Browsing by Author "Malinić, Marija (58029831700)"

Background/Aim. Psoriasis is a chronic, immune-mediated, genetically determined disease, which is manifested by the appearance of erythematous scaly plaques. Treatment includes conventional therapies and biologics. The coronavirus disease 2019 (COVID-19) raised widespread concern for patients with psoriasis treated with immunosuppressive drugs, especially biologics. Even though there was no data at the beginning of the pandemic on the efficacy and safety of vaccines against COVID-19 in patients with psoriasis treated with biologics, the National Psoriasis Foundation (United States of America) recommended vaccination in these patients. The aim of this study was to evaluate the influence of COVID-19 on clinical characteristics and quality of life of psoriatic patients treated with biologics and evaluate the effectiveness of biologic therapy during the pandemic. Methods. A retrospective cross-sectional study was conducted at the Clinic of Dermatology and Venereology of the University Clinical Center of Serbia from March 2020 to January 2022. Data was collected from medical documentation during the consecutive hospitalization of patients with psoriasis who received biologics. Results. The study included a total of 181 patients with psoriasis divided into two groups. Patients from each group were treated with different biologics (ustekinumab in 63.0% and secukinumab in 37.0% of patients). They achieved significant improvement regarding their clinical characteristics after a two-year follow-up [Psoriasis Area and Severity Index (PASI) before treatment: 14.1 (0-50.5) and after treatment: 1.2 (0-49.7), p < 0.001] and quality of life [Dermatology Life Quality Index (DLQI) before treatment: 15.0 (0-34) and after treatment: 0 (0-28), p < 0.001]. Due to unsatisfactory therapeutic response in 4 (2.2%) patients, secukinumab was changed to ustekinumab. The vaccine against COVID-19 was given to 53.0% of patients, but only 20.4% received all three doses. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed in 64 (35.4%) patients, and 68.0% of those infected contracted the disease before the first dose of the vaccine. Therapy with biologics was delayed due to SARS-CoV-2 infection in 52 (28.7%) patients, of which 11 (21.2%) had exacerbation of psoriasis. Conclusion. The vaccination rate in patients with psoriasis receiving biologics was hardly 50.0%, and about a third of the vaccinated patients had a milder form of COVID-19. The therapy with biologics was successful regardless of the short-term interruption of drug administration due to the beginning of the COVID-19 pandemic and the worsening of psoriasis in some patients during that time. © 2024 Inst. Sci. inf., Univ. Defence in Belgrade. 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.