Povezanost alergijskih reakcija i upale usnica (heilitisa)

The purpose of this study was to examine the possible association between cheilitis and allergic reactions, and to use allergy skin tests to identify the allergens that induce allergic reactions in cheilitis patients (type I and type IV). We included 50 patients with recurrent cheilitis (reversible cheilitis) who were dermatologically examined and agreed to undergo allergy skin tests, i.e., patch test and prick test. Additionally, clinical pictures and patient mental stress levels were examined using the Perceived Stress Scale (PSS). Positive prick tests (atopy) were recorded in 84% of patients with cheilitis. The most frequently found allergens were contact allergens (54%) (cobalt chloride, nickel sulfate and thimerosal) and inhalant allergens (46%). The patch test positive subjects who used cosmetic, hygiene, and decorative products were significantly more likely to have swollen and red lips than the patch test negative subjects. Also, low stress levels were recorded less frequently in patients with confirmed allergies than in non-allergic patients. The results indicated a higher incidence of cheilitis in the people prone to allergies (atopics) and confirmed an association between cheilitis and allergies. To our knowledge, this is the first study in patients with cheilitis, which simultaneously analyzed allergies, their clinical features and PSS in the same patients.Svrha ovoga rada bila je istražiti moguću povezanost između upale usnica (heilitisa) i alergijskih reakcija te pomoću alergoloških testova utvrditi najčešće alergene koji uzrokuju alergijske reakcije u bolesnika s upalom usnica (tip I. i tip IV.). Ukupno je 50 ispitanika s reverzibilnim heilitisom bilo podvrgnuto dermatološkom pregledu te u konačnici pristalo na alergološka testiranja kože, patch test i prick test. Zatim su zabilježeni simptomi koji se pojavljuju nakon primjene raznih proizvoda za usnice. Također, ispitanici su ispunili upitnik kojim se utvrđuje razina psihičkog stresa, Perceived Stress Scale (PSS). U 84% ispitanika s heilitisom bio je pozitivan barem jedan alergen iz prick testa (atopija). Najčešće utvrđeni alergeni bili su alergeni patch testa (54%, kobalt klorid, nikal sulfat i timerosal) te inhalacijski alergeni (46%). Ispitanici koji su bili pozitivni na kontaktne alergene (alergene patch testa) nakon uporabe kozmetičkih, higijenskih i dekorativnih proizvoda češće su imali otečene i crvene usnice nego ispitanici koji nisu imali niti jedan pozitivan kontaktni alergen. Također, u bolesnika u kojih je utvrđena alergija, niska razina stresa uočena je rjeđe nego u ne-alergičara. Rezultati ovoga istraživanja pokazuju višu incidenciju heilitisa u bolesnika sklonih alergijama (atopičari) te potvrđuju povezanost heilitisa i alergija. Prema našim spoznajama, ovo je prvo istraživanje u kojem su u bolesnika s upalom usnica istodobno analizirane alergijske reakcije, simptomi i klinička slika te razina stresa

Disease Progression in Cases of Multiple Primary Melanoma

Multiple primary melanoma (MPM) is a well-known phenomenon, but outcome studies regarding patients with MPM are rare. Aim of our study was to analyze whether MPM are less likely to metastasize than single primary melanomas (SPM). In our study disease progression (defined by the occurrence of regional lymph node or distant metastases) in cases of MPM was compared to cases of SPM on a sample of 1698 melanomas. Statistically significant difference in the occurrence of disease progression was found between the analyzed groups, progression being significantly less frequent in patients with MPM (P=0.009). Also, MPM occurred significantly more frequently in male patients (P= 0.001).We attribute these results not only to early detection of subsequent MPM, but to a variety of possible reasons, including different genetics and biology of tumors and, possibly, the immune response of the host. Further studies are required to elucidate these interesting findings.</p

Differencijalna dijagnoza heilitisa – kako klasificirati heilitis?

Although cheilitis as a term describing lip inflammation has been identified and recognized for a long time, until now there have been no clear recommendations for its work-up and classification. The disease may appear as an isolated condition or as part of certain systemic diseases/conditions (such as anemia due to vitamin B12 or iron deficiency) or local infections (e.g., herpes and oral candidiasis). Cheilitis can also be a symptom of a contact reaction to an irritant or allergen, or may be provoked by sun exposure (actinic cheilitis) or drug intake, especially retinoids. Generally, the forms most commonly reported in the literature are angular, contact (allergic and irritant), actinic, glandular, granulomatous, exfoliative and plasma cell cheilitis. However, variable nomenclature is used and subtypes are grouped and named differently. According to our experience and clinical practice, we suggest classification based on primary differences in the duration and etiology of individual groups of cheilitis, as follows: 1) mainly reversible (simplex, angular/infective, contact/eczematous, exfoliative, drug-related); 2) mainly irreversible (actinic, granulomatous, glandular, plasma cell); and 3) cheilitis connected to dermatoses and systemic diseases (lupus, lichen planus, pemphi-gus/pemphigoid group, ­angioedema, xerostomia, etc.).Iako je heilitis kao pojam koji opisuje upalu usnica bio zapažen i prepoznat već prije dugo vremena, dosad nema jasnih preporuka za dijagnostički postupak i klasifikaciju. Bolest se može javiti kao izolirano stanje ili kao dio nekih bolesti/stanja poput anemije (zbog nedostatka vitamina B12 i željeza) ili lokalne infekcije (npr. herpes i oralna kandidijaza). Heilitis tako-đer može biti simptom kontaktne reakcije na iritans ili alergen te može biti potaknut izlaganjem suncu (aktinički heilitis) ili uzimanjem lijeka (osobito retinoida). Općenito se najčešće spominju oblici angularni, kontaktni (alergijski i iritativni), aktinički, glandularni, granulomatozni, eksfolijativni i plazmacelularni heilitis. Ipak se u literaturi o heilitisu rabi različita nomenklatura pa su podtipovi grupirani i nazvani različito. Prema našem iskustvu i kliničkoj praksi predlažemo klasifikaciju temeljenu na primarnoj razlici u trajanju i etiologiji pojedinih skupina heilitisa: 1. pretežno reverzibilni (simpleks, angular-ni/infektivni, kontaktni/ekcematoidni, eksfolijativni, lijekom potaknuti), 2. pretežno ireverzibilni (aktinički, granulomatozni, glandularni, plazmacelularni) i 3. heilitisi povezani s dermatozama i sustavnim bolestima (lupus, lihen planus, skupina pemfigusa/pemfigoida, angioedem, kserostomija it

Correlation of Anaemia and Cognitive Functions Measured by the Complex Reactiometer Drenovac

Cognitive impairment impinges significantly on the quality of life. Previous research revealed that anaemia can have a major influence on cognitive functioningt. The article is a correlational study examining the relationship between anaemia levels and cognitive functioning in adult patients. Sixty-one patients (both inpatients and outpatients), among them 30 anemic and 31 non- anaemic, 33 female and 28 male, aged 32–60 (median 43) treated at the Dept. of Hematology, Clinical Hospital Center Rijeka, Croatia were analysed according to hemoglobin (Hb) level and cognitive ability. Assessment of cognition (convergent inductive thinking) was performed by the Complex reactiometer Drenovac (CRD). The results showed that anaemia significantly undermines cognitive functions in adult patients (p<0.01). Even in non-anaemic patients (Hb higher than 120 g/L), Hb level is related to better cognitive ability

Mindfulness in atopic dermatitis

Cilj rada je prikazati učinak mindfulnessa (usredotočene svjesnosti, pomnosti) u liječenju atopijskog dermatitisa. Atopijski dermatitis je česta, kronično recidivirajuća upalna bolest kože kompleksne etiopatogeneze, kliničke slike i terapije. Svrbež kao najneugodniji simptom atopijskog dermatitisa ima značajan utjecaj na kvalitetu života. Budući da je stres često pokretač pogoršanja dermatitisa, a mentalni komorbiditeti poput tjeskobe i depresije često prate atopijski dermatitis, uz klasičnu dermatološku terapiju u liječenju se primjenjuju psihološke intervencije. Uvježbavajući mindfulness učimo kako se nositi sa svakodnevnim životnim izazovima i smanjiti utjecaj stresa na pogoršanja dermatitisa. Uvježbava se promatrati svrbež kao tjelesnu senzaciju, a akt češanja odgoditi i svrbež bolje kontrolirati. Redovitim vježbanjem mindfulnessa smanjuje se utjecaj atopijskog dermatitisa na kvalitetu života oboljele osobe.The aim of the paper is to present the impact of mindfulness in the treatment of atopic dermatitis. Atopic dermatitis is a common, chronic, recurring inflammatory skin disease with a complex etiopathogenesis, clinical presentation, and therapy. Itching, as the most unpleasant symptom of atopic dermatitis, significantly reduces the quality of life. Since stress is often a trigger for the exacerbation of dermatitis, and mental comorbidities such as anxiety and depression frequently affect patients with atopic dermatitis, psychological interventions are important part of treatment regimen in addition to conventional dermatological therapy. By practicing mindfulness, individuals learn how to cope with everyday life challenges and reduce the impact of stress on exacerbations of dermatitis. Patients are trained to observe itching as a bodily sensation, and the act of scratching is delayed to better control the itch. Practicing mindfulness regularly reduces the impact of atopic dermatitis on the quality of life of affected individuals

Psychodermatology in children and adolescents

Cilj rada je prikazati značaj psihodermatologije u liječenju kroničnih bolesti kože dječje i adolescentne dobi. Razdoblje odrastanja i sazrijevanja važno je za razvoj percepcije vlastitog tijela, samopoštovanja i osjećaja zadovoljstva. Odrastati opterećen i pod pritiskom kožne bolesti može imati dugoročne posljedice ne samo za razdoblje djetinjstva i adolescencije, već i za odraslu dob. Upravo se zato uz klasičnu dermatološku terapiju, edukaciju o bolesti i načinima liječenja, sve više kao dio dermatološke terapije kroničnih bolesti kože dječje i adolescentne dobi koristi i psihoterapija koja pomaže lakše se suočiti s bolesti i smanjiti utjecaj bolesti na kvalitetu života.The aim of the paper is to show the importance of psychodermatology in the treatment of chronic skin diseases in children and adolescents. The period of growing up and maturing is important for the development of the perception of one’s own body, self-esteem and sense of satisfaction. Growing up burdened and under the pressure of a skin disease can have long-term consequences, not only for the period of childhood and adolescence, but also for adulthood. This is precisely why, in addition to classic dermatological therapy, education about the disease and methods of treatment, psychotherapy is increasingly used as part of chronic skin diseases treatment in children and adolescents, helping them to face the disease more easily and reducing the impact of the disease on the quality of life

Povezanost alergijskih reakcija i upale usnica (heilitisa)

The purpose of this study was to examine the possible association between cheilitis and allergic reactions, and to use allergy skin tests to identify the allergens that induce allergic reactions in cheilitis patients (type I and type IV). We included 50 patients with recurrent cheilitis (reversible cheilitis) who were dermatologically examined and agreed to undergo allergy skin tests, i.e., patch test and prick test. Additionally, clinical pictures and patient mental stress levels were examined using the Perceived Stress Scale (PSS). Positive prick tests (atopy) were recorded in 84% of patients with cheilitis. The most frequently found allergens were contact allergens (54%) (cobalt chloride, nickel sulfate and thimerosal) and inhalant allergens (46%). The patch test positive subjects who used cosmetic, hygiene, and decorative products were significantly more likely to have swollen and red lips than the patch test negative subjects. Also, low stress levels were recorded less frequently in patients with confirmed allergies than in non-allergic patients. The results indicated a higher incidence of cheilitis in the people prone to allergies (atopics) and confirmed an association between cheilitis and allergies. To our knowledge, this is the first study in patients with cheilitis, which simultaneously analyzed allergies, their clinical features and PSS in the same patients.Svrha ovoga rada bila je istražiti moguću povezanost između upale usnica (heilitisa) i alergijskih reakcija te pomoću alergoloških testova utvrditi najčešće alergene koji uzrokuju alergijske reakcije u bolesnika s upalom usnica (tip I. i tip IV.). Ukupno je 50 ispitanika s reverzibilnim heilitisom bilo podvrgnuto dermatološkom pregledu te u konačnici pristalo na alergološka testiranja kože, patch test i prick test. Zatim su zabilježeni simptomi koji se pojavljuju nakon primjene raznih proizvoda za usnice. Također, ispitanici su ispunili upitnik kojim se utvrđuje razina psihičkog stresa, Perceived Stress Scale (PSS). U 84% ispitanika s heilitisom bio je pozitivan barem jedan alergen iz prick testa (atopija). Najčešće utvrđeni alergeni bili su alergeni patch testa (54%, kobalt klorid, nikal sulfat i timerosal) te inhalacijski alergeni (46%). Ispitanici koji su bili pozitivni na kontaktne alergene (alergene patch testa) nakon uporabe kozmetičkih, higijenskih i dekorativnih proizvoda češće su imali otečene i crvene usnice nego ispitanici koji nisu imali niti jedan pozitivan kontaktni alergen. Također, u bolesnika u kojih je utvrđena alergija, niska razina stresa uočena je rjeđe nego u ne-alergičara. Rezultati ovoga istraživanja pokazuju višu incidenciju heilitisa u bolesnika sklonih alergijama (atopičari) te potvrđuju povezanost heilitisa i alergija. Prema našim spoznajama, ovo je prvo istraživanje u kojem su u bolesnika s upalom usnica istodobno analizirane alergijske reakcije, simptomi i klinička slika te razina stresa

Differential Diagnosis of Cheilitis – How to Classify Cheilitis?

Although cheilitis as a term describing lip inflammation has been identified and recognized for a long time, until now there have been no clear recommendations for its work-up and classification. The disease may appear as an isolated condition or as part of certain systemic diseases/conditions (such as anemia due to vitamin B12 or iron deficiency) or local infections (e.g., herpes and oral candidiasis). Cheilitis can also be a symptom of a contact reaction to an irritant or allergen, or may be provoked by sun exposure (actinic cheilitis) or drug intake, especially retinoids. Generally, the forms most commonly reported in the literature are angular, contact (allergic and irritant), actinic, glandular, granulomatous, exfoliative and plasma cell cheilitis. However, variable nomenclature is used and subtypes are grouped and named differently. According to our experience and clinical practice, we suggest classification based on primary differences in the duration and etiology of individual groups of cheilitis, as follows: 1) mainly reversible (simplex, angular/infective, contact/eczematous, exfoliative, drug-related); 2) mainly irreversible (actinic, granulomatous, glandular, plasma cell); and 3) cheilitis connected to dermatoses and systemic diseases (lupus, lichen planus, pemphi-gus/pemphigoid group, ­angioedema, xerostomia, etc.)

Giant rhinophyma with olfactory and breathing dysfunction successfully treated by shave excision and electrocautery

Rhinophyma is a benign, progressive, and disfiguring proliferative skin disorder characterized by a large, bulbous, and erythematous-appearing nose. It is considered as the final stage of acne rosacea. Surgical treatment is necessary in cases of breathing and vision difficulties, cosmetic deformity, or psychological distress. Herein we describe the case of a giant rhinophyma with breathing and olfactory difficulties successfully treated by surgical excision and bipolar electrocautery with an excellent cosmetic result and without complications in a five-year follow-up period