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Biomedical subjects

M Poljacki

Publications and source records attributed to M Poljacki.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Personal experience with the use of 13-cis-retinoic acid in the therapy of severe forms of acne vulgaris].

The authors present the results of the study of the use of 13-cis-retinoic acid in the therapy of patients with a severe clinical form of acne. Twenty patients with a conglobate form of acne were included in the study. The drug was dosed in the initial phase of treatment at the dose of 0.5 mg/kg. During therapy the dose was reduced to 0.2 mg/kg depending on the clinical efficiency and appearance of unwanted effects. Therapy was conducted in the total duration of 16-20 weeks so that the patients received a mean drug dose of 0.31-0.60 mg/kg. The complete withdrawal of skin changes was registered in two patients (10%) after 12 weeks of therapy, in 15 patients (75%) after 16 weeks, and in 3 patients (15%) after 20 weeks of therapy. After the stop of drug action, the favorable effect was maintained from 2-12 months which was how long the patients were followed. The most frequently evidenced unwanted effects of therapy were dryness of the lip mucous membranes and skin. All unwanted therapy effects diminished or disappeared with drug dose decrease.

Acne Vulgaris↗
PubMed1990

[Parrot's method of angiostereometry in the evaluation of the status of chronic venous disease].

The authors present the results of capillary resistance measurements (CR) in three groups of examined subjects: with postthrombophlebitic syndrome, in patients with primary varicosis and in examined subjects which comprised the control group. We started from the fact that in more severe clinical conditions within venous insufficiency there also develop severe consequent conditions with the liberation of inflammatory reaction mediators in a greater extent than in the less severe cases and the assumption that in such patients CR is also lowered in the distant parts of the body. Angiostereometry by Parrot was the used technique. A total of 200 hundred persons was investigated. The examined subjects were divided into three groups. In group I there were 80 persons, all with the postthrombophlebitic syndrome which had the CR mean value of 15.26 cmHg (20.3 kPa). In group II there were 60 patients with primary varicosis, and the mean value of their CR was 17.7 cmHg (23.6 kPa). Group III had 60 examined subjects which comprised the control group, and their CR mean value was 19.90 cmHg (26.5 kPa). The difference was statistically significant. Capillary resistometry by Parrot is a very convenient method for the follow up and evaluation of clinical conditions of many diseases, as well as the follow up of therapy results. Due to all of its advantages it is superior to all stoppage methods such as Rumpel-Leed, for example.

Capillary Resistance↗
PubMed1989

[The importance of local administration of 5% 5-fluorouracil in the therapy of senile keratoses and basocellular carcinoma].

The results of the local application of 5-fluorouracil in the form of cream ("Efudix" Roche) in the therapy of senile keratoses and basocellular carcinomas were presented in this paper. A total of 205 changes of senile keratoses and 27 changes of basocellular carcinomas were treated in 90 patients. The cream was put on changes of senile keratoses without covering two times daily during a three--week period on the average up to the appearance of erosion. In cases of basaloma the cream was administered in the form of occlusive bandage with the duration of six hours each day. The treatment was undertaken until the appearance of ulceration and lasted three weeks. In all treated cases after the appearance of erosion and ulceration cream for epithelization was applied in further therapy. Out of all 232 treated changes either of senile keratosis or basaloma, successful treatment was attained in 230 (99.15%) cases and in only 2 cases of nodous basaloma successful treatment was not attained which accounted for 0.85% of treated lesions. Cosmetic results of the treatment were excellent. The appearance of relapse was not observed in any case during a three--year period.

Administration, Topical↗
PubMedDate not supplied

[Clinico-epidemiologic characteristics of superficial multiple basal cell carcinoma at the Dermatovenereology Clinic in Novi Sad 1986-1996].

INTRODUCTION: Multiple superficial basal cell carcinomas of the skin (MSBCC) appear as a rare clinical form of basal cell carcinoma (BCC) on the trunk. The aim of this paper was to display the clinical characteristics and frequency of superficial basal cell carcinomas on the trunk. MATERIAL AND METHODS: The examination was done on a 10-years material of the Department of Dermatological Oncology of the Dermatovenererology Clinic in Novi Sad (in the period 1986-1996). The examination included only MSBCC. RESULTS: In the 10-year period the total number of nonmelanotic malignant epithelial tumors of the skin (NMETS) was 2218 with 22 of MSBCC with total incidence of 0.99%. The average annual number of NMETS was 221.8. The average annual number of MSBCC was 2.2. In regard to the incidence of BCC of the skin in the same period, the total number of BCC of the skin was 1220, with the incidence of MSBCC 1.80%. The total number of changes of the superficial types BCC in the examined group was 110, and the average number of changes 5. The localization of MSBCC in the examined group shows the greatest number of tumors on the skin of the back (42--38.18%), hence thorax (29--26.36%), abdomen (25--22.73%) and the least on the presternum (14--12.73%). The average period from discovery of MSBCC in the examined group until the moment of inspection was about 2.5 years. In one case nevocellular syndrome was established, MSBCC was established in 35 patients, while in 80 cases these were different types of BCC of the face, capillitium, neck, trunk and extremitites. In the examined group 22.73% patients with positive familial anamnesis in regard to malignancy. Most were pensioners (11 cases--50.00%) mainly living in towns, while agriculturers are on the second place (7 cases--31.82%) mostly living in the village. In regard to the age, it appears that increasing number of patients are in the seventh decade of life. DISCUSSION: The recent literature data point to the genetic dispositions for MSBCC on the skin of the trunk, probably due to poorphotoexposition of the skin. CONCLUSION: Authors principally point to the genetic pre-disposition as the main etiological factor for MSBCC of the skin of the trunk. Professional or accidental photoexposition to ultraviolet radiation, also have a secondary role. The disease mostly affects the elderly and mostly males.

Aged↗
PubMedDate not supplied

[Persistent dyschromic erythema].

INTRODUCTION: Erythema dyschromicum perstans (ashy dermatosis) is a very rare skin disease included in the group of acquired, idiopathic hypermelanosis, with development of blue-gray macules. This disease appears more frequently in dark coloured persons, especially women in the first and second life decade. CASE REPORT: A male patient, 42 years of age, was admitted to Clinic of Dermatovenereology in Novi Sad due to appearance of slightly pruriginous, brown-reddish macules on the trunk, upper and lower extremities, without affecting the skin of the face, scalp, palm soles and visible mucous membranes. Later, the color of the macules changed into blue-gray and new lesions appeared in axilla and flexor side of the big joints, with active, erythematous and thin raised borders. Laboratory findings showed no abnormalities; antinuclear antibodies were negative. Histopathological examination of the skin specimens (which were taken from two different places) showed vacuolar degeneration of the basal cell layer, numerous pigmentophages in papillary dermis and presence of lymphohistiocytic infiltrate in dermis. No history of drug intake or exposure to UV light was established. DISCUSSION: Ashy dermatosis is included in the group of hypermelanosis of unknown origin. As possible etiological factors we can mention ingestion of ammonium nitrate, environmental pollution, hypersensitivity to cobalt chloride and postinflammatory pigmentation. Clinical characteristics: occurrence of blue-gray and gray macules on the trunk, face, neck and extremities (absence on the palms, soles, visible mucous membranes, scalp and nails). In the active phase of the disease, these macules are surrounded by erythematous and thin, raised borders. The lesions are mostly permanent. Due to clinical, histopathological, immunofluorescent and electron microscopy established similarities with lichen planus, it is considered that ashy dermatosis is a variant of lichen planus. Absence of previous drug intake, exposure to UV light, absence of the antinuclear antibodies, clinical picture and histological findings confirm the diagnosis of erythema dyschromicum perstans. CONCLUSION: This case of ashy dermatosis shows that there is a need for differential diagnosis of acquired skin pigmentations, because this dermatosis must also be taken into consideration.

Adult↗
PubMedDate not supplied

[The Koebner phenomenon, a prognostic sign of PUVA therapy effectiveness in patients with psoriasis vulgaris--yes or no?].

INTRODUCTION: Former investigations of Koebner phenomenon had demonstrated its higher incidence in patients with severe generalized and/or unstable forms of psoriasis which expressed increased resistance to various treatment modalities. The aim of this study was to establish the correlation between the presence of Koebner phenomenon and the PUVA therapy effects, total number of PUVA treatments, total dose of UVA radiation and the duration of remission after PUVA therapy discontinuation. MATERIAL AND METHODS: Sixty patients with severe clinical picture of psoriasis vulgaris, treated with PUVA therapy, were included in this research. According to the presence of Koebner phenomenon they were divided into two groups, 20 patients with positive and 40 patients with negative Koebner reaction, who were the control group at the same time. RESULTS AND DISCUSSION: 95% of patients treated with PUVA, were cleared of psoriatic changes in the Koebner positive, as well as in the Koebner negative group. There were also no differences between the Koebner positive and Koebner negative group in the mean number of PUVA treatments, mean total dose and the last dose of UVA radiation, which led up to the clinical remission of psoriasis. Our results of investigation have demonstrated increased relapse of psoriasis, during the first 6 months after cessation of PUVA therapy, in the Koebner positive group, with a high statistical significance (p < 0.001), comparing with Koebner negative group in the same period. Furthermore, the tendency of relapse of Koebner positive and Koebner negative psoriatic patients was higher in Koebner positive group even in the first 3 months after PUVA therapy. CONCLUSIONS: PUVA therapy effects, total number of PUVA treatments, total dose of UVA radiation didn't depend on presence of Koebner phenomenon. However, Koebner phenomenon was a mark of high relapsing tendency of psoriasis in the first 6 months after PUVA therapy cessation.

Humans↗
PubMedDate not supplied

Frequency estimation of the gene alleles for genodermatoses in the population of Vojvodina.

Genodermatoses are hereditary skin disorders or anomalies. The authors had investigated the frequency of genes, species and clinical forms of hereditary dermatoses in Vojvodina including age and sex distribution. The experimental group was selected by random sampling of the diseased of genodermatosis and/or genetic diseases at the Clinic of Dermatology and Venereology and Institute for Children and Adolescents in Novi Sad. The experimental group included 152 cases, and that made simultaneously the experimental and positive control group in relation to the diseased population with genodermatoses and/or genetic diseases in Vojvodina. In the investigation we applied the following methods: family history taking including genealogy; dermatoglyphic examination; screening tests in medical genetics; cytogenetic analysis of patient's karyotype; histopathological analysis of the material obtained by skin biopsy; dermatovenereological, genetic and dysmorphologic examination of skin diseases by analysis of dysmorphologic signs on the skin using a special computer program--POSSUM (Pictures of Standard Syndromes and Undiagnosed Malformations). Application of non-parametric statistics and Log-linear analysis, revealed that there is no statistically significant difference between the experimental group and the group with genetic diseases in population of Vojvodina. The obtained incidence of genodermatoses and/or genetic diseases was computed by "Hardy-Weinberg's principle". These methods of genetic population investigations give possibilities for valid incidence estimation of the diseases and frequency of the gen allele's for genodermatoses and/or genetic disorders and syndromes in defined population. Our results of investigation of the incidence genodermatoses in our's population showed significantly increased values in relation to literature data for the same hereditary disorders.

Adolescent↗
PubMedDate not supplied

[Skin diseases and hepatitis virus C infection].

INTRODUCTION: Using a creative molecularbiologic technique in 1989 Choo and co-workers isolated a new virus of hepatitis C, an agent responsible for numerous cases of parenterally transmissible viral hepatitis. Hepatitis C virus is a RNA virus with unique genomic organisation. Six genotypes of hepatitis C virus have been identified, which differ in geographical distribution, tendency towards chronicity and sensitivity to antiviral therapy. Transmission occurs due to apparent and inapparent parenteral procedures (after transfusion, transplantation, transplacentally, during lactation, sexually or after accidental injury of medical staff). Mode of transmission through intact skin or mucosa has not been proved yet. Due to development of laboratory methods for detection of anti-hepatitis C virus antibodies and obligation for routine testing of blood donors for hepatitis C in majority of countries in the world, risk of post-transfusion hepatitis C is minimised to less than 1%. In 70% of patients the infection runs a chronic course, affecting numerous extrahepatic organ systems, including skin. VASCULITIS ASSOCIATED WITH MIXED ESSENTIAL CRYOGLOBULINEMIA: Mixed essential cryoglobulinemia is a disorder with deposition of circulating immune complexes in small and medium blood vessels. Clinical characteristics comprise palpable purpura on lower extremities, arthralgias and weakness. It might occur during autoimmune disorders, liver diseases and viral infections, among which hepatitis C infection has a central part. Mixed cryoglobulins can be detected in 35-54% of patients with hepatitis C and symptomatic vasculitis associated cryoglobulinemia, decreased C4 component of complement, positive rheumatoid factor and elevation of hepatic enzymes occurs in 10-21% of patients. Findings of anti-hepatic C virus antibodies and/or viral RNA in 96% of patients with mixed cryoglobulinemia can be considered as a definitive proof of etiopathogenetic association between hepatitis C infection and mixed cryoglobulinemia. Interferon alpha therapy is a first-choice therapy, although transient responses are frequent. PORPHYRIA CUTANEA TARDA: Hepatitis C infection has recently been recognised as an important precipitating factor of clinical porphyria cutanea tarda sympotomatology. Apart from high level of seropositivity among porphyria cutanea tarda patients (62-100%), association between these two entities hasn't been clearly revealed yet. The question whether hepatitis C infection is enough to be the only precipitating factor, or other hepatotoxic cofactors are necessary, still exits. Interferon therapy has been a meter of several studies, but no definite recommendations had been given about its administration in these cases. LICHEN PLANUS: About possible association between lichen planus and chronic liver diseases, and hepatitis C infection as well, suggest 35% prevalence of hepatic disorders in patients with lichen planus, and 9.8-23% of hepatitis C virus seropositivity. The clinical picture of lichen planus in hepatitis C virus infection is characterised by generalised skin lesions, with erosive involvement of oral mucous membrane, and by chronic course. Therapeutical efficiency of interferon is unpredictable, with possible improvement, cure or deterioration of lichen planus. OTHER DERMATOLOGICAL DISORDERS: Other dermatological disorders (erythema nodosum, erythema multiforme, urticaria) may be direct consequences of hepatitis C infection, of other extrahepaic non-dermatological manifestations, or fortuitous reports. CONCLUSION: Considering big pathogenetic potentials of hepatitis C virus with possible skin involvement, and proved association between cutaneous necrotising vasculitis with mixed essential cryoglobulinemia, porphyria cutanea tarda, lichen planus and chronic hepatitis C infection, all patients with these disorders should be tested for hepatitis C and all cases of hepatitis C should be searched for signs and symptoms of these skin diseases.

Hepatitis C↗
PubMedDate not supplied

[Characteristics of the Koebner phenomenon in patients with psoriasis vulgaris].

INTRODUCTION: Koebner phenomenon in psoriasis presents development of psoriatic lesions, after injury of uninvolved skin, which are identical in morphology with the previous trauma. The aim of this study was to establish the correlation of Koebner phenomenon with sex and age distribution, clinical variants of psoriasis vulgaris, age of onset and incidence in psoriasis among relatives of affected patients. MATERIAL AND METHODS: Sixty patients, with severe clinical picture, participated in this study: 38 patients in acute flare of a chronic form; 10 with acute exanthematic form; 8 with a chronic stable form; 3 with psoriatic changes on palms and soles and one patient with psoriatic erythroderma. According to the presence of Koebner phenomenon they were divided in two groups, one with positive and the other with negative Koebner phenomenon which presented the control group at the same time. RESULTS AND DISCUSSION: The Koebner reaction is often thought to be more frequent in actively spreading, severe psoriasis. Although this may be true, it has to be established by prospective studies. According to our investigation, Koebner phenomenon did not depend on clinical picture of psoriasis vulgaris. This reaction also appears to be a marker for a subgroup of patients with a tendency to early onset, but that was not confirmed by our study. In available literature we did not find any data about relations of Koebner phenomenon to sex and age or familiar incidence of psoriasis vulgaris. Our results demonstrated no connection of Koebner phenomenon with sex and age structure. At the same time its presence did not depend on familiar incidence of psoriasis vulgaris. CONCLUSIONS: There is no relationship between Koebner phenomenon and sex and age distribution. It does not depend on clinical picture and also does not predict the age of onset and familiar incidence of psoriasis vulgaris.

Adolescent↗
PubMedDate not supplied

[Congenital giant pigmented hairy nevus--case report].

INTRODUCTION: Authors present the characteristics of a giant congenital pigmented hairy nevus (GCPN) of the skin. CASE DESCRIPTION: A case of a female patient, 21 years of age, with many changes of the skin, namely: giant congenital pigmented hairy nevi involving the skin of the trunk, the upper and lower extremities and the face is reported. There have not been any changes in regard to the color, size or distribution of the nevi. The family anamnesis is negative. The involvement of the skin is 20% of the total body surface, according to Wallace. Since there was a suspicion of neurocutaneous melanosis, the patient underwent electroencephalography (EEG) and nuclear magnetic resonance (NMR). These examinations could not ratify the pathologic changes of the brain structures, which could affirm the neurocutaneous melanosis. DISCUSSION: The frequency of occurrence of GCPN larger than 20 cm in diameter in pediatric patients is estimated as 1:4,150 of children with female predominance. Data on possible malignant alteration of GCPN into a malignant melanoma vary from 6-12%. Authors have decided to follow-up the patient and to perform a clinical observation of the nevi, mostly due to extent of the skin changes and signs of malignant alterations. CONCLUSION: Authors have presented this case because of the risk of malignant melanoma development in a patient with GCPN and in the aim of pointing to the problem of melanocytic tumor progression.

Adult↗
PubMedDate not supplied

[What do we know today about diaminodiphenylsulfone?].

INTRODUCTION: Diaminodiphenylsulfone or dapsone is a chemical analogue of sulfapyridine, synthesized in 1908. Dapsone is a bacteriostatic agent that proved to be efficient in treating leprosy and malaria, but today it is used in treating dermatologic noninfectious inflammatory diseases. PHARMACOLOGY: Dapsone is orally used in a dose of 50-400 mg per day in treatment of dermatologic diseases, and also in a dose of 50-100 mg per day in leprosy treatment. Dapsone is mainly eliminated from the body by urine and smaller part by faeces. Pharmacological interaction was reported when it is used with rifampicin and probenecid. MECHANISM OF ACTION: The bacteriostatic effect of dapsone is well known. It involves inhibition of folic acid synthesis in susceptible organisms. The anti-inflammatory effect of dapsone, which proves to be efficient in treating noninfectious inflammatory diseases, has not been explained completely yet. There are some pieces of evidence that anti-inflammatory action is not connected with its antibacteriological action. CLINICAL USE: Based on previous studies about therapy efficiency of dapsone in treating some diseases, there are two groups of diseases: the group responding well to dapsone (leprosy, malaria, DH, linear IgA-dermatosis, erythema elevatum diutinum, bullous systemic lupus erythematosus) and a group responding with average good response to dapsone (pyoderma gangrenosum, bullous and cicatricial pemphigoid, acne conglobata, discoid cutaneous lupus erythematosus, subcorneal pustulosis dermatosis, granuloma faciale, rheumatoid arthritis, polychondritis, leucocytoclastic vasculitis). ADVERSE EFFECTS: Adverse effects depend on the dose and they rarely occur at doses less than 100 mg per day. They are mainly shown on skin, nervous system, digestive system, hepatobiliary system, and kidney and hematologic system. The most important adverse effects are hemolytic anaemia and methemoglobinemia. Hemolysis usually occurs at doses of 200 mg and more per day. In patients with glucose-6-phosphate dehydrogenase deficiency, hemolysis may be provoked by a dose less than 50 mg per day. For prevention, before using dapsone in therapy, clinical examination with history, blood parameters, liver and renal parameters and determination of glucose-6-phosphate dehydrogenase level are recommended. CONCLUSION: The use of dapsone is absolutely indicated in DH treatment and erythema elevatum diutinum. Because of anti-inflammatory effects, dapsone can also be used in treating other inflammatory noninfectious dermatoses when one should take care about "therapy efficiency/adverse effect" balance using the correct dose, monitoring relevant clinical and laboratory parameters and educating patients.

Anti-Infective Agents↗