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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.

Procjenjuje se da virusne infekcije pridonose nastanku 15 – 20 % svih malignih tumora ljudi. Kao obligatorni intracelularni paraziti, virusi kodiraju proteine koji reprogramiraju signalne puteve odgovorne za kontrolu proliferacije, diferencijacije, smrti stanice, genomskog integriteta, kao i prepoznavanja od strane imunološkog sustava. Virusni sustavi podržavaju koncept da je za razvoj tumora potrebna akumulacija međusobno povezanih događaja. Virusi koji su do sada prihvaćeni kao etiološki čimbenici ljudskih malignoma uključuju hepatitis B virus, Epstein-Barr virus, humani papiloma virus, virus leukemije ljudskih T-stanica, hepatitis C virus, te još nekoliko ljudskih onkogenih virusa. Obično protekne niz godina od infekcije do razvoja tumora i većina inficiranih osoba ne razvije rak, iako imunološki kompromitirane osobe pokazuju veći rizik za nastanak tumora povezanih s virusima. Malo je vjerojatno da je virus sam dovoljan da transformira normalnu stanicu u tumorsku. Vjerojatnija je mogućnost da kombinirano djelovanje virusnih proteina i mutacije staničnih gena zajedno vode tumorogenezi., It is estimated that viral infections contribute to 15-20 % of all human cancers. As obligatory intracellular parasites, viruses encode proteins which reprogramme host cellular signalling pathways which in turn control proliferation, differentiation, cell death, genomic integrity, and recognition by the immune system. Viral systems support the concept that cancer development occurs by accumulation of multiple cooperating events. Viruses are now accepted as etiologic factors of human cancer, and include hepatitis B virus, Epstein-Barr virus, human papillomaviruses, human T-cell leukemia virus and hepatitis C virus, plus several candidate human cancer viruses. Many years may pass between initial infection and tumor appearance. Most infected individuals do not develop cancer, although immunocompromised individuals are at elevated risk of viral-associated cancers. It is unlikely that a tumor virus is sufficient to convert a normal cell to a tumor cell. Rather, a combination of the action of viral proteins and cellular gene mutation cooperate to drive tumorogenesis.

Alopecija areata (AA) česta je bolest koja se očituje neožiljnim gubitkom dlake na vlasištu i/ili tijelu. Folikul dlake u alopeciji areati nije nepovratno uništen, stoga potencijal za ponovni rast kose ostaje. Budući da je etiopatogeneza nepoznata, liječenje AA je simptomatsko i usmjereno na zaustavljanje aktivnosti bolesti. Limfociti oko dlačnog folikula, povišena razina autoprotutijela, poremećaj citokina te udruženost s drugim autoimunosnim bolestima, podupiru hipotezu da je AA organ-specifična autoimunosna bolest. Nova su istraživanja stoga usmjerena na razvoj lijekova koji bi imunomodulatornim ili imunosupresivnim djelovanjem potaknuli rast dlake. Proučavanje utjecaja novih bioloških lijekova na rast kose, kao i razvoj genske terapije u tijeku su. U radu će biti raspravljeni suvremeni principi i dostupne metode liječenja alopecije areate., Alopecia areata (AA) is a frequent disease with nonscarring hair loss on the scalp and/or body. Hair follicle in alopecia areata is not irreversibly destroyed, so potential for hair regrowth remains. Considering unknown etiopathogenesis, treatment of AA is symptomatic and directed toward halting disease activity. Lymphocytic inflammatory infiltrate around hair follicle, increased levels of autoantibodies, cytokine abnormalities and increased prevalence of autoimmune comorbidities, support the hypothesis of AA as an organ-specific autoimmune disorder. Therefore, investigations are directed toward new immunomodulatory or immunosupresive drugs with induction effect on hair growth. New biologic drugs and their influence on hair growth as well as genetic therapy for alopecia areata are currently under investigation. Contemporary principles in therapy of alopecia areata and treatments available will be discussed in this article.

Psorijaza je kronična, recidivirajuća bolest kože koja traje čitav život. Četvrtina bolesnika boluje od teškog oblika psorijaze koji zahtijeva primjenu sustavne terapije. Unatoč razvoju novih skupina lijekova, tradicionalna terapija i dalje je veoma važna. Metotreksat, ciklosporin i acitretin cijenom su prihvatljivi i pružaju odličnu kontrolu bolesti. Metotreksat i acitretin dobar su izbor u smislu terapije održavanja, dok je ciklosporin idealan kao intermitentna terapija. Strah od teških nuspojava tradicionalnih lijekova može se izbjeći individualnim određivanjem terapije i pažljivim nadzorom bolesnika., Psoriasis is a chronic, recurrent skin disease that lasts a whole life. A quarter of adults are suffering from severe forms of psoriasis that requires the application of the systemic treatment. Despite the development of new groups of medicines, traditional therapy is still of great importance. Methotrexate, cyclosporine and acitretin are cost-effective and provide excellent disease control. Methotrexate and acitretin are good choice in terms of maintenance therapy, whereas cyclosporin would ideally be used as intermittent therapy. Fear of serious side effects of traditional drugs can be avoided by setting individualized plan for each patient and careful monitoring.

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.