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Classic Kaposi's sarcoma is primarily a skin disease of the lower extremities affecting predominantly elderly men of Mediterranean origin. We report classic Kaposi's sarcoma first presenting in the third decade in two heterosexual, HIV-negative, males of Greek origin from Albania. Ten years after onset, the disease became aggressive with unusual clinical features that included exophytic tumors, extensive lesions on the hands as well as the legs, and prominent leg edema. One of the patients also presented lesions on the face, trunk and palate, and bubonic lymphadenopathy. In both cases, CD4 counts were normal and HLA-DR5 was positive. Treatment included radiation therapy, subcutaneous interferon (alpha -2b) and combined chemotherapy (ABV). At follow up 1 and 2 years later, both patients remain in partial remission with significant improvement in clinical disease, on maintenance interferon.

To determine the incidence rates and to describe the epidemiological patterns of non AIDS Kaposi’s sarcoma in the central southern area of Greece during the period 1974-1989, all 473 incidence cases reported to Pathology Departments were studied, The mean age (SD) was 67.6 (12.9) years among 297 males and 66.1 (15.9) years among 176 females. The mean age-standardized (Greek population 1981) incidence rate was 0.47 cases per 100,000 total population per year (males 0.62, females 0.32), The standardized incidence rates increased over time for males, with the incidence-rate ratios relative to the earliest period, 1974-1978, being 1.44 (95% CI, 1.02-2.04) for the 1979-1983 interval and 2.12 (95% CI, 1.55-2.90) for the 1984-1989 interval, However, the rates for females did not show a similar pattern, The age-adjusted male:female ratio was 1.6 in 1974-1983 and 2.6 in 1984-1989, Poisson-regression modelling suggested a shift in the age-specific incidence rate in men, towards younger ages during the last period. (C) 1997 Wiley-Liss, Inc.

Objectives: To examine the nature of psychopathology of children with alopecia areata (AA) and to investigate the frequency and quality of life events in the year before AA developed in comparison with a control group. Method: Thirty-three subjects with AA, mean age 10.5 +/- 0.3 years, were compared with 30 controls who visited a pediatrician for a mild condition. In addition, 16 preschool children with AA were compared with 17 preschool children who visited the pediatrician for a mild condition. The following measures were used: Child Psychiatric Interview, Children’s Depression Inventory (CDI), Children’s Manifest Anxiety Scale (CMAS), Life Events Scale for Children, and Child Behavior Checklist (CBCL). Results: On the CBCL, children with AA had more psychological problems, in total, than controls, and in particular, they were more anxious or depressed, withdrawn, aggressive, and delinquent. They also had more somatic problems as well as problems in social relations and in attention. Girls with AA seem to have been affected more in dimensions of total problems, anxiety/depression, and internalizing/externalizing syndromes. In terms of anxiety (CMAS), more children with AA than controls seemed to worry and to have difficulties in concentration and physiological symptoms of anxiety. In the Child Psychiatric Interview, all children with AA exhibited symptomatology of anxiety or depression or both, usually of a mild or moderate nature. Major depression was not detected through the CDI. Fewer children with AA had positive life events the year before AA than controls in a similar time period. Conclusions: Compared with controls, children with AA had more psychiatric symptoms in general and symptoms of anxiety or depression, or both, in particular. There is also evidence that lack of positive life events in the prealopecia period played a role in their lives. Psychiatric assessment, and if necessary treatment, is warranted for all children with this condition.

Fifty-four (54) unrelated patients with Mediterranean Kaposi’s sarcoma (MKS) and 8 patients members of 4 unrelated families with familial MKS were serotyped for HLA-A,B and DR antigens. The diagnosis was histologically confirmed and all patients were negative for anti-HN antibodies. An increased frequency of HLA-B18 (44.4% vs 14.2% in the controls, p

Background PUVA has become a preferred method of treatment for vitiligo and psoriasis. However, 8-methoxypsoralen (8-MOP) as well as a high galactose diet may cause liver and kidney function damage and enhance cataract formation. Patients and Methods Twenty one patients aged 32 ± 2.6 yrs with vitiligo (N = 11) or psoriasis (N = 10) underwent eye-examination, liver and kidney function tests and galactose + galactose 1-phosphate (gal + gal P) blood evaluation using Porton-Cambridge Ltd reagents, before and after the 12th PUVA treatment during a 35-40 day study. Results All these functional tests including eye-examination were normal before and after commencing therapy. However, the mean gal + gal P blood levels (1.29 ± 0.41 mg/dl) were statistically elevated (2.95 ± 0.42 mg/dl) at the end of the study. It is suggested that 8-MOP either impairs liver function or acts as an inhibitor of the enzymes responsible for galactose metabolism. We propose gal + gal P blood estimation in all patients before and, at intervals, after the initiation of PUVA therapy in order to prevent as early as possible an additional risk factor for liver or kidney dysfunction as well as cataract formation. © 1995.

The examination of the role of the atmospheric circulation in the lower stratosphere in relation to the vertical ozone structure in the subtropical atmosphere is attempted. This analysis is based on the vertical ozone profiles collected by balloon-borne sondes released at Athens, Greece (38°N, 24°E), throughout the time period 1989–1994. The occurrence of the laminated ozone structure as well as the appearance of the characteristic ozone minima, correlated with the general circulation, leads to the following results: (a) The laminated ozone profiles are associated with the north-Northwest circulation in the lower stratosphere; and (b) the characteristic ozone minima are related to the influence of the subtropical jet stream circulation. These results have recently been reported in the literature by using ozonesoundings for the time period 1989–1992. The present study confirms these results by using the entire data set of ozonesoundings up to 1994. © 1995, Taylor & Francis Group, LLC. All rights reserved.

Cyclosporin (CyA) was used to treat 13 patients suffering from allergic cutaneous vasculitis (AVC) with multiple recurrences. CyA at a dose of 5 mg/kg was administered orally for the first 2 months. For the following 4 months, CyA at a dose of 2.5 mg/kg alone or in combination with prednisolone was used, depending on the clinical response. Clinical and laboratory examinations were performed once weekly throughout the study period. Seven patients remained in excellent condition under CyA (2.5 mg/kg) monotherapy. Three patients showed an excellent response to the combination of CyA (2.5 mg kg) and prednisolone (10 mg/24 h). Finally, in three patients the treatment was discontinued during the first month because the creatinine level increased by more than 30% of the initial value. This study shows that CyA alone or in combination with prednisolone is an effective treatment for ACV with multiple recurrences. © 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

Measurements of the ultraviolet region of the solar spectrum have been made at Argolida, location not influenced by air pollution, southeast Greece (37.5°N, 24°E), since July 1993. The data presented here show the daily and monthly variability within the ultraviolet-B wave band and its relation to total ozone amount during the summer - fall period, mainly characterized by the lowest total ozone values ever observed at the Southern Europe, since 1978. © 1994, Taylor & Francis Group, LLC. All rights reserved.

The objective of the present study was an extensive analysis of the autoantibody profile in the most common subsets of cutaneous lupus erythematosus (LE), acute and subacute cutaneous lupus erythematosus (ACLE, SCLE) as well as discoid lupus, localized or disseminatus (DLE loc, DLE dis). Antibodies (Abs) against glomerular extracts, actin. myosin and cardiolipin were examined in the various cutaneous lupus subgroups, in addition to ANA and Abs against DNA, ENA and IgG (rheumatoid factor). Abs against glomerular extracts were detected mainly in ACLE and SCLE, whereas Abs against actin, myosin and cardiolipin were found in all cutaneous lupus subsets. The detailed record of the autoantibody profile helped in the serological differential diagnosis of the various cutaneous lupus subsets, suggesting also that SCLE and DLE dis are distinct subsets in the spectrum of cutaneous LE. Finally, correlations between autoantibodies of the same isotype were carried out, providing implications for regulation of autoantibody production. Copyright © 1994, Wiley Blackwell. All rights reserved

With the depletion of the stratospheric ozone layer, the atmosphere became more transparent to solar ultraviolet radiation. The penetration of this radiation is also affected by tropospheric ozone, aerosol, and clouds. Increases in tropospheric ozone may have decreased the levels of the solar ultraviolet radiation in industrialized regions by amounts comparable to the increases estimated from stratospheric ozone change. Using the surface ozone mixing ratios monitored in Athens, Greece from the beginning to the end of the 20th century, the estimation of the reduction of the solar ultraviolet reaching the ground is attempted. © 1994, Taylor & Francis Group, LLC. All rights reserved.

Surface ozone mixing ratios based on the coloration of De James test papers were monitored in Athens from 1931 to 1940. Taking into account the findings of recent laboratory experiments on the response of such test papers to variations in humidity and in duration of outdoor exposure, a re-evaluated historic ozone series is presented. Furthermore, the assocation of the wind field with the surface ozone variations is examined. Strong indications of protochemical ozone production at that time are detected and the possible relevant atmospheric processes are discussed. Furthermore the influence of the temporal surface ozone variations on the solar ultraviolet radiation reaching the ground is investigated. © 1994, Taylor & Francis Group, LLC. All rights reserved.

Forty-five patients with tinea corporis or tinea cruris were treated with oral itraconazole 100 mg daily for 15 days. At the end of the 15-day treatment, 80% of the patients were healed or had markedly improved. At the first follow-up visit, 2 weeks after stopping therapy, 80% of patients were considered responders. An additional follow-up visit another month later (i.e. 6 weeks post-treatment) showed that 32 of 41 patients had responded (78%). Overall, the mycological cure rate (culture and microscopy negative) was somewhat lower than the clinical response rate. Only three patients reported minor side effects (7%). Nausea was reported by two patients and an urticarial reaction was seen in one patient after 8 days treatment. This latter patient discontinued therapy because of the adverse experience. It is concluded that itraconazole, given at a daily dose of 100 mg for 15 days, is effective in the treatment of tinea corporis and tinea cruris. Response rates at the last visit (6 weeks post-therapy) remained at the same satisfactory levels as at the first follow-up visit (2 weeks post-therapy), even though treatment was stopped after 2 weeks. Itraconazole appears to be well tolerated by patients. These results, both in terms of efficacy and side effects, are in line with results reported by other investigators. The fact that the mycological cure rates were somewhat lower than the clinical response rates had apparently no influence on the relapse rate at 6 weeks follow-up post-therapy.

Objective: Monitoring HIV infection in sentinel populations of sexually transmitted disease (STD) patients in several geographical areas. This paper describes the main characteristics of the study populations and compares HIV seropositivity rates within and between networks in different subgroups: homo-/bisexuals, intravenous drug users (IVDU) and non-IVDU heterosexuals. Design: HIV testing is performed with informed consent in most networks. It is mandatory for STD patients in Hungary, while the English and Welsh, Scottish and French networks use unlinked anonymous testing. Setting: Eighteen networks in 17 European countries are participating in the study. The networks usually consist of STD or dermato-venereology clinics. Patients: Patients presenting at any of the clinic sites with a new episode of one or more of a selected list of 12 STD were eligible for the study. This study recorded a total of 36827 STD episodes, registered between June 1990 and December 1991. HIV test results were known for 33004 (89.6%) of the patients. Results: HIV seropositivity rates were usually much higher for the homo-/bisexual and IVDU patients than for the non-IVDU heterosexuals. However, HIV-seropositive patients were found among non-IVDU heterosexuals in all but the Czech network. Conclusion: This Concerted Action has successfully launched an HIV sentinel surveillance programme among STD patients in 17 European countries using a standard methodology.

We have examined various autoimmunity parameters in AIDS with special emphasis on the expression of pemphigus and bullous pemphigoid antibodies. Sera from healthy seropositive individuals without syphilis (cs-, n = 17), seropositive individuals with syphilis (cs+, n = 11), and patients with AIDS (n = 6) were studied and compared with normal controls (n = 30); autoimmunity parameters related to dermatology were evaluated. Indirect immunofluorescence (IIF) for pemphigus and pemphigoid antibodies, antinuclear antibodies (ANA), anti-DNA antibodies, antismooth muscle antibodies (ASMA) antimitochondrial antibodies (AMA), and antithyroid antibodies (ATA) was carried out and findings were graded with a cumulative index (CI) for each patient group. Pemphigus and bullous pemphigoid-like antibodies (IgG, PV + BP) were detected in 33% of the AIDS patients. Statistically increased CI (P < 0.01) was found in the cs- group compared with the cs+ group and in the AIDS group compared with cs- (P < 0.01).

One hundred and sixty HIV‐infected Greek patients were prospectively examined and the oral signs and symptoms were recorded. At the time of oral examination, 76 patients were asymptomatic seropositive, 47 were in ARC stage and 37 had AIDS. One or more oral findings were recorded in 90.6% of the patients while a total of 33 different lesions were observed. The more common oral lesions (highly suspicious) were candidiasis (61%), hairy leukoplakia (24%), periodontitis (19%), necrotizing gingivitis (11%) and Kaposi's sarcoma (12%). In addition some unclassified lesions or symptoms (xerostomia 26%, burning mouth syndrome 19%, patchy depapillated tongue 16%, hairy tongue 10%, exfoliative cheilitis 4%), were common while submandibular and cervical lymph node enlargement were found in 49% of the patients. Interestingly in 16 patients (10%) the suspicion of HIV infection was exclusively based on oral lesions. Our findings show that oral signs and symptoms are common and some times early manifestations of HIV infection and it is in association to those reported in previous studies. Copyright © 1992, Wiley Blackwell. All rights reserved

Hereditary sensory neuropathies comprise a group of rare childhood diseases which are classified into four types. We present a Greek boy 11 years old with hereditary sensory neuropathy type IV (congenital sensory neuropathy with anhidrosis) whom we have followed up and studied during the last seven years. Our patient presented for the first time with recurrent hyperthermic episodes without sweating, and lack of pain sensation from the first months of life. Insensitivity to pain and thermal stimuli had resulted in burns on the extremities and self‐mutilation of the tongue, lips and fingertips. When he was five and seven years old respectively he had two painless fractures of the ankles which led to insoluble orthopedic problems. He also suffered from mental retardation, which was obvious from his first years of life. Sweat gland investigations showed significant hypohidrosis or anhidrosis although the sweat glands were normal microscopically. Hereditary sensory neuropathy type IV, although rare, is important for dermatologists because it must be differentiated from other anhidrotic syndromes, and in view of the poor prognosis of the condition. Copyright © 1992, Wiley Blackwell. All rights reserved

One hundred seventy-eight HIV-infected Greek patients were examined and the gingival lesions were recorded. At the time of oral examination, 77 patients were HIV positive, 53 had ARC, and 48 had AIDS. The mean age of the patients was 36.6 years; 158 were men and 20 were women. Fifteen different gingival lesions were recorded. Necrotizing gingivitis (10.1%), gingivitis (5.0%), periodontitis (18.5%), candidiasis (5.8%), and Kaposi’s sarcoma (5.0%) were the most common lesions observed. Oral lymphomas and other lesions were recorded in low numbers. Our findings show that dentists should be aware of gingival lesions of HIV disease because some of them are common and diagnostically important.

The purpose of this study is to present a new simple model algorithm for simulating the solar ultaviolet radiation reaching the surface of the Earth. The algorithm is capable of providing both the direct and diffuse solar ultraviolet radiation, for different atmospheric conditions, time, and geographic locations. An application of the model relates to the calculation of the minimum energy input of ultraviolet radiation to be received by a human to allow an erythema development. © 1991 Kluwer Academic Publishers.