Browsing by Author "Lekić, Branislav (56092444000)"

Hailey–Hailey disease is a rare chronic autosomal-dominant blistering disease characterized by erosions, fissures, and vegetations occurring in intertriginous regions. To date, there is no specific treatment and there are no therapeutic guidelines, which makes management of the disease challenging. We present the case of a 43-year-old man unsuccessfully treated for Hailey–Hailey disease with topical and systemic corticosteroids, antibiotics, and surgical debridement. At presentation he had erosions, vegetations, and infection in the axillae and groin. We introduced oral methotrexate, 10 mg weekly, and complete remission was achieved in 3 weeks. After 8 weeks, we decided to discontinue methotrexate due to lesion absence. Over 3 years of follow-up, mild flares were effectively managed with topical miconazole or mild steroid creams. We conclude that oral methotrexate is safe and effective for achieving long-term remission in Hailey–Hailey disease. © 2024, Slovene Medical Society. All rights reserved.

Hailey‒Hailey disease is a rare chronic autosomal-dominant blistering disease characterized by erosions, fissures, and vegetations occurring in intertriginous regions. To date, there is no specific treatment and there are no therapeutic guidelines, which makes management of the disease challenging. We present the case of a 43-year-old man unsuccessfully treated for Hailey‒Hailey disease with topical and systemic corticosteroids, antibiotics, and surgical debridement. At presentation he had erosions, vegetations, and infection in the axillae and groin. We introduced oral methotrexate, 10 mg weekly, and complete remission was achieved in 3 weeks. After 8 weeks, we decided to discontinue methotrexate due to lesion absence. Over 3 years of follow-up, mild flares were effectively managed with topical miconazole or mild steroid creams. We conclude that oral methotrexate is safe and effective for achieving long-term remission in Hailey‒Hailey disease.

Introduction. Pemphigus herpetiformis is the rare variant of pemphigus with characteristic clinical features, histopathological findings different from the convectional pemphigus, and immunological findings consistent with pemphigus. Case report. We presented a 65-year-old woman with initial pruritus followed by pruritic urticarial papules and plaques, some with annular rings of tense vesicles on the periphery, on the trunk and extremities, with no mucous lesions. Histopathological examination demonstrated spongiosis and intraepidermal vesicles in the mid or subcorneal epidermis in some biopsy specimen, with neutrophil and eosinophil infiltrate. Direct immunoflorescent microscopy revealed intercellular IgG deposition, most prominent in the upper layers of epidermis. Indirect immunoflorescent microscopy showed intercellular binding of IgG autoantibodies in the patient’s sera. Initially the patient was threated with systemic corticosteroids and azathioprine, but dapson provided complete clinical remission. Conclusion. This entity was established 40 years ago, and around 100 patients have been reported worldwide. It is important to be aware of this particular form of pemphigus because clinical presentation, course of the disease and therapeutic approach are different from conventional forms of pemphigus. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Cutaneous necrotizing eosinophilic vasculitis (CNEV) is a rare type of vasculitis. Eosinophilic vasculitis is a necrotizing vasculitis with eosinophilic vascular infiltration, in which eosinophils mediate vascular damage in the disease process. We present a case of an 18-year-old girl who developed palpable purpura and hemorrhagic bul-lae over the lower extremities associated with itching, 7 days after the commencement of penicillin therapy. Plasma cryofibrinogen was positive. Histopathology showed an infiltration of eosinophils within and around the vessel walls and a complete absence of nuclear dust and neutrophils. Oral prednisone at 1 mg/kg induced remission in 2 weeks; the prednisone dose was tapered and discontinued after 2.5 months. There was no evidence of recurrence after 37 months of follow-up. Our patient represents a rare case of drug/penicillin-induced CNEV associated with cryofibrinogenemia, without systemic organ involvement. © 2019, Croatian Dermatovenerological Society. All rights reserved.

Introduction Tinea incognita is a dermatophyte skin infection with atypical clinical presentation modified using previous topical immunosuppressive therapy. Case outline We present a 59-year-old female patient with a pruritic rash on her face. Over three months, she was misdiagnosed with rosacea, contact dermatitis, and atopic dermatitis, and treated with various topical steroids, metronidazole cream, oral antihistamines, dexamethasone, and methylprednisolone. At the first examination in our clinic, she had a pruritic widespread erythema, papules, and plaques on the face, eyelids, and neck, and a few plaques on the chest and extremities (covered with a thick layer of corticosteroid ointment), resembling various skin conditions. Two days after the exclusion of topical treatment, sharply demarcated erythematous lesions with raised scaly edges and numerous pustules appeared. Fungal culture was positive for Trichophyton mentagrophytes var. granulosum. A skin biopsy confirmed dermatophyte fungal infection, and the lesions resolved after systemic and topical antifungal therapy. Conclusion We present the case of an unrecognized fungal infection of the skin to highlight the importance of a simple laboratory examination of fungal smears and culture before prescribing topical steroids and other immunosuppressive agents in order to avoid misdiagnosis and inappropriate treatment of patients in the future. © 2024, Serbia Medical Society. All rights reserved.