Biomedical subjects

M Poljacki

Publications and source records attributed to M Poljacki.

49 records · Page 3Linked to original sources

PubMedDate not supplied

[Von Recklinghausen's neurofibromatosis (neurofibromatosis type I)--a familial case report].

INTRODUCTION: Neurofibromatosis is a term used for two disorders: NF-1 and NF-2. NF-1 is Von Recklinghasusen's neurofibromatosis and comprises characteristic skin lesions (cafe au lait spots, intertriginous freckles, neurofibromatous skin tumors) and other congenital and hamartomatous bone, endocrine glands and central nervous system lesions. Its incidence is one in every 2500 to 3300 births. CASE REPORT: Two female patients, a 20 years old daughter and her mother 46 years of age were admitted to the Clinic of Dermatovenereology in Novi Sad due to appearance of many sessile and pedunculated neurofibromas, cafe au lait spots and freckles on their trunks, axillary and inguinal regions. Laboratory findings showed no abnormalities. Both of them were examined by many specialists. No systemic disturbances were established. The daughter was sent to plastic surgery for operative treatment. DISCUSSION: The clinical presentation of NF-1 is very variegated. Beside characteristic skin lesions, other clinical features include skeletal bony abnormalities, mental deficiency, seizures, neurofibromas of the spinal and cranial nerve roots, iris hamartomas, optic nerve gliomas, endocrine disorders, endocrine tissue tumors, other visceral tumors, etc. Some of these disorders can be life-threatening. Malignant transformations of the NF-1 lesions occur approximately in 5% of patients, most often as neurofibrosarcomas, Wilms' tumors, rhabdomyosarcomas or various forms of leukemias. CONCLUSION: We present familial cases of Von Recklingausen's neurofibromatosis without systemic abnormalities so far. The clinical course of this disease is unpredictable and a multidiscipline clinical assessment is necessary during whole life.

Adult↗

PubMedDate not supplied

[Microcirculatory changes in chronic venous insufficiency].

INTRODUCTION: The venous system of lower leg can be topographically divided into two subsystems: superficial (extrafascial) and profound (subfascial). Functionally, we can divide circulation in to macrocirculation (arteries and veins) and microcirculation (arterioles, capillaries, and venules). Blood flow towards heart can be disturbed by different pathological conditions, and than chronic venous insufficiency (CVI) develops. First alterations occurs in macrocirculation, and after some period changes in microcirculation also appear. Those changes are leading to the ultimate stage in CVI--venous ulcer. RESULTS AND DISCUSSION: Previous conceptions that alterations in microcirculation in CVI are consequences of venous stasis, high pressure in capillaries and anoxic tissue are still actual. Observations that partial pressure of oxygen is higher in venous blood of lower limbs with ulceration than in limbs without ulceration lead to hypothesis that blood is passing directly from arterioles to venules over arterio-venous temperature-regulating shunts in dermis. Histological and electron-microscopic examinations certain alterations in the structure of capillaries. Raised pressure in these altered capillaries leads to exudation of plasma and fibrinogen in the interstitial space. Soluble fibrinogen is transformed to insoluble fibrin and forms fibrin cuffs. These cuffs are a barrier for normal diffusion of oxygen. Recently, it was observed that blood cells can adhere to the endothelial cells--Leukocyte trapping hypothesis. It can be explained by slower blood flow velocity and also by expression of certain endothelial and leukocyte adhesion molecules intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1). This causes congestion of white blood cells which leads to tissue damage due to secretion of inflammatory mediators.

Chronic Disease↗

PubMedDate not supplied

[Etiopathogenesis, clinical picture and diagnosis of onychomycoses].

ETIOLOGY OF ONYCHOMYCOSES: Onychomycoses can be caused by dermatophytes, molds and yeasts. However, dermatophytes appear to be the chief organisms capable of a primary attack on the nail. By far the most frequent dermatophytes isolated from nails are Trichophyton rubrum, T. mentagrophytes var. interdigitale and Epidermophyton floccosum. Molds virtually only invade toenails, but their role as a primary pathogen is still debated. Yeasts have been isolated from diseased nails at highly different rates. Nails may be infected by two different dermatophytes, two dermatophytes and a yeast, a dermatophyte, a yeast and a mold, etc. PATHOGENESIS OF ONYCHOMYCOSES: The mode of infection is still under debate. In many cases palmar and/or plantar tinea, exists but can often remain asymptomatic for years. After spreading to the nail, the fungus invades the hyponychium or lateral nail sulcus to finally reach the nail bed where it moves proximally to the matrix. Proximal subungual onychomycosis probably starts with a fungal skin infection, whereas white superficial onychomycosis seems to be a culture of T. mentagrophytes on a softened nail surface. Total dystrophic onychomycosis may result from both distal and proximal subungual onychomycosis or from C. albicans in chronic mucocutaneous candidiasis. Candida infections occur most often due to previous Candida paronychia, but it appears that a number of cases of so called idiopathic onycholysis are also caused by C. albicans with damage to the hyponychium being the portal-of entry. CLINICAL PICTURE OF ONYCHOMYCOSES: Onychomycoses can be divided into four different types. Distal subungual onychomycosis is the most common. The most frequent presenting clinical features are thickening and opaci-fication of the nail plate along the distal and lateral borders. The discoloration ranges from white to brown. The edge of the affected nail is usually uneven and often one or more streaks of dystrophic discoloured nail extend towards the distal border. Proximal subungual onychomycosis is uncommon. A white spot appears beneath the proximal nail fold and may extend distally to involve the deeper layers of the whole nail. Superficial white onychomycosis is also uncommon. The surface is the initial site of invasion. The causative organisms produce small superficial white and powdery patches over the nail. The surface becomes rough and the texture softer than normal. Total dystrophic onychomycosis represents the most advanced from all the previous three types, especially the distal subungual onychomycosis. The nail matrix has become permanently scarred by chronic infection. The nail is thick, elevated, denser and opaque. Candidomycotic onychomycosis shows erythematous and swollen proximal and lateral nail folds. Consequently, the nail plate becomes detached from the eponychium. Mycotic onycholysis is characterized by detachment of the nail plate from the bed, distal nail erosions, and grayish-yellow paste-like material under the nail. DIAGNOSIS OF ONYCHOMYCOSES: The diagnosis of onychomycoses cannot be made on the basis of clinical observation alone. Direct microscopy plays an important role in diagnosing nail fungal infections. However, fungal cultures are the only definitive test that can be used to identify the genus and the species of the infectious organism. Histological examination is a routine technique useful for defining the nature and localization of fungi in the nail plate. Immunohistochemistry applied to onychomycosis is an experimental approach bringing prominent information about identification of fungi. In vivo confocal microscopy represents a technique of the future.

Humans↗

PubMedDate not supplied

[Epidemiologic characteristics of onychomycosis--results of a retrospective study].

INTRODUCTION: The term onychomycosis is used for fungal infections of the nail unit. Tinea unguium is defined as a dermatophyte nail infection. The aim of this study was to determine the epidemiological characteristics of onychomycoses. MATERIAL AND METHODS: Ambulatory patients of the policlinic department of the Clinic of Dermatovenereology in Novi Sad were included in this study. Every patient with clinically suspected nail changes was examined. Direct microscopy of nail clippings and isolation of fungi on Sabouraud agar were performed. The results were evaluated using standard statistic methods. RESULTS: During a one-year-period (1995-1996) 70 cases of onychomycoses were registered that is 1.07% of the total number of patients examined in this period (N = 6535). The vast majority of observed patients were females (N = 47-67.14%), and male patients were significantly less frequent (N = 23-32.86%, p < 0.01). The most frequent type was dermatophyte onychomycosis (N = 39-55.71%), and the most often isolated agent was Trichophyton mentagrophytes (N = 38-54.29%). Manual workers were most often affected (N = 18-25.71%). Most patients were in the 41-50 year age group (N = 23-32.86%). The mean age of patients was X = 47.64 years (SD = 15.39). Table 4 shows the clinical duration of different types of onychomycoses. The longest clinical course was in the group of dermatophyte onychomycosis (20 years, one case). The mean clinical duration of the whole group was 26.81 months (SD = 40.04). Table 5 shows presence of other dermatomycoses associated with onychomycoses. Tinea pedis was the most frequently observed dermatomycosis (N = 9-60.00%). DISCUSSION: The incidence (1.07%) is something less than usual, and other findings are compatible with standard results. A lower incidence could be the result of the fact that children under 17 years are managed at the Institute of Mother and Child Health Care in Novi Sad. CONCLUSION: This study is a contribution to epidemiological investigations of onychomycoses. This disorder, with its social and medical importance and dubious treatment results, puts onychomycoses on high level of interest in modern dermatovenereology.

Adolescent↗

PubMedDate not supplied

[Small-plaque parapsoriasis: case report].

INTRODUCTION: Small plaque parapsoriasis is a relatively rare, chronic, idiopathic dermatosis, most often seen in middle age people. This disease shows a definite male predominance of approximately 3-4: 1. It is characterized by presence of round or oval erythematous, slightly scaly plaques on the limbs and trunk, which histologically reveal mild eczematous changes. CASE REPORT: A male patient, 61 years of age, was admitted to the Clinic of Dermatovenereology in Novi Sad due to long persisting erythematous patches on his upper and lower limbs. Plaques were of oval and round shape, pretty well marginated. They were of light red colour, covered with fine scales with a slightly wrinkled surface. He complained of itching. Laboratory findings showed no abnormalities. Histopathologic examination of the skin specimen revealed epidermal atrophy, focal parakeratosis, perivascular dermal infiltrate of mononuclear cells with exocytosis in the epidermis. This finding was compatible with the clinical diagnosis. After treatment with topical corticosteroid cream combined with whole body exposure to sunlight irradiation, vast majority of skin lesions regressed. DISCUSSION: The clinical course of small plaque parapsoriasis is very long. The plaques are remarkably stubborn, responding to treatment with steroid creams or to natural or artificial sunlight, but usually reappearing promptly when treatment is discontinued. The patches increase in number for a time, and then remain relatively constant for a long time. A small minority of cases clears entirely. Recent studies provided evidence of monoclonality and immunophenotypic abnormalities. Rearrangement of T-cell receptor genes was demonstrated by using PCR method. Detection of monoclonal T-cell populations in skin lesions, as a characteristic of lymphoproliferative diseases, forced some authors to include this dermatosis into a group of abortive cutaneous T-cell lymphomas. CONCLUSION: This case deserves a long and probably life-long clinical and histological assessment, especially due to new knowledge about the possible nature of this disease.

Humans↗

PubMedDate not supplied

[Etiopathogenic importance of human herpes viruses type 6, 7 and 8 in manifestations of certain skin diseases].

INTRODUCTION: In the past few years new human herpes viruses (HHV): HHV-6, -7 and -8 have been discovered. According to the most recent literature, they might have an important role in etiopathogenesis of some dermatological diseases. HUMAN HERPESVIRUS 6: HHV-6 was isolated in 1984 from peripheral blood lymphocytes of AIDS patients and patients with different lymphoproliferative diseases. Up to now, two variants of this virus have been identified, A and B, which differ in genetic, biological and immunological characteristics. The etiological importance of variant A, has not yet been clarified, while variant B is considered to be the major cause of many diseases, such as exanthema subitum in infants. In many cases primary infection is associated with elevated temperature, without rash. HUMAN HERPESVIRUS 7: HHV-7 was isolated in 1990 from activated peripheral blood CD4+ T cells of healthy persons. The virus is ubiquitous and more than 80% of babies and infants are affected. Presence of DNA sequences of this virus in mononuclear cells of peripheral blood, skin and plasma of pityriasis rosea patients, points to possible connection between this illness and HHV-7 infection. HUMAN HERPESVIRUS 8: HHV-8 was first identified in tissue samples of patients with Kaposi's sarcoma associated with AIDS in 1994. DNA virus sequences were also isolated in HIV negative persons with Kaposis's sarcoma. Presence of virus can be established in mononuclear cells of peripheral blood, endothelial cells that cover vascular spaces and spindle cells within skin changes. Modes of transmission are still not clarified. However, HHV-8 was identified in some other dermatological diseases as well.

Exanthema Subitum↗

PubMedDate not supplied

[Atrophic pilar keratosis of the face: case report].

INTRODUCTION: Keratosis pilaris atrophicans faciei (KPAF), previously called ulerythema ophryogenes, belongs to a group of follicular syndromes with inflammation and atrophy. The disease often starts at birth or during the first months of life with autosomal dominant inheritance. CASE REPORT: We report a case of a 24-year-old woman, who noticed the first lesion two years ago. Skin lesion spread symmetrically on the cheeks, forehead and chin. Keratotic follicular papules were surrounded by erythema. After disappearance of follicular papules, atrophy occurred. Histopathological analysis from skin biopsy specimens confirmed the diagnosis of KPAF. DISCUSSION: Follicular syndrome with inflammation and atrophy starts in early childhood, but first lesions can also appear among teenagers or in adults. The course of the disease is progressive with permanent follicular destruction. The histopathologic changes are dynamic and follow the clinical course of the disease. A topical retinoid: tretinoin therapy was introduced. After one month of treatment good effects were visible, including decrease of erythema and follicular hyperkeratosis.

Adult↗

PubMedDate not supplied

[Darier's disease--a familial case report].

INTRODUCTION: Darier's disease is a slowly progressive autosomal dominant disorder characterized by a gene with variable penetrance. However, many cases of this disease are considered to be a new mutation in the genealogic tree. The prevalence of the disease was estimated as 1/55,000 to 1/100,000. CASE REPORT: The authors report a case of a female patient, 66 years of age, with Darier's disease, hospitalized at the Clinic of Dermatovenereology of the Clinical Center Novi Sad. The first changes of the skin occurred at the age of 16 originally on the shins and face, as miniature hard papules confluent in larger areas. Skin changes always exacerbated in the summer. At hospital admission the patient's head and hair were whole covered with white, thick, keratotics layer, resembling a helmet. The skin of the trunk was covered with white-gray, hyperkeratotic, fused papules like verrucous plaques, more expressed on the back. The skin of forearms presented with hyperkeratotic papules, and dorsum of the hands presented with plaques. Lower legs were covered with fused papilokeratotic, rough cauliflower-like layers with macerates and foetor. Buccal mucous was covered with whitish papules on erythematous lesions of cobblestone-like appearance. The nails were thickened with longitudinal furrowing, whereas the left third finger presented with V-shaped onychorrhexis. 4 generations were investigated, and the disease occurred only in the patient's younger daughter. DISCUSSION: Beside the classic "seborrheic" forms of Darier's disease there are a few clinical types: hypertrophied (intertriginous), vesiculo-bullous and linear (zosteriform) type. CONCLUSION: This case is a very severe classic form of Darier's disease, with variable penetrance and severity in the family.

Adult↗

PubMedDate not supplied

[Occurrence of sexually transmitted diseases in Vojvodina during the last 20 years].

INTRODUCTION: Sexually transmitted diseases are the most often registered communicable diseases in a great number of countries. The aim of this study was to analyze dynamics and distribution of gonorrhea, syphilis and scabies in Vojvodina region during the last twenty years. MATERIAL AND METHODS: Epidemiological characteristics of gonorrhea, syphilis and scabies were analyzed on the basis of data obtained from the Section of Epidemiology of the Institute of Public Health in Novi Sad. The research included the period between 1980 and 1999, with sex and age distribution of patients. Morbidity rates were given per number of inhabitants of Vojvodina. RESULTS: In the period between 1980-1999 there were 454 registered patients with the diagnosis of syphilis in Vojvodina. The morbidity ratio was highest in 1980 (3.41/100.000), and lowest in 1991 (0.24/100.000). In the twenty-year period there were more patients with gonorrhea, than patients with syphilis. There were 44.621 registered patients with gonorrhea. The maximum morbidity ratio was in 1980 (25.09/100.000), but the minimum was in 1998 (1.68/100.000). Within the examined period scabies was recorded in 56.490 patients. The highest morbidity ratio was in 1984 (232.37/100.000) and the lowest was in 1992 (73.56/100.000). DISCUSSION: The average morbidity ratio of syphilis in USA, between 1992-1994, was 11.8/100.000 and at the same time in Vojvodina it was only 0.42/100.000. In Vojvodina most patients with this disease were 20-39 years old. In the same period in USA the ratio of gonorrhea patients was 309/100.000 and in Vojvodina it was 2/100.000. In this group also, most patients were 20-39 years old. However, scabies mostly appeared at the age of 7-14. CONCLUSION: According to the obtained results, the number of registered patients with these three diseases in Vojvodina stagnates or it decreases. In order to deal with real data, it is necessary to report these diseases regularly.

Adolescent↗

PubMedDate not supplied

[Modern psychosomatic aspects of dermatology].

Concerning their origin most diseases are multifactorial and that goes for skin diseases too. Emphasizing just one must not exclude further research and other aspects of etiopathogenetic mechanisms. It has been known for along time that psychological factors have a certain influence on the start, aggravation and maintenance on skin changes and that cosmetic defects of this kind disturb the psychological peace of the sick person and his capacity of establishing satisfactory social relations. Psychosomatic approach in dermatology cannot be reduced to investigation of specific etiology in the field of psyche without physical or social spheres. It unites all of them and in that way the old question what cause and what the consequence is has no importance, because there is no time or distance limit among them. They act simultaneously, holistically.

Humans↗

PubMedDate not supplied

[Case report of Klippel-Trenaunay-Weber syndrome].

This is a case report on a very rare and interesting clinical form of a generalized nevus flammeus as a part of Klippel-Trenaunay-Weber syndrome. Authors point to necessity of cooperation among dermatologists and other specialists in treatment and follow-up of such diseases.

Adult↗

PubMedDate not supplied

[Clinico-histologic characteristics of spinocellular carcinoma of the skin].

INTRODUCTION: Authors present clinical-histological characteristics of squamous cell carcinomas of the skin in patients treated at the Clinic of Infectious and Dermato-Venereology Diseases in Novi Sad in the period from 1989 to 1995. MATERIAL AND METHODS: The examined group comprised 26 cases (2.32%) with histologically verified squamous cell carcinomas of the skin out of 1119 nonmelanomatous epithelial skin tumors, clinically examined by dermatologists and treated by x-ray surface therapy. All patients with SCC were clinically examined by dermatologists at the Clinic of Dermatology and Venereology in Novi Sad, while histological examinations were performed by pathologists of the department of Pathology and Histology of the Faculty of Medicine in Novi Sad. Tumor biopsy specimens were obtained by shave biopsy, saucer biopsy and punch biopsy. All the biopsy specimens wee histologically examined and verified with standard methods with haematoxyllineosin-staining. RESULTS: In the group of examined patients most were with SCC--that is exophytic tumor of the skin in 16 cases (61.54%). Histological examination revealed: squamous cell carcinoma of the skin in 9 cases (56.25%), keratotic squamous cell carcinoma in 5 cases (31.25%) and invasive squamous cell carcinoma in 2 cases (12.50%). In the examined group there were also 9 cases of SCC (36.41%) with clinical forms of endophytic tumor of the skin. By histological examination the following tumors were diagnosed: Morbus Bowen in 3 cases (incipient squamous cell carcinoma of the skin) (33.33%); squamous cell carcinoma of the skin in 5 cases (55.56%) and keratotic squa- mous cell carcinoma in 1 case (11.11%). In one case SCC with clinical features like keratoacanthoma was found (3.85%), while by histological examination keratotic squamous cell carcinoma of the skin was diagnosed. DISCUSSION: In regard to the biopsy technique, SCC of the skin was diagnosed mostly as spinocellular carcinoma of the skin in 14 cases (53.85%) without a more precise description of the degree of tumor cells degeneration as well as tumor edge characteristics and type of histological type of tumor. Keratotic squamous cell carcinoma was found in 7 cases (26.92%); it is a tumor of mature structure (1-2 Broders' grade of clinical stage of tumors), but also without a detailed description of the tumor edge and type of histological type of tumor. Invasive squamous cell carcinoma was found in 2 cases (7.96%) and it reveals a SCC of the skin with deep infiltration into the dermis and hypodermis, sometimes involving the neighboring tissue (cartilage tissue, bone, muscle tissue and so on). This histological form of SCC had 3-4 Broders' grade of clinical stage of tumors. CONCLUSION: Authors of the paper conclude that histological examinations of SCC of the skin are necessary meaning detailed analysis: degree of differentiation of tumor cells by Broders' examination, examination of tumor edges and histological types of tumor. The incisional biopsy of tumor lesions had only been used to confirm clinical diagnosis in order to perform x-ray therapy, but it could not meet necessary criteria the excisional biopsy could in regard to evaluate tumor edges and histological type of the tumor.

Aged↗

PubMedDate not supplied

[Epidemiologic characteristics of viral dermatoses--results of a retrospective study].

INTRODUCTION: A great number of skin diseases are caused by viruses (1, 2, 3). Virus infections can cause skin diseases due to three mechanisms: direct inoculation, systemic infection and local spreading of the internal focus. The aim of this study was to determine the characteristics of virus-associated dermatoses (VD). MATERIAL AND METHODS: Ambulant patients of policlinical department of the Clinic of Infectious and Dermatovenereological Diseases Novi Sad were included in this study. Epidemiologic characteristics were analyzed by retrospective studying of medical documentation. RESULTS: During a five-year-period (1991-1995), 1,461 cases of VD were registered or 7.09% of the total number of patients examinated in this period (N = 20.596). Majority of the observed patients were males (N = 788-53.25%) and female patients were less frequent (N = 683-46.75%, table 1). Table 2 shows the age distribution of our patients. Most of the patients were in the 20-29 year age group (N = 443 or 30.32%). The mean age of patients was X = 36.14 years (SD = 19.02). Table 3 shows the occupational structure of our patients. The most frequent was the group of employed (N = 773 or 50.17%). Table 4 shows the structure of the patients according to pathogenic agents. The most frequent was the group of warts and condylomata (N = 900 or 61.60%). It is apparent that the number of VD is increasing. DISCUSSION: According to collected data, patients with VD make up a great group being treated at dermatological clinics. Our findings (7.09%) are compatible to the standard results. A relative high mean age of our patients is determinated by the fact that the children are managed at the Institute of Health Care of Mother and Child Novi Sad (the warts are most frequent in this population) or in other dermatological ambulants. There is no evidence that actual socio-political events affect the spreading of VD. Most patients belong to the urban population making up dominant groups (employed, scholars, pensioners). CONCLUSION: The number of patients with VD is increasing. Although from year to year the number of diseased increases or decreases, generally speaking there is an increasing trend of VD.

Adolescent↗