14 research outputs found
Perifolliculitis Capitis Abscedens et Suffodiens Treated with Anti-tumor Necrosis Factor-alpha ā Possible New Treatment Option
The case of a 26-year-old male patient with perifolliculitis capitis abscedens et suffodiens (PCAS) who later developed hidradenitis suppurativa (HS) and exacerbation of acne is presented. The patient did not respond well to conventional treatment including isotretinoin and oral antibiotics. Quality of life was significantly impaired. After introduction of anti-tumor necrosis factor-alpha (TNF-Ī±) treatment, the patientās clinical picture improved dramatically and quality of life increased. The treatment has been well tolerated by the patient for 15 months at time of writing this report.Ā </p
The incidence of fatigue that symptoms in malignant diseases
Umor je jedan od najÄeÅ”Äih simptoma u bolesnika sa zloÄudnom bolesti. Može se javiti tijekom cjelokupnog trajanja bolesti: od dijagnoze, tijekom lijeÄenja, a može trajati mjesecima, pa i godinama nakon zavrÅ”etka terapije. Prevalencija se kreÄe od 15% do 90% ovisno o koriÅ”tenim metodama za mjerenje umora i karakteristikama bolesti i lijeÄenja. Umor u onkoloÅ”kih bolesnika znaÄajno utjeÄe na kvalitetu života, fiziÄko funkcioniranje i psihiÄko zdravlje. Ima jaÄi negativni utjecaj na svakodnevni život bolesnika od ostalih simptoma povezanih sa zloÄudnom bolesti. Umor takoÄer može imati negativan uÄinak na ishod lijeÄenja smanjujuÄi preživljenje, stoga je neophodno rano otkrivanje i odgovarajuÄa intervencija. Ipak simptom umora u ovih bolesnika kontinuirano je zanemaren, nedovoljno prijavljen i lijeÄen. Uzroci umora u bolesnika sa zloÄudnom bolesti su multifaktorijalni i slabo razjaÅ”njeni, i njegova terapija Äesto stvara velike poteÅ”koÄe lijeÄnicima i bolesnicima. S obzirom na to da je umor subjektivan simptom, najbolje se može procijeniti s pomoÄu upitnika koje ispunjavaju sami bolesnici. SpecifiÄno lijeÄenje provodi se ako su identificirani uzrok ili pridonoseÄi Äimbenici. NespecifiÄno lijeÄenje umora ukljuÄuje nefarmakoloÅ”ke metode poput psihosocijalnih intervencija, tjelesne aktivnosti, terapije poremeÄaja spavanja, akupunkture i joge, dok farmakoloÅ”ko lijeÄenje ukljuÄuje psihostimulanse, antidepresive i kortikosteroide. Ovaj rad predstavlja pregled prevalencije, patogeneze, dijagnostike i moguÄeg lijeÄenja simptoma umora u bolesnika sa zloÄudnom bolesti.Fatigue is one of the most prevalent symptoms in cancer patients. It can occur at any time throughout the course of the disease: at time of diagnosis, during treatment and even months to years after completion of therapy. Prevalence estimates have ranged from 15% to 90% of all cancer patients, depending on methods used for measuring fatigue and patient group characteristics. Cancer-related fatigue (CRF) has an adverse effect on quality of life, physical functioning and can significantly affect daily activities, in some cases more than any other cancer-related symptom. It can also be a risk factor for reduced survival so awareness, early diagnosis and effective intervention are necessary. Despite its impact on patients and caregivers, fatigue is underreported and underrecognized, and remains undertreated among patients with cancer. The causes of CRF are multifactorial and poorly understood. This is the why alleviating CRF is a challenge for physicians and patients. Management of fatigue is cause-specific when conditions known to contribute to fatigue can be identified and treated. Otherwise treatment modalities for CRF are nonspecific and include nonpharmacologic interventions such as psychosocial interventions, exercise, sleep therapy, acupuncture and yoga, while pharmacologic interventions include psychostimulants, antidepressants and corticosteroids. This paper focuses on prevalence, pathogenesis, assessment and possible treatment of cancer-related fatigue
The incidence of fatigue that symptoms in malignant diseases
Umor je jedan od najÄeÅ”Äih simptoma u bolesnika sa zloÄudnom bolesti. Može se javiti tijekom cjelokupnog trajanja bolesti: od dijagnoze, tijekom lijeÄenja, a može trajati mjesecima, pa i godinama nakon zavrÅ”etka terapije. Prevalencija se kreÄe od 15% do 90% ovisno o koriÅ”tenim metodama za mjerenje umora i karakteristikama bolesti i lijeÄenja. Umor u onkoloÅ”kih bolesnika znaÄajno utjeÄe na kvalitetu života, fiziÄko funkcioniranje i psihiÄko zdravlje. Ima jaÄi negativni utjecaj na svakodnevni život bolesnika od ostalih simptoma povezanih sa zloÄudnom bolesti. Umor takoÄer može imati negativan uÄinak na ishod lijeÄenja smanjujuÄi preživljenje, stoga je neophodno rano otkrivanje i odgovarajuÄa intervencija. Ipak simptom umora u ovih bolesnika kontinuirano je zanemaren, nedovoljno prijavljen i lijeÄen. Uzroci umora u bolesnika sa zloÄudnom bolesti su multifaktorijalni i slabo razjaÅ”njeni, i njegova terapija Äesto stvara velike poteÅ”koÄe lijeÄnicima i bolesnicima. S obzirom na to da je umor subjektivan simptom, najbolje se može procijeniti s pomoÄu upitnika koje ispunjavaju sami bolesnici. SpecifiÄno lijeÄenje provodi se ako su identificirani uzrok ili pridonoseÄi Äimbenici. NespecifiÄno lijeÄenje umora ukljuÄuje nefarmakoloÅ”ke metode poput psihosocijalnih intervencija, tjelesne aktivnosti, terapije poremeÄaja spavanja, akupunkture i joge, dok farmakoloÅ”ko lijeÄenje ukljuÄuje psihostimulanse, antidepresive i kortikosteroide. Ovaj rad predstavlja pregled prevalencije, patogeneze, dijagnostike i moguÄeg lijeÄenja simptoma umora u bolesnika sa zloÄudnom bolesti.Fatigue is one of the most prevalent symptoms in cancer patients. It can occur at any time throughout the course of the disease: at time of diagnosis, during treatment and even months to years after completion of therapy. Prevalence estimates have ranged from 15% to 90% of all cancer patients, depending on methods used for measuring fatigue and patient group characteristics. Cancer-related fatigue (CRF) has an adverse effect on quality of life, physical functioning and can significantly affect daily activities, in some cases more than any other cancer-related symptom. It can also be a risk factor for reduced survival so awareness, early diagnosis and effective intervention are necessary. Despite its impact on patients and caregivers, fatigue is underreported and underrecognized, and remains undertreated among patients with cancer. The causes of CRF are multifactorial and poorly understood. This is the why alleviating CRF is a challenge for physicians and patients. Management of fatigue is cause-specific when conditions known to contribute to fatigue can be identified and treated. Otherwise treatment modalities for CRF are nonspecific and include nonpharmacologic interventions such as psychosocial interventions, exercise, sleep therapy, acupuncture and yoga, while pharmacologic interventions include psychostimulants, antidepressants and corticosteroids. This paper focuses on prevalence, pathogenesis, assessment and possible treatment of cancer-related fatigue
Are Multiple Primary Melanomas a Rare Entity?
Multiple primary melanomas are described in literature as a relatively rare, but nevertheless well known entity. The incidence varies from 0.2 to 23 % worldwide. Many risk factors for the development of multiple primary melanomas have been observed, including multiple dysplastic nevi, positive family history, over 60 years of age at diagnosis of first melanoma, male sex and white race. The first primary melanoma in patients with multiple primary melanomas has the greatest tumour thickness, while subsequent melanomas are usually significantly less invasive, most probably due to strict follow-up schedules and regular self-examinations. We will report of two patients with multiple primary melanomas and follow-up methods for early detection of other primary melanomas
Notalgia paresthetica
Notalgia paresthetica is a common, although under-recognized condition characterized by localized chronic pruritus in the upper back, most often affecting middle-aged women. Apart from pruritus, patients may present with a burning or cold sensation, tingling, surface numbness, tenderness and foreign body sensation. Additionally, patients often present with hyperpigmented skin at the site of symptoms. The etiology of this condition is still poorly understood, although a number of hypotheses have been described. It is widely accepted that notalgia paresthetica is a sensory neuropathy caused by alteration and damage to posterior rami of thoracic spinal nerves T2 through T6. To date, no well-defined treatment has been found, although many treatment modalities have been reported with varying success, usually providing only temporary relief.Notalgia paresthetica je uÄestalo, iako slabo prepoznato stanje koje obilježava lokalizirani kroniÄni pruritus gornjeg dijela leÄa, a najÄeÅ”Äe se javlja u žena srednje životne dobi. Uz svrbež u bolesnika se takoÄer može javiti osjeÄaj žarenja ili hladnoÄe, trnci, utrnulost, osjetljivost i osjeÄaj stranog tijela. Uz to, na mjestu simptoma Äesto se javlja podruÄje hiperpigmentirane kože. Iako postoji viÅ”e hipoteza, etiologija ove bolesti slabo je poznata. OpÄe je prihvaÄeno da je notalgia paresthetica senzorna neuropatija uzrokovana oÅ”teÄenjem stražnjih ogranaka torakalnih kralježniÄnih živaca od T2 do T6. UnatoÄ mnogim razliÄitim terapijskim metodama koje su bile promjenjivoga uspjeha i najÄeÅ”Äe pružale privremeno olakÅ”anje, do danas nema uspjeÅ”noga lijeÄenja ove bolesti
Effect of allergens and irritants on levels of natural moisturizing factor and corneocyte morphology
BACKGROUND:
The irritant sodium lauryl sulfate (SLS) is known to cause a decrease in the stratum corneum level of natural moisturizing factor (NMF), which in itself is associated with changes in corneocyte surface topography. ----- OBJECTIVE:
To explore this phenomenon in allergic contact dermatitis.
----- METHODS:
Patch testing was performed on patients with previously positive patch test reactions to potassium dichromate (Cr), nickel sulfate (Ni), methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI), or p-phenylenediamine. Moreover, a control (pet.) patch and an irritant (SLS) patch were applied. After 3ādays, the stratum corneum from tested sites was collected, and NMF levels and corneocyte morphology, expressed as the amount of circular nanosize objects, quantified according to the Dermal Texture Index (DTI), were determined. ----- RESULTS:
Among allergens, only MCI/MI reduced NMF levels significantly, as did SLS. Furthermore, only MCI/MI caused remarkable changes at the microscopic level; the corneocytes were hexagonal-shaped with pronounced cell borders and a smoother surface. The DTI was increased after SLS exposure but not after allergen exposure. ----- CONCLUSIONS:
MCI/MI significantly decreased NMF levels, similarly to SLS. The altered corneocyte morphology suggests that skin barrier damage plays a role in the pathogenesis of MCI/MI contact allergy. The DTI seems to differentiate reactions to SLS from those to the allergens tested, as SLS was the only agent that caused a DTI increase