Browsing by Author "Nikolić, Miloš (56910382000)"

Introduction: Hidradenitis suppurativa (HS) is a chronic skin disease marked by recurrent abscesses, sinus tracts, and scarring, often accompanied by systemic symptoms. Diagnosed clinically, HS affects around 0.4% of people in western populations, but standardized treatment options are limited, leading to inconsistent outcomes. This study retrospectively analyzes 15 years of HS cases in southeastern Europe to better understand regional characteristics and treatment responses. Methods: This is a retrospective, cross-sectional study encompassing 103 HS patients hospitalized from 2007 to 2022 at a university dermatology and venereology clinic. Results: Women were younger than men at onset of HS (19 vs. 28 years old) and at first hospitalization (31 vs. 39 years old). Men were most often diagnosed as Hurley stage III at hospital admission (50.8%), whereas women predominantly had Hurley stage II (57.5%, p = 0.032). Trunk involvement was more prevalent in women (62.5% vs. 41.3%, p = 0.036) and the back of the neck in men (30.2% vs. 7.5%, p = 0.006). Obesity was the most commonly found concurrent disease (35.9%) overall, and a history of acne was the most frequent dermatological comorbidity (29.1%). HS patients had a fivefold increase in their chance of having psoriasis. The most commonly employed systemic treatments were oral antibiotics: rifampicin with clindamycin (62.1%) followed by tetracyclines (42.7%). Conclusions: HS patients had a fivefold higher likelihood of having psoriasis. Female patients were less likely to experience severe disease presentations. Although metabolic syndrome and its components were relatively common, they showed no correlation with disease severity. Treatment approaches for HS varied notably between males and females. © 2024, Association of Slovenian Dermatovenerologists. All rights reserved.

Background and objectives: While most previous surveys on the clinico-epidemiological features of autoimmune bullous diseases (AIBDs) have predominantly focused on a single disease entity or just one disease group, there have been only few studies examining the incidence of various AIBDs. In the present study, we set out to determine the spectrum of AIBDs, to estimate the incidence of the most common AIBDs, and to examine their temporal trends in Central Serbia over a period of 20 years. Methods: We retrospectively recruited 1,161 new AIBD cases diagnosed in Central Serbia during the period from January 1991 to December 2010. The diagnosis was based on strict clinical, histological, and immunohistological evaluation. Results: The incidence rates were: 4.35 per million population/year (pmp/year) for pemphigus, 4.47 pmp/year for pemphigoid, 1.42 pmp/year for dermatitis herpetiformis (DH), 0.25 pmp/year for linear IgA disease, and 0.08 pmp/year for epidermolysis bullosa acquisita. In the period observed, age-adjusted incidence rates significantly increased for pemphigus and particularly for pemphigoid, whereas they decreased, albeit not significantly, for DH. Conclusions: For the first time, our study evaluates the incidence rates of the entire spectrum of AIBDs in Serbia, and examines their temporal trends over a 20-year period. To the best of our knowledge, our finding of similar incidence rates for pemphigus and pemphigoid has previously not been reported. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Children with epidermolysis bullosa (EB) experienced the highest quality of life impact among several skin conditions and have problems which had not been reported by parents of children with other skin diseases. The EB-specific module of the Infants and Toddlers Dermatology Quality of Life (InToDermQoL) questionnaire was recently developed to measure the impact of disease-specific aspects in children from birth to the age of 4 years. The aim of this study was initial validation of the InToDermQoL-EB questionnaire. Parents of 44 children with EB from seven countries completed the InToDermQoL-EB questionnaire. Cronbach's alpha was.86,.89 and.91 for three age-specific versions. Differences between severity levels were all significant except for that between moderate and severe level in the version for 3- to 4-year-old children. All items of the three versions of the InToDermQoL-EB showed very high levels of relevance except “problems with defecation” in children younger than 1 year and “rejection by other children” in 3- to 4-year-old children. The three versions of the InToDermQoL-EB instrument showed good internal consistency and discriminated well between different severity levels. All InToDermQoL-EB items were confirmed as being of high relevance and the questionnaire may be used in practice and clinical trials. © 2020 Wiley Periodicals LLC.

Scarlet fever typically presents with distinctive erythematous papular rash following pharyngitis. Atypical forms may develop, making the diagnosis difficult. We present the case of a girl with feve, and unusual vesicular skin eruption (miliaria scarlatinosa) preceded by a skin infection, without mu-cosal changes. Leukocyte count, C-reactive protein, and antistreptolysin O-titer were elevated. Bacteriological swabs of the skin injury revealed Streptococcus pyogenes. Histopathology was compatible with scarlet fever exanthema. Intra-muscular penicillin and topical wound care induced complete remission. It is of great importance to be aware of uncommon clinical presentations of scarlet fever in order to establish a timely diagnosis and prevent potential com-plications. © 2021, Croatian Dermatovenerological Society. All rights reserved.

Objective − To assess the prevalence of allergic rhinitis and asthma in children with and without parental history of atopic dermatitis (AD) as well as to explore the association between parental history of atopic diseases and presence of allergic rhinitis or asthma in children diagnosed with AD. Methods − From January to June 2014, we recruited a total of 98 children with AD and their parents who presented at the Clinic of Dermatovenereology, Clinical Center of Serbia, Belgrade, Serbia. The parents filled in a questionnaire. The severity of AD was assessed using the SCORing Atopic Dermatitis (SCORAD) Index. Results − Of 98 parents, 33 (33.7%) reported having history of AD. In children with parental history of AD, the prevalence of allergic rhinitis and asthma was 18.2% and 24.2%, respectively. In children without parental history of AD, the prevalence of allergic rhinitis and asthma was 12.3% and 23.1%, respectively. Adjusted logistic regression analyses showed that: neither mothers’ nor fathers’ history AD were associated with presence of allergic rhinitis or asthma; fathers’ history of asthma was associated with presence of asthma and mothers’ history of asthma was associated with presence of allergic rhinitis. Fathers’ history of allergic rhinitis was associated with presence of allergic rhinitis and mothers’ history of allergic rhinitis was associated with presence of asthma. Conclusion − Our findings suggest that, compared to parental history of AD, parental history of asthma and allergic rhinitis were stronger contributors to the presence of atopic comorbid disorders in children with AD. © 2020 by the University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.

Background: Successful control of atopic dermatitis (AD) in children depends on parents' knowledge on the disease and attitude toward ill child, but there is a lack studies exploring parental knowledge, attitude, and behaviors. The aim of this study was to investigate parents' knowledge, attitude, and behavior toward AD. Methods: A cross-sectional study was conducted at the Clinic of Dermatovenereology, Clinical Center of Serbia, Belgrade, between February 2015 and March 2016. Parents of children with AD were invited to complete the questionnaire, which was comprised of five parts: parental sociodemographic characteristics, demographic and clinical characteristics of children, knowledge, attitude, and behavior. To assess factors associated with a higher knowledge level on AD, stronger positive attitude, and more supportive behavior, we performed two multiple linear regression models. Results: The average parental knowledge score was 9.5 ± 1.9 out of 12. The level of knowledge did not correlate with parental conviction that they were well-informed on AD (ρ = −0.121; P = 0.319). Older (β = 0.08, 95% confidence interval [CI] 0.00–0.16, P = 0.040), married/partnered parents (β = −2.14, 95% CI −3.55 to 0.72, P = 0.004), and those who have had AD themselves were more likely to be more knowledgeable on AD. Older (β = 0.18, 95% CI 0.01–0.34, P = 0.036) and employed (β = 3.99, 95% CI 1.59–6.38, P = 0.002) parents had stronger positive attitudes toward their children with AD. More supportive behavior of parents of children with AD was associated with being older (β = 0.24, 95% CI 0.04–0.45, P = 0.020) and less educated (β = −0.76, 95% CI −1.24 to 0.28, P = 0.003). Conclusion: The importance of understanding AD and accounting for attitudes by family members is obvious for successful control of the disease. © 2017 The International Society of Dermatology

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.

Actinic lichen planus (ALP) is a rare photosensitive subtype of lichen planus (LP) with four major forms recognized: annular, pigmented (melasma-like), dyschromic, and classic lichenoid. The prevalence is highest among dark-skinned younger females resid-ing in tropical and subtropical regions. There are very few reports of ALP across Europe, with most of the cases among individuals living in warm countries or in people of Middle Eastern and Indian ancestry. We report a case of a 68-year-old white man that presented with a 9-year history of a mildly pruritic solitary hyperpigmented patch on the tip of his nose. Histopathological examination demonstrated signs of classic LP with epidermal atrophy, pigmentary incontinence, and signs of solar elastosis. Based on these findings, a diagnosis of pigmented ALP was established. Topical pimecrolimus and tretinoin along with rigorous photo-protection proved effective, with mild residual hyperpigmentation after 6 months of treatment. Many differential diagnostic pos-sibilities should be considered for such a lesion. Nevertheless, a biopsy and correlation of histopathological and clinical findings can shorten the time from onset to a proper diagnosis. Treating both the hyperpigmented and inflammatory component of this dermatosis is necessary, as well as strict long-term photoprotection to prevent recurrences. © 2024, Association of Slovenian Dermatovenerologists. All rights reserved.

We report two unusual patients with Rothmund-Thomson syndrome (RTS), a rare genodermatosis. The first patient is a 5-year-old girl with congenital poikiloderma, photosensitivity, plantar punctate keratoderma, stunted growth and severe mental retardation. Plantar keratoderma associated with RTS has been reported only once. The second patient is a 21-year-old female presenting with rounded "moon" face, trunk obesity, coeliac disease, short stature and mild mental retardation. This is the first case of RTS associated with coeliac disease.

Hemophagocytic syndrome (HPS) may be provoked by infections, malignancies and autoimmune diseases. We report on a 56-year-old woman with long-lasting systemic lupus erythematosus (SLE) who presented with malar rash, inflammatory livedo reticularis, fever, weight loss, pancytopenia and mild splenomegaly with cervical lymphadenopathy. She had criteria for SLE flare-up (malar rash, high antinuclear antibody titer, complement consumption, pathological urinary sediment, and retinal vasculitis). Despite high-dose glucocorticoid therapy, pancytopenia and fever worsened. Important elevations of triglycerides and ferritin were also found. Bone marrow aspirate demonstrated hemophagocytosis, which confirmed the coexistence of HPS and SLE. The treatment with glucocorticoids, immunoglobulins, cyclophosphamide, filgrastim and antimicrobial therapy was unsuccessful. After one month, the patient developed Pneumocystis jirovecii pneumonia with fatal outcome. Bone marrow biopsy, taken 5 days before death, showed high grade diffuse large B-cell (CD20+, Ki-67+) non-Hodgkin's lymphoma (DLBCL). We are the first to report the association of both SLE and non-Hodgkin's lymphoma complicated by HPS. We showed that, based on clinical and laboratory data, it was difficult to distinguish the early phase of HPS from SLE flare-up and new-onset DLBCL. Therapy of such a complex case of HPS has not been standardized, and opportunistic infections remain a difficult issue.