Development and significance of the E-surveillance system for contact allergies in Slovenia

This paper describes the development and significance of online systems for the collection and analysis of medical data (patch test results) with a web application. Modern digital tools greatly aid in collecting, combining, and preserving the data in a way that is friendly, undemanding and time-efficient for the dermatologist. Creating a central database for the results of patch testing provides a better picture of contact sensitivity and characteristics of allergic contact dermatitis in Slovenia. An electronic database and connected network was started in Slovenia in 2010. Data from skin allergy units since 2000 has also been included retrospectively. At present (Oct 2016), the database contains the data of 19,772 patch tests performed by seven skin allergy units. Creating a central database of the results of patch testing provides a larger and therefore more credible collection of data. Immediate integration and data processing enable a current overview of contact sensitivity for each participating center as well as at the national level. Data can be easily transferred to other databases or edited with other software tools. This on-line register has worked flawlessly for more than five years. We have contributed data to the European Surveillance System on Contact Allergies (ESSCA) network database since 2012, which, along with the Deutsche Kontaktallergie-Gruppe system of collecting patch test data for German-speaking countries, represents the only multicenter surveillance system of patch test results in Europe. </p

Differential diagnosis of contact dermatitis: A practical-approach review by the EADV Task Force on contact dermatitis.

The diagnosis of eczema ('dermatitis') is mostly clinical and depends on the clinical history and exploratory objective findings (primary lesions, patterns). Contact dermatitis remains as an important condition in the group of eczematous disorders, with important socioeconomic and occupational relevance. Although irritant and allergic contact dermatitis have a different pathogenesis, both are characterized by a rather typical morphology, are triggered by external factors and tend to occur primarily in the area of contact with the exogenous agent. In addition, allergic and irritant dermatitis may also co-exist. The importance of diagnosing contact dermatitis, especially when allergic in nature, is both due to the possibility of avoiding the trigger, and due to its role in aggravating other skin conditions. Nevertheless, the heterogeneity of clinical presentations in daily practice may pose an important challenge for the suspicion and correct diagnosis of contact dermatitis. Furthermore, other conditions, with different pathogenesis and treatment, may clinically simulate contact dermatitis. The Task Force aims to conduct a review of the unifying clinical features of contact dermatitis and characterize its main clinical phenotypes, and its simulators, in order to contribute to an early suspicion or recognition of contact dermatitis and enable a correct differential diagnosis

Patch test results with the European baseline series, 2019/20-Joint European results of the ESSCA and the EBS working groups of the ESCD, and the GEIDAC

BACKGROUND Continual analyses of patch test results with the European baseline series (EBS) serve both contact allergy surveillance and auditing the value of included allergens. OBJECTIVES To present results of current EBS patch testing, obtained in 53 departments in 13 European countries during 2019 and 2020. METHODS Anonymised or pseudonymised individual data, and partly aggregated data on demographic/clinical characteristics and patch test rest results with the EBS were prospectively collected and centrally pooled and analysed. RESULTS In 2019 and 2020, 22581 patients were patch tested with the EBS. Sensitization to nickel remained most common (19.8 (19.2-20.4)% positivity (95% confidence interval)). Fragrance mix I and Myroxylon pereirae yielded very similar results with 6.80 (6.43-7.19)% and 6.62 (6.25-7.00)% positivity, respectively. Formaldehyde at 2% aq. yielded almost one percentage point more positive reactions than 1% concentration (2.49 (2.16-2.85)% vs. 1.59 (1.33-1.88)); methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI alone up to around 5% positives. Among the new additions, propolis was most commonly positive (3.48 (3.16-3.82)%), followed by 2-hydroxyethyl methacrylate (2.32 (2.0-2.68)%). CONCLUSIONS Ongoing surveillance on the prevalence of contact sensitization contributes to an up-to-date baseline series containing the most frequent and/or relevant contact sensitizers for routine patch testing in Europe. This article is protected by copyright. All rights reserved

Priporočila za obravnavo bolnikov z bazalnoceličnim karcinomom

no abstractni abstrakt

Vloga dermatologa pri zgodnjem odkrivanju in obravnavi bolnika z melanomom

Skin melanoma is one of cancers with the largest annual increase both in the world and Slovenia. Alongside the rapidly increasing incidence, the epidemiological data show stable mortality in the last two decades and a constant share of fatty tumours in male patients aged over 60 years. Melanoma is a result of a complex interaction between the genotype and environmental factors that also determine the phenotypic characteristics signalling an increased risk of the occurrence of melanoma in one’s life. The role of a dermatologist is to detect melanoma at early stages of the disease, when it is still difficult to recognise it clinically and melanoma can be mistaken for melanocytic nevi or other skin lesions. Early diagnosis of melanoma is based on new diagnostic methods in dermatology, such as dermoscopy, confocal microscopy and teledermatology, as well as on well-organised work which allows identification and monitoring of individuals with an increased risk for developing melanoma. In thin melanomas, the dermatologist also performs the therapeutic part, namely tumour excision, while in invasive and metastatic forms of the disease, he decides on the patient’s interdisciplinary treatment. Due to an increased risk for the development of a new primary melanoma, management of patients following detection of melanoma also requires lifelong monitoring by the dermatologist. The dermatological associations design and implement primary and secondary prevention programmes aimed at reducing the risk factors and early detection of melanoma, as well as other forms of skin cancer. New findings confirm the pathogenic diversity of melanoma, which indicates the need to implement changes and individualise measures aimed at primary and secondary prevention of skin melanoma.Kožna oblika melanoma sodi med rakava obolenja z največjim letnim prirastkom tako v svetu kot pri nas. Epidemiološki podatki ob hitro rastoči incidenci nakazujejo stabilno mortaliteto v zadnjih dveh desetletjih in konstantni delež debelih tumorjev za moške nad 60. letom starosti. Melanom je posledica kompleksne prepletenosti genotipa in dejavnikov iz okolja, ki določajo tudi fenotipske značilnosti, ki opozarjajo na povečano tveganje za pojav melanoma v življenju. Vloga dermatologa je odkrivanje melanoma v zgodnjih stadijih bolezni, ko je klinično težje prepoznaven, zamenljiv z melanocitnimi nevusi ali drugimi lezijami na koži. Zgodnja diagnostika melanoma temelji na poznavanju novih diagnostičnih metod v dermatologiji, kot so dermoskopija, konfokalna mikroskopija in teledermatologija, kot tudi ustrezni organizaciji dela, ki omogoča prepoznavanje ter spremljanje posameznikov z večjim tveganjem za pojav melanoma. Pri tankih melanomih dermatolog opravi tudi terapevtski del, ekscizijo tumorja, medtem ko pri invazivnih in metastatskih oblikah bolezni predvidi interdisciplinarno zdravljenje pacienta. Zaradi povečanega tveganja za razvoj novega primarnega melanoma je v obravnavi bolnikov po odkritem melanomu določena potreba po doživljenjskem spremljanju s strani dermatologa. Dermatološka zdrużenja oblikujejo in izvajajo programe primarne ter sekundarne preventive, katerih namen je zmanjševanje dejavnikov tveganja in zgodnje odkrivanje melanoma kot tudi drugih oblik kožnega raka. Nova spoznanja potrjujejo patogenetsko raznolikost melanoma, kar kaže na potrebo po spremembah in individualizaciji ukrepov primarne ter sekundarne preventive kožnega melanoma