Browsing by Author "Milčić, Danijela (55218170900)"

Background: Psoriasis has a substantial impact on patients' quality of life. Objectives: The aims of this study were to assess the impact of the clinical severity of psoriasis on patients' quality of life and to determine the effects of psoriasis-related stress on patients' everyday life. Methods: The cross-sectional study was conducted at the Institute of Dermatovenereology, Clinical Center of Serbia, Belgrade. The study included 201 patients (124 men and 77 women), aged 18-70 with a diagnosis of psoriasis, hospitalized or treated as outpatients during 2009. For the assessment of patients' quality of life, the psoriasis disability index (PDI) was used. The stress related to psoriasis was measured with the psoriasis life stress inventory (PLSI) and disease severity with the psoriasis area and severity index (PASI). Results: We found moderate correlation between PLSI and all PDI subscales and overall score (correlation coefficients ranged from 0.334 to 0.521). The correlation between PASI and PDI subscales was weak, while we failed to find any significant correlation between PASI and the PLSI. The results of multiple regression analysis indicated that stress, more severe disease, and lower educational level are significant determining factors of a poorer quality of life in patients with psoriasis. Conclusion: Our results support the importance of assessing the quality of life in psoriasis and effects of stress in patients' adjustment to their condition and may have important implications for a psychological stress management approach in the clinical management of psoriasis. © 2014 The International Society of Dermatology.

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.

[No abstract available]

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.

Background: Emerging epidemiological evidence suggests independent associations between psoriasis and metabolic syndrome. Objectives: The aim of the study was to examine the prevalence of metabolic syndrome and its components in patients with psoriasis, and to assess which factors may predict metabolic syndrome in these patients. Methods: A hospital-based, cross-sectional study with 244 psoriatic patients and 163 control subjects with skin diseases other than psoriasis was conducted at the Clinic of Dermatovenerology, Clinical Center of Serbia, Belgrade, from October 2011 to October 2012. Metabolic syndrome was defined using the revised National Cholesterol Education Program Adult Treatment Panel III. Severity of psoriasis was measured by Psoriasis Area and Severity Index and Body Surface Area. Results: The adjusted odds ratios (ORs) and 95% confidence intervals (CI) for psoriasis patients vs. non-psoriasis patients were 2.66 (95% CI, 1.58-4.42) for metabolic syndrome, 3.81 (95% CI, 2.30-6.31) for hypertension, 2.29 (95% CI, 1.39-3.78) for central obesity, 1.92 (95% CI, 1.08-3.41) for hyperglycemia, 1.87 (95% CI 1.18-2.96) for low high-density lipoprotein cholesterol level, and 1.42 (95% CI, 0.87-1.04) for hypertrigliceridemia. We failed to find any statistically significant association between the metabolic syndrome and clinical severity of psoriasis. Later onset and longer duration of psoriasis were predicting factors for metabolic syndrome in our patients. Study limitations: The cross-sectional design of the study does not allow us to draw directional causal inferences concerning the association between psoriasis and metabolic syndrome. Factors such as diet, alcohol consumption or mental health, which have not been evaluated in this study, may be confounders in this relation. Conclusion: A higher prevalence of metabolic syndrome and its components in patients with psoriasis than in controls, regardless of disease severity, emphasizes the need for early treatment and follow-up of all psoriatic patients with respect to metabolic diseases. © 2017 by Anais Brasileiros de Dermatologia.

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.