The epidemics of noduli mulgentium in Europe and the largest one in Croatia.

The first part of the paper describes all extensive epidemics of milker's nodules (noduli mulgentium) in Europe until 1967, also presenting the then state-of-the-art on the disease. This is followed by description of the largest recorded epidemic that occurred in Rijeka hinterland from August to November 1967 involving 136 individuals, mostly women. The epidemiological, clinical, immunologic and genetic aspects of the epidemic are analyzed. Epidemiologically, direct disease transmission from one human to another one, with at least minimal skin lesion preceding the infection, was demonstrated in three cases. The pattern of dissemination to 18 different locations suggested the infection in animals to have also been mediated by some insect species. Clinically, the recorded complications of the disease included pyoderma and secondary exanthema (30% and 15% of cases), the latter being accompanied by eosinophilia in 10% to 19% of cases. Both complications regularly disappeared before the clearance of primary efflorescence. Three pregnant women were affected in the first trimester when the fetal effect of the virus is most risky. However, no teratogenic effect on the fetus could be proved in these children at birth or at the age of two years. The prevalence of the disease has been on a decrease worldwide owing to the very successful and inexpensive preventive measures in humans (wearing rubber gloves on milking affected cows). As the disease, still burdened with some obscurities, belongs to the group of zoonoses that are interesting not only to dermatologists but also to veterinarians, epidemiologists, microbiologists and others, it appears worthy to present this shortened version of a thesis entitled "Tubercula mulgentium s.s. according to Berger" (then the accepted term for the disease in human and veterinary medicine), defended at School of Medicine, University of Ljubljana, in Ljubljana, Slovenia.

[Professor Andelko Wolf, MD, PhD. (1922-2007), eminent epidemiologist and dermatovenerologist]. / Prof. Dr. Sc. Andelko Wolf (1922.-2007.), ugledni epidemiolog i dermatovenerolog.

Professor Andelko Wolf graduated medicine from the University of Zagreb School of Medicine in 1947. First he specialised in epidemiology and became head of the Brucellosis Centre in Rijeka for the Istria region. Later he also specialised in dermatovenerology at the Department for Skin and Venereal diseases in Rijeka. He passed the specialty board exam in dermatovenerology in 1958 and became teaching assistant. In 1973, he became assistant professor and in 1981 full professor. At the Department he founded the Laboratory for Mycology and allergology. Later he focused on occupational skin diseases and photodermatology. His doctoral thesis was on the action of light on the skin. He chaired the Clinic and was a member of various Hospital and Medical School committees. He was an excellent clinician undergraduate and graduate student teacher in Rijeka and Zagreb. He published around eighty papers on dermatology, but also on the necessity to reform medical studies.

Professor Ante Vukas (1910-1991) - always ahead of his time.

The biography of Professor Ante Vukas, MD, PhD, is accompanied by due account of his professional and organizing competences, at first as head of the Department of Dermatology and Venereology, Susak Hospital, later head of the University Department at the same hospital, introducing the latest methods in the diagnosis and therapy of skin and venereal diseases (epidermotectoscopy, corrective dermatology, immunotherapy, electron microscopy, immunohistology, PUVA therapy, etc.). Although all these methods were introduced at the institution headed by Professor Vukas first in the former state, and some of them even first in Europe, he had never received any formal recognition of his professional and scientific work from either his University Hospital, or School of Medicine where he was also employed, or the city where he worked for more than 40 years. Professor Vukas was a proud man, standing these insults with dignity, steadily keeping his feelings about them as well as his own achievements to himself.

Clinical and genetic heterogeneity of erythrokeratoderma variabilis.

The skin disease erythrokeratoderma variabilis (EKV) has been shown to be associated with mutations in GJB3 and GJB4 encoding connexin (Cx)31 and Cx30.3, respectively. Gap junctions composed of Cx proteins are intracellular channels providing a mechanism of synchronized cellular response facilitating metabolic and electronic functions of the cell. In the skin, Cx31 and Cx30.3 are expressed in the stratum granulosum of the epidermis with a suggested role in late keratinocyte differentiation. Molecular investigations of GJB3 and GJB4 were performed in five pedigrees and three sporadic cases of EKV. Mutational analyzes revealed disease-associated Cx31 or Cx30.3 mutations in only three probands of which two were novel mutations and one was a recurrent mutation. These genetic studies further demonstrate the heterogeneous nature of the erythrokeratodermas as not all individuals that were clinically diagnosed with EKV harbor Cx31 or Cx30.3 mutations.

Hyalinosis cutis et mucosae: a 30 year follow up of a female patient.

Hyalinosis cutis et mucosae is an inherited disease, characterized by deposition of a hyaline-like substance in the dermis and internal organs. In the present study, we report a 30 year follow up in a female patient with hyalinosis cutis et mucosae treated using dermabrasion and oral retinoids. In our opinion, the lesion on uncovered body areas should be corrected as soon as possible to enable a normal psychophysical development. The lesions on skin and oral mucosa may be successfully removed without remission with dermabrasion in early childhood. In addition, oral retinoids in adulthood may produce some improvement.

Removal of traumatic and decorative tattoos by dermabrasion.

Dermabrasion generally produces excellent results in the removal of congenital or acquired nonesthetic skin changes. Results obtained by use of dermabrasion in the removal of foreign bodies penetrating the skin by accident (undesired tattoo) and variously motivated voluntary tattoos (decorative skin ornaments) are presented. Unless surgically removed, such tattoos remain in the skin for life. Superficial traumatic tattoos can be removed immediately after the accident, whereas decorative tattoos can be successfully removed by repeat surface dermabrasion. In case of granuloma formation in traumatic tattoos, dermabrasion will not produce satisfactory results.

Corrective dermatosurgery in childhood--own experience.

Congenital and acquired lesions on children's skin impose great burden upon the children and their parents. These children are frequently faced with various kinds of embarrassment in communication with their peers, ranging from sneering and mockery to isolation. That is why these lesions, especially if readily observable, should be completely removed or at least corrected as soon as possible to enable the child to establish normal communication with the environment and to prevent psychic trauma that may entail serious consequences later in life. Seven pediatric patients burdened with such lesions are presented (naevus papillomatous et verrucosus colli, atrophia linearis cutis faciei, naevus hyperkeratoticus systemicus dorsi, ichthyosis nigra, poikiloderma congenitum, hyalinosis cutis et mucosae, and alopecia post combustionem). Dermabrasion was used in six patients, whereas occipital hair graft transplantation to the alopecic sites was used in a girl with posttraumatic alopecia.