A case of lupus vulgaris with rare localization diagnosed 30 years after onset.

Cutaneous tuberculosis (tuberculosis cutis) is one of the extrapulmonary forms of tuberculosis, which may affect the skin only or co-exist with tuberculosis of other organs, particularly the lungs. We describe a case of lupus vulgaris in a 72-year-old male patient with a single lesion localized on his lower extremity, developing for 30 years before correct diagnosis and previously treated with topical steroids. Bacillus infection in other organs was not detected. Diagnosis of tuberculosis was made based on personal history, clinical picture, hypersensitivity to tuberculin, histopathology and polymerase chain reaction. A multidrug therapy with rifampicin, isoniazid and pyrazinamide resulted in regression of the lesion. The common lack of knowledge about the clinical picture of cutaneous tuberculosis causes its late diagnosis and treatment.

Evaluation of skin barrier function in allergic contact dermatitis and atopic dermatitis using method of the continuous TEWL measurement.

PURPOSE: The aim of study was to determine usefulness of the method of continuous TEWL measurement in the evaluation of skin barrier function in physiological conditions and in allergic contact dermatitis (ACD) and atopic dermatitis (AD). MATERIAL AND METHODS: Study was conducted on a group of 86 persons: 48 patients with allergic contact dermatitis, 18 with atopic dermatitis and 20 healthy individuals. Measurements of transepidermal water loss were made using custom-constructed device for continuous TEWL measurement. In each person the measurements of TEWL were made 4 times: measurement 0 (baseline)--before occlusion with 1% lauryl sulphate for 24 h, measurement 1-15 minutes after SLS patch removal, measurement 2-30 minutes after measurement 1 and measurement 3-30 minutes after measurement 2. Obtained data were statistically analyzed. RESULTS: TEWL ratio values obtained in measurement 0 were as follows in individual groups of patients: 13.20 +/- 8.25 in the AD patients, 10.09 +/- 8.29 in ACD patients and 9.02 +/- 5.99 in control group. Analogous TEWL values in the subsequent measurements were: in measurement 1--16.08 +/- 11.17; 11.63 +/- 6.43; 17.39 +/- 12.41, in measurement 2--23.72 +/- 14.58; 14.71 +/- 6.46; 17.55 +/- 8.25, measurement 3--24.09 +/- 14.93; 16.34 +/- 6.32; 18.44 +/- 8.26. TEWL ratio values were higher in both groups of patients as compared to control group but not statistically significant (p = 0.1778). After 24 h exposition to SLS, TEWL ratio values increased in all examined groups as compared to baseline (0) measurement. All measurements, except for measurement No 1 in AD group of patients, showed statistically significant differences. The highest increase of TEWL values were observed in group of AD patients. CONCLUSIONS: Delay in skin reaction to SLS in patients with atopic dermatitis provides evidence for different properties of water barrier of the skin in this group as compared to healthy individuals. Increasing tendency in TEWL values 1 hour after SLS removal might reflect persistent damage to water barrier of the skin by detergent. Method of continuous assessment of water barrier of epidermis, through the possibility of multiple measurement by TEWL in examined periods of time, decreased the risk of mistake and increased accuracy of measurement. Measurement of TEWL values allows for assessment of otherwise unnoticed damage to water barrier of the skin.

[Application of pentoxiphylline to treatment of leg ulcers: a Polish multicenter study]. / Zastosowanie pentoksyfiliny w leczeniu owrzodzen goleni--polskie badania wieloosrodkowe.

Aim of the study was to evaluate the efficacy, tolerance and safety of treatment of leg ulcer with pentoxiphylline administered orally in daily dose of 1200 mg divided for 3 doses for six months. The study was carried out in 19 centres in Poland. The results of clinical and laboratory (HGB, WBC, PTL) examinations made before, during and after treatment were documented in individual case-records. Pentoxiphylline was administered to 184 patients (124 F and 60 M) aged 22-86 (mean-61.6) yrs. One hundred and thirty-five patients had non-arterial ulcers, 37-partly arterial and 12-arterial. The duration of the disease was 1 to 1620 (mean 158) weeks. Resting pain was reported by 131 patients. In 9 persons the treatment was stopped after 1-2 months; in 6 (3%) of them due to side effects. In 175 patients pentoxiphylline was administered as follows: 1200 mg daily for 6 months in 92 cases, 1200 mg daily for 2-5 months--in 58, 1200 mg daily for 3-5 months and 800 mg daily for next 1-3 months--in 12 cases, and 800 mg daily for 1-6 months--in 13 cases. In 161 (92%) cases a beneficial effect was achieved including complete healing of the ulcers in 79 (45%) or improvement in 82 (47%); in 14 (8%) there was no improvement. The resting pain was significantly reduced in 114 (87%) patients within 1-24 weeks and completely disappeared in 69 (53%) patients within 2-20 weeks of treatment. No significant abnormalities in the results of laboratory tests were found. Transient side effects of the therapy appeared in 11 patients but they did not require administration of the drug to be discontinued. The study showed that pentoxiphylline is a effective, well tolerated and safe drug in the treatment of leg ulcers.

Study on clinical picture of erythema migrans.

Clinical picture of erythema migrans (EM) was evaluated in 83 patients from north-eastern Poland. Patients were in mean age of 42,8. Most of patients (71%) were women. Tick bite remembered 64% patients. Mean incubation period of EM was 33 days. The mean diameter of the skin lesions was 14.8 cm. They persisted for 2-270 (mean-54) days. Lesions were located mostly on the skin of lower extremities. The largest lesions were found on trunk and the smallest on lower extremities. EM of diameter exceeding 20 cm were observed in patients with longer history of the disease. Specific antibodies were found in 53% of cases and were present more frequently (78%) in patients with shorter incubation period (< 30 days).