Granulomatous rosacea: Like leukemid in a patient with acute myeloid leukemia

Introduction. Skin findings in leukemias may be divided into specific lesions (leukemia cutis) and non-specific lesions (leukemids) which may be found in up to 80% of all patients with leukemias. The leukemids vary clinically and they are usually a manifestation of bone marrow or immunologic impairment, but also Sweet syndrome, pyoderma gangrenosum, erythroderma, maculopapular exanthema, prurigo-like papules, generalized pigmentation, follicular mucinosis, generalized pruritus may be found during the course of leukemia. Case report. We report a 70-year-old male with a 3-month history of erythema, papules and pustules on the face, ears and neck and over a month history of refractory anemia, anorexia, weight loss, malaise, and fever. Physical examination revealed symmetric erythematous, violaceous papules, papulo-nodules and plaques with slate scale and sparse, small pustules on the face, earlobes and neck. Histopathologic findings of involved skin showed diffuse mixed inflammatory cell infiltrate with perifollicular accentuation and focal granulomatous inflammation in the papillary and upper reticular dermis. Extensive checkup revealed the presence of acute myeloid leukemia French- American-British (FAB) classification subtype M2, with signs of three-lineage dysplasia. The patient was treated by L6 protocol which led to complete remission, both in bone marrow and skin, but after seven months he had relapse of leukemia with the fatal outcome. Conclusion. This case indicates the importance of skin eruptions in the context of hematological malignancies

Atypical pyoderma gangrenosum in a patient with osteomyelofibrosis

Background. Atypical forms of pyoderma gangrenosum generally appear on the upper extremities; most frequently they are associated with myeloproliferative disorders, including osteomyelofibrosis. A response to systemic steroids is more pronounced than in classical form. Sometimes it may be the first sign of an underlying malignancy. Case report. We reported a patient with atypical pyoderma gangrenosum developed during the course of a myeloid malignancy - osteomyelofibrosis. The lesions occurred after a minor trauma. Painful blistering plaques, with an elevated, bluish-gray border were located on the dorsal aspect of hands. No skin malignancy was found. The lesions resolved rapidly to systemic steroids. Conclusion. Considering the unusual clinical presentation which makes the diagnosis difficult, as well as the fact that atypical forms of pyoderma gangrenosum can be the first sign of malignancies, especially myeloproliferative ones, recognizing this entity enables timely guiding future investigations toward their prompt detection

Imunski sistem uretre muškaraca

Sluznica muške uretre je inicijalno mesto infekcije brojnim patogenima koji su prenosivi seksualnim putem. U njenim donjim segmentima ce odvijaju složene aktivnosti vezane za kontrolu infekcije i sprečavanje njenog širenja prema gornjim segmentima muškog genitalnog trakta. Sluznica urogenitalnog trakta i kod muškaraca i kod žena sagledava ce kao integralni deo svekolikog mukoznog imunskog sistema, ali i kao imunološki samosvojni induktivni prostor sa specifičnim mehanizmima ugrađivanja i procesiranja antigena i pokretanja sekretornih imunskih odgovora. U velikoj meri neispitan, imunoglobulinski sistem muške uretre je predmet naših istraživanja i povod za ovaj osvrt na novija saznanja o mukoznom imunitetu, jednom od uzbudljivih polja savremenih istraživanja u imunobiologiji

Značaj alergena biljke Ambrosia artemisiifolia u etiopatogenezi atopijskog dermatitisa pasa

Pollens from Ambrosia species have a strong allergenic potential and they represent a complex mixture of at least 52 different antigens. This weed is widespread in Serbia and has a long pollination period (appr. 100 days). Pollens are present in very high concentrations during the pollination season (up to 300 pg/m3 of air). Fifty dogs with a clinical diagnosis of canine atopic dermatitis (CAD) and positive intradermal skin test (IDST) reactions to other environmental allergens were included in this study along with 30 dogs without clinical signs of CAD. Both groups were tested intradermally with Ambrosia artemisiifolia extract in concentration of 1000 PNU/mL (provided by ''Institute of virology, vaccines and sera - Torlak''). We have found that Ambrosia extract was second most common allergen to yield positive intradermal test reactions just after house dust mites. The positive reaction of IDST was observed in 66% of the atopic dogs and in 10% of clinically healthy dogs. Dogs that had a positive reaction on intradermal skin test to Ambrosia pollens, mostly showed secondary skin lesions on the pads and perioral skin. In 88% of cases, Malassezia pachydermatis have been isolated from the skin in an increased number and 64% of dogs had otitis externa. These results indicate, that allergens from Ambrosia artemisifolia are of great importance in the etiopathogenesis of atopic dermatitis in dogs originating from the Belgrade region.Polen ambrozije ima jaka alergijska svojstva i sastoji se od kompleksne mešavine od do sada poznatih 52 antigena. Ova korovska biljka je znatno rasprostranjena u Srbiji i ima dugačak period polinacije od prosečno 100 dana. Polen je prisutan u izrazito visokim koncentracijama tokom avgusta i septembra ide i do 300 polenovih zrna u m3 vazduha. Ovim ispitivanjem obuhvaćeno je 50 pasa kod kojih je dijagnostikovan atopijski dermatitis na osnovu kliničkih simptoma i pozitivne reakcije na intradermalnom testu, kao i 30 pasa bez klinički manifestnih simptoma atopijskog dermatitisa. Kod obe grupe pasa uradjeno je intradermalno testiranje standardnim rastvorima proizvođača Instituta za imunologiju i virusologiju Torlak, kao i vodenim rastvorom alergena ambrozije u koncentraciji 1000 PNU/ml. U našem ispitivanju polen ambrozije predstavlja drugi alergen po učestalosti pozitivne reakcije na intradermalnom testu kod ispitivanih pasa, odmah posle kućnih grinja. Pozitivna reakcija zabeležena je kod 66% pasa iz grupe atopičara i kod 10% klinički zdravih pasa. Kod pasa koji su pokazali pozitivnu reakciju na intradermalnom testu na polen ambrozije, sekundarne lezije kože su se najčešće javljale na šapama i oko usana. Kod 88% ovih pasa na koži je u povećanom broju dijagnostikovana Malassezia pachydermatis, a kod 64% jedinki je registrovan otitis externa različite etiologije. Na osnovu dobijenih rezultata se može zaključiti da je alergen biljke Ambrosia artemisiifolia veoma značajan u indukciji atopijskog dermatitisa kod populacije pasa sa šireg područja Beograda