[Show abstract][Hide abstract] ABSTRACT: 5(3): 305e Comment to the article Cyclosporine is a potent immunomodulatory drug and best choice in refractory or severe chronic plaque Psoriasis type with immediate improvement in clinical manifestations. Kidney functions test should be monitored before and during therapy. FDA approved that cyclosporine not be used more than one year. Alternation with other forms of treatment should be considered in long term management of patients with lifelong disease.
[Show abstract][Hide abstract] ABSTRACT: Collagen is the fundamental protein forming the connective tissues matrix, improves the ability of keratinocytes to migrate to sites that require rebuilding of the damaged epidermis, is one of the component of dressings used to accelerate wound healing. Because of the potential risk of the presence of pathogenic prions in bovine collagen, part of collagen dressings is formed on the basis of porcine collagen. Currently, a least of an immunogenic form of collagen is atelocollagen, which is subjected to enzyme-treated collagen, in which the terminal amino acids are removed from the collagen. It is assumed that in the near future atelocollagen will be used also as a carrier for drugs which support the healing processes.
No preview · Article · Jul 2013 · Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
[Show abstract][Hide abstract] ABSTRACT: The number of various diagnostic criteria for atopic eczema that have been carried out world-wide shows how many difficulties and doubts this diagnose still causes. In 1994 one of those criteria were presented by the UK working party's (Williams et al.). The aim of his study was to examine the validity of the UK diagnostic criteria for atopic dermatitis in children and to compare the results with those of Hanifin and Rajka. One hundred and sixty six children from paediatric out-patient clinic (67 boys and 99 girls) aged 4-15 lat (mean age 10.3) were examined. All of them beside the skin changes had pruritus. They underwent thorough clinical examination and were assessed according to Hanifin and Rajka criteria. The results were then subjected to statistical analysis. Atopic eczema was diagnosed in 108 children, remaining 58 infants suffered from scabies, seborrhoic dermatitis, irritant reactions, psoriasis vulgaris, acne vulgaris and urticaria. All of the examined children had a history of dry skin in the last year. History of involvement of typical skin areas, onset under the age of 2, visible eczema of typical localization and a personal history of asthma or hay fever were noted in 96,3% (104/108), 71.3% (77/108), 67.6% (73/108) and 64.3% (70/108) respectively. All of those features were observed more frequently in comparison with the group of non-atopic children and that fact was statistically significant (p<0.001). In 3/108 examined children the results turned false negative and in 2/58 - false positive. The Williams criteria showed sensitivity and specificity of 97.2% and 96.6% respectively. Conclusions: 1. The UK diagnostic criteria for atopic dermatitis are very useful in paediatrician everyday practice, especially in children over 3 years old. 2. Both features general dry skin and history of skin involvement in typical localization are the most useful in diagnosing atopic eczema in children. 3. In complicated and doubtful cases the age limit of the early onset below 2 might be stretched up to 5 which improves overall diagnostic efficiency.
No preview · Article · Jan 2009 · Pediatria i Medycyna Rodzinna
[Show abstract][Hide abstract] ABSTRACT: Studies on apoptosis and the influence of UVB radiation on this process have important cognitive aspects. They are a source of information about the interaction between the ultraviolet radiation and the biological material. The purpose of the study was to compare the narrow- and broad-band UVB radiation in terms of its influence on the epidermis apoptosis in experimental animals. Immunohistochemically, the number of apoptosis cells was counted in the epidermis. In 6 consecutive fields of vision measuring 82.4 μm × 82.4 μm, the number of cells with positive PARP reaction was counted. They were counted in three slices in the control group and in each of the experimental groups. The results underwent statistical analysis. Percentages, arithmetic means and standard deviations were calculated. It was proved that UVB radiation leads to enhanced apoptosis in the epidermis. The largest number of apoptotic cells per a surface assessed was observed in the BB-UVB-D experimental group. In this group there were 20 times more apoptotic cells than in the controls. When the number of apoptotic cells was compared between the narrow-band irradiated group and that irradiated with the broad band of UVB, the latter was found to induce about three times more apoptotic cells than the former did. The data obtained after the analysis of the results allowed for a comparative evaluation of the both radiation wavebands, which was also important from the clinical point of view. A full understanding of the complex apoptosis process can contribute to the knowledge about the process of photocarcinogenesis and help find a possible relation between an increased risk of skin carcinogenesis and a distorted apoptotic response.
No preview · Article · Jan 2008 · International Review of Allergology and Clinical Immunology
[Show abstract][Hide abstract] ABSTRACT: Photoaging is a skin aging caused by long-term exposure to the ultraviolet radiations of the sun. Ultraviolet activates activating protein-1 and generate reactive oxygen species which play a substantial role in collagen degradation. Clinically, photoaged skin appears as a coarse with deep wrinkles. Presently there are available several agents to reverse the photodamage. There is conclusive evidence that synthetic vitamin A derivatives are the most effective in the treatment of photoaging. Erythema and scaling may be experienced initially.
No preview · Article · Jul 2007 · Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
[Show abstract][Hide abstract] ABSTRACT: The diagnosis of atopic dermatitis (AD) in children might cause difficulties, especially when its course is atypical. There are no symptoms or laboratory findings which could be said to be specific for AD only. Therefore the diagnosis of AD can only be made when certain groups of criteria proposed by Hanifin and Rajka are observed. As the validation studies of the criteria showed widely variable results, the aim of the study was to evaluate the clinical significance of Hanifin and Rajka's criteria in the diagnosis of atopic eczema in children by determining the frequency of their appearance. Two hundred and sixteen children were examined. One hundred and sixteen (44 boys and 72 girls) aged 3-15 years (mean age 10.7) suffered from AD. The control subject group consisted of 100 healthy children combined proportionally in terms of age and gender. The number of each major and minor criterion and the frequency of its appearance were determined in both groups of children, also including their age and gender. The results were then subjected to statistical analysis. 84.5% of children with AD presented four and 15.5% presented three major criteria. All children with AD had pruritus and showed chronic and relapsing character of their skin changes. Personal or family history of atopy and dermatitis in classical distribution were present in 93.1% and 94.8%, respectively. 20% of healthy volunteers showed history of atopy in their family only (p<0.001). The frequency of minor features ranged from 3.5 % for nipple eczema and 100% for pruritus. Apart from nipple eczema and pityriasis alba, the minor features were observed more frequently in children suffering from AD, and the fact was statistically significant. In all healthy children at least one minor feature was observed, and 45% of them showed two minor features. In children with AD an increased total IgE level was observed more often in boys than in girls, and the difference was statistically significant (84.1% vs 59.7%. p<0.005). The early age of onset of the disease, aggravation by food, infra-orbital fold, susceptibility to infections, anterior neck folds and facial pallor were observed more often in younger children, while older ones showed more frequently hand and foot eczema, and the differences observed were statistically significant. Conclusions: 1. The major criteria proposed by Hanifin and Rajka are clinically most useful in the diagnosis of AD in children. 2. Significant discrepancy in the frequency of minor features and occasional appearance of some of them also in healthy children seem to be less useful in the diagnosis of atopic eczema. 3. Further studies should be made to evaluate the diagnostic criteria of AD in children in terms of their age and gender.
No preview · Article · Mar 2007 · Pediatria i Medycyna Rodzinna
[Show abstract][Hide abstract] ABSTRACT: Sarcoidosis is a generalized granulomatous disease of unknown aetiology. It affects many organs, most commonly the lungs, eyes and skin. The diagnosis is based on clinical symptoms, chest X-rays and histopathological examinations. A case of a 42-year-old female affected with sarcoidosis of the respiratory system with coexisting skin lesions is presented. The final diagnosis of cutaneous sarcoidosis was made after histopathological examination of lesional skin. The immunosuppressive treatment, introduced due to pulmonary involvement, had no effect on skin changes. Topical tacrolimus applied for several months prevented further progression of skin lesions.
[Show abstract][Hide abstract] ABSTRACT: The complex pathomechanisms underlying skin lesions in atopic dermatitis (AD) result in variations of the clinical picture and frequent diagnostic difficulties. The purpose of this study was to evaluate the usefulness of atopy patch tests (APT) for aeroallergens in the diagnosis of AD. The study involved 115 adult patients with AD and 98 healthy volunteers (the control group). APTs for cat dander allergens, birch pollen, a mixture of house dust mite species and a mixture of 5 grass pollen allergens were applied for both groups. Positive reaction to at least one test allergen was found in 53.9% patients compared to 6.2% in the control group (p<0.001). The most frequent hypersensitivity (45.2%) observed was to house dust mite allergens. Polyvalent allergy to 2-4 allergens was found in 56.5% patients. The specificity of tests exceeded 75%, whereas the sensitivity varied from 18 to 66%. CONCLUSIONS: 1. Atopy patch tests, which are characterised by considerable specificity, confirm the role of polyvalent contact hypersensitivity to aeroallergens in the development of atopic dermatitis. 2. Positive aeroallergen ATP results are observed in the majority of patients and can thus be regarded as an additional diagnostic criterion in atopic dermatitis.
No preview · Article · Mar 2006 · European journal of dermatology: EJD
[Show abstract][Hide abstract] ABSTRACT: Disturbed cellular adhesion, incorrect intercellular interactions and faulty immune mechanisms are those elements which contribute to the development and proliferation of metastases. Integrins belong to a group of adhesion molecules which participate in cellular adhesion and passing signals. They are heterodimers composed of an a chain linked to α β chain by means of a noncovalent bond. Their structure includes an extracellular fragment, a transmembrane component and a short cytoplasmic sequence. The β chain determines the functions of the integrin receptor, hence its biochemical composition determines how integrins are divided. The integrins best studied are β1, β2, β3. The expression and activity of integrins are influenced by a large number of agents, which may act as activators or inhibitors. Both quantitative and qualitative changes in integrins are mainly controlled at the transcription level. Cells altered neoplastically exhibit a disturbed expression of adhesion cells and integrin receptors. The degree of integrin expression may also affect the course of neoplastic process. Integrins, together with other adhesion molecules, take part in consecutive stages of adhesion cascade, thus contributing to the development of metastatic foci.
No preview · Article · Jan 2006 · International Review of Allergology and Clinical Immunology
[Show abstract][Hide abstract] ABSTRACT: Cell adhesion molecules (CAM) constitute a varied group of proteins connected with the cell membrane. Being both receptors and ligands for specific receptors, they participate in the adhesion, recognition, intercellular interaction and communication between cells and extracellular matrix (ECM) elements. Their biochemical structure and the range of their functions has been taken as the criterion to divide them into: selectins, integrins, superfamily of immunoglobulins (a family of immunoglobulin supergenes), cadherins and other adhesion particles, including CD 44. Integrins are heterodimers composed of α and β chains. The integrins best studied are β1, β2 and β3 types. The expression and activity of these proteins are influenced by a large number of agents that act as both activators and inhibitors. Adhesion molecules, being involved in the subsequent stages of the adhesion cascade, play a significant role in inflammation processes and inflamations of allergic origin. Using the degree of expression of specific integrins, an attempt to develop new diagnostic methods has been made with particular regard to identifying specific inflammation markers. A therapy that makes use of particular mechanisms of action on CAMs can also become a method of restricting the extent of pathology. Competence arrest of a CAM or its ligand by means of monoclonal antibodies (anti-adhesion therapy) is a promising method of controlling pathological processes.
No preview · Article · Jan 2006 · International Review of Allergology and Clinical Immunology
[Show abstract][Hide abstract] ABSTRACT: Mycoses are classified into superficial, subcutaneous and systemic infections. Superficial infections are referred to glabrous skin, mucous membranes and skin appendages. Diagnosis is based on significant clinical findings confirmed by positive mycological examination. Therapy of mycoses consist of systemic, topical and combination therapy. In this article is presented deep insight into superficial mycoses and are carefully discussed several classes of antifungal agents. These include imidazoles antifungals (ketoconazole, itraconazole, fluconazole), allylamines (terbinafine), polyenes (amphotericin B) and variety of other classes of antifungal agents like griseofulvin and flucytosine. Drugs of each classes have been comprehensively reviewed, including spectrum and mechanisms of action, tracts of elimination. Doses and drug interactions, with focused attention on side effects and efficacy have been also pointed. Antifungal agents are relatively small class of drugs as compared with antibacterial ones, but this group of drugs is still extending. In connection with this have been presented modern antifungal agents administered in the oral therapy. Administration due to superficial mycoses of the new antifungal drugs have increased safety profile and efficacy of the therapy. It should be emphasized that strategy to succeed antifungal therapy is related not only to the efficacy of the treatment against the skin infection, but is based on the searching of the primary infection and on the treatment of diseases which predisposes to fungal infections as well as is based on the prophylaxis. In case of prophylaxis pivotal role play coordination patient - clinician. Patient education is one of the key for improved control of fungal infections.
[Show abstract][Hide abstract] ABSTRACT: of the study was to evaluate the seroprevalance of antibodies against Anaplasma phagocytophilum and Babesia Microti in healthy north-eastern Poland, adult population.
The study was conducted in a group of 142 healthy adults (mean age 19-22), bitten by ticks within last 2 years. The control group consisted of 50 adults from central Poland (nonendemic area). The antibody levels for A. phagocytophilum (IgG/Ap-Ab) and B. microti (IgM/Bm-Ab) were evaluated in two series of samples from the same persons (interval 5-6 months) by immunoenzymatic tests (Borrelia Biomedica, Austria), immunofluorescence test (Human Granulotic Ehrlichiosis IFA IgG and Babesia microti IFA IgG from MRL Diagnostics).
Positive results for A. phagocytophilum were defined as titres > or =1:256 and for B. microti > or =1:64 and B. burgdorferi > or = 11 BBU/ml. Positive results for IgG B. burgdorferi during the first collection were revealed in 16% (n=24/142) of individuals from endemic area and in 4% (n=2/50) of the control group, which was statistically relevant (p<0,05). IgG A. phagocytophilum antibodies were present in 3,5% (n=5/142) of individuals from the endemic area, but for IgG B. microti antibodies (IgG/Bm-Ab) no positive results were found. No IgG antibodies against A. phagocytophilum and B.microti, were found in individuals from non-endemic area. During the second collection, in individuals from the endemic area, the antibodies against B. burgdorferi were found in 9,8% (n=14/142), IgG A. phagocytophilum antibodies (IgG/Ap-Ab) in 4,9% (n=7/142) and against B. microti (IgG/ Bm-Ab) in 1,4% (n=2/142). The antibodies against B. Burgdorferi were found in 2% (n=1/150) of the control group during the second collection, and no IgG against A. phagocytophilum and B. microti were found. CONLCUSION: Evaluating the seroprevalance of the studied antibodies in both collections, a conclusion was drawn that there was no significant increase of antibodies levels directly after the highest exposition to tick bites. None of individuals showed 4-fold antibody level increase between the first and second collection. The seroconversion for IgG/Bm-Ab antibodies was present in 1,4% (n=2/142) of individuals, in those 2 cases a 2-fold antibodies level increase was observed. As far as IgG/Ap-Ab antibodies are concerned the seroconversion was observed in 2,1% (n-3/142), but only one case shown a 3-fold antibodies level increase. No seroconversion of B. burgdorferi antibodies were found in the second collection.
No preview · Article · Dec 2005 · Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
[Show abstract][Hide abstract] ABSTRACT: Clinical observation indicates limited usefulness of skin-prick-tests (SPT) and specific IgE (sIgE) assessment in detecting hypersensitivity to aeroallergens in patients with atopic dermatitis (AD). The aim of the study was to evaluate the usefulness of atopy patch tests (APT) and commonly-used allergic tests in detecting hypersensitivity to aeroallergens in AD patients. 115 patients were analysed. Hypersensitivity to: mixture of the house-dust-mite, white birch pollen, five-grass mixture and cat dander was evaluated with APT, SPT and assessment of sIgE level. The frequency of hypersensitivity to house dust-mite, detected with SPT and sIgE concentration tests was 58.2%, and additionally increased, up to 75.7%, when APTs were used. The difference was statistically significant (p < 0.01). The discrepancy between positive SPT and sIgE versus APT results were as follow: for white birch pollen: 41.3% versus 55.1% (p < 0.05), grass pollen: 46.8% versus 56.0% (p > 0.05), and cat dander 42.7% versus 47.3% (p > 0.05). The results of the study show that atopy patch tests significantly widen the possibilities of detection of hypersensitivity to aeroallergens in patients with AD.
[Show abstract][Hide abstract] ABSTRACT: The possibility of forecasting of atopic dermatitis (AD) course is limited. The aim of the study was to determine the prognostic usefulness of determination of total and specific IgE concentrations and the results of immediate skin tests in AD patients. The study included 480 adult patients with AD. Immediate skin tests with extracts of 18 aeroallergens and 10 food allergens were performed by PRICK method. Total IgE concentration and concentration of specific IgE (sIgE) against 13 aeroallergens and 12 food allergens were determined by the FAST method. For the assessment of the degree of pathologic process intensity the occurrence was determined of selected AD features according to Hanifin and Rajka exerting direct effect on the severity of the disease, urticaria, extensive cutaneous lesions and remission of the disease. The results were subjected to statistical analysis. In patients in whom total IgE concentration was significantly increased and/or hypersensitivity was found to aeroallergens, coexistence of atopic diseases of the airways, ectodermal defect, urticaria and extensive skin lesions was more frequently observed. Extensive skin lesions were also more frequent in patients with hypersensitivity to food allergens. The studies performed demonstrated that the diagnostic tests discussed are useful for prognostication of AD course. The presence of SIgE, positive results of immediate skin tests and high total IgE concentration prognosticate a more severe course of the disease.
No preview · Article · Mar 2004 · Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
[Show abstract][Hide abstract] ABSTRACT: No objective laboratory tests are available that make possible to diagnose or prognosticate the course of atopic dermatitis (AD). The aim of the study was to assess the usefulness of determinations of B, T, Th and Ts lymphocytes in serum of AD patients for the diagnosis and prognostication of the course of the disease. The study included 148 adult AD patients. The control group consisted of 51 healthy subjects. For the assessment of the degree of pathological process intensity, the incidence was determined of selected AD features according to Hanifin and Rajka that have direct influence on disease severity, as well as the coexistence of extensive cutaneous lesions and frequency of remissions in the course of the disease. The results were subjected to statistical analysis. In patients with AD, as compared to healthy subjects, a statistically significant decrease of Th and Ts lymphocyte percents and increase of Th:Ts percent quotient were demonstrated. In the case of Th lymphocyte percent, a negative correlation with total IgE serum concentration was also found. No correlation was disclosed between disease course and percents of the studied lymphocytes. The obtained results demonstrate that determination of Th and Ts lymphocyte percents and Th:Ts percent quotient value is useful in the diagnosis of AD in adults, The determination of B, T, Th, Ts lymphocyte percents is, however, of low prognostic value.
No preview · Article · Jan 2003 · International Review of Allergology and Clinical Immunology
[Show abstract][Hide abstract] ABSTRACT: Recurrent bacterial skin infections are one of the features of atopic dermatitis (AD). A disturbance of polymorphonuclear leucocyte (PMN) function can be one of the causes of this phenomenon. The aim of this study was to estimate the ability of peripheral blood PMN and skin PMN of migration, reduction and absorption and to evaluate the usefulness of these tests for prediction of atopic dermatitis course. The study group consisted of 32 atopic dermatitis patients (18 females, 14 males; mean age 23.6 ± 6.2 years) and 32 healthy persons (13 females, 19 males; mean age 23.4 ± 2.7 years). The assessment of function of peripheral blood and skin PMNs was performed by Clausen method and was based on their ability of spontaneous migration and NBT reduction as well as latex absorption - Park test. The obtained results were subjected to statistical analysis. It was found that in AD patients a partial disturbance of PMN function was observed i.e. a decreased ability of spontaneous migration. Determination of this parameter could be of help in atopic dermatitis diagnosis but is useless in the prognosis of the disease. The increased value of NB T test observed only in skin PMNs may suggest that these cells maintain their bactericidal properties and that they can be activated by bacterial colonization of skin surface.
No preview · Article · Jan 2002 · International Review of Allergology and Clinical Immunology
[Show abstract][Hide abstract] ABSTRACT: The case is described of a 20-year-old man in whom cutaneous lesions on the face with accompanying pruritus were regarded as allergic. The heliotrope colour of the skin changes, lacking effect of treatment with topical corticosteroids and antihistamines pointed to the necessity of differentiation against dermatomyositis. In spite of absent clinical manifestations of decreased muscular strength and normal enzyme concentrations, EMG examination demonstrated the features of primary muscle damage. The administered combined systemic treatment with corticosteroids and chloroquine caused regression of the pathological lesions.
No preview · Article · Jan 2001 · International Review of Allergology and Clinical Immunology
[Show abstract][Hide abstract] ABSTRACT: This study was designed to test the prevalence of bronchial hyperresponsiveness in patients with atopic dermatitis (AD) and which of the Hanifin's and Rajka's factors in patients with AD are associated with bronchial hyperresponsiveness. Study group involved 112 patients aged 16-62 (mean age 24): 60 patients with AD, 32 patients with bronchial asthma as a reference group (BA) and 20 healthy subjects as control. All patients underwent determination of VC, FEV, FEF 50 and Raw using Pneumoscreen equipment (Jaeger). Patients with AD and BA underwent challenge test with 1% solution of histamine using Bronchoscreen equipment (Jaeger). Patients with AD did not demonstrated higher prevalence of flow obstruction, however 20% of them had bronchial hyperresponsiveness. Following these preliminary result patients with AD were further studied. Initially the patients were divided into 10 group based on Hanifin's and Rajka's factors. FEV, FEF 50 were lower and Raw was higher in patients with penfolicullar keratosis or ichtyosis or patients that did not have remission of AD for longer than 1 year. It was also demonstrated that those patients are significantly more likely to suffer from bronchial hyperresponsiveness. Subsequently patients with AD were divided into 3 groups based on the number of Hanifin's and Rajka's features. Patients with more than 4 factors had evidence of air flow obstruction and also were more likely to suffer from bronchial hyperresponsiveness.
No preview · Article · Jan 2001 · International Review of Allergology and Clinical Immunology
[Show abstract][Hide abstract] ABSTRACT: Prognostication of the course of atopic dermatitis (AD) is of special importance in prophylaxis of this disease. The aim of the study was to describe the AD minor feature sets, according to Hanifin and Rajka, on the basis of which one can predict the occurrence of extensive skin lesions, allergic rhinitis, atopic bronchial asthma, cataracts, hand and/or foot dermatitis, food intolerance, urticaria and elevated IgE serum in AD patients. Two-hundred-fifty-four patients were included in the study. Minor feature sets of prognostic value were selected using the MANOVA method in conjunction with the discriminant analysis. On the basis of the above sets, one can predict: involvement of more than 60% of body surface, occurrence of allergic rhinitis, elevated serum IgE, cataracts, atopic bronchial asthma, food intolerance and urticaria with the probability ratio of 90.8%, 82.8%, 79.9%, 78.4%, 77.3%, 77.1% and 76.1% respectively. In the examined group, no association was found between hand and/or foot dermatitis and the tendency towards skin infection.
No preview · Article · Feb 2000 · Journal of medicine