Kerion Celsi due to Microsporum canis with a Dermatophytid Reaction.

Microsporum (M.) canis is the most common fungus to cause tinea capitis in Europe, especially in the Mediterranean region and South and Central Europe. Fungal scalp infections caused by M. canis tend to be non-inflammatory. Recently, a growing number of cases of tinea capitis characterized by inflammatory infection caused by M. canis and M. gypseum have been registered. We present a case of highly inflammatory tinea capitis, also known as kerion celsi, caused by M. canis in a 6-year-old-patient. Scalp infections due to M. canis are a growing problem in dermatological practice. Changes in epidemiology, etiology, and clinical patterns of fungal infections due to M. canis are significant. Greater awareness of this problem is needed in order to establish proper diagnosis and successful treatment strategy for these patients.

Tinea Incognita in a Patient with Crest Syndrome: Case Report.

Tinea incognita is a dermatophytic infection that is difficult to diagnose, usually modified by inappropriate topical or systemic corticosteroid therapy. We report an extensive case of tinea incognita caused by the zoophilic dermatophyte Trichophyton mentagrophytes (var. granulosa) in a 49-year-old female patient with CREST (Calcinosis; Raynaud phenomenon; Esophageal involvement; Sclerodactyly; Teleangiectasia) syndrome. Immunocompromised patients, as well as patients with keratinization disorders, seem to be especially susceptible to dermatophytic infections with atypical clinical presentation that is sometimes bizarre and difficult to recognize. Therefore, close monitoring and mycological skin examination is recommended in order to avoid misdiagnosis and to give the patient the best chance of recovery.

Allergic contact dermatitis to antibacterial agents.

Topical antibiotics are frequently introduced in therapy by various specialists, e.g., dermatologists-venereologists, ENT specialists, proctologists, ophthalmologists, and others. In dermatology, topical antibiotics are used in the treatment of superficial inflammatory skin lesions, acne and rosacea. These agents are also used in the prevention of inflammatory lesions after surgical and corrective procedures. Long-term and uncontrolled application of topical antibiotics, on the skin with impaired protective barrier in particular, implies a risk for the development of hypersensitivity to these agents. Considering the very wide utilization of these agents, hypersensitivity to topical antibiotics poses a major problem worldwide. The groups at a high risk of contact sensitivity to topical antibiotics include patients with chronic venous insufficiency, chronic ulcers and chronic otitis externa, as well as individuals at occupational exposure to antibiotics, e.g., human medicine and veterinary medicine professionals, pharmaceutical industry workers, cattle breeders, etc. When long-term therapy fails to result in improvement in the above mentioned chronic states, the possibility of allergic reactions to topical agents should be taken in consideration. Cross-sensitivity, which is frequently associated with the use of topical aminoglycoside antibiotics, poses a significant problem.

Obesity and allergic diseases.

In the last few decades, the prevalence of allergic diseases, asthma, allergic rhinoconjunctivitis and atopic dermatitis in particular, has been observed to increase in urban settings. In addition, epidemiological data show the proportion of overweight individuals to rise in the last two decades. Obesity and overweight are a major public health problem not only in industrialized countries but also in developing ones because the morbidity and mortality rates are greater in the obese. An increased body mass index is considered a risk factor for the occurrence of myocardial infarction, stroke, atherosclerosis, hypertension, insulin resistance, dyslipidemia and some types of carcinoma. An ever greater body of available data point to the possible association of allergic diseases with obesity and overweight. Impaired immune tolerance is considered to be a sequel of immune changes due to the activity of adipokines, bioactive molecules secreted in white adipose tissue. About 50 adipokines are currently known to be secreted in adipose tissue, some of them belonging to the group of cytokines such as tumor necrosis factor alpha and interleukin-6. The association between obesity and allergic diseases has not yet been fully clarified. While the observations recorded to date should not be neglected, additional studies are necessary to help understand the complex function of adipokines involved in allergic events.

Topical management of psoriasis - corticosteroids and sparing corticosteroid therapy.

Psoriasis is a complex disease that requires safe, long-term treatment. Topical steroid therapy, topical non-steroid therapy only, and a combination of various topical therapies in the treatment of mild to moderate forms of psoriasis are presented. Topical therapy includes corticosteroids, vitamin D3 analogs, retinoids, tars, anthralin, keratolytics, and topical immunomodulators. While most medications are approved for use as a single agent in the treatment of psoriasis, some of these drugs are most effective when used in combination with topical corticosteroids. Topical therapy is generally administered for mild and localized forms of psoriasis, whereas phototherapy and systemic therapy are reserved for extensive lesions and more severe forms of the disease. Individual approach is absolutely necessary in each patient with psoriasis.