Aging – what do we know?

Skin aging is a combination of reduction in the biological activity of cells, a slowing down of regenerative processes, and a loss of resistance to environmental factors. Genetics, lifestyle, and hormones significantly affect proper functioning of the skin. The aim of this article was to present the current knowledge about aging processes and concurrent therapies which can influence skin aging.  </p

Morfea i sklerotični lihen kod bolesnice s hipotireozom

Thyroid gland is one of the key organs regulating the metabolism of carbohydrates, proteins and fats. Its primary function is connected with increase of the metabolic conversion of the body. Skin lesions are often one of the first symptoms of hypothyroidism. In a 71-year-old patient, skin lesions in the form of thickened areas with severe hyperkeratosis first appeared 12 years before. Eight years before, the patient was diagnosed with hypothyroidism of unknown cause. Upon admission, lesions were observed in the trunk area, left arm and vulva. These lesions had the appearance of brownish spots with hyperkeratosis. Initially, they were localized on the trunk, then involving upper limbs and neck area with time. Significant progression was present in the back area. In the anogenital area, porcelain-white discolorations were observed. Laboratory examinations were normal. During hospital stay, iv. ceftriaxone at a dose of 2.0 g/day for 10 days and intramuscular injection of vitamin B6 were administered, along with 10% urea ointment for hyperkeratosis lesions as topical therapy. The patient had lesions in the form of skin induration and discoloration, with visible, very severe hyperkeratosis, which is not characteristic of changes of the scleroderma and lichen sclerosus type. These lesions caused diagnostic problems due to the atypical clinical appearance.Štitna žlijezda jedan je od ključnih organa koji regulira metabolizam ugljikohidrata, bjelančevina i masti. Njezina glavna funkcija povezana je s porastom konverzije u organizmu. Kožne promjene često su jedan od prvih simptoma hipotireoze. Kod naše bolesnice u dobi od 71 godine kožne promjene u vidu zadebljanih područja uz tešku hiperkeratozu prvi put su se pojavile 12 godina ranije, a osam godina ranije dijagnosticirana joj je hipotireoza nepoznatog uzroka. Kod prijma bolesnice opažene su promjene u području trupa, lijeve ruke i vulve. Te promjene izgledale su poput smeđkastih točkica s hiperkeratozom. U početku su bile lokalizirane na trupu, da bi kasnije s vremenom zahvatile gornje udove i područje vrata. Značajna progresija lezija zabilježena je na leđima. U anogenitalnom području opažene su porculanski bjelkaste mrlje na koži. Laboratorijski testovi bili su normalni. Za vrijeme hospitalizacije bolesnica je primala ceftriakson iv. u dozi od 2,0 g/dan kroz 10 dana i intramuskularne injekcije vitamina B6, uz lokalnu terapiju kremom s 10% ureje za hiperkeratotične lezije. Bolesnica je imala promjene u obliku kožne induracije i diskoloracije, uz vidljivu i vrlo tešku hiperkeratozu, što nije karakteristično za promjene tipa sklerodermije i skleroznog lihena. Ove promjene izazvale su dijagnostičke probleme zbog netipičnog kliničkog izgleda

Topical treatment of acne using a compounded medication based on clindamycin

Clindamycin, a lincosamide antibiotic, is widely used in the treatment of bacterial infections. It acts by inhibiting protein synthesis inbacteria, primarily targeting the peptidyl transferase centre in the bacterial ribosome. It exhibits bacteriostatic activity, inhibiting bacterialgrowth, and at higher doses, it can be bactericidal. In the treatment of acne vulgaris, clindamycin not only exerts direct antibacterialeffects but also possesses anti-inflammatory and immunomodulatory properties. It reduces the growth of Cutibacterium acnes and inhibitsthe production of proteins and lipases, which contribute to skin inflammation. Clindamycin also enhances bacterial opsonization andphagocytosis and reduces neutrophil chemotaxis. Combination therapy with benzoyl peroxide can help minimize antibiotic resistance.Topical clindamycin, often in combination with benzoyl peroxide or retinoids, is recommended in treatment for mild to moderate papulopustularacne. In hidradenitis suppurativa clindamycin improves disease control and reduces cutaneous lesions, particularly superficialones like papules and pustules. Various topical preparations containing clindamycin are available commercially, including gels, lotions, andcombination products with tretinoin or benzoyl peroxide. Additionally, the registration of clindamycin as a pharmaceutical raw materialallows for compounding personalized formulations, providing a cost-effective alternative. Compounded medications can be tailored toindividual patient needs and increase treatment effectiveness

Miescher's granulomatosis (granulomatosis disciformis chronica et progressiva) in a non-diabetic patient – case report

<p>Abstract</p> <p>Introduction</p> <p>Necrobiosis lipoidica diabeticorum is a rare disease of unclear etiology, that occurs in about 1% of diabetic patients.</p> <p>Case report</p> <p>We present case of granulomatosis disciformis chronica et progressiva Miescher with good response to systemic corticosteroids therapy.</p> <p>Patient 45 years old woman, with primary yellow-brown areas skin lesions, with foci well separated from surroundings on both lower legs, that occurred 5 years ago. In laboratory tests there was no abnormalities. Because of advance suggestion (after last admit in dermatological ward) of observation according to xantogranuloma necrobioticum tests for paraproteinemia were made. Immunoelectrophoresis, IgG, IgM, IgA levels, kappa light chain, lambda heavy chain; were correct, Bence-Johns protein-negative. During hospitalization in Clinic methylprednisolone in dose of 32 mg od, vascular drugs and local steroidotherapy was applied with good therapeutic response.</p> <p>Conclusion</p> <p>We described case of typical clinical and histological characters of necrobiosis lipoidica. without diabetes-granulomatosis disciformis chronica et progressiva Miescher that despite of suspicion of proper diagnosis for a long time was not treat effective.</p

Drug-induced subacute cutaneous lupus erythematosus caused by topical beta blocker - timolol

Drug-induced lupus erythematosus (DI-LE) is an autoimmune condition secondary to a recent pharmacological intervention. There are no established specific diagnostic criteria for DI-LE, and the disease is recognized based on the medical history of the patient. Typically, the onset is closely related to a recent drug exposure, and the disease terminates after discontinuation of the inducing factor. The most frequent form of DI-LE is drug-induced subacute cutaneous lupus erythematosus (DI-SCLE). There has been an increasing number of drugs which are suspected to provoke SCLE lesions. Previously, systemic beta-blockers (antiarrhythmics and antihypertensives) were shown to be inducing factors of SCLE, however data regarding its topical usage are lacking in the literature. We present the case of a 78-year-old woman who developed annular polycyclic erythema in sun-exposed areas of the skin, four weeks after an initiation of topical timolol treatment of glaucoma. A resolution of cutaneous manifestations within only a few weeks after a cessation of the agent confirmed a clinical suspicion of drug-induced SCLE.</p

Side effects of retinoid therapy on the quality of vision

Retinoids are compounds chemically related to vitamin A, which are frequently used in dermatological practice (1). They are characterized by numerous mechanisms of action leading to normalization of keratinocyte proliferation and maturation. They have anti-seborrhoeic, immunomodulatory and anti-inflammatory effects (1, 2). A number of side- effects to retinoid treatment have been recorded; one group of such side-effects relates to eyes and vision. Dry eye syndrome and blepharoconjunctivitis are the most common side-effects, appearing in 20–50 % of patients treated with retinoids (14). They often contribute to the occurrence of other side-effects such as eye discomfort and contact lens intolerance. Due to widespread use in clinical practice, the adverse effects, including ocular side effects, should be studied. To confirm the variety of adverse effects of retinoids, several case reports of rare side-effects are presented

Associations between site of skin lesions and depression, social anxiety, body-related emotions and feelings of stigmatization in psoriasis patients

Introduction: Research has demonstrated a link between psoriasis and a multitude of psychological impairments; however, relatively few studies have examined the importance of site of skin lesions for negative psychological outcomes in psoriasis patients. Aim: To investigate relationships between anatomical location of psoriatic lesions and experiences of stigmatization, negative emotional attitude towards the body, depression and social anxiety. Material and methods: Adult psoriasis patients (N = 193) completed the Stigmatization Scale, the Body Emotions Scale, the Beck Depression Inventory and the Social Anxiety Questionnaire. The body surface area index was used to assess the location and extent of psoriasis. Results: Feelings of stigmatization were found to be most closely related to the presence of psoriatic lesions on the chest, and the arms and hands. Higher levels of social anxiety were found to be most closely related to the location of psoriatic lesions on the head and neck. Negative emotional attitude towards the body was found to be most closely related to the location of psoriatic lesions on the arms and hands, and on the head and neck. Higher levels of depressive symptoms were most closely related to the presence of psoriatic lesions on the head and neck, the arms and hands, and the genital area. Conclusions: The presence of psoriatic lesions on the head, neck, and chest, and also on the arms and hands and the genital area, should alert clinicians to a higher risk of psychological impairments. This may help to better recognize and prevent cumulative life course impairment

Gender, Body Image and Social Support: Biopsychosocial Deter-minants of Depression Among Patients with Psoriasis

The aim of this study was to examine the importance of psychosocial factors, such as emotional and instrumental social support, distress, and assumptions about appearance and its salience to one’s self-worth, and to relate these factors to depressive symptoms in patients with psoriasis, according to gender. A group of 219 patients with psoriasis, aged 18-70 years completed the Beck Depression Inventory, the Appearance Schemas Inventory-Revised, the Berlin Social Support Scales, and the Distress Thermometer. Body Surface Area index was used to assess the severity of psoriasis. The main contributors to depression were: female gender, beliefs about appearance and its salience to one’s self-worth, greater psychological distress, and lower levels of emotional social support. Therefore, improving the body image of patients with psoriasis, by reducing its salience in their personal lives, may play a role in the prevention of depression, especially in women