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1. Characteristics and management of generalized pustular psoriasis (GPP): Experience from the Central and Eastern Europe (CEE) GPP Expert Network.

Author

Wolf, P., Ceovic, R., Conrad, C., Falkensteiner, K., Graier, T., Kołt‐Kamińska, M., Marovt, M., Mateeva, V., Maul, J.‐T., Navarini, A. A., Nicolescu, A. C., Ratzinger, G., Pavlovsky, L., Sanzharovskaya, M., Szegedi, A., and Reich, A.

Subjects
*PSORIASIS, *SKIN diseases, *HYPERLIPIDEMIA, *PATHOLOGICAL laboratories, *PHYSICIANS
Abstract

Background: Generalized pustular psoriasis (GPP) is a rare, inflammatory skin disease characterized by widespread eruption of sterile pustules with or without systemic symptoms. Objectives: This study aimed to describe the demographics of patients with GPP in Central and Eastern Europe (CEE), present the clinical characteristics of individual GPP flares and explore the current treatment landscape. Methods: Patient demographics were collected at the times of last observation and previous treatment. Characteristics of a patient's last (most recent) and most severe (from all documented episodes) flare were provided at clinician's discretion. Results: Fifty‐eight patients were recruited from 12 centres in nine CEE countries; median (range) age was 61 (16–92) years and 60.3% (35 out of 58) were female. The most common comorbidities were hypertension (43.1% [25 out of 58]) and hyperlipidaemia (32.8% [19 out of 58]). Thirty‐four patients (58.6%) presented with concomitant plaque psoriasis before or during the course of GPP. Data from two separate flares were recorded in 26 individuals; in 32 patients, the most recent flare was reported as the most severe. Over 90% of patients with a flare episode classified as most severe by clinicians were hospitalized, with >75% of these individuals having a Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) total score of 3 or 4. Systemic symptoms were more common in patients with a GPPGA score of 3 or 4 but were also manifest in individuals with a GPPGA score ≤2. A significant correlation was observed between a combined systemic disease score of clinical and laboratory features and both GPPGA total score (r = 0.385, p < 0.001) and GPPGA pustulation subscore (r = 0.305, p < 0.05). Conclusions: Considerable heterogeneity in the presentation of GPP flares was observed, both between patients and within‐patient. All GPP flares were associated with a significant clinical burden, highlighting the unmet need for accurate and early diagnosis. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Lymphogranuloma venereum: diagnostic and treatment challenges

Author

Ceovic R and Jerkovic Gulin S

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Romana Ceovic,1 Sandra Jerkovic Gulin21Department of Dermatology and Venereology, University Hospital Center Zagreb and School of Medicine, Zagreb, Croatia; 2Department of Dermatology and Venereology, General Hospital Sibenik, Sibenik, CroatiaAbstract: Lymphogranuloma venereum is a sexually transmitted disease caused by L1, L2, and L3 serovars of Chlamydia trachomatis. In the last 10 years outbreaks have appeared in North America, Europe, and Australia in the form of proctitis among men who have sex with men. Three stages of disease have been described. The disease in primary stage may go undetected when only a painless papule, pustule, or ulceration appears. The diagnosis is difficult to establish on clinical grounds alone and frequently relies upon either serologic testing, culture, or more recently, nucleic acid amplification testing of direct specimens. A proper treatment regimen cures the infection and prevents further damage to tissues. Lymphogranuloma venereum causes potentially severe infections with possibly irreversible sequels if adequate treatment is not begun promptly. Early and accurate diagnosis is essential. Doxycycline is the drug of choice. Pregnant and lactating women should be treated with erythromycin or azithromycin. Patient must be followed up during the treatment, until disease signs and symptoms have resolved. Repeated testing for syphilis, hepatitis B and C, and HIV to detect early infection should be performed.Keywords: sexually transmitted disease, Chlamydia trachomatis, early and accurate diagnosis

Published
2015

4. Factors associated with adverse COVID-19 outcomes in patients with psoriasis—insights from a global registry–based study

Author

Mahil, S, Dand, N, Mason, K, Yiu, Z, Tsakok, T, Meynell, F, Coker, B, Mcateer, H, Moorhead, L, Mackenzie, T, Rossi, M, Rivera, R, Mahe, E, Carugno, A, Magnano, M, Rech, G, Balogh, E, Feldman, S, De La Cruz, C, Choon, S, Naldi, L, Lambert, J, Spuls, P, Jullien, D, Bachelez, H, Mcmahon, D, Freeman, E, Gisondi, P, Puig, L, Warren, R, Di Meglio, P, Langan, S, Capon, F, Griffiths, C, Barker, J, Smith, C, Shah, A, Barea, A, Romero-Mate, A, Singapore, A, Paolino, A, Mwale, A, Morales Callaghan, A, Martinez, A, Decrescenzo, A, Pink, A, Jones, A, Sergeant, A, Essex, A, Bewley, A, Makrygeorgou, A, van Huizen, A, Perez-Suarez, B, Farida, B, Clareus, B, Prims, C, Davis, C, Quinlan, C, Maybury, C, Cesar, G, Barclay, C, Greco, C, Brassard, D, Cummings, D, Kolli, D, Descamps, V, Genao, D, Carras, E, Hawryluk, E, Martinez-Garcia, E, Klujszo, E, Dwyer, E, Toni, E, Sonkoly, E, Loayza, E, Dauden, E, Valenzuela, F, Popov, G, King, G, Celine, G, Aparicio, G, Johnston, G, Cardozo, G, Pearson, I, Yanguas, I, Weisman, J, Carolan, J, Hughes, J, Ortiz-Salvador, J, Carrascosa, J, Schwartz, J, Jackson, K, Kerisit, K, Wu, K, Asfour, L, de Graaf, L, Lesort, C, Meuleman, L, Eidsmo, L, Skov, L, Gribben, L, Rustin, M, Velasco, M, Panchal, M, Lakhan, M, Franco, M, Svensson, M, Vandaele, M, Marovt, M, Zargari, O, De Caso, P, Varela, P, Jenkin, P, Phan, C, Hampton, P, Goldsmith, P, Bak, R, Speeckaert, R, Romiti, R, Woolf, R, Mercado-Seda, R, Khatun, R, Ceovic, R, Taberner, R, Cohen, R, Stefanescu, S, Kirk, S, Reeken, S, Ayob, S, Perez-Barrio, S, Piaserico, S, Hoey, S, Torres, T, Talme, T, Desai, T, van Geest, A, King, V, Di Lernia, V, Koreja, Z, Hasab, V, Mahil S. K., Dand N., Mason K. J., Yiu Z. Z. N., Tsakok T., Meynell F., Coker B., McAteer H., Moorhead L., Mackenzie T., Rossi M. T., Rivera R., Mahe E., Carugno A., Magnano M., Rech G., Balogh E. A., Feldman S. R., De La Cruz C., Choon S. E., Naldi L., Lambert J., Spuls P., Jullien D., Bachelez H., McMahon D. E., Freeman E. E., Gisondi P., Puig L., Warren R. B., Di Meglio P., Langan S. M., Capon F., Griffiths C. E. M., Barker J. N., Smith C. H., Shah A., Barea A., Romero-Mate A., Singapore A., Paolino A., Mwale A., Morales Callaghan A. M., Martinez A., DeCrescenzo A., Pink A. E., Jones A., Sergeant A., Essex A., Bewley A., Makrygeorgou A., van Huizen A., Perez-Suarez B., Farida B., Clareus B. W., Prims C. T., Davis C., Quinlan C., Maybury C., Cesar G. A., Barclay C., Greco C., Brassard D., Cummings D., Kolli D., Descamps V., Genao D. R., Carras E., Hawryluk E., Martinez-Garcia E., Klujszo E., Dwyer E., Toni E., Sonkoly E., Loayza E., Dauden E., Valenzuela F., Popov G., King G., Celine G., Aparicio G., Johnston G. A., Cardozo G. A., Pearson I., Yanguas I., Weisman J., Carolan J. E., Hughes J., Ortiz-Salvador J. -M., Carrascosa J. -M., Schwartz J. J., Jackson K., Kerisit K. G., Wu K., Asfour L., de Graaf L., Lesort C., Meuleman L., Eidsmo L., Skov L., Gribben L., Rustin M., Velasco M., Panchal M., Lakhan M., Franco M. D., Svensson M. -L., Vandaele M., Marovt M., Zargari O., De Caso P., Varela P., Jenkin P., Phan C., Hampton P., Goldsmith P., Bak R., Speeckaert R., Romiti R., Woolf R., Mercado-Seda R., Khatun R., Ceovic R., Taberner R., Cohen R. W., Stefanescu S., Kirk S., Reeken S., Ayob S., Perez-Barrio S., Piaserico S., Hoey S., Torres T., Talme T., Desai T. V., van Geest A. J., King V., Di Lernia V., Koreja Z., Hasab V. Z., Mahil, S, Dand, N, Mason, K, Yiu, Z, Tsakok, T, Meynell, F, Coker, B, Mcateer, H, Moorhead, L, Mackenzie, T, Rossi, M, Rivera, R, Mahe, E, Carugno, A, Magnano, M, Rech, G, Balogh, E, Feldman, S, De La Cruz, C, Choon, S, Naldi, L, Lambert, J, Spuls, P, Jullien, D, Bachelez, H, Mcmahon, D, Freeman, E, Gisondi, P, Puig, L, Warren, R, Di Meglio, P, Langan, S, Capon, F, Griffiths, C, Barker, J, Smith, C, Shah, A, Barea, A, Romero-Mate, A, Singapore, A, Paolino, A, Mwale, A, Morales Callaghan, A, Martinez, A, Decrescenzo, A, Pink, A, Jones, A, Sergeant, A, Essex, A, Bewley, A, Makrygeorgou, A, van Huizen, A, Perez-Suarez, B, Farida, B, Clareus, B, Prims, C, Davis, C, Quinlan, C, Maybury, C, Cesar, G, Barclay, C, Greco, C, Brassard, D, Cummings, D, Kolli, D, Descamps, V, Genao, D, Carras, E, Hawryluk, E, Martinez-Garcia, E, Klujszo, E, Dwyer, E, Toni, E, Sonkoly, E, Loayza, E, Dauden, E, Valenzuela, F, Popov, G, King, G, Celine, G, Aparicio, G, Johnston, G, Cardozo, G, Pearson, I, Yanguas, I, Weisman, J, Carolan, J, Hughes, J, Ortiz-Salvador, J, Carrascosa, J, Schwartz, J, Jackson, K, Kerisit, K, Wu, K, Asfour, L, de Graaf, L, Lesort, C, Meuleman, L, Eidsmo, L, Skov, L, Gribben, L, Rustin, M, Velasco, M, Panchal, M, Lakhan, M, Franco, M, Svensson, M, Vandaele, M, Marovt, M, Zargari, O, De Caso, P, Varela, P, Jenkin, P, Phan, C, Hampton, P, Goldsmith, P, Bak, R, Speeckaert, R, Romiti, R, Woolf, R, Mercado-Seda, R, Khatun, R, Ceovic, R, Taberner, R, Cohen, R, Stefanescu, S, Kirk, S, Reeken, S, Ayob, S, Perez-Barrio, S, Piaserico, S, Hoey, S, Torres, T, Talme, T, Desai, T, van Geest, A, King, V, Di Lernia, V, Koreja, Z, Hasab, V, Mahil S. K., Dand N., Mason K. J., Yiu Z. Z. N., Tsakok T., Meynell F., Coker B., McAteer H., Moorhead L., Mackenzie T., Rossi M. T., Rivera R., Mahe E., Carugno A., Magnano M., Rech G., Balogh E. A., Feldman S. R., De La Cruz C., Choon S. E., Naldi L., Lambert J., Spuls P., Jullien D., Bachelez H., McMahon D. E., Freeman E. E., Gisondi P., Puig L., Warren R. B., Di Meglio P., Langan S. M., Capon F., Griffiths C. E. M., Barker J. N., Smith C. H., Shah A., Barea A., Romero-Mate A., Singapore A., Paolino A., Mwale A., Morales Callaghan A. M., Martinez A., DeCrescenzo A., Pink A. E., Jones A., Sergeant A., Essex A., Bewley A., Makrygeorgou A., van Huizen A., Perez-Suarez B., Farida B., Clareus B. W., Prims C. T., Davis C., Quinlan C., Maybury C., Cesar G. A., Barclay C., Greco C., Brassard D., Cummings D., Kolli D., Descamps V., Genao D. R., Carras E., Hawryluk E., Martinez-Garcia E., Klujszo E., Dwyer E., Toni E., Sonkoly E., Loayza E., Dauden E., Valenzuela F., Popov G., King G., Celine G., Aparicio G., Johnston G. A., Cardozo G. A., Pearson I., Yanguas I., Weisman J., Carolan J. E., Hughes J., Ortiz-Salvador J. -M., Carrascosa J. -M., Schwartz J. J., Jackson K., Kerisit K. G., Wu K., Asfour L., de Graaf L., Lesort C., Meuleman L., Eidsmo L., Skov L., Gribben L., Rustin M., Velasco M., Panchal M., Lakhan M., Franco M. D., Svensson M. -L., Vandaele M., Marovt M., Zargari O., De Caso P., Varela P., Jenkin P., Phan C., Hampton P., Goldsmith P., Bak R., Speeckaert R., Romiti R., Woolf R., Mercado-Seda R., Khatun R., Ceovic R., Taberner R., Cohen R. W., Stefanescu S., Kirk S., Reeken S., Ayob S., Perez-Barrio S., Piaserico S., Hoey S., Torres T., Talme T., Desai T. V., van Geest A. J., King V., Di Lernia V., Koreja Z., and Hasab V. Z.

Abstract

Background: The multimorbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse outcomes of coronavirus disease 2019 (COVID-19), but the data are limited. Objective: Our aim was to characterize the course of COVID-19 in patients with psoriasis and identify factors associated with hospitalization. Methods: Clinicians reported patients with psoriasis with confirmed/suspected COVID-19 via an international registry, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection. Multiple logistic regression was used to assess the association between clinical and/or demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviors. Results: Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% were receiving a nonbiologic, and 10% were not receiving any systemic treatment for psoriasis. In all, 348 patients (93%) were fully recovered from COVID-19, 77 (21%) were hospitalized, and 9 (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted odds ratio [OR] = 1.59 per 10 years; 95% CI = 1.19-2.13), male sex (OR = 2.51; 95% CI = 1.23-5.12), nonwhite ethnicity (OR = 3.15; 95% CI = 1.24-8.03), and comorbid chronic lung disease (OR = 3.87; 95% CI = 1.52-9.83). Hospitalization was more frequent in patients using nonbiologic systemic therapy than in those using biologics (OR = 2.84; 95% CI = 1.31-6.18). No significant differences were found between classes of biologics. Independent patient-reported data (n = 1626 across 48 countries) suggested lower levels of social isolation in individuals receiving nonbiologic systemic therapy than in those receiving biologics (OR = 0.68; 95% CI = 0.50-0.94). Conclusion: In this international case series of patients with moderate-to-severe psoriasis, biologic use was associated with lower risk of COVID-19–related hospitalization than with

Published
2021

6. Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society

Author

Errichetti, E., primary, Apalla, Z., additional, Geller, S., additional, Sławińska, M., additional, Kyrgidis, A., additional, Kaminska‐Winciorek, G., additional, Jurakic Toncic, R., additional, Bobos, M., additional, Rados, J., additional, Ledic Drvar, D., additional, Ceovic, R., additional, Akay, B. N., additional, Piccolo, V., additional, Myskowski, P., additional, Vitiello, P., additional, Russo, T., additional, Argenziano, G., additional, Sokołowska‐Wojdyło, M., additional, Sobjanek, M., additional, Stojkovic‐Filipovic, J., additional, Longo, C., additional, Pellacani, G., additional, Stinco, G., additional, and Lallas, A., additional

Published
2022
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7. IMPLEMENTATION AND DISSEMINATION OF CHRONIC GRAFT-VERSUS-HOST DISEASE NIH CRITERIA AND RECOMMENDATIONS - FORMATION OF A MULTIDISCIPLINARY TEAM AND PROGRAM AT THE UNIVERSITY HOSPITAL CENTER ZAGREB, CROATIA: PH-P419

Author

Grkovic, L., Pulanic, D., Serventi-Seiwerth, R., Matic, N., Mravak-Stipetic, M., Bilic, E., Ceovic, R., Ljubas, D., Rajic, L., Durakovic, N., Peric, Z., Pulanic, Klepac T., Kovac, K., Dusek, D., Bojanic, I., Grce, M., Batinic, D., Vrhovac, R., Pavletic, S. Z, and Nemet, D.

Published
2014

11. High levels of FVIII and Von Willebrand Factor in chronic Graft-versus-Host Disease patients

Author

Pulanic D, Samardzic A, Desnica L, Zadro R, Milošević M, Serventi Seiwerth R, Durakovic N, Peric Z, Coen Herak D, Milos M, Kraljevic L, Mravak Stipetic M, Bilic E, Ceovic R, Klepac Pulanic T, Petricek I, Saban N, Zelic Kerep A, Ljubas Kelecic D, Vukic T, Mazic S, Bojanic I, Bilić E, Batinic D, Vrhovac R, Pavletic SZ and Mohammad Mohty, Hillard M. Lazarus

Subjects
chronic graft versus host disease, von Willebrand, factor VIII
Abstract

Studija razina von Willebrandova faktora i faktora 8 u bolesnika sa kroničnim GVHD-om.

Published
2019

12. PF773 LOWER SERUM LEVELS OF ZINC AND MAGNESIUM ARE ASSOCIATED WITH WORSE ORAL CGVHD AND DYSGEUSIA IN CGVHD PATIENTS

Author

Mravak-Stipetic, M., primary, Radman, M., additional, Desnica, L., additional, Sabol, I., additional, Serventi-Seiwerth, R., additional, Perić, Z., additional, Durakovic, N., additional, Kelecic, D. Ljubas, additional, Bilic, E., additional, Ceovic, R., additional, Karas, I., additional, Vukic, T., additional, Samardzic, A., additional, Zelic, A. Kerep, additional, Katić, M., additional, Vrhovac, R., additional, Pavletic, S.Z., additional, and Pulanic, D., additional

Published
2019
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14. Oral Candida species colonization in chronic Graft-versus-Host Disease

Author

Dusek, D., Stipetic, M. Mravak, Grce, M., Pulanic, D., Grkovic, L., Seiwerth, R. Serventi, Pulanic, T. Klepac, Ceovic, R., Bukovski, S., Jelic, M., Cindric, M., Rajic, L., Bilic, E., Peric, Z., Durakovic, N., Vince, A., Vrhovac, R., Pavletic, S. Z., and Nemet, D.

Subjects
immune system diseases, hemic and lymphatic diseases, cGVHD, Candida
Abstract

Introduction: Colonization with Candida sp has significant role in occurrence and pathogenesis of acute Graft-versus-Host Disease (aGVHD) via induction of mucosal innate immunity (Th 17/IL 23 responses). However, data about prevalence and role of Candida sp in chronic Graft-versus- Host Disease (cGVHD) are scarce. The aim of this study was to determine prevalence of oral colonization with different Candida sp in patients with cGVHD and possible association with cGVHD characteristics. Materials (or patients) and methods: This study enrolled cGVHD patients who are part of a larger multidisciplinary cGHVD project at the University Hospital Center Zagreb, Croatia. Patients were evaluated for clinical and cGVHD characteristics ; severity of cGVHD and oral involvement were determined by using established NIH Consensus criteria. Swabs from oral cavity were collected from all patients. Specimens were analyzed by standard cultivation methods (Sabouraud and blood agar, identification by automated biochemical test). Molecular detection was performed by real-time in house PCR designed to distinguish 12 Candida species. Candida isolates were analyzed at proteomic level by Mass Spectrometry (MS/MS). Data were evaluated descriptively. Fisher’s exact test or Wilcoxon test were used to calculate statistical significance. Results: Twenty-one patient was enrolled, median age was 42 years 38% were male. In 15 patients (71%) underlying disease was AML, ALL or MDS, 3 patients had CML or MPN, 1 patient had severe aplastic anemia and 2 patients had lymphoma. Nine patients (43%) underwent myeloablative conditioning. Majority (71%) received PSBC as stem source. Sixteen patients (76%) had previous aGVHD. Ten patients (48%) had oral cGVHD ; 6 patients had moderate or severe NIH oral cGVHD score. Nine patients (43%) had moderate and 12 (57%) had severe NIH global cGVHD score. Six patients (29%) were positive for C. albicans and 3 patients for C. krusei by standard cultivating methods. When using real- time PCR method, 13 patients (61%) were positive for C. albicans, 4 patients for C. krusei, 2 patients with C. dubliensis, 1 patient with C. tropicalis and 1 patient with C. glabrata. Coinfection with 2 or 3 different Candida sp. was found in 6 patients. Ten samples were analyzed by proteomics with 5 samples confirmed as C. albicans. Although more patients were positive for C. albicans and C. non albicans sp by multiplex PCR than cultivation, this was not statistically significant (P¼0.335 and 0.184, respectively). Nine patients with oral cGVHD (90%) had colonization with at least one Candida sp, while 7 patients without oral cGVHD (64%) had colonization with Candida sp (P¼0.311). Ten patients with global severe cGVHD (83%) and 5 patients with moderate cGVHD (55.5%) had Candida sp colonization (P¼0.331). Conclusion: Significant proportion of patients with cGVHD, especially patients with severe global cGVHD were colonized with Candida sp. Use of molecular methods is important in diagnosing C.non albicans (3 new species identified only by PCR). Majority (90%) of patients with oral cGVHD were colonized with Candida sp, however larger studies are needed to determine association between cGVHD global severity and organ involvement with Candida colonization. Considering significant proportion of cGVHD patients colonized with Candida sp, further studies investigating its possible role in pathogenesis of cGVHD, as well as possible prophylactic/therapeutic are needed. Disclosure of Interest: None declared.

Published
2015

15. PUVA therapy: The present state of art and perspectives

Author

Pasic, A., Lipozencic, J., Mirna Situm, Basta-Juzbasic, A., Ceovic, R., and Barisic- Drusko, V.

Subjects
heterocyclic compounds, PUVA therapy, indications, side effects
Abstract

Photochemotherapy (PUVA) is a therapeutic method that uses psoralen (P) and exposure to longwave ultraviolet A (UVA) radiation. The Mechanism of PUVA action, pharmacokinetics of psralens, and specific properties of UVA radiation are presented. Various forms of PUVA therapy, i.e. PUVA therapy with peroral psoralen administration, PUVA bath therapy, PUVA therapy with topical psoralen application, and extracorporeal photopheresis are described. Due attention is paid to major indications for PUVA therapy (various forms of psoriasis, T-cell lymphoma, vitiligo, atopic dermatitis, graft-versus-host disease, etc.). Emphasis is also given to PUVA therapy side effects, with special reference to its potential carcinogenic effect.

16. Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society

Author

E. Errichetti, Z. Apalla, S. Geller, M. Sławińska, A. Kyrgidis, G. Kaminska‐Winciorek, R. Jurakic Toncic, M. Bobos, J. Rados, D. Ledic Drvar, R. Ceovic, B. N. Akay, V. Piccolo, P. Myskowski, P. Vitiello, T. Russo, G. Argenziano, M. Sokołowska‐Wojdyło, M. Sobjanek, J. Stojkovic‐Filipovic, C. Longo, G. Pellacani, G. Stinco, A. Lallas, Errichetti, E., Apalla, Z., Geller, S., Slawinska, M., Kyrgidis, A., Kaminska-Winciorek, G., Jurakic Toncic, R., Bobos, M., Rados, J., Ledic Drvar, D., Ceovic, R., Akay, B. N., Piccolo, V., Myskowski, P., Vitiello, P., Russo, T., Argenziano, G., Sokolowska-Wojdylo, M., Sobjanek, M., Stoikovic-Filipovic, J., Longo, C., Pellacani, G., Stinco, G., and Lallas, A.

Subjects
Skin Neoplasms, lymphoma, Dermoscopy, Dermatology, lymphomas, infiltrative dermatoses, infiltrative dermatose, Article, Folliculotropic mycosis fungoides, dermoscopy, folliculotropic mycosis fungoides, mycosis fungoides, Mycosis Fungoides, Infectious Diseases, Infiltrative dermatoses, Humans, folliculotropic mycosis fungoide, Retrospective Studies, Skin
Abstract

Background: The dermoscopic features of classic patch stage mycosis fungoides (MF) have been described, but data on plaque and tumoral stage as well as rarer MF subtypes is limited. Objective: To evaluate dermoscopic morphology and dermoscopic-pathological correlations of classic MF stages and investigate dermoscopic features of MF variants. Methods: Patients with histopathologically confirmed lesions of classic MF (patch, plaque and tumoral stage) or folliculotropic, erythrodermic and poikilodermatous MF were included. Standardized evaluation of dermoscopic pictures of the included MF variants and comparative analysis and dermoscopic-pathological correlation assessment of different stages of classic MF were performed. Results: A total of 118 instances were included (75 classic MF, 26 folliculotropic MF, 9 erythrodermic MF and 8 poikilodermatous MF). Linear/linear-curved vessels and white scales in the skin furrows were significantly associated with patch-stage MF, while clustered dotted vessels were related to plaque-stage MF and peripheral linear vessels with branches, ulceration and red globules separated by white lines to tumour-stage MF. Moreover, patchy white scales were significantly more common in patches and plaques compared to tumours, whereas focal bright white structureless areas were related to plaque and tumoral stage. Vessels histopathologically corresponded to dilated vascular structures in the dermis, orange structureless areas to either dermal hemosiderin (patch/plaque stage) or dense cellular infiltration (tumours), bright white lines/structureless areas to dermal fibrosis and ulceration to loss of epidermis. The main dermoscopic findings of folliculotropic MF were lack of hairs, dilated follicles and follicular plugs, while erythrodermic MF was mainly characterized by linear/dotted vessels, patchy white scales and focal orange structureless areas and poikilodermatous MF by focal white and brown structureless areas, white patchy scales and brown reticular lines. Conclusion: Dermoscopy may allow a more precise characterization of classic MF and reveal clues suggestive of the main MF variants.

Published
2022

17. Dermatoscopy of nodular/plaque-type primary cutaneous T- and B-cell lymphomas: A retrospective comparative study with pseudolymphomas and tumoral/inflammatory mimickers by the International Dermoscopy Society

Author

Alejandro Lobato-Berezo, Ruzica Jurakic Toncic, Elena Sotiriou, Małgorzata Sokołowska-Wojdyło, Giovanni Damiani, Paola Vitiello, Teresa Russo, Martyna Sławińska, Patricia L. Myskowski, Enzo Errichetti, Piergiacomo Calzavara-Pinton, Bengü Nisa Akay, Ayşe Tülin Güleç, Aimilios Lallas, Giuseppe Argenziano, Caterina Longo, Giuseppe Stinco, Zorana Kremic, Iris Zalaudek, Jaka Radoš, Camilla Reggiani, Shamir Geller, Michał Sobjanek, Vincenzo Piccolo, Athanassios Kyrgidis, Pedro Zaballos, Vincenzo Maione, Grażyna Kamińska-Winciorek, Romana Čeović, Sven Lanssens, Zoe Apalla, Daniela Ledić Drvar, Errichetti, E., Geller, S., Zalaudek, I., Longo, C., Kyrgidis, A., Akay, B. N., Piccolo, V., Myskowski, P., Vitiello, P., Russo, T., Argenziano, G., Slawinska, M., Sokolowska-Wojdylo, M., Sobjanek, M., Toncic, R. J., Rados, J., Drvar, D. L., Ceovic, R., Kaminska-Winciorek, G., Zaballos, P., Reggiani, C., Kremic, Z., Lanssens, S., Gulec, A. T., Lobato-Berezo, A., Damiani, G., Maione, V., Calzavara-Pinton, P., Sotiriou, E., Stinco, G., Apalla, Z., Lallas, A., Errichetti, Enzo, Geller, Shamir, Zalaudek, Iri, Longo, Caterina, Kyrgidis, Athanassio, Akay, Bengu Nisa, Piccolo, Vincenzo, Myskowski, Patricia, Vitiello, Paola, Russo, Teresa, Argenziano, Giuseppe, Sławińska, Martyna, Sokołowska-Wojdyło, Małgorzata, Sobjanek, Michał, Toncic, Ruzica Jurakic, Rados, Jaka, Drvar, Daniela Ledic, Ceovic, Romana, Kaminska-Winciorek, Grażyna, Zaballos, Pedro, Reggiani, Camilla, Kremic, Zorana, Lanssens, Sven, Güleç, Ayşe Tülin, Lobato-Berezo, Alejandro, Damiani, Giovanni, Maione, Vincenzo, Calzavara-Pinton, Piergiacomo, Sotiriou, Elena, Stinco, Giuseppe, Apalla, Zoe, and Lallas, Aimilios

Subjects
tumors, Pathology, medicine.medical_specialty, tumor, Lymphoma, B-Cell, Skin Neoplasms, pseudolymphoma, Dermoscopy, Breast Neoplasms, lymphoma, Dermatology, dermatoscopy, lymphomas, infiltrative dermatose, Retrospective Studie, hemic and lymphatic diseases, dermatoscopyinfiltrative dermatosesinflammatory dermatoseslymphomaspseudolymphomastumors, Medicine, Humans, Lymphoma, T-Cell, Cutaneou, B cell, Retrospective Studies, Dermatoscopy, infiltrative dermatoses, inflammatory dermatoses, pseudolymphomas, Case-Control Studies, Female, Lymphoma, T-Cell, Cutaneous, Pseudolymphoma, medicine.diagnostic_test, business.industry, Primary cutaneous lymphoma, B-Cell, T-Cell, humanities, medicine.anatomical_structure, Cutaneous, Correlation analysis, Plaque type, business, Case-Control Studie, inflammatory dermatose, Retrospective design, Breast Neoplasm, Human
Abstract

Background Limited data on dermatoscopy of nodular/plaque-type T-/B-cell primary cutaneous lymphomas (PCLs) is available. Objective To describe dermatoscopic features of nodular/plaque-type PCLs, comparing them with those of clinical mimickers (pseudolymphomas, tumors, and inflammatory lesions) and investigating possible differences according to histologic subtypes. Methods Participants were invited to join this retrospective, multicenter case-control study by submitting histologically/immunohistochemically confirmed instances of nodular/plaque-type PCLs and controls. Standardized assessments of the dermatoscopic images and comparative analyses were performed. Results A total of 261 lesions were included (121 PCLs and 140 controls). Orange structureless areas were the strongest PCL dermatoscopic predictor on multivariate analysis compared with tumors and noninfiltrative inflammatory dermatoses. On the other hand, a positive association was found between PCLs and either unfocused linear vessels with branches or focal white structureless areas compared with infiltrative inflammatory dermatoses, whereas white lines were predictive of PCLs over pseudolymphomas. Differences in the vascular pattern were also seen between B- and T-cell PCLs and among B-cell PCL subtypes. Limitations Retrospective design and the lack of a dermatoscopic-pathologic correlation analysis. Conclusion Nodular/plaque-type PCLs display dermatoscopic clues, which may partially vary according to histologic subtype and whose diagnostic relevance depends on the considered clinical differential diagnoses.

Published
2021

18. Factors associated with adverse COVID-19 outcomes in patients with psoriasis—insights from a global registry–based study

Author

Silvia Pérez-Barrio, Lucy Moorhead, Manpreet Lakhan, Saskia Reeken, Vito Zeeshaan Hasab, Rogelio Mercado-Seda, Gustavo Anibal Cardozo, Georgi Popov, Enrique Loayza, Marie-Louise Svensson, Emmanuel Mahe, Fernando Valenzuela, Victoria King, Michela Magnano, Danielle Brassard, Annette Essex, Deanna Cummings, Manisha Panchal, Trupti V. Desai, Jennifer E. Carolan, Areti Makrygeorgou, Zenas Z N Yiu, Teena Mackenzie, Esteban Daudén, Emmanuel Toni, Ian Pearson, Andrea Carugno, Lorraine Gribben, Leontien de Graaf, Liv Eidsmo, Esther A. Balogh, Gloria Aparicio, Andrew Pink, Manel Velasco, Adrienne J. van Geest, Steven R. Feldman, Tiago Torres, Elzbieta Klujszo, Malcolm H.A. Rustin, Ignacio Yanguas, Anthony Bewley, Eliseo Martínez-García, Benhadou Farida, Emily Dwyer, Susannah Hoey, Richard B. Warren, Esther E. Freeman, Diana Ruiz Genao, Rohima Khatun, Giulia Rech, Elena B. Hawryluk, Zahira Koreja, Ricardo Romiti, Gonzalez A. Cesar, Alice Mwale, Charlotte Barclay, Aadarsh Shah, Catherine Quinlan, Kathryn G. Kerisit, Christopher E.M. Griffiths, Carla Tubau Prims, Lone Skov, Céline Phan, Vincent Descamps, Jenny Hughes, Siew Eng Choon, Shanti Ayob, Efrossini Carras, Girard Celine, Jo Lambert, Alberto Barea, Jonathan Barker, Reinhart Speeckaert, Raquel Rivera, Portia Goldsmith, Nick Dand, Beatriz Pérez-Suárez, Andrew DeCrescenzo, F. Meynell, Francesca Capon, Toomas Talme, Teresa Tsakok, Deepti Kolli, Stefano Piaserico, Jamie Weisman, Manuel D. Franco, K.J. Mason, Pablo De Caso, Catriona Maybury, Rachel Bak, Ann Sergeant, Keith Wu, Graham A. Johnston, Alexandra Paolino, Cécile Lesort, Mark Vandaele, H. McAteer, Birgitta Wilson Claréus, Sinead Langan, Jose-Manuel Carrascosa, Enikö Sonkoly, Claudia de la Cruz, Maruska Marovt, Luigi Naldi, Leila Asfour, Paola Di Meglio, Jose-Maria Ortiz-Salvador, Alekya Singapore, Peter Jenkin, Romana Ceovic, R. Taberner, P.J. Hampton, Alberto Romero-Maté, Russell W. Cohen, Omid Zargari, Maria Teresa Rossi, Devon E. McMahon, Denis Jullien, Bola Coker, Carrie Davis, Georgie King, Catherine H. Smith, Richard Woolf, Luis Puig, Ann Jones, Astrid van Huizen, Joseph J. Schwartz, Paolo Gisondi, Phyllis I. Spuls, Satveer K. Mahil, Sarah Kirk, Paulo Varela, K. Jackson, Ana Maria Morales Callaghan, Vito Di Lernia, Lieve Meuleman, Claudio Greco, Simina Stefanescu, Hervé Bachelez, Ana Martinez, Dermatology, AII - Inflammatory diseases, APH - Methodology, APH - Quality of Care, Mahil, S, Dand, N, Mason, K, Yiu, Z, Tsakok, T, Meynell, F, Coker, B, Mcateer, H, Moorhead, L, Mackenzie, T, Rossi, M, Rivera, R, Mahe, E, Carugno, A, Magnano, M, Rech, G, Balogh, E, Feldman, S, De La Cruz, C, Choon, S, Naldi, L, Lambert, J, Spuls, P, Jullien, D, Bachelez, H, Mcmahon, D, Freeman, E, Gisondi, P, Puig, L, Warren, R, Di Meglio, P, Langan, S, Capon, F, Griffiths, C, Barker, J, Smith, C, Shah, A, Barea, A, Romero-Mate, A, Singapore, A, Paolino, A, Mwale, A, Morales Callaghan, A, Martinez, A, Decrescenzo, A, Pink, A, Jones, A, Sergeant, A, Essex, A, Bewley, A, Makrygeorgou, A, van Huizen, A, Perez-Suarez, B, Farida, B, Clareus, B, Prims, C, Davis, C, Quinlan, C, Maybury, C, Cesar, G, Barclay, C, Greco, C, Brassard, D, Cummings, D, Kolli, D, Descamps, V, Genao, D, Carras, E, Hawryluk, E, Martinez-Garcia, E, Klujszo, E, Dwyer, E, Toni, E, Sonkoly, E, Loayza, E, Dauden, E, Valenzuela, F, Popov, G, King, G, Celine, G, Aparicio, G, Johnston, G, Cardozo, G, Pearson, I, Yanguas, I, Weisman, J, Carolan, J, Hughes, J, Ortiz-Salvador, J, Carrascosa, J, Schwartz, J, Jackson, K, Kerisit, K, Wu, K, Asfour, L, de Graaf, L, Lesort, C, Meuleman, L, Eidsmo, L, Skov, L, Gribben, L, Rustin, M, Velasco, M, Panchal, M, Lakhan, M, Franco, M, Svensson, M, Vandaele, M, Marovt, M, Zargari, O, De Caso, P, Varela, P, Jenkin, P, Phan, C, Hampton, P, Goldsmith, P, Bak, R, Speeckaert, R, Romiti, R, Woolf, R, Mercado-Seda, R, Khatun, R, Ceovic, R, Taberner, R, Cohen, R, Stefanescu, S, Kirk, S, Reeken, S, Ayob, S, Perez-Barrio, S, Piaserico, S, Hoey, S, Torres, T, Talme, T, Desai, T, van Geest, A, King, V, Di Lernia, V, Koreja, Z, and Hasab, V

Subjects
Male, IMID, immune-mediated inflammatory disease, immunosuppressant, BMI, body mass index, ACEi, angiotensin-converting enzyme inhibitor, PsoProtect, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 infecTion, Logistic regression, Systemic therapy, 030207 dermatology & venereal diseases, 0302 clinical medicine, RC705, Interquartile range, COVID-19, biologics, hospitalization, immunosuppressants, psoriasis, risk factors, Risk Factors, Epidemiology, Immunology and Allergy, 030212 general & internal medicine, Registries, NSAID, non-steroidal anti-inflammatory drug, 610 Medicine & health, COVID-19, Coronavirus disease 2019, TNF, tumor necrosis factor, Age Factors, Middle Aged, Hospitalization, risk factor, 95% CI, 95% confidence interval, Female, JAK, Janus kinase, biologic, Adult, medicine.medical_specialty, Immunology, Lower risk, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, Article, 03 medical and health sciences, Sex Factors, Internal medicine, Psoriasis, medicine, Humans, SARS-CoV-2, IFN, interferon, IQR, interquartile range, psoriasi, business.industry, Odds ratio, medicine.disease, ARB, angiotensin II receptor blocker, IL, interleukin, OR, odds ratio, business, Body mass index
Abstract

Background The multi-morbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse COVID-19 outcomes but data are limited. Objective Characterize the course of COVID-19 in psoriasis and identify factors associated with hospitalization. Methods Clinicians reported psoriasis patients with confirmed/suspected COVID-19 via an international registry, PsoProtect. Multiple logistic regression assessed the association between clinical/demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviours. Results Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% a non-biologic and 10% no systemic treatment for psoriasis. 348 (93%) fully recovered from COVID-19, 77 (21%) were hospitalized and nine (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted OR 1.59 per 10 years, 95% CI 1.19-2.13), male sex (OR 2.51, 95% CI 1.23-5.12), non-white ethnicity (OR 3.15, 95% CI 1.24-8.03) and comorbid chronic lung disease (OR 3.87, 95% CI 1.52-9.83). Hospitalization was more frequent in patients using non-biologic systemic therapy than biologics (OR 2.84, 95% CI 1.31-6.18). No significant differences were found between biologic classes. Independent patient-reported data (n=1,626 across 48 countries) suggested lower levels of social isolation in individuals receiving non-biologic systemic therapy compared to biologics (OR 0.68, 95% CI 0.50-0.94). Conclusion In this international moderate-severe psoriasis case series, biologics use was associated with lower risk of COVID-19-related hospitalization than non-biologic systemic therapies, however further investigation is warranted due to potential selection bias and unmeasured confounding. Established risk factors (being older, male, non-white ethnicity, comorbidities) were associated with higher hospitalization rates. Clinical Implications We identify risk factors for COVID-19-related hospitalization in psoriasis patients, including older age, male sex, non-white ethnicity and comorbidities. Use of biologics was associated with lower hospitalization risk than non-biologic systemic therapies., Capsule summary: In this global registry-based study, risk factors for COVID-19-related hospitalization in psoriasis patients were older age, male sex, non-white ethnicity and comorbidities. Use of biologics was associated with lower hospitalization risk than non-biologic systemic treatment.

Published
2021

19. The Prognostic Value of Histopathological Features in Early-Stage Mycosis Fungoides: Insights from a Retrospective-Prospective Cohort Study.

Author

Jerkovic Gulin S, Ilic I, and Ceovic R

Abstract

Primary cutaneous lymphomas (PCLs), especially mycosis fungoides (MF), pose significant diagnostic and therapeutic challenges. This study aims to correlate initial histological features with the disease course and survival in MF patients. A retrospective-prospective cohort study was conducted on 83 patients diagnosed with early-stage MF at the Departments of Dermatovenerology and Pathology, UHC Zagreb, from January 2003 to December 2012. The analyzed histopathological parameters included lichenoid dermal lymphocyte infiltrate, Pautrier microabscesses, and lymphocyte atypia. Patients with more than 30 guardian lymphocytes per 100 keratinocytes exhibited worse overall and progression-free survival. Furthermore, those with over 50% atypical lymphocytes demonstrated a faster progression rate. A dense lichenoid dermal infiltrate and a high count of lymphocyte "keepers" significantly increased the mortality risk within five years of diagnosis. This study did not fully confirm the hypothesis regarding the prognostic value of large Pautrier microabscesses but highlighted the importance of dense lichenoid infiltrates. The study identified new potential histopathological prognostic factors in early-stage MF, suggesting the need for larger studies to confirm these findings. The identification of such predictors could enhance the prognostic stratification and guide more tailored therapeutic approaches for MF patients.

Published
2024
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21. International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis.

Author

van Huizen AM, Menting SP, Gyulai R, Iversen L, van der Kraaij GE, Middelkamp-Hup MA, Warren RB, Spuls PI, Schejtman AA, Egeberg A, Firooz A, Kumar AS, Oakley A, Foulkes A, Ramos AMC, Fougerousse AC, Carija A, Akman-Karakas A, Horváth B, Fábos B, Matlock BH, Claréus BW, Castro C, Ferrándiz C, Correa CC, Marchesi C, Goujon C, Gonzalez C, Maldonado-García C, Hong CH, Griffiths CEM, Vestergaard C, Echeverría CM, de la Cruz C, Conrad C, Törocsik D, Drvar DL, Balak D, Jullien D, Appelen D, Kim DH, de Jong EMGJ, El Gamal E, Laffitte E, Mahé E, Sonkoly E, Colombo EP, Vilarrasa E, Willaert F, Novoa FD, Handjani F, Valenzuela F, Vílchez-Márquez F, Gonzalez GO, Krisztián G, Damiani G, Krnjevic-Pezic G, Pellerano G, Carretero G, Hunter HJA, Riad H, Oon HH, Boonen HPJ, Moussa IO, García-Doval I, Csányi I, Brajac I, Turchin I, Grozdev I, Weinberg JM, Nicolopoulos J, Wells J, Lambert JLW, Ingram JR, Prinz JC, de Souza Sittart JA, Sanchez JL, Hsiao JP, Castro-Ayarza JR, Maul JT, van den Reek JMPA, Trcko K, Barber K, Reich K, Gebauer KA, Khobzei K, Maul LV, Massari LP, Fardet L, le Cleach L, Misery L, Chandrashekar L, Muresanu LI, Lecluse L, Skov L, Frez ML, Babic LT, Puig L, Gomez LC, Ramam M, Dutil M, El-Sayed MH, Olszewska M, Schram ME, Franco MD, Llamas-Velasco M, Gonçalo M, Velásquez-Lopera MM, Abad ME, de Oliveira MFSP, Seyger MMB, Kaštelan M, Rademaker M, Sikora M, Lebwohl M, Wiseman MC, Ferran M, van Doorn M, Danespazhooh M, Bylaite-Bucinskiene M, Gooderham MJ, Polic MV, de Rie MA, Zheng M, Gómez-Flores M, Salleras I Redonnet M, Silverberg NB, Doss N, Yawalkar N, Chosidow O, Zargari O, de la Cueva P, Fernandez-Peñas P, Cárdenas Rojas PJ, Gisondi P, Grewal P, Sator P, Luna PC, Félix PAO, Varela P, Holló P, Cetkovska P, Calzavara-Pinton P, Ghislain PD, Araujo RR, Romiti R, Kui R, Ceovic R, Vender R, Lafuente-Urrez RF, Del-Río R, Gulin SJ, Handa S, Mahil SK, Kolalapudi SA, Marrón SE, Azimi SZ, Janmohamed SR, da Cruz Costa SA, Choon SE, Urbancek S, Ayanlowo O, Margasin SM, Wong TW, Mälkönen T, Hurtová T, Reciné TR, Huldt-Nystrøm T, Torres T, Liu TY, Leonidze T, Sharma VK, Weightman W, Gulliver W, and Veldkamp W

Subjects
Adult, Child, Consensus, Folic Acid, Humans, Surveys and Questionnaires, Methotrexate, Psoriasis therapy
Abstract

Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide., Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics., Design, Setting, and Participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience)., Main Outcomes and Measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree., Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients., Conclusions and Relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.

Published
2022
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22. Dermatoscopy of nodular/plaque-type primary cutaneous T- and B-cell lymphomas: A retrospective comparative study with pseudolymphomas and tumoral/inflammatory mimickers by the International Dermoscopy Society.

Author

Errichetti E, Geller S, Zalaudek I, Longo C, Kyrgidis A, Akay BN, Piccolo V, Myskowski P, Vitiello P, Russo T, Argenziano G, Sławińska M, Sokołowska-Wojdyło M, Sobjanek M, Toncic RJ, Rados J, Drvar DL, Ceovic R, Kaminska-Winciorek G, Zaballos P, Reggiani C, Kremic Z, Lanssens S, Güleç AT, Lobato-Berezo A, Damiani G, Maione V, Calzavara-Pinton P, Sotiriou E, Stinco G, Apalla Z, and Lallas A

Subjects
Case-Control Studies, Dermoscopy, Female, Humans, Retrospective Studies, Breast Neoplasms, Lymphoma, B-Cell diagnostic imaging, Lymphoma, T-Cell, Cutaneous, Pseudolymphoma diagnostic imaging, Skin Neoplasms diagnostic imaging, Skin Neoplasms pathology
Abstract

Background: Limited data on dermatoscopy of nodular/plaque-type T-/B-cell primary cutaneous lymphomas (PCLs) is available., Objective: To describe dermatoscopic features of nodular/plaque-type PCLs, comparing them with those of clinical mimickers (pseudolymphomas, tumors, and inflammatory lesions) and investigating possible differences according to histologic subtypes., Methods: Participants were invited to join this retrospective, multicenter case-control study by submitting histologically/immunohistochemically confirmed instances of nodular/plaque-type PCLs and controls. Standardized assessments of the dermatoscopic images and comparative analyses were performed., Results: A total of 261 lesions were included (121 PCLs and 140 controls). Orange structureless areas were the strongest PCL dermatoscopic predictor on multivariate analysis compared with tumors and noninfiltrative inflammatory dermatoses. On the other hand, a positive association was found between PCLs and either unfocused linear vessels with branches or focal white structureless areas compared with infiltrative inflammatory dermatoses, whereas white lines were predictive of PCLs over pseudolymphomas. Differences in the vascular pattern were also seen between B- and T-cell PCLs and among B-cell PCL subtypes., Limitations: Retrospective design and the lack of a dermatoscopic-pathologic correlation analysis., Conclusion: Nodular/plaque-type PCLs display dermatoscopic clues, which may partially vary according to histologic subtype and whose diagnostic relevance depends on the considered clinical differential diagnoses., Competing Interests: Conflict of interest None disclosed., (Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Published
2022
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24. Tofacitinib, an Oral Janus Kinase Inhibitor: Perspectives in Dermatology.

Author

Kostovic K, Gulin SJ, Mokos ZB, and Ceovic R

Subjects
Administration, Oral, Alopecia Areata drug therapy, Alopecia Areata metabolism, Alopecia Areata pathology, Dermatitis, Atopic drug therapy, Dermatitis, Atopic metabolism, Dermatitis, Atopic pathology, Humans, Janus Kinases antagonists & inhibitors, Piperidines chemistry, Piperidines pharmacology, Protein Kinase Inhibitors chemistry, Protein Kinase Inhibitors pharmacology, Protein Kinase Inhibitors therapeutic use, Psoriasis drug therapy, Psoriasis metabolism, Psoriasis pathology, Pyrimidines chemistry, Pyrimidines pharmacology, Pyrroles chemistry, Pyrroles pharmacology, Signal Transduction drug effects, Skin Diseases metabolism, Skin Diseases pathology, Vitiligo drug therapy, Vitiligo metabolism, Vitiligo pathology, Janus Kinases metabolism, Piperidines therapeutic use, Pyrimidines therapeutic use, Pyrroles therapeutic use, Skin Diseases drug therapy
Abstract

Background: Tofacitinib (formerly known as CP-690,550, CP690550, tasocitinib), a novel selective immunosuppressant, is a small molecule classified as Janus kinase inhibitor. The aim of this review article is to present updated data summary on the tofacitinib in the field of dermatology., Method: We undertook a structured search of bibliographic databases for peer-reviewed scientific articles, including review articles, original research articles as well as case report articles based on inclusion/exclusion criteria. Technical reports on tofacitinib from U.S. Food and Drug Administration and European Medical Agency were also included., Results: Forty-three papers were included in this review. We report current data on tofacitinib chemical properties, pharmacology, non-clinical toxicity, as well as efficacy and safety in potential new indications in dermatology: psoriasis, alopecia areata, vitiligo, atopic dermatitis and nail dystrophy associated with alopecia areata., Conclusion: JAK/STAT pathway has an important role in the pathogenesis of psoriasis, alopecia areata, atopic dermatitis, and vitiligo. Despite encouraging efficacy, due to concerns about the overall safety profile of tofacitinib, additional studies will have to determine the adequate risk-to-benefit ratio., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Published
2017
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25. Topical Ingenol Mebutate: A New Treatment Modality for Multiple Actinic Keratoses and Field Cancerization.

Author

Kostovic K, Gulin SJ, Mokos ZB, and Ceovic R

Subjects
Antineoplastic Agents chemistry, Diterpenes chemistry, Dose-Response Relationship, Drug, Humans, Molecular Structure, Structure-Activity Relationship, Antineoplastic Agents pharmacology, Diterpenes pharmacology, Keratosis, Actinic drug therapy, Neoplasm Recurrence, Local drug therapy
Abstract

Background: Ingenol mebutate gel is a recent stirring weapon recommended for the treatment of multiple actinic keratoses (AKs) and field cancerization. This review brings a summary of recent data on the treatment of AKs with ingenol mebutate (IM) providing critical commentary with regard to drug's characteristics, drug's safety profile, treatment regimen, treatment outcome, patient compliance, AK recurrence, costeffectiveness and cost-utility, as well as guidelines for the management of the treatment of AK., Method: We undertook a structured search of bibliographic databases for peer-reviewed scientific articles, including review articles, original research articles as well as case report articles based on inclusion/exclusion criteria. Reports on ingenol mebutate from U.S. Food and Drug Administration and European Medical Agency were also included., Results: Sixty-six papers were included in this review. We report current data on ingenol mebutate chemical properties, pharmacology, efficacy, safety, and tolerability, potential new indications in dermatology, costeffectiveness, and cost-utility analysis., Conclusion: Treatment of AKs is necessary in order to prevent possible transition to invasive SCC. Although the mechanism of action of ingenol mebutate is not fully elucidated, dual mechanism of action is presumed. Ingenol mebutate is an effective and cost-saving topical agent for the treatment of AK, especially multiple AKs and field cancerization, with acceptable safety profile. It may also have perspective in dermatology regarding the treatment of superficial BCC, Bowen disease, actinic cheilitis, and anogenital warts that has to be evaluated in clinical trials. Patients' adherence to recommended treatment regimen and auspicious safety profile make this drug attractive., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Published
2017
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26. Radiotherapy of primary cutaneous follicle center lymphoma: case report and review of literature.

Author

Ceovic R, Jovanovic I, Kostovic K, Rados J, Dotlic S, Radman I, Kulisic SM, and Loncaric D

Subjects
Humans, Male, Middle Aged, Dose Fractionation, Radiation, Lymphoma, B-Cell radiotherapy, Skin Neoplasms radiotherapy
Abstract

Primary cutaneous follicle center lymphoma is an indolent primary cutaneous B-cell lymphoma originating from the follicle center cells, composed of a combination of centrocytes (small and large cleaved cells) and centroblasts (large noncleaved cells) with a follicular, follicular/diffuse, or diffuse growth pattern. Lesions are mostly located on the head, neck and trunk. A case is presented of a 56-year-old male patient with primary cutaneous follicle center lymphoma, with lesions involving the skin of the back, shoulders, presternal area and right forearm. As the patient presented a disseminated cutaneous form of the disease that involved several anatomical regions, complete work-up was followed by superficial fractionated radiotherapy of eight fields in VI expositions, with total irradiation dose of 1400 cGy upon the following fields: right and left pectoral region, left and right shoulders, right suprascapular region, and proximal third of the right forearm. Total irradiation dose applied upon each field for the lesions located on the left and right side of the back was 1500 cGy. This therapy resulted in significant reduction of visible tumor. The patient was regularly followed up on outpatient basis for 12 months of radiotherapy, being free from local recurrence and systemic spread of the disease.

Published
2013
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27. Psoriasis: female skin changes in various hormonal stages throughout life--puberty, pregnancy, and menopause.

Author

Ceovic R, Mance M, Bukvic Mokos Z, Svetec M, Kostovic K, and Stulhofer Buzina D

Subjects
Female, Humans, Male, Menopause physiology, Pregnancy, Psoriasis complications, Puberty physiology, Psoriasis physiopathology, Skin pathology, Skin Physiological Phenomena
Abstract

Psoriasis is one of the most prevalent immune mediated skin diseases worldwide. Despite the large prevalence in both men and women, the pathogenesis of this disease has not yet been fully clarified. Nowadays, it is believed that psoriasis is most likely a T helper Th1/Th17 induced inflammatory disease. Stressful life situations are known to cause flare-ups and psoriasis activity may be linked to stress from major life events. We know that stress greatly affects both the hormone and immune systems and that there are many different hormonal phases throughout a woman's lifetime. The severity of psoriasis may fluctuate or be influenced by each phase and this relationship can be seen as disease frequency seems to peak during puberty, postpartum, and menopause when hormone levels fall, while symptoms improve during pregnancy, a state when hormone levels are increased.

Published
2013
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