THE AUTOIMMUNE CONSTELLATION IN LICHEN AMYLOIDOSIS.

Localized cutaneous amyloidosis is a rare disease among white people, being more common in South-Asia, China and South America. The disease is characterized by deposition of amyloid material in the papillary dermis without visceral involvement. Nevertheless, there is a growing list of immune-mediated disorders that have been linked to cutaneous amyloidosis. We present two cases of concomitant occurrence of lichen amyloidosis and autoimmune thyroiditis/atopic dermatitis in two Caucasian women.

BLASTIC PLASMACYTOID DENDRITIC CELL NEOPLASM --A RAPIDLY EVOLVING ENTITY. CASE REPORT.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN), CD4+/CD56+hematodermic neoplasm was formally known as blastic NK-cell lymphoma. It is in fact a form of acute myeloid leukemia notable for highly aggressive behavior with cutaneous, lymph node and bone marrow involvement. This entity is derived from plasmocytoid dendritic cells and has a predilection for extranodal sites, especially the skin. Elderly male patients are the most affected and the prognostic is poor. The first case was reported in 1994 and sice then, single cases and a few small series have been published. This article presents the case of a previously healthy 56-years-old man, who presented himself to a skin eruption consisting in multiple, large dermal ulcerated tumors, located on the trunk and scalp. The lesions were painless and grew in size rapidly. Physical examination was normal except for the skin lesions. Histological examination of a biopsy specimen and immunohistochemical studies (positive for next markers: CD4, CD 45, CD56, CD68, Ki 67) revealed the rare diagnostic-blastic plasmacytoid dendritic cell neoplasm.

Pachydermodactyly--role of local corticotherapy.

Pachydermodactyly is a rare skin disease, defined as a benign form of digital fibromatosis. It is clinically characterized by painless hypertrophy of the skin around the proximal interphalangeal joints of the fingers, more common in males. This rare condition can affect both hands and is often associated with mechanical injury of the skin. Although there is no specific therapy, cessation of mechanical trauma associated with topical corticosteroid therapy can lead to satisfactory results. We present 3 sporadic cases of classical pachydermodactyly, anatomopathologically confirmed by the presence hyperkeratosis and acanthosis, which responded favorably to topically applied corticosteroids under occlusive dressings.

Chronic venous disease cases at the Iasi dermatology clinic.

UNLABELLED: Chronic venous disease (CVD) is defined as a disturbance of blood return to the deep venous system, superficial venous system, and communicating (perforating) veins. Once present, CVD persists throughout life, so like heart failure it is nowadays considered "a condition for life". Severe CVD of the lower limbs is one of the most common medical problems, affecting up to 25% of the general adult population of industrialized countries. AIM: to determine the incidence of CVD among the cases admitted to the Dermatology Clinic of the' "Sf. Spiridon" Emergency Clinical Hospital Iasi, CVD incidence by sex, age, area of residence and the main pathogens incriminated in super infection of ulcerative lesions. MATERIAL AND METHODS: We did a retrospective study of patients admitted to the Dermatology Clinic of the Iasi "Sf. Spiridon" Emergency Hospital over a five years period. RESULTS: Of the total number of patients admitted to our clinic (9375), 57% were diagnosed with CVD and 26.61% of them were with CEAP 6 class chronic venous insufficiency. There was an approximately equal sex distribution and most patients (44%) were older than 65 years. CONCLUSIONS: We did a large epidemiological study of venous disease, based on revised CEAP classification, showing again that it is not only a very important medical problem, with various clinical manifestation and multidisciplinary approach, but also an important issue for health insurance system.

[Demographic, clinical and laboratory characteristics of erisypelas in the period 2001-2010]. / Erizipelul--caracteristici demografice, clinice si paraclinice în perioada 2001-2010.

AIM: to describe demographic and clinical characteristics of erysipelas and to compare the sensitivity of two laboratory tests. MATERIAL AND METHODS: we studied patients with erysipelas hospitalized in the Dermatological Clinic between 2001 and 2010. RESULTS: the investigated 140 cases represented 8% of all skin infections hospitalized. Distribution of annual admissions has shown a gradual reduction in the number of admissions in the second half of the decade. A higher frequency was found in the second half of the year. Most patients were from rural areas (55%). The female gender predominated (69.3%). With few exceptions, the patients were adults averaging 59 years. The most common location was the lower leg (91.4%). Most clinical forms were mild and medium. Septic complications were absent. Recurrent erysipelas occurred in 5% of cases. Comorbidity included: chronic venous insufficiency (14.2%), hypertension (10%), obesity (8%), diabetes mellitus (5.7%) or chronic hepatitis (3.5%). CONCLUSIONS: the "benign" appearance of our cases is contrary to the trend rate of severe cases of cutaneous streptococcal infections in some western areas. From comparing laboratory tests results we observed their frequent mismatch. The ESR and the increase in percentage of polymorphonuclear neutrophils were more significant than the total number of leukocytes. Etiological therapy with penicillin G at a dose of 4 million UI/day was effective. The analysis allows the establishment of demographic and clinical features of erysipelas during the period and given territory.

[Clinico-epidemiological features and antimicrobial resistance pattern in gonococcal infection]. / Aspecte clinico-epidemiologice si particularitati ale sensibilitatii la antibiotice în infectia gonococica.

AIM: To analyze clinical and epidemiological features in patients with gonococcal infection attended Dermato-Venerology Clinic in Iasi and regional dermato-venerology offices and to evaluate gonococcal antimicrobial resistance pattern. METHODS: The study was carried out on 129 patients clinically diagnosed and bacteriologically confirmed with gonococcal infection who were subsequently submitted to a questionnaire. We studied their demographic characteristics (sex, age, nationality, marital status), clinical features (site of infection, symptoms, concurrent STI, previous history of gonorrhoea) and behavioral aspects (education, number and type of sexual partners, safe sexual practices). RESULTS: We found in our patients a strong association of gonorrhoea with young male individual, poor educational level and with clinical symptoms of urethritis. The level of antimicrobial resistance is higher than in other European countries. CONCLUSIONS: The poor health-seeking behavior, symptoms not specific enough, resistance pattern, lack of accessible and sensitive diagnostic methods lead to undiagnosed and probably mistreated gonorrhoea.

[Fungal infections and nail psoriasis]. / Infectiile fungice si psoriazisul unghial.

Onychomycosis and psoriasis are common diseases and it is possible that they coexist in the same patient. Psoriasis is a common cause of disturbance of the nail morphology. Nail disorders was reported in 10-80% of patients with psoriasis and may be associated with all clinical forms of disease. It has been suggested that the nail dystrophy in patients with psoriasis produce the lose of the natural protective barrier and increase vulnerability to fungal infections. But most authors report that in patients with psoriasis the prevalence of onychomycosis is no higher than in the general population. We conducted an observational analytical retrospective study of case report forms of patients with nail psoriasis hospitalized in Iasi Dermatology Clinic, 2004-2008. 360 patients were hospitalized with psoriasis. Of these 32 patients had nail disorders.

[Comorbidities in psoriatic patients of Iasi Dermatological Clinic from 2004-2008]. / Comorbiditati la pacientii cu psoriazis internati in Clinica dermatologica Iasi in perioada 2004-2008.

UNLABELLED: Psoriasis is a chronic inflammatory disease of the skin, relatively frequent in the population. Recent studies have shown that psoriasis can have a great impact on quality of life, even in patients with limited disease. Although the cause of this disease remains unknown, research suggests that psoriasis is a complex disease caused by the interaction of many genes, the immune system and environmental factors. In principle, any disease can coexist with psoriasis. MATERIAL AND METHOD: We conducted a retrospectiv study based on observation files of hospitalized patients with psoriasis admitted in the Dermatology Clinic Iasi during January 2004 - December 2008. RESULTS: Current data suggests that smoking and obesity increase the risk of developing psoriasis. Psoriasis may be an independent risk factor for developing diabetes, atherosclerosis and myocardial infarction. Therefore the patients with psoriasis die 3-4 years earlier than the rest of the population. Patients should be advised to stop excessive alcohol consumption and smoking. CONCLUSION: Further studies are needed to clarify the link between severity of skin lesions, treatments and the evolution of associated diseases.

Serum zinc and copper levels in some dermatological diseases.

UNLABELLED: Zinc (Zn) and copper (Cu) are essential metals for biochemical processes in the body. Many researchers have main interest in these two metals because it was establish that they are involved in immunological and inflammatory reactions. MATERIAL AND METHODS: The study comprised 49 patients of Dermatology Clinic from Iasi with different skin diseases (21 with psoriasis and 28 with varicose ulcer), during January - May 2006. The patients, both sexes, had ages between 19 and 81 years old. We determined serum Zn and Cu levels by atomic absorption spectrophotometry. The results were expressed in mg/L and we calculated Cu/Zn ratio, too; the values were compared with 50 healthy controls. RESULTS: In psoriasis, serum Zn and Cu mean levels (5.61 mg/L, respectively 1.27 mg/L) were higher as compared to controls (significance level p=0.04); the mean Cu/Zn ratio was 0.81 in psoriasis and 0.96 in control group. In varicose ulcer, mean levels were significantly increased (Zn-7.62 mg/L, Cu- 1.38 mg/L) compared to control group (Zn-0.81 mg/L, Cu-0.75 mg/L) and serum normal values; the mean Cu/Zn ratio was 1.00. 18 of all patients with psoriasis and varicose ulcer had higher serum Zn and Cu levels than normal values.