
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    ABSTRACT: Several controversies exist regarding the relationship between hepatitis C virus (HCV) infection and some cutaneous manifestations, lichen planus (LP) in particular. To determine the prevalence of LP and other cutaneous manifestations in a cohort of patients infected with HCV from low HCV endemic area of Slovenia, to correlate findings with chosen biological variables and to assess the role of interferon (IFN)-based treatment of HCV infection in cutaneous manifestations. Methods A total of 171 consecutive HCV-seropositive patients and 171 HCV-seronegative age- and gender-matched controls were studied prospectively. Prevalence of cutaneous manifestations, comparison between study patients and controls and correlation of skin findings with demographic, biochemical, virological and liver histologic findings as well as IFN-based therapy were assessed. Overall presence of LP in HCV-seropositives was 2.3%; although LP was not found in controls, the difference was not statistically significant (P = 0.123). Significantly higher than in controls was the prevalence of pruritus (31.0%, P < 0.001), dry skin (16.4%, P < 0.001) and hair loss (9.9%, P < 0.001). In IFN-based treatment naïves, skin findings were more frequent compared with controls, but not significantly, with no correlation to chosen biological variables. Current IFN-based treatment was significantly connected to pruritus (P < 0.001) and dry skin (P < 0.001). Compared with treatment naïves, in post-treated patients pruritus (odds ratio, 19.13; 95% confidence interval, 6.85-53.42; P < 0.001), dry skin (odds ratio, 4.21; 95% confidence interval, 1.44-12.31; P < 0.001) and hair loss (P < 0.001) were significantly more common. LP was not significantly related to HCV infection. Prevalence of pruritus, dry skin and hair loss was significantly higher in post-compared with pre-treated patients. The role of IFN in post-treatment persistence of skin manifestations needs to be assessed.
    Journal of the European Academy of Dermatology and Venereology 07/2008; 22(7):779-88. · 2.69 Impact Factor
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    ABSTRACT: Chronic venous insufficiency (CVI) is a venous disorder in the lower extremities associated with changes in the skin and subcutaneous tissue. Treatment with short-stretch compression bandages is highly recommended for advanced stages of CVI. The compression systems Rosidal Sys, Porelast, Coban, and Proguide were evaluated in 4 groups of mobile and active patients (n = 18) with CVI stage II or III. Sub-bandage pressures at point B1 were measured in the upright and supine positions 30 min and 12 h after the bandage was applied. Average pressures and values of the static stiffness index (SSI) were calculated for each group. The Porelast, Rosidal Sys and Coban systems had SSI values in excess of 10 mmHg, 30 min and 12 h after application. The corresponding values for Proguide were below 10 mmHg. Conclusion: Porelast, Rosidal Sys and Coban are very stiff systems, whereas Proguide is more similar to long-stretch compression bandages with a lower degree of stiffness.
    Acta dermatovenerologica Alpina, Panonica, et Adriatica 04/2008; 17(1):17-21.
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    ABSTRACT: There is a need for practical methods to predict the healing time of venous leg ulcers. In a prospective cohort study of 81 patients with venous leg ulcers, we used a recently described laser-based three-dimensional measurement of the ulcers at days 0 and 28 to estimate the predictive power of horizontal (HIHR) and vertical initial healing rates (VIHR) for wound healing by week 24. The rates were calculated by Gilman's equation [(A(1)-A(2))/((p(1)+p(2))/2)((0-4))] and by its modification [(V(1)-V(2))/((A(1)+A(2))/2)((0-4))], respectively. The influence of risk factors on both the initial healing rates was also studied. The HIHR and VIHR are important predictors of healing at 24 weeks. They are not influenced by age, ulcer duration, initial ulcer area, and insufficient sapheno-femoral junction, and/or calf perforating veins. Together with ulcer duration, they are independent predictors of the 24-week healing (the area under ROC curve equals to 0.9). VIHR gives us additional information and significantly improves the prediction of 24-week healing.
    Wound Repair and Regeneration 01/2008; 16(4):507-12. · 2.76 Impact Factor
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    ABSTRACT: A lack of reproducible and practical methods to assess venous leg ulcer healing is a major problem encountered by investigators evaluating various treatments. We aimed to compare a new laser-based three-dimensional (3D) measuring device with computer planimetry with photography for the assessment of venous leg ulcers, and to estimate the reliability of measurements by the methods. Sixty measurements of perimeter and area of 15 venous leg ulcers, < 10 cm in diameter (eight patients; six females; mean age 71 years; range 52-90 years), were made with both methods. Two independent investigators performed the measurements at the first visit and 2-4 weeks later. The precision and accuracy of the methods were determined and compared. The accuracies for computer planimetry with photography in comparison with the laser-based 3D measuring method were 8.4% for perimeter and 16.0% for area measurements. The precisions of ulcer area and perimeter measurements did not differ significantly between the two methods (p=0.993 and 0.201, respectively). The main advantage of the laser-based measuring method is the 3D ulcer measurement with a precision of 7.5%, which also takes into account distortions created by the limb convexity. The system is accurate, inexpensive, user-friendly, and appropriate for everyday practice.
    Wound Repair and Regeneration 01/2007; 15(5):767-71. · 2.76 Impact Factor
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    ABSTRACT: Follicular mucinosis is characterized by mucin deposits within the hair follicles and sebaceous glands. It can occur as a primary idiopathic benign disorder; it can be found as an incidental phenomenom in rare cases of different dermatoses; or it can arise as a secondary symptom of a malignant disorder, most commonly mycosis fungoides. Youth and localization in a single area used to be regarded as indicative of the benign nature of follicular mucinosis. However, recent reports demonstrate that no clear-cut criteria allow for the differentiation of idiopathic from lymphoma-associated follicular mucinosis. We report the case of a 16-year old girl who presented with a 2-year history of a single, slightly pruritic, erythematous patch on the left side of the neck. Different local treatments (local corticosteroids, antibiotics, antifungal ointments and moisturizers) were ineffective. Overall, she was healthy. Histopathological examination of the lesion showed the typical histological picture of follicular mucinosis.
    Acta dermatovenerologica Alpina, Panonica, et Adriatica 10/2005; 14(3):111-4.