Diagnostic difficulties in a case of a female patient with pemphigus vulgaris

Introduction . Autoimmune blistering diseases are mediated by autoantibodies directed against structural proteins of the skin. Pemphigus vulgaris (PV) is the most common type of pemphigus. The main auto-antigen in PV is desmoglein 3, although other antigens such as desmoglein 1, desmocollins, plakoglobin and pemphaxin may also be involved. More than 50% of cases begin with oral lesions. Skin lesions on the face appear occasionally. Objective. To present an unusual clinical manifestation of pemphigus vulgaris. Case report . We present a case of a 54-year-old female patient with skin lesions localized on the nose, who due to suspicion of skin cancer not confirmed by histopathology was referred to us by an oncologist. Pemphigus vulgaris was suspected when erosions on the oral mucosa were observed, and this diagnosis was established on the basis of immunological tests. The patient was treated with prednisone and azathioprine, with very good results. Conclusions . We present the case owing to the difficulties in the diagnostic process and, moreover, due to spectacular clinical improvement after the treatment

The frequency of polymorphic variants of filaggrin gene and clinical atopic dermatitis

Introduction: As far as pathogenesis of the atopic dermatitis (AD) is concerned, the roles of an impaired epidermal barrier and cornified cell envelope are widely emphasized. Aim : The assessment of mutations of the filaggrin gene and their connection with the clinical picture of AD as well as selected allergological and environmental indicators. Material and methods: 105 patients with diagnosed AD on the basis of diagnostic criteria were included. For every patient of the examined group, quantitative determination of the total concentration of IgE and the concentration of IgE antibodies to selected allergens were examined. For all patients, studies were performed by means of analysis of two genomic gene variants of profilaggrin (FLG) – R501X and 2282del4. Results : Loss-of-function mutations in the filaggrin gene were shown in 12 (11.4%) patients in the examined group. All patients in the study group who developed one of the tested loss-of-function mutations in the filaggrin gene demonstrated an extrinsic, allergic form of atopic dermatitis. A significant association (p = 0.0002) between the presence of one of the tested loss-of-function mutations in the filaggrin gene and elevated levels of total concentration of immunoglobulin E was shown. Conclusions : Patients with AD of null mutations in the filaggrin gene demonstrate a relationship with the total and specific concentration of immunoglobulin E, specifically higher concentrations of IgE against aeroallergens and alimentary allergens as well as elevated levels of total immunoglobulin E

Analysis of selected allergic reactions among psoriatic patients

Introduction : Psoriasis is a chronic and recurrent inflammatory skin disease. The aetiology is still unknown in spite of numerous scientific researches. There is very little evidence which does not provide enough knowledge about allergic reactions in psoriatic patients. Based on the fact that the epidermal barrier damage allows different allergen types to penetrate into deep layers of epidermis and skin, we can assume that it may lead to immunological reactions. Aim : To investigate the allergic reaction indicators and hypersensitivity assessment about contact, inhalant and food allergens. The results were analysed with regard to clinical disease indicators and progression stage of dermal lesions. Material and methods: Eighty patients with psoriasis were examined. The concentration of total IgE antibodies and allergen specific IgE antibodies (asIgE) were analysed. Standard epidermal tests and atopy patch tests were performed. All the patients were estimated for their dermatological condition based on the PASI scale. The control group consisted of 50 patients without psoriasis and allergic history. Results : Significantly higher concentration of total E immunoglobulin has been stated in the patients with psoriasis. Higher concentrations of specific allergic IgE antibodies were more often observed in the examined group but the most frequently observed values were present in 1–3 class. The most common airborne allergens were birch, artemisia, timothy and rye pollens. There have not been any significant statistical differences in the case of positive epidermal test results. Conclusions : There is slightly expressed hypersensitivity in psoriatic patients. This hypersensitivity degree correlates with the intensification of symptoms