Histopathological and clinical traps in lichen sclerosus: a case report.

Lichen sclerosus et atrophicus and limited systemic scleroderma (acrosclerosis) are inflammatory skin diseases that ultimately evolve into two distinct modes of atrophic scar formation, but which can easily be confused clinically. They are very rarely associated. The literature has reported cases in which lichen sclerosus was associated with various forms of scleroderma, but often with localized morphea. The characteristic histopathological picture of lichen sclerosus includes a thin epidermis, with orthohyperkeratosis and vascular degeneration in the basal layer, loss of elastic fibers, and band-like inflammatory infiltrate in the papillary dermis, while systemic sclerosis is characterized by excessive deposition of collagen in the dermis, accompanied by reduction in adnexal structures and their entrapment in collagen, and the presence of perivascular lymphocytic inflammatory infiltrate. We present the case of a 40-year-old female patient clinically diagnosed with systemic scleroderma and lichen sclerosus involving the genital mucosa. Physical examination in conjunction with laboratory findings (elevated antinuclear, anti-Scl-70, anti-SSA antibodies and immunogram) induced the supposition of the coexistence of lichen sclerosus and systemic scleroderma, fact confirmed by pathological examination. Systemic therapy with corticosteroids, immunosuppressive and phlebotropic drugs, peripheral vasodilators and other tropic adjuvants and topically potent topical corticosteroids was initiated. The course was favorable under therapy, the hardened skin slightly regaining elasticity, relief of itching and disappearance of lichen sclerosus lesions. Our case reaffirms the uncommon association of these two disorders. The importance of history, physical and laboratory examinations in making a diagnosis of certainty in emphasized.

[Viral hepatitis--trends]. / Hepatitele virale--încotro?

Viral hepatitis is a serious health problem all over the world. The aim of the study is to present the actual achievements in the therapeutically field and the general knowledge concerning the subject. Are presented the etiological agents of the acute and chronic hepatitis with the focus on hepatitis B and C, which has become a priority of WHO, with an incidence of the diseases of 360 billion/year for hepatitis B and an sub estimated level for C hepatitis. The most used drugs are presented and the therapeutical combination meant to decrease biological and virusological markers (ALAT, viral load) and to ameliorate the histological aspects of the liver. In conclusion, acute and chronic viral hepatitis represents a challenge for epidemiologists who try to stop the spread of the disease, but also for the infectious diseases specialists and gastroenterologists.

[Statins and endothelial dysfunction]. / Statinele si disfunctia endoteliala.

UNLABELLED: Studies carried out to determine the abilities of statins showed that they have multiple cholesterol-independent benefits, named pleiotropic. These effects are highly diverse and assume such properties as the improvement of endothelial dysfunction, damaged by multiple pathologic conditions, with secondary increase in NO bioavailability. Also at endothelial level, statins have the ability of diminishing the adhesion molecules expression, thus having an indirect vasodilatator role. Their antioxidant ability is manifest in various ways: decreases the superoxide radical anion production, fact that theoretically makes them useful in the treatment of other conditions like dyslipidemia or cardiovascular diseases. Their antiinflammatory role is complex and consists, among others, in the increase of antiinflammatory cytokines production, diminution of the action of the proinflammatory ones, and decrease of monocyte recruitment. CONCLUSION: From this perspective, we believe the understanding of the innermost mechanisms through which statins act, their effects, and their use in other therapeutic schemes than the already accepted ones is useful.