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The authors describe the case of a 42-year-old woman with typical targetoid lesions of erythema multiforme. The histopathological examination confrmed the diagnosis, local and systemic corticosteroid were started. Following the treatment initiation, symptoms showed regression. While tapering the systemic therapy, symptoms recurred and showed slightly changed clinical picture as well. Second histopathological examination confrmed. The diagnosis of erythema annulare centrifugum. After ophthalmological examination systemic chloroquine therapy was started, which resulted in gradual improvement of the symptoms. The authors summarized by evaluating this patient’s case the diferential diagnostic difculties of fgurate erythemas.

Background Allergen immunotherapy (AIT) is considered a curative treatment in some atopic diseases, but in AD contradictory clinical results exist and the action of AIT has not been elucidated. In the literature, there is no evidence for parallel investigations of permeability barrier, cutaneous and blood immune responses after AIT in AD. Objectives The objective was to investigate immune parameters in the blood and skin and to detect clinical and barrier changes after AIT in AD. Methods Mild-to-moderate AD patients (n = 14) with concomitant allergic rhinitis to house dust mites were selected. All patients received topical treatment, while eight patients were randomly selected for adjuvant AIT also. At baseline and after 6 months, clinical, barrier and immunological investigations (serum and skin tests) were performed. In selected patients, biopsies from atopy patch tests (APTs) were analysed by immunohistochemistry for AD-relevant immune cells and mediators. Results In the adjuvant AIT group, clinical parameters and barrier functions improved significantly. Blood immune parameters displayed no significant changes. Post-AIT APT became negative in all patients in the AIT group, but remained positive in the non-AIT group. Cutaneous dendritic cell and T-cell recruitment decreased significantly after allergen challenge in the AIT group, but no significant changes in skin or serum immunoglobulin E levels or prick test (SPT) reactivity were detected. Conclusions Allergen immunotherapy is a beneficial adjuvant treatment for sensitized AD patients. AIT improves not only clinical symptoms, but also permeability barrier functions. The effect of AIT on sensitization should be detected by APT, not by SPT.

Background The formation of metastases and the efficacy of systemic therapies in cutaneous malignant melanoma (CMM) depend on the characteristics of the tumour cells and the host immune response. Aberrant expression of metallothionein (MT) has been observed in several types of cancers with poor prognoses. Objective To perform an immunohistochemical study on primary CMM comparing the MT expression of tumours without metastases (n = 23) to that of samples with haematogenous metastases (n = 23) and to examine the correlation between MT staining and immunological markers relevant in CMM progression. Methods The immunohistochemical labelling of different tumour sections was analysed using tissue microarrays for the evaluation of the suitability of this method in future studies. Results Our results suggest that MT overexpression is significantly more frequent in primary CMM with haematogenous metastases (P = 0.018) and that the overexpression is independent of the Breslow tumour thickness (R = 0.102, P = 0.501). Interestingly, MT overexpression of the tumour cells was correlated with the presence of tumour-infiltrating CD68+ macrophages (P = 0.003), a known predictive factor for melanoma progression, thereby suggesting a role for MT in the development of a defective host immune response. Furthermore, the presence of CD163+ macrophages infiltrating the tumours correlated with metastasis formation (P

Az erythroderma a testfelszín csaknem egészét érintő bőrgyulladás, amelyet hyperaemia, bőrmegvastagodás, hámlás jellemez. A testfelület nagy részére lokalizálódó gyulladás az etiológiai tényezőtől függetlenül önmagában is előidézhet életveszélyes állapotot. Parazitafertőzés az erythroderma hátterében extrém ritka. A scabieses megbetegedésért (közismerten rühesség) egy, az atkák családjába tartozó élősködő, a Sarcoptes scabiei var. hominis tehető felelőssé. Míg a „klasszikus” scabies prevalenciája világviszonylatban magas, addig a súlyosabb, veszélyesebb formával – a scabies norvegicával, más néven crustosus scabiesszel – jóval ritkábban találkozhat a klinikus, felismerése és kezelése epidemiológiai szempontból kiemelkedően fontos. A szerzők scabies norvegica két esete kapcsán ismertetik az erythroderma és a scabies differenciáldiagnosztikai problémáit és a fertőzés epidemiológiai jelentőségét.

Nijmegen breakage syndrome (NBS) is a rare autosomal recessive chromosomal instability syndrome characterized by severe immunodeficiency, growth retardation, microcephaly, a distinct facial appearance, and a high predisposition to lymphoid malignancy. We report a 7-year-old white girl with NBS associated with cutaneous tuberculosis. The patient presented with multiple red-brown, centrally scaring plaques on the leg and had neither pulmonary nor systemic manifestation of tuberculosis. Polymerase chain reaction testing using Mycobacterium genus- and Mycobacterium tuberculosis species-specific primers confirmed the clinical diagnosis of cutaneous tuberculosis. This is the first report describing the simultaneous presentation of NBS and cutaneous tuberculosis.