B. Chodynicka

Medical University of Bialystok, Belostok, Podlasie, Poland

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Publications (71)26.81 Total impact

  • J. Bacharewicz · T. Reduta · A. Pawłoś · B. Chodynicka · I. Flisiak
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    ABSTRACT: Introduction. Carcinoma planoepitheliale is a non-melanotic skin cancer with infiltrative growth that may metastasize most often to lymph nodes. The prognosis depends on localization, magnitude, depth of infiltration and histopathological type of tumour. Presence of metastases to lymph nodes decreases the cure index to less than 20%. Aggressive, unfavourable course is observed in elderly and immunosuppressed persons. Objective. Presentation of a case of squamous cell carcinoma of the vestibule of the nose with rapid, aggressive course and atypical appearance suggesting bacterial or fungal infection. Case report. A 53-year-old healthy male was admitted tothe Department of Dermatology and Venereology due to a painful skin lesion in the vestibule of the nose lasting for one month. On admission an inflammatory, swollen, livid-red nodular lesion with presence of follicular pustules on the surface in the left nose vestibule and upper lip was observed. Histopathology revealed squamous cell carcinoma G2. At the diagnosis the tumour infiltrated the jaw bone and metastasis to the lymph node was found. Despite complex treatment fast progression of the neoplastic process was observed. Conclusions. Atypical clinical picture of cancer may delay the proper diagnosis and make the prognosis worse. All lesions with non-characteristic appearance resistant to therapy should be verified by histopathological examination.
    No preview · Article · Jan 2013
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    ABSTRACT: Introduction. Tuberculosis luposa, themost common type of cutaneous tuberculosis, usually develops slowly as a single lesion located on the face. There are only a few case reports describing the onset of skin tuberculosis in the site of BCG vaccination. Objective. Presentation of a case of tuberculosis luposa with unusual course. Case report. We present a rare case of a 71-year-old patient with multiple foci of tuberculosis luposa lasting for 60 years with unusual location and onset in the site of BCG vaccination. In this case very fast development of the last lesion was probably connected with impaired immunity in the course of the progressing neoplastic process. Conclusions. At present the diagnosis of cutaneous tuberculosismay be late due to insufficient knowledge of its clinical picture and lack of awareness of increasing frequency of this disease.
    No preview · Article · Jan 2013
  • A. Okruszko · A. Baran · D. Zwierz-Gugała · B. Chodynicka · I. Flisiak
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    ABSTRACT: Introduction. Drug reaction with eosinophilia and systemic symptoms (DRESS) is a serious, potentially life-threatening syndrome with skin lesions, fever, internal organ involvement and eosinophilia. Objective. To present the case of a woman with DRESS syndrome after the anticonvulsant drug lamotrigine. Case report. A woman, 25 years old, suffering from epilepsy, was admitted to the hospital after the change of valpromic acid to lamo-trigine, which caused generalized maculopapular eruptions and laboratory blood test abnormalities. After withdrawal of the causative drug and treatment with corticosteroids and antihistaminic preparations, skin lesions disappeared and the values of laboratory blood tests improved. Conclusions. Due to the high rate of mortality (10%) in DRESS, a quick diagnosis is of crucial value. Most important is a detailed anamnesis, immediate withdrawal of the causative drug, and in severe cases therapy with systemic corticosteroids.
    No preview · Article · Jan 2013
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    Hanna Myśliwiec · Iwona Flisiak · Anna Baran · Maria Górska · Bożena Chodynicka
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    ABSTRACT: Psoriasis is a chronic, recurrent, inflammatory disease. Recent investigations indicate an autoimmune pathogenesis of the disease. Apoptosis plays an important role in the regulation of immune mechanisms in many autoimmune diseases. Although CD40, CD40L, and Bcl-2 have already been studied in psoriatic skin lesions, little is known about their circulating forms. The aim of the present study was to evaluate the serum concentrations of Bcl-2, soluble CD40 and CD40L in psoriatic patients. The study was performed using ELISA kits in 39 psoriatic patients before treatment and after two weeks of topical ointment. Data was analyzed with respect to severity of psoriasis, duration of the disease, and coexisting psoriatic arthritis. Our results revealed that serum concentrations of soluble CD40 and CD40L before and after treatment were significantly higher (p < 0.01 and p < 0.001) in patients with psoriasis compared to the control group. Topical treatment of psoriatic lesions with dithranol ointment failed to decrease serum of CD40 and CD40L, which has not been described until now. There was no significant difference in serum Bcl-2 concentration between the compared groups. We did not find significant differences in serum concentrations of Bcl-2, CD40 or CD40L between patients with mild or severe psoriasis, nor any correlation between disease duration and the presence of psoriatic arthritis symptoms. Our data indicates upregulation of the CD40/CD40L system in psoriatic patients despite topical treatment and suggests their possible role in the pathogenesis of psoriasis.
    Full-text · Article · Apr 2012 · Folia Histochemica et Cytobiologica
  • A. Baran · I. Flisiak · B. Chodynicka
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    ABSTRACT: Introduction. Psoriasis is a chronic and recurrent skin disease, affecting 2-3% of the population. Emotional distress, infections and mechanical trauma are well known precipitating factors. Association between psoriasis and other systemic diseases, i.e. obesity or diabetes mellitus was reported. In the literature there are a few reports about coexistence of psoriasis with other skin diseases, especially with scleroderma and lichen sclerosus. Objective. The aim of this paper was to present a patient with 5-year-history of psoriasis and 3-year-history of lichen sclerosus in whom, during the hospitalization additionally morphea was diagnosed. Case report. We present a case of 61-year-old woman in whom after cardiac valvuloplasty surgery first psoriatic lesions on the skin of scalp, trunk and lower and upper extremities occurred. Two years later porcelain-white papules, forming bigger, a bit indurated plaques affecting the vulva and perineum were noticed. The biopsy from vulvar lesions confirmed the diagnosis of lichen sclerosus. The patient did not report any other symptoms and was treated with metronidasole cream and corticosteroid ointment. During the hospitalization the foci of slightly indurated hiperpigmentation on the skin of abdomen lasting for over 20 years were noticed. The clinical picture and skin biopsy were consistent with morphea. Conclusions. Although psoriasis, scleroderma and lichen sclerosus are quite common in the population, there are only a few reports on the coexistence of all these diseases. Mechanical trauma as a provoking factor of psoriasis, lichen sclerosus and morphea was reported. In presented case cardiac surgery could be one of factors triggering appearance of skin lesions. There are assumptions that psoriasis in morphea patients may be regarded as a bad prognostic sign of possible transition of morphea into progressive systemic scleroderma. The patient requires detailed diagnostic procedures and treatment in dermatological and rheumatologic units.
    No preview · Article · Jan 2012
  • H Laudańska · T Reduta · G Zalewski · B Chodynicka
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    ABSTRACT: Cutaneous tuberculosis (tuberculosis cutis) is one of the extrapulmonary forms of tuberculosis, which may affect the skin only or co-exist with tuberculosis of other organs, particularly the lungs. We describe a case of lupus vulgaris in a 72-year-old male patient with a single lesion localized on his lower extremity, developing for 30 years before correct diagnosis and previously treated with topical steroids. Bacillus infection in other organs was not detected. Diagnosis of tuberculosis was made based on personal history, clinical picture, hypersensitivity to tuberculin, histopathology and polymerase chain reaction. A multidrug therapy with rifampicin, isoniazid and pyrazinamide resulted in regression of the lesion. The common lack of knowledge about the clinical picture of cutaneous tuberculosis causes its late diagnosis and treatment.
    No preview · Article · Jun 2011 · Advances in Medical Sciences
  • I Flisiak · P Zaniewski · M Rogalska-Taranta · B Chodynicka
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    ABSTRACT: Vascular endothelial growth factor (VEGF) is recognized a pivotal pro-angiogenic factor responsible for new blood vessels formation in psoriatic lesion. The aim of the study was to analyse serum concentrations of VEGF and its soluble receptors (sVEGF) R1 and R2 in psoriatic patients before and after treatment. Serum samples were collected before and after 14 days of standard topical therapy, from 44 patients with exacerbated chronic plaque-type psoriasis and VEGF, sVEGF R1 and sVEGF R2 concentrations were measured using an enzyme immunoassay. Data were analysed with respect to baseline values of the psoriasis area severity index (PASI). Baseline mean serum levels of VEGF and sVEGF R1, but not sVEGF R2 were significantly higher in patients than in healthy controls. VEGF demonstrated significant correlation with PASI score. Treatment resulted in significant reduction of VEGF serum concentration, particularly in patients with severe course of the disease (PASI >20) and increase in sVEGF R1 concentration in patients with mild disease activity (PASI <10). Moreover, serum sVEGF R1 level after treatment termination was significantly higher in patients with mild than severe course of psoriasis. We confirmed the association between psoriasis activity and serum VEGF concentrations, which can be recognized as an indicator of the disease severity. However, the increase of serum sVEGF R1 concentrations can predict amelioration of clinical signs.
    No preview · Article · Mar 2011 · Journal of the European Academy of Dermatology and Venereology
  • A. Baran · I. Flisiak · B. Chodynicka
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    ABSTRACT: Psoriasis is a chronic and recurrent skin disease, affecting 1.5-3% of the population. It is characterized by abnormal epidermal proliferation, immunological disturbances with predominance of Th1 response and complex pathogenesis. There are correlations between psoriasis and obesity, cardiovascular diseases, diabetes and metabolic syndrome. Adipokines, bioactive substances secreted by adipose tissue, exert a variety of metabolic activities and are associated with many diseases. In the article the possible role of adipokines in psoriasis is evaluated.
    No preview · Article · Jan 2011
  • A. Baran · B. Chodynicka
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    ABSTRACT: Introduction. Herpes zoster oticus is caused by varicella zoster virus (VZV), affecting 10-20% of the population. Ramsay Hunt syndrome, a complication of herpes zoster oticus, presents a reactivation of latent VZV infection in the sensory dorsal root ganglia of the facial nerve. Objective. To present three patients in whom a VZV infection caused complications in the course of zoster oticus. Case report. Erythematous and oedematous skin lesions with vesicles in the right auricle and dizziness appeared in an 87-year-old woman 10 days before admission to the ward. After a few days, shivering and fever (39°C) developed. During hospitalization peripheral facial paralysis was observed. In the second patient, left-sided facial palsy was preceded by acute pharyngalgia and pain of the left ear with skin hyperesthesia and vesicles in the left external auditory canal. In the third patient, the first symptoms were pain and oedema of the right ear. After a few days, vesicles in the right auricle and hard palate and right-sided facial palsy occurred. The systemic and topical treatment led to healing of skin lesions. In one case, facial palsy and partial hearing loss persisted. Conclusions. In the presented cases, VZV infection was complicated by facial paralysis and dizziness, partial hearing loss and erysipelas in one patient. Old age, diabetes mellitus, arterial hypertension are prognostic factors of severe complications and decreased chance of complete recovery.
    No preview · Article · Jan 2011
  • A. Baran · I. Flisiak · H. Myśliwiec · B. Chodynicka
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    ABSTRACT: Introduction. Gastrointestinal stromal tumour (GIST) is a rare mesenchymal tumour of the gastrointestinal tract and mesentery. Standard treatment is surgical resection. First-line therapy of unresectable or metastatic GIST is imatinib mesylate - a tyrosine kinase inhibitor. Objective. The aim of this paper is to present a patient with GIST in whom treatment with imatinib caused dermatitis as an adverse effect and a change of therapy was necessary. Case report. We present a case of a 57-year-old woman with nonoperative GIST diagnosed 2 years ago in whom, after 3 months of treatment with imatinib, papulo-erythematous, pruritic eruption on the trunk, lower and upper extremities and face occurred. The histopathological picture corresponded with lichenoid reaction caused by the drug. Despite lowering the dose of imatinib, new infiltrated lesions with a tendency to disintegration were observed. Due to systemic (intravenous pulses of corticosteroids, antihistaminics) and topical treatment (corticosteroid ointments) and the change of imatinib for a second-line drug, sunitinib, improvement of skin lesions was observed. Conclusions. Therapy with imatinib is generally well tolerated, but dermatitis can appear in 30% of patients taking this drug. In the presented case with unresectable GIST therapy with imatinib caused skin complications.
    No preview · Article · Jan 2011
  • P. Zaniewski · I. Flisiak · B. Chodynicka
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    ABSTRACT: Introduction. Erythema nodosum belongs to a group of diseases connected with subcutaneous tissue inflammation. It occurs mainly in people 20-40 years of age, more frequently in women. Typical changes appear as inflammatory nodules on the frontal surface of lower legs. There is a significant influence of streptococcal infections on erythema nodosum appearance. Objective. To present a case of erythema nodosum in a child caused by tonsillitis. Case report. A 9-year old girl was admitted to the Department with numerous, tender, red nodules on the anterior parts of the lower legs. Physical examinations revealed hypertrophy of tonsils. Laboratory examinations showed increased erythrocyte sedimentation rate, increased level of C-reactive protein and anti-streptolysin O (ASO). After systemic and topical treatment, significant improvement was achieved. Conclusions. In cases of erythema nodosum in children, it is important to exclude infections of the upper respiratory tract and to carry out the proper treatment.
    No preview · Article · Jan 2011
  • A. Baran · I. Flisiak · B. Chodynicka
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    ABSTRACT: Psoriasis is a chronic and recurrent skin disease, affecting 1.5-3% of the population. Its complex pathogenesis is composed inter alia of abnormal epidermal proliferation and immunological disturbances with predominance of Th1 response. There were correlations between psoriasis and obesity, cardiovascular diseases, diabetes and metabolic syndrome revealed. Adipokines, bioactive substances secreted by adipose tissue, play a role in a variety of metabolic processes and occurrence of many diseases. Based on actual literature data, we evaluated possible role of leptin in pathogenesis of psoriasis.
    No preview · Article · Jan 2011 · Dermatologia Kliniczna
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    ABSTRACT: Vascular endothelial growth factor (VEGF) demonstrating pro-angiogenic activity promote new blood vessel formation in psoriatic lesions. The aim of this study was to evaluate the serum concentrations of VEGF, its soluble receptors (sVEGF R1 and R2) and VEGF content in scales of patients with psoriasis. To analyze possible association with activity of the disease, serum and scales from plaques were collected from 59 patients with exacerbated chronic plaque-type psoriasis. Mean concentrations of VEGF and sVEGF R1 in sera of patients were respectively two and four times higher than in healthy controls. Serum VEGF and sVEGF R1, but not sVEGF R2 demonstrated significant correlation with psoriasis area and severity index (PASI). There was also significant correlation between VEGF levels in serum and scales. Serum sVEGF R1 concentration was significantly elevated even in patients with low psoriasis activity (PASI<10), whereas increase of serum VEGF became significant in patients with medium activity (PASI: 10-20). Levels of serum VEGF and sVEGF R1 were the highest in patients with PASI>20. We confirmed association of both serum and scales VEGF concentrations with degree of psoriasis activity and demonstrated predominant increase of sVEGF R1 vs. VEGF in serum of patients with low psoriasis activity.
    No preview · Article · Oct 2010 · Cytokine
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    ABSTRACT: PURPOSE: Necrotizing fasciitis (NF) is a rare, life-threatening soft-tissue infection, characterized by rapidly spreading inflammation, with secondary necrosis of the fascia and surrounding tissues. It is mostly caused by group A beta-haemolytic streptococci or multibacterial. A case of the 25-year-old man admitted on September 2006 to the Department of Dermatology and Venereology with suspicion of erysipelas of the left upper limb and left foot is presented. On admission the pain, erythema, diffuse oedema of the left upper limb and erythema of the left foot were observed. Laboratory results revealed elevated: ESR, acute phase parameters (C-reactive protein, D-dimer), CPK and fibrinogen. Within 72-hours, despite treatment with antibiotics and anticoagulants, the oedema and pain increased, initial necrosis of the skin and extreme local tenderness appeared. Suspecting NF the patient had been transported to the Department of Surgery from where, after surgical debridement of devitalized tissue, was moved to the Intensive Care Unit and then transferred to the National Centre of Hyperbaric Medicine of the Medical University of Gdansk. Despite of repeated debridement, aggressive antibiotic therapy and hyperbaric oxygen therapy, necrosis was spreading. The patient developed sepsis and acute respiratory distress syndrome. Amputation of the left upper limb was performed. Five months later patient was admitted to ICU in Bialystok after a suicide attempt. After next four months he died. The dramatic course of the disease is the evidence, that having an adequate knowledge about early symptoms of NF can save patient's life.
    No preview · Article · Apr 2010 · Advances in Medical Sciences
  • P. Zaniewski · I. Flisiak · B. Chodynicka
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    ABSTRACT: Psoriasis is a chronic, relapsing skin disease, characterized by epidermal hyperplasia, a chronic inflammatory process, especially associated with the Th1 immune response, and local up-regulation of numerous inflammatory mediators. The pathogenesis of psoriasis is also closely associated with angiogenesis defined as formation of new capillaries from pre-existing blood vessels in psoriatic lesions. One of the most important pro-angiogenic factors is vascular endothelial growth factor (VEGF), whose concentration is elevated in the blood and skin lesions of psoriatic patients. In this review we present the role of VEGF and its receptors in psoriasis and the relation between this cytokine and genetic and immunological processes involved in the pathogenesis of psoriasis.
    No preview · Article · Jan 2010
  • A. Baran · I. Flisiak · H. Myśliwiec · M. Baran · B. Chodynicka
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    ABSTRACT: Psoriasis is one of the most common skin disease, affecting 1.5-3% population, with chronic course and complex clinical picture. It is characterized by abnormal epidermis proliferation, immunological disturbances with predominance of Th1 response activity and complex pathogenesis. Among many factors inducing the disease development hormonal disorders are mentioned. Half of all patients with psoriasis are females diagnosed mostly within childbearing period of their life. It is stated that pregnancy, puerperium, menstruation and menopause modulate a natural course of psoriasis. Based on current literature search, we evaluated in this paper the role of sex hormones in pathogenesis of this dermatosis.
    No preview · Article · Jan 2010 · Dermatologia Kliniczna
  • J. Sałata-Nowak · I. Flisiak · B. Chodynicka
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    ABSTRACT: Tobacco smoking is considered to be one of the main factors which negatively affect the skin, mucous membranes and teeth. Apart from nicotine, smoke contains many toxic substances, with several carcinogens among them. The relationship between smoking and wound healing, skin ageing, skin cancers, neoplasms of mucous membranes, psoriasis, palmoplantar pustulosis, hidradenitis suppurativa, genital warts and Buerger's disease is well documented. The influence of smoking on the course of diseases such as acne, hand eczema or malignant melanoma is still a theme of discussion. However, smoking also has a beneficial effect on some diseases, such as pyoderma gangrenosum, pemphigus vulgaris, aphthous and genital ulcers in Behçet's disease, acral melanoma or labial herpes and Kaposi's sarcoma in AIDS patients.
    No preview · Article · Jan 2010
  • H. Myśliwiec · I. Flisiak · A. Baran · B. Chodynicka
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    ABSTRACT: Introduction. Tinea faciei is quite a rare infection in the developed countries. Proper diagnosis of the causative pathogen is essential for successful treatment. Objective. To present the case of an 11-year-old patient in whom wrong diagnosis and treatment led to complications and finally to face deformation. Case report. A small inflammatory skin lesion appeared on the chin and extended quickly to form a deep infiltration. Despite surgical incision, drainage and broad-spectrum antibiotics, the skin lesion progressed to an ulceration of 2 x 3 cm in diameter with necrotic crust. In direct mycological smear hyphae were observed and in the culture Stenotrophomonas maltophilia was found. Systemic treatment with terbinafine and trimethoprim-sulfamethoxazole led to almost complete healing with a scar and chin deformation as a result. Conclusions. In the differential diagnosis of skin lesions on the chin fungal infection should always be considered, confirmed or ruled out before starting the therapy.
    No preview · Article · Jan 2010
  • J. Sałata-Nowak · I. Flisiak · B. Chodynicka
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    ABSTRACT: Prolonged glucocorticosteroid therapy is the most common cause of secondary osteoporosis, named glucocorticoid-induced osteoporosis. It is estimated that 30 to 50% of chronic glucocorticosteroid users experience vertebral or hip fractures. Prevention of osteoporosis is a very important public health concern. Dermatologists are among the leading prescribes of oral glucocorticosteroids; therefore, this topic is of utmost importance. Dermatological patients treated with glucocorticosteroids for longer than 3 months should receive prophylactic treatment to decrease the risk of bone loss. When glucocorticoids are used for a period shorter than 3 months, current literature does not suggest prophylaxis. All patients starting glucocorticosteroid treatment should be given instructions on general measures for prevention of bone loss.
    No preview · Article · Jan 2010
  • A. Baran · I. Flisiak · H. Myśliwiec · B. Chodynicka
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    ABSTRACT: Psoriasis is a chronic and recurrent skin disease, affecting 1.5-3% of the population. It is characterized by abnormal epidermal proliferation, immunological disturbances with predominance of the Th1 response, and complex pathogenesis. Correlations have been found between psoriasis and obesity, cardiovascular diseases, diabetes and metabolic syndrome. Adipokines, bioactive substances secreted by adipose tissue, exhibit a variety of metabolic activities and are associated with many diseases. Based on current literature data, we discussed the possible role of adiponectin in psoriasis.
    No preview · Article · Jan 2010