Search

Introduction/Objective. The aim of this study was to evaluate psoriasis severity and psoriatic arthritis (PsA) as metabolic syndrome (MetS) and insulin resistance (IR) predictors in patients with chronic plaque psoriasis as well as to evaluate if psoriasis severity and PsA are independent predictors for IR regardless of the MetS presence. Methods. This prospective, observational descriptive cross-sectional study was conducted at Dermatovenereological Clinic of the University Clinical Centre of Vojvodina, and included a total of 105 psoriasis patients divided into three groups: group with mild psoriasis (Psoriasis Area Severity Index – PASI score < 10), group with moderate to severe psoriasis (PASI ≥10), and group with PsA diagnosed on the basis of the CASPAR criteria. Results. Percentage of patients who had MetS was higher in the group with the severe form of psoriasis (p < 0.05) as well as IR (p = 0.05). PsA was also more frequently associated with MetS (p = 0.05) and IR (p < 0.01). In patients without MetS, no association between psoriasis severity and IR was found (p = 1.0), although there was a positive correlation between PASI and index of β-cells secretory capacity % (HOMA B), which shows tendency for IR development. The association between PsA and presence of IR in patients without MetS was statistically significant (p < 0.05). Conclusion. MetS and IR prevalence increases in patients with PsA and in patients with the moderate and severe form of chronic plaque psoriasis. Both psoriasis severity and PsA are independent predictors for IR regardless of the MetS presence.

Introduction/Aim. Psoriasis is a common, chronic, immune-mediated, inflammatory and proliferative skin disease in which both genetic and environmental influences have a role in its pathogenesis. The relationship between psoriasis and obesity is probably bidirectional. The aim of this study was to evaluate the association between psoriasis and obesity, whether a quantitative graduation of overweight using Body Mass Index (BMI) shows direct correlation with various clinical variants of psoriasis, disease duration and having positive family history of psoriasis. Methods. This prospective, observational descriptive cross-sectional study included 120 psoriatic patients who were referred to Clinic of Dermatovenereology at the University Clinical Centre of Vojvodina. Clinical variants of psoriasis were determined. Age, gender, duration of the disease, BMI and family history of psoriasis were measured and compared. Results. In total, 53.3% males and 46.7% females were included in this study. The mean age was 49.5 ± 15.5 years. The most present clinical variants of psoriasis were psoriasis vulgaris (55%) and psoriatic arthritis (30%). Most of the patients (42.5%) were overweight, 23.3% were obese, and 1.7% were morbidly obese. The mean BMI was high (27.7 ± 5.2). Mean duration of the disease was 15.6 ± 14.9 years. Positive family history of psoriasis was found in 33 (27.5%) patients. Conclusion. There was no correlation between the BMI and gender of the patients, psoriasis clinical variants, duration of the disease and positive family history of psoriasis. The slight positive correlation was found between BMI and age of psoriatic patients. That requires further studies that include physical activities questionnaire, considering that lack of physical activities in older patients might be an explanation.

Background/Aim. Development of allergic contact der-matitis as a complication of treatment of chronic venous insufficiency (CVI) is well known. The aim of this study was to determine the incidence and risk of eczematous contact sensitization in patients with CVI, as well as the correlation between disease duration and contact sensitization. Methods. The study involved 266 subjects examined during three-year-period who were divided into two groups: the study group included patients with CVI referred for allergy testing due to suspected contact dermatitis, and the control group included the ones without CVI patch tested for suspected contact dermatitis. The severity of CVI was assessed by Clinical Etiology-Anatomy-Pathophysiology (CEAP) classification. Thereafter, each patient underwent patch testing. Results. The incidence of contact sensitization among patients with CVI was 49.3%. In these patients, the incidence of contact sensitization to the European standard battery of allergens was 31.55%; to the battery specific for CVI it was 28.45%. Patients with CVI had a 2.45-fold higher risk for developing contact sensitization to two or more allergens, and a 3.69-fold higher risk for developing contact sensitization to five or more allergens compared to those without CVI. The prevalence of contact sensitization in patients with CVI was not significantly different from those without CVI. There was a positive correlation between the incidence of contact sensitization and the duration of the disease. Conclusion. Patients with CVI had no statistically significantly distinct contact sensitization prevalence and had 2.45 and 3.69 times higher risk to manifest contact sensitization to two and more allergens and five and more allergens, respectively, than patients with no CVI. The positive correlation between frequency of contact sensitization and disease duration was found.

Background: The use of alternative treatment methods, particularly medicinal herbs from the family Compositae, significantly contributes to the increase in the incidence of allergic contact dermatitis among patients with chronic venous insufficiency. Objective: Estimating frequency of contact sensitization among patients with chronic venous insufficiency and determining the most common contact sensitizers from the series of bio-origin allergens from the Compositae family and ubiquitous weeds of Vojvodina. Materials and Methods: The total number of 266 patients with suspected contact dermatitis was divided into two groups: the experimental group consisted of patients with chronic venous insufficiency (EG), and the control group consisted of patients without chronic venous insufficiency (CG). All subjects were tested with allergens of biological origin from the family Compositae, screening allergen SL-mix and original extracts of ubiquitous weed plants of Vojvodina. Results: Patch test revealed a positive reaction to allergens of the Compositae family in 6.69% in the experimental group, and in 4.17% in the control group. The standardized response rate to the SL-mix in the experimental group was 2.07%, while in the control group, it was 1.51%. The presence of a positive reaction to at least one extract of ubiquitous weed plants of Vojvodina was determined in 6.11% in the experimental group, and in 3.23% of patients in the control group. No statistically significant difference in response rates was found between the examined groups. Conclusions: Establishing the diagnosis of Compositae dermatitis can be supplemented by additional testing with weed plant extracts from a specific geographical area, resulting in the detection of novel unknown allergens.

Introduction. Hydroxyurea (HU) is a cytostatic agent, frequently used for the treatment of myeloproliferative disorders, sickle cell anemia and severe forms of psoriasis. Cutaneous side effects occur in up to one third of patients taking hydroxyurea, with the most serious side effect being susceptibility to develop non-melanoma skin cancers. Case report. We report 3 patients using HU that have developed multiple skin malignancies on the head and neck region and dorsa of the hands, arranged according to the level of the overall squamous dysplasia expressed. Conclusion. A cumulative dose of hydroxyurea affects skin cancer promotion in concordance with other risk factors determining cumulative ultraviolet exposure (age of the patients, skin phototype, sun habits), but the exact influence of each of them and enrollment of other possible cofactors remains to be elucidated. We point out the importance of adequate skin cancer preventive and therapeutic approach to the patients treated with hydroxyurea.

Background/Aim. Treatment of psoriasis is very complex and there are no still universal, nor unique treatment modalities. Apart from conventional treatment, which includes topical calcipotriol (vitamin D3 analogue), balneotherapy is drawing increased attention worldwide. Being part of climatotherapy, balneotherapy is defined as the use of natural environmental factors in the treatment of health conditions, whereas in the treatment of psoriasis it means the use of mineral baths and peloids. The aim of this study was to examine the therapeutic efficacy of mineral waters and peloids of the Rusanda Spa on plaque psoriasis in patients also treated with calcipotriol. Methods. The study included 60 patients divided into two groups. The first group included patients treated with mineral waters, peloids and calcipotriol in the Rusanda Spa, while the second one included those treated only with calcipotriol. The study took 21 days, and each patient was followed up for at least one month after ending the treatment. The treatment efficacy was measured by psoriasis area severity index (PASI) scores on the days 0, 7, 14 and 21 during the treatment and 30 after the end of the therapy. Results. After a 3-week treatment in the Rusanda Spa, the first group showed a decrease in PASI score by 59.45%, whereas in the group of outpatients treated by calcipotriol it was 39.34%. On the day 30 following the treatment, the first group presented with the PASI score reduction of 58.44%, and the second group of 34.78%. The therapeutic efficacy of mineral waters and peloids combined with calcipotriol showed to be significantly higher in regard to monotherapy with calcipotriol (p < 0.05). In regard to clinical symptoms, the best results were obtained in the reduction of desquamation (p < 0.001). Conclusion. The results of our study show that in the treatment of plaque-type psoriasis, topical calcipotriol combined with Spa Rusanda balneotherapy is more effective than topical calcipotriol alone. Randomized controlled trials are needed to confirm the effects of balneotherapy as monotherapy in treatment of this type of psoriasis.

The authors present the results of the systemic application of flukonazole in therapy of Pityriasis versicolor. It was arranged for the total number of 38 patients, 18 females and 20 males. The diagnosis of diseases was established on the base of the clinical examination, the native mycological examination and by the using of Wood lamps. The therapy was passed by the using of 300 mg flukonazole in a single dose, once weekly, during two weeks. The following period amounted to one week after the passed therapy. The therapeutic efficacy was assessed with regard to the clinical and mycological healing. The clinical efficacy was assessed semiquantitative on the base of increasing of the percentage rates of the total score of disease that was computed by collecting of the numeric values for every clinical argument typical for the disease, and the mycological efficacy on the base of the mycological findings and the fluorescence finding after lightening with the Wood's lamp. The controlling examinations were performed on day 0, 14 and 22. The results of investigations have shown that the complete clinical healing was achieved after two weeks of therapy in 94,74%, and the mycological healing in 92,11% patients. The rate of the mycological healing was evaluated after 1 week of following period equal to the rate of the clinical healing and it was also 94,74%. The undesirable effects of the drug applications weren't by any patient.

Lobular panniculitis is a skin condition that may be the first sign of underlying pancreatic disease. Though rare, the condition has been sufficiently well defined and pathognomonic, thus making differentiation from idiopathic lobular panniculitis quite possible. A 77-year-old woman was in apparently good general health condition when developed skin lesions in a form of erythematous painful fluctuant nodules localized predominantly on the breast, but also present on the arms, thighs, and trunk. Her serum and urinary amylase levels were respectively 3 and 8 fold higher than normal. On histology, skin biopsy showed acute lobular panniculitis with large foci of adipocyte necrosis. Examination of the breast excluded any specific process other than nodular subcutaneous inflammation, but revealed a tumor of the pancreatic head. The nodules spontaneously ulcerated exuding an oily thick brownish material. Her condition deteriorated, and she became progressively debilitated. The patient died before operation, within the next 3 weeks. Subcutaneous fat necrosis was the first manifestation of an otherwise occult pancreatic disease with fatal outcome.

Background/Objectives: Adequate knowledge and correct attitudes about the HPV vaccine influence awareness of the importance of preventing HPV-related diseases, which is particularly important for future healthcare professionals. We aim to examine the share of correct answers and the prevalence of different attitudes about the HPV vaccine among active regular students of the Faculty of Medicine in Novi Sad. Methods: A cross-sectional study was conducted from 1 to 30 November 2023 using a structured survey questionnaire. Results: A total of 1760 students were included, of which 78% were female, with an average age of 21 years. Students who participated in prior HPV education) demonstrated significantly higher knowledge (81.92% vs. 65.60%, p < 0.001) and were more likely to recommend the vaccine to patients (89.91% vs. 82.99%, p < 0.001). Almost all vaccinated students (99.41%) would recommend the vaccine, compared to 82.91% of unvaccinated students (p < 0.001). Students who actively sought HPV information also showed a higher likelihood of recommending the vaccine (93.05% vs. 83.02%, p < 0.001). Moreover, those with sufficient self-assessed knowledge were more inclined to recommend the vaccine (89.88%) than those with insufficient knowledge (81.66%, p < 0.001). The analysis demonstrated that an increase in the number of correct answers in the knowledge evaluation corresponds to higher odds of recommending the HPV vaccine to patients (OR = 1.23, 95% CI 1.17–1.28). Positive attitudes prevailed, with 68.89% supporting more education on HPV vaccination. Conclusions: Students who previously attended education on HPV infection/vaccination and those who would recommend the vaccine have significantly higher levels of knowledge. The study highlights the importance of HPV-related education in shaping future healthcare professionals' attitudes and knowledge. [ABSTRACT FROM AUTHOR]

Introduction. In contact with insects, people present a wide range of reactions, local or systemic, whether caused by insect bites or a venom injections, sucking blood or exposure to insect's body and its secretions. Simulium erythrocephalum is an aggressive anthropophilic species, and following its bite humans may develop purpuric macules, edema and erythema surrounding the bite site. Our case series indicates frequent occurrence of Simulium erythrocephalum bites in Serbia. Case Series. We present a series of 30 cases reviewed between April and July 2006, who developed a local reaction at the site of this insect's bite. In all patients, the skin lesions were located on the extremities, mainly the lower legs. The number of bites varied from two to more than ten. In all patients the bites occurred either during outdoor activities on the riverside or their residence was near the Danube. The therapy with antihistamines, local and/or systemic corticosteroids, as well as symptomatic therapy, with compression and limb elevation was recommended. The skin lesions regressed in one week in most patients, but in few they lasted for several weeks. Conclusion. In addition to its impact on human health, Simulium erythrocephalum also has a role in veterinary medicine. Insect bites in animals can cause significant livestock losses, occasionally resulting in animal mortality. Apart from this, Simulium erythrocephalum may also be a vector in the transmission of the parasite from the genus of Leucocytozoon that infests birds. [ABSTRACT FROM AUTHOR]

Introduction Sexually transmitted infections (STIs) are major global public health problems. Present strategies for prevention have limitations. Vaccines are an attractive addition to the current prevention armamentarium because they provide durable protection and do not require repetitive adherence to be effective. Challenges for vaccination include induction and long- term maintaince of mucosal immune responses in the female genital tract. Vaccines: a realistic goal? For the time being, US Centers for Disease Control and Prevention have recommended only hepatitis and HPV immunization to be routinely offered. Final, III stage trials are underway on other prophylactic vaccines for human papillomavirus and genital herpes. Though vaccines against Chlamydia trachomatis and Neisseria gonorrhoeae are in early stages of development they do offer the hope of preventing pelvic inflammations. The high incidence of HIV-infection for which a vaccine would not be readily available, "cries out" for an effective vaccine. Vaccines for HPV infections According to a recent meta-analysis of worldwide prevalence data, vaccinating with HPV-16/18 VLP against HPV-16 and HPV-18 could prevent over 70% of invasive cervical cancer worldwide. The latest release of data from the phase III trial of a quadrivalent recombinant non-infectious vaccine HPV-6.H 16/18 LI VLP, including HPV types 6.11.16.18 have given complete protection against HPV-16/18-related cervical intraepithelial neoplasias 1, 2/3. and adenocarcinoma in situ and cancer through 2 years of post-vaccination follow up. Conclusion Despite the fact that the development of vaccines for STI prevention was rather slow in the past, the ideal vaccine would decrease transmission of the infection between partners and would prevent complications of disease. Moreover, in future decades, increasingly successful universal vaccination of new-borns and children will substantially reduce the need for vaccination of persons with specific risk factors, including sexual risk. [ABSTRACT FROM AUTHOR]

Introduction. Hypertensive ischemic leg ulcer, also known as Martorell ulcer, is not very rare, but an under-recognized type of leg ulcer. It has specific clinical and histopathological characteristics. It occurs almost exclusively in patients with arterial hypertension. It is more common in women and in patients with type 2 diabetes. It is localized particularly in the laterodorsal distal third of the lower leg. This ulcer is extremely painful. Its clinical features may very much resemble pyoderma gangrenosum. Case Report. We are presenting a case of a 40-year-old obese male, who suffered from arterial hypertension during the past 26 years. His ulcer appeared spontaneously on the lateral aspect of the right lower leg and progressed gradually. From the very onset, the ulcer was extremely painful. At first, it was diagnosed as pyoderma gangrenosum and treated with systemic corticosteroids and immunosuppressants. Since the response to therapy was not satisfactory, the histopathology was revised and the diagnosis of hypertensive ischemic leg ulcer was made. After initial wound debridement and local negative pressure therapy, split-thickness skin grafting was performed. The pain disappeared right away almost completely and complete epithelization was achieved two weeks after skin grafting. Conclusion. It is important to consider Martorell ulcer in hypertensive patients with extremely painful ulcers of the lower leg. In order to establish the appropriate diagnosis, it is essential to take a deep skin biopsy and correlate the finding with a specific histopathological picture. It is the only way not to confuse hypertensive ischemic leg ulcer with pyoderma gangrenosum, since the management of the two conditions is completely different. [ABSTRACT FROM AUTHOR]

Background/objectives: Adequate knowledge and correct attitudes about the HPV vaccine influence awareness of the importance of preventing HPV-related diseases, which is particularly important for future healthcare professionals. We aim to examine the share of correct answers and the prevalence of different attitudes about the HPV vaccine among active regular students of the Faculty of Medicine in Novi Sad., Methods: A cross-sectional study was conducted from 1 to 30 November 2023 using a structured survey questionnaire., Results: A total of 1760 students were included, of which 78% were female, with an average age of 21 years. Students who participated in prior HPV education) demonstrated significantly higher knowledge (81.92% vs. 65.60%, p < 0.001) and were more likely to recommend the vaccine to patients (89.91% vs. 82.99%, p < 0.001). Almost all vaccinated students (99.41%) would recommend the vaccine, compared to 82.91% of unvaccinated students ( p < 0.001). Students who actively sought HPV information also showed a higher likelihood of recommending the vaccine (93.05% vs. 83.02%, p < 0.001). Moreover, those with sufficient self-assessed knowledge were more inclined to recommend the vaccine (89.88%) than those with insufficient knowledge (81.66%, p < 0.001). The analysis demonstrated that an increase in the number of correct answers in the knowledge evaluation corresponds to higher odds of recommending the HPV vaccine to patients (OR = 1.23, 95% CI 1.17-1.28). Positive attitudes prevailed, with 68.89% supporting more education on HPV vaccination., Conclusions: Students who previously attended education on HPV infection/vaccination and those who would recommend the vaccine have significantly higher levels of knowledge. The study highlights the importance of HPV-related education in shaping future healthcare professionals' attitudes and knowledge.