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Cilj: Istražiti učestalost haplotipskih sveza HLA-DRB1-DQA1-DQB1 te produženog haplotipa Cw*0602-B57-DRB1*07-DQA1*0201 DQB1*0201 u pacijenata s pozitivnom i negativnom obiteljskom anamnezom psorijaze. Ispitanici i metode: Istraživanje povezanosti gena sustava HLA razreda I i II sa psorijazom obuhvatilo je 118 nesrodnih pacijenata s vulgarnom psorijazom. Učestalost haplotipskih sveza ispitana je serološki i metodom hibridizacije specifičnim probama. Rezultati: Utvrđena je povišena učestalost haplotipa DRB1*07-DQA1*0201- -DQB1*0201 i DRB1*07-DQA1*0201-DQB1*0303 u psorijatičara s pozitivnom obiteljskom anamnezom te također produženog haplotipa Cw6-B57-DRB1*0701-DQA1*0201- -DQB1*0201 (P = 0,004). U psorijatičara s negativnom obiteljskom anamnezom učestalost produženog haplotipa gotovo je ista kao u kontrolnoj skupini. Zaključak: Rezultati istraživanja ukazuju na jaču i značajniju povezanost s podložnim haplotipovima HLA za pacijente s pozitivnom obiteljskom anamnezom psorijaze, stoga upućuju na značajnu ulogu gena sustava HLA u nasljeđivanju psorijaze., Aim: To analyze the distribution of HLA-DRB1-DQA1-DQB1 haplotypes as well as the extended haplotype Cw*0602-B57-DRB1*07 DQA1*0201-DQB1*0201 in patients with positive and negative family history of psoriasis. Patients and methods: The association of HLA genes classes I and II with psoriasis has been studied in 118 patients with chronic stable psoriasis. The frequency of HLA haplotypes was analyzed by means of serology and hybridization with specific oligonucleotide probes. Results: The group with positive family history showed a significant association with DRB1*07-DQA1*0201-DQB1*0201 and DRB1*07- DQA1*0201-DQB1*0303 as well as with the extended haplotype Cw6-B57-DRB1*0701- DQA1*0201-DQB1*0201 (P = 0,004). The frequency of extended haplotype in the group with negative family history was similar to the control group. Conclusion: Psoriatics with positive family history show stronger association with susceptible

Cilj: Perioralni dermatitis je kronična ekcematoidna i papulopustulozna upalna dermatoza kože lica od koje najčešće obolijevaju žene mlađe i srednje dobi. Etiopatogeneza je nepoznata, a od mogućih etioloških čimbenika u obzir dolaze dugotrajna uporaba topičkih kortikosteroida, kozmetičkih preparata na bazi petrolata i parafina, infektivni uzročnici, hormoni, gastrointestinalni poremećaj, neurogena upala i emocionalni stres. Prikaz slučaja: Prikazana je 49-godišnja žena s izrazitim eritemom kože lica, edemom kapaka te brojnim grupiranim papulama i papulopustulama na koži lica, uz brojne subjektivne simptome. Bolesnica je samoinicijativno duže od godinu dana na licu primjenjivala potentni kortikosteroidni pripravak. Rasprava i zaključak: Prikaz slučaja govori u prilog hipotezi o važnoj ulozi topičkih kortikosteroida u patogenezi perioralnog dermatitisa. U radu je prikazan i pregled recentne literature o etiologiji, patogenezi i liječenju bolesti., Aim: Perioral dermatitis is a chronic papulopustular and eczematous facial dermatitis which predominantly affects young to middle aged women. The etiology of perioral dermatitis is unknown, and possible etiological factors include long time use of topical corticosteroids, cosmetics with petrolatum or paraffin base, microbiological factors, hormonal factors, gastrointestinal disturbances, neurogenic inflammation and emotional stress. Case report: A 49-year-old woman presented with expressive facial skin erythema, edema of the eyelids, a number of grouped papules and papulopustules on the face, accompanied with a number of subjective symptoms. Patient used potent corticosteroid preparations on the face for more than a year. Discussion and conclusion: The case supports the hypothesis that topical corticosteroids have an important role of in the pathogenesis of perioral dermatitis. This paper presents an overview of recent literature on the etiology, pathogenesis and treatment of the disease.

Koža je najgušće inerviran organ ljudskog tijela, u vrlo bliskom kontaktu sa živčanim sustavom. U međusobnu intenzivnu komunikaciju uključene su sve strukture živčanog, endokrinog i imunološkog sustava, kao i sve stanice kože. Interakcija je posredovana različitim tipovima kožnih živčanih vlakana koja otpuštaju neuromedijatore i aktiviraju specifične receptore na ciljnim stanicama kao što su keratinociti, mastociti, Langerhansove stanice, endotelne stanice, stanice mikrovaskulature, fibroblasti i infiltrirajuće imunološke stanice. Ove interakcije utječu na brojne fiziološke i patofiziološke funkcije, uključujući rast i razvoj stanica, diferencijaciju, imunost, vazoregulaciju i cijeljenje rana. Nova saznanja o čimbenicima uključenim u ove interakcije utvrdila su suvremeni koncept neurobiologije kože., The skin is the most densely innervated organ in the body and there is a close relationship between the skin and the nervous system. Monodirectional and/or bidirectional pathways exist in which the central and peripheral nervous system, endocrine and immune system, and almost all skin cells are involved. The interaction between peripheral nerves and immune system is mediated by different types of cutaneous nerve fibers which release neuromediators and activate specific receptors on target cells in the skin such as keratinocytes, mast cells, Langerhans cells, microvascular endothelial cells, fibroblasts, and infiltrating immune cells. These interactions influence a variety of physiologic and pathophysiologic functions including cellular development, growth, differentiation, immunity, vasoregulation, leukocyte recruitment, pruritus, and wound healing. Information is emerging about the factors involved in these immunomodulatory mechanisms. Recent findings have established a modern concept of cutaneous neurobiology.

Psorijaza je diljem svijeta jedna od najčešćih upalnih bolesti kože kroničnog tijeka. Dok se blagi oblici bolesti uspješno liječe primjenom lokalne terapije, trećina bolesnika s umjereno teškim do teškim oblikom bolesti zahtijeva primjenu sustavne terapije. Tradicionalni lijekovi za sustavnu primjenu u dosadašnjem su iskustvu, kao i u mnogim kliničkim studijama, pokazali visoku učinkovitost u liječenju psorijaze. Metotreksat, ciklosporin i acitretin cjenovno su isplativi i pružaju odličnu kontrolu bolesti. Njihova primjena ograničena je isključivo mogućnošću teških nuspojava koje se pažljivim praćenjem bolesnika mogu uspješno kontrolirati i svesti na minimum., Psoriasis is one of the most common chronic inflammatory skin disease worldwide. While mild forms of the disease can be successfully controlled by applying local therapy, one third of patients with moderately severe to severe form of psoriasis, requires the application of systemic therapy. As indicated in many clinical studies, the conventional drugs for systemic use in so far experience have shown high efficacy in treating psoriasis. Methotrexate, cyclosporin and acitretin are cost affordable and provide excellent disease control. Their application is limited only by the possibility of serious side effects, which can be successfully controlled and kept to a minumum through carefully monitoring of patient.

Alopecija areata neožiljni je upalni gubitak dlake na vlasištu i/ili tijelu, nepoznate etiopatogeneze. Najčešće zahvaćeno mjesto je vlasište. Histopatologija se očituje povećanim brojem katagenih i telogenih folikula te nazočnošću upalnog limfocitnog infiltrata u peribulbarnoj regiji. U liječenju alopecije areate najčešće se primjenjuju kortikosteroidi. U radu je opisana klinička i patohistološka slika uz suvremene metode liječenja alopecije areate., Alopecia areata is a nonscarring, inflammatory hair loss on the scalp, and/or body. Etiology and pathogenesis are still unknown. The most common affected site is the scalp. Histopathology is characterized by an increased number of the catagen and telogen follicles along with the presence of inflammatory lymphocytic infiltrate in the peribulbar region. Corticosteroids are the most popular drugs for the treatment of this disease. Clinical features, histological data as well as modern treatment options will be discussed in this article.

Cilj: Cilj rada je prikaz slučaja bolesnika s generaliziranim oblikom vitiliga koji je liječen lokalnim kortikosteroidima i uskospektralnom UVB fototerapijom, kao i pregled novih oblika liječenja vitiliga. Prikaz slučaja: Četrdesetdvogodišnji bolesnik zaprimljen je zbog generalizirane pojave vitiliga. Kliničkim pregledom uočene su depigmentirane mliječnobijele makule simetrično raspoređene po koži lateralnih strana trupa, gornjih i donjih ekstremiteta, kao i vratu te periorbitalno na desnoj strani lica. U terapiju je uvedena kortikosteroidna krema, mometazon furoat, a potom i uskospektralna UVB fototerapija koja se provodila tri puta tjedno uz povećanje doze za 20% prilikom svakog obasjavanja do pojave blagog eritema. Ukupna primljena doza iznosila je 69.213 J/cm2. Liječenje je dovelo do poboljšanja u smislu mjestimične repigmentacije vitiliginoznih lezija, zaustavljena je progresija postojećih, kao i nastajanje novih lezija. Rasprava i zaključak: Iako postoje brojne dostupne metode liječenja, ne postoji univerzalna terapija koja bi bila učinkovita u svih bolesnika s vitiligom. Raznolikost kliničke slike vitiliga posljedica je različitih patogenetskih mehanizama, stoga zahtijeva i različite pristupe u liječenju. Nova istraživanja na polju etiopatogeneze vitiliga omogućit će razvoj novih učinkovitijih modaliteta liječenja koji bi doveli do trajnog izlječenja bolesti., Aim: To present a patient with generalized vitiligo who was treated with topical corticosteroids and narrow band ultraviolet B phototherapy and to give an overview of treatment modalities for vitiligo. Case report: A 42 year-old men was admitted because of generalized vitiligo. Clinical examination revealed depigmented milky-white macules distributed symmetrically on lateral sides of trunk, upper and lower extremities, neck and periorbital region of the right facial side. A topical corticosteroid, mometazon furoat, was prescribed once a day and narrow band UVB phototherapy was initiated. Phototherapy was administered three times a week with the initial dose of 0.3 J/cm2 and dose increment at the rate of 20% of the previous dose until the formation of a mild erythema. Total dose received was 69.213 J/cm2. After received therapy, repigmentation was partially achieved, and the progression, as well as the appearance of the new vitiliginous lesions, were stopped. Discussion and conclusion: Various modalities of treatment are used in therapy of vitiligo, but there is still no universal therapy that could be effective in all vitiligo patients. Different clinical manifestations of vitiligo are the result of different pathogenetic mechanisms and require different treatment approaches. Therefore, future research is needed in order to clarify the etiopathogenetic mechanisms and provide new, more effective therapeutic opportunities