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Stamatis Gregoriou, Ourania Efthymiou, Christina Stefanaki, Dimitris Rigopoulos 2nd Department of Dermatology and Venereology, University of Athens Medical School, Attikon Hospital, Athens, Greece Abstract: The main objective in the treatment of pemphigus vulgaris is to control the disease, prevent relapses, and avoid adverse events associated with the prolonged use of steroids and immunosuppressive agents. Systemic corticosteroids remain the gold standard treatment for pemphigus vulgaris. Azathioprine and mycophenolate mofetil are the first line of steroid-sparing treatment. Rituximab is extremely effective in recalcitrant pemphigus, when other treatments fail to control the disease. The European Dermatology Forum recommends tapering prednisolone by 25% every 2 weeks after the consolidation phase, and a 5 mg reduction every 4 weeks when the dose is reduced to

Objectives This study aimed to characterize the spectrum of skin diseases affecting children in Greece. Methods We retrospectively studied data for 4071 children, aged 0-12 years, who were examined and diagnosed with dermatoses at the outpatient clinic of a university dermatological hospital between December 2005 and August 2007. To evaluate changes in disease patterns, these data were compared with data for a cohort of 12,700 children diagnosed with skin diseases at the same clinic two to three decades earlier (in 1977, 1980, and 1983). Results The most frequent disease was dermatitis/eczema (34.7%), with atopic dermatitis found in 20.7% of children, contact dermatitis in 6.9%, pityriasis alba in 2.1%, and seborrheic dermatitis in 1.8%. Infections (19.3%), nevi (5.6%), scabies (4.8%), and insect bites (4.3%) followed. More viral (12%) than bacterial (3.7%) and fungal (3.6%) infections were noted. Warts constituted 53.2% of viral infections. Immigrants had an increased risk for bacterial infections and scabies. Conclusions Children diagnosed with skin diseases 24-30 years earlier were younger; exhibited lower prevalences of dermatitis/eczema (P = 0.01), viral infections (P < 0.001) and nevi (P < 0.001); higher prevalences of bacterial and fungal infections (P < 0.001) and insect bites (P < 0.01); and similar rates of scabies (P = 0.17). This study documents the high prevalence of atopic dermatitis in the region, the increasing incidence of viral infections and nevi, and the continuing problem of scabies, especially in immigrants.

Background: Narrowband UVB (NB-UVB) phototherapy is considered an accepted therapy for vitiligo. Objective: We sought to estimate the effectiveness of NB-UVB in patients with vitiligo, identify predictive factors of response, and assess the stability of NB-UVB-induced repigmentation. Methods: In all, 70 patients with vitiligo were treated twice weekly with NB-UVB. Results: Cosmetically acceptable (>75%) repigmentation was achieved in 34.4% of patients with lesions on the face and in 7.4% of patients with lesions on the body. Patients with phototypes III to V had a greater chance to achieve greater than 75% repigmentation on the face. Patients who responded in the first month of treatment were more likely to achieve better repigmentation rates. Repigmentation was stable in 14.3% of patients 4 years after cessation of treatment. Limitations: The study was uncontrolled. Treatment frequency was twice weekly. These results may not be representative of different treatment regimens. Conclusion: Patients with vitiligo who have lesions on the face, darker phototypes, and early response to treatment have a greater chance to achieve satisfactory repigmentation after NB-UVB phototherapy.

Our purpose was to investigate the human papillomavirus (HPV) type distribution using the Hybrid Capture 2 (HC2) Microplate assay in males. We tested a urethral swab from 550 HIV-negative males with genital warts and 64 HIV-negative males clinically free of genital warts, partners of HPV-infected females, using the HC2 Microplate assay. A perianal swab was also obtained from patients with perianal warts. In the first group, HPV DNA of any type was detected in 280 (50.9%) patients. Relatively few patients with urethral or perianal warts demonstrated a negative test (both P < 0.0001). Low-risk types were commoner, accounting for 60.0% of the HPV cases, high/intermediate-risk types accounted for 23.6%, while 46 men (116.4%) were infected with both types. Of 13 subjects (20.3%) of the second group who tested positive for HPV DNA, 61.5% were infected by low-risk types, 23.1% by high/intermediate-risk types and 15.4% had a dual infection. In conclusion, male partners of infected females and males with genital warts are predominantly infected by low-risk HPV types, but a substantial proportion is also or only affected by high-risk types.

In general, steroid hormones exert their effects through intracellular receptors, the glucocorticoid (GR), mineralocorticoid (MR), androgen (AR), estrogen (ER), and progesterone (PR) receptors. In this brief review, we will focus on glucocorticoid and sex hormone actions in the skin through their distinct receptors and discuss their clinical relevance.