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Pemphigus is an autoimmune blistering disease that is rare in children and adolescents, but all clinical types of pemphigus occur in children. To our knowledge 105 cases of pemphigus in children have been reported till now. In current review we described the clinical manifestations, sites of involvement, treatment and course of the disease. We would like to emphasize that although juvenile pemphigus occurs rarely it should always be considered in differential diagnosis of bullous diseases in children. Early diagnosis and therapy influence the course of the disease toward better prognosis.

Unlabelled: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with hyperproduction of immunoglobulin E directed against common environmental allergens., Objectives: The aim of the study was to evaluate the immediate type of immunological reaction indicated by airborne allergens in the pathomechanism of atopic dermatitis., Material and Methods: 529 patients with AD aged (0.5-60 years) who fulfilled basic Hanifin and Rajka criterias and 60 healthy volunteers in the control group were investigated. In order to evaluate IgE-mediated allergy to common airborne and alimentary allergens skin prick tests (SPT) were performed (26 airborne and 7 basic alimentary allergens) and concentration of serum antigen specific IgE (asigE) was measured., Results: Our results indicated airborne allergy in case of 405 patients (76.6%) and food allergy only in 67 cases (12.7%). In the group of children aged 0.5-4 years food allergy was predominant but later on the predominance of airborne allergy was observed., Conclusions: We conclude that airborne allergy plays an important and predominant role in the pathomechanism of atopic dermatitis.

Treatment modalities of patients with atopic dermatitis (AD) are dependent on patient age, on the intensity of both skin symptoms and subjective signs of the disease i.e. itch and sleep disturbances, on the body surface involved with lesions, as well as on the type of sensitizing allergens. The characteristic of these allergens is crucial to start prophylaxis and to make decision about specific immunotherapy. In asymptomatic period of the disease the most important factor is to prevent dryness of the skin using emollients, which reconstruct integrity and continuity of stratum corneum. This procedure prevents penetration of air-borne allergens across damaged skin barrier into the skin. In mild AD cases, pimecrolimus (mainly in children) and corticosteroids of the lowest potency alternatively with their basis should be recommended. In moderate intensity AD either topical treatment with calcineurin inhibitors i.e. tacrolimus and pimecrolimus or topical corticosteroids from 4-5 group of American classification should be applied. In addition, PUVA/UVB phototherapy may be beneficial, as well as immunotherapy with specific airborne allergen/s. Coexisting bacterial skin infections should be treated with systemic antibiotics (macrolides, quinolones, and cephalosporins), viral herpes infection systemically using acyclovir for 5-7 days, and fungal infections applying ketoconazole orally, accompanied by topical treatment with miconazole or other antimycotics. Severe AD is an indication for the systemic use of cyclosporin A (rather than corticosteroids), and antibiotics as mentioned above. Prolonged 3-5 year specific immunotherapy is significant concern for selected cases. Sensitive skin areas such as face, orbicular skin, flexures should be treated with pimecrolimus and tacrolimus rather than with corticosteroids, however, topical corticosteroids are recommended on involved skin of the trunk and the extremities besides of flexures. While the improvement of severe AD is reached, the treatment modalities for benign and mild AD should be observed. In all AD patients with active skin lesions antihistaminic drugs of 2nd generation reactive with H1 receptor are a gold standard (or short treatment with these drugs of 1st generation to achieve a sedative effect, followed by the 2nd generation drug), as well as tranquilizers as the combined treatment. There is no reason for the use of anti-leukotriene drugs.

Topical inhibitors of calcineurin--tacrolimus and pimecrolimus have recently been approved in the treatment of atopic dermatitis. These are the first topical immunosuppressants other than glucocorticosteroids, awaited in dermatology since approximately 50 years. Both medications present similar mechanism of action, good therapeutic and safety profiles and should be considered as important factors in the treatment of atopic dermatitis.

The study involved 22 patients with seasonal allergic rhinitis between 13 and 53 years of age. The level of antigen specific IgE (AS IgE) to 5 grass and 3 weed pollens was determined with the use of CAP FEIA (Pharmacia, Uppsala, Sweden). The control group consisted of 20 persons. All above AS IgE were significantly higher in the patients with seasonal allergic rhinithis than in the control group. The most commonly present hypersensitivities were to Meadow fescue (Festuca elatior), Meadow grass (Poa pratensis), Cocksfoot (Dactylis glomerata), Ribwort (Plantago lanceolata) and Mugwort (Artemisia vulgaris) allergens. The authors believe that the pathomechanism of the development of seasonal allergic rhinithis is governed to a large degree by hypersensitivity to grass and weed pollens and suggest that precise determination of AS IgE to these allergens in patients blood sera should form the basis of the construction of the vaccine used in their immunotherapy.

From among 810 persons subjected to a medical examination, skin lesions were found in 33.3%. These were mostly: seborrhea (89 cases), occupational naevi (55 cases), dermatomycosis (49 cases), urticaria (21 cases), eczema (12 cases). Other dermatoses were found in 44 workers, however, in a small percentage, not greater than in other non-industrial populations. No occupational dermatoses resulting from exposure to fundamental materials or dyes used in production were found.