Congenital infantile digital fibromatosis: a case report and review of the literature

Infantile digital fibromatosis (IDF) is a rare benign fibroproliferative tumor of early childhood. IDF preferentially affects the fingers and the toes. Malignant transformation or metastases have never been reported. Surgical treatment has been advocated previously but local recurrences were observed frequently. Recent literature supports clinical surveillance without any medical or surgical intervention as spontaneous regression usually occurs after two to three years. A six-month-old Caucasian girl with IDF on the left fourth digit is presented here. The tumor progressively increased in size after birth. Topical imiquimod cream and diflucortolone valerate cream, both displaying antifibrotic properties, had no effect on tumor growth. Currently the lesion size remains stable without any treatment. Early recognition of IDF is important in order to avoid unnecessary surgical intervention that may prove to be potentially aggravating, unless serious functional or cosmetic concerns intervene. Parents should be reassured concerning the benign nature of IDF and be informed that spontaneous involution of IDF might be expected

Context server on a mobile device

Da bi mobilne aplikacije lahko učinkovito nudile vse svoje storitev in jih prilagodile uporabniku, bi morale pri tem uporabiti ves kontekst uporabnika in njegove okolice. V obstoječih raziskavah to nalogo prevzema poseben kontekstni strežnik, ki skrbi za zbiranje podatkov ter posredovanje informacij aplikaciji. V primeru, da bi tak kontekstni strežnik deloval na mobilni napravi, bi bila postopoma odpravljena potreba po omenjenem sistemu. V sklopu naloge smo predlagani model kontekstnega strežnika uspešno implementirali in njegovo delovanje preizkusili s pomočjo kontekstno odvisne aplikacije, ki deluje na principu tekstovne klasifikacije uporabnikovih vnosov v spletnih iskalnikih in njegovi trenutni lokaciji. Aplikaciji omenjenih podatkov ni potrebno zajeti ročno, saj so ti ob pojavitvi novega podatka avtomatično posredovani preko kontekstnega strežnika.In order for mobile applications to efficiently offer all of their services and adjust them according to the end user, they would need to monitor all of his context and surroundings. In the existing researches this is done by a special context server which is responsible for data retrieval and transmission of information application. In the event, when the context server would work on a mobile device, the before mentioned system would gradually not be needed anymore. In the context of the thesis we have successfully implemented the proposed model of context server and tested it with a context application, which operates in the principle of text classification of user entries in the search engines and its current location. The application of this data does not need to be captured manually, since they are automatically transmitted to the server when the new data appears

Photodynamic therapy for multi-resistant cutaneous Langerhans cell histiocytosis

Langerhans cell histiocytosis is a rare group of proliferative disorders. Beside cutaneous involvement, other internal organs can be affected. The treatment of cutaneous lesions is difficult and relies on topical corticosteroids, carmustine, nitrogen mustard, and photochemotherapy. Systemic steroids and vinblastine are used for recalcitrant skin lesions. However, some cases fail to respond. An 18-month old boy presented a CD1a+, S100a+ Langerhans cell histocytosis with cutaneous and severe scalp involvement. Topical corticosteroids and nitrogen mustard failed to improve the skin lesions. Systemic corticosteroids and vinblastine improved the truncal involvement but had no effect on the scalp lesions. Methylaminolevulinate (MAL) based photodynamic therapy (PDT) resulted in a significant regression of the scalp lesions. Control histology revealed an almost complete clearance of the tumor infiltrate. Clinical follow-up after six months showed no recurrence

Oral antifungal-exacerbated inflammatory flare-up reactions of dermatomycosis: Case reports and review of the literature

Inflammatory flare-up reactions of some dermatomycoses, particularly those caused by zoophilic fungi, are typical and potentially severe adverse effects following the intake of some oral antifungals. However, this condition has not previously been reported with the most frequently used antifungals in dermatology, namely fluconazole, itraconazole, and terbinafine. In this report, we describe five patients, observed over a 10-year period, who presented with inflammatory exacerbations following oral antifungal therapy for dermatomycoses. We also review the literature on inflammatory reactions exacerbated by oral antifungal agents. Details of the patients' age, sex, occupation, and atopic background; the site of the lesion, its clinical and histologic features, and any systemic signs; the identity of the fungal pathogen; the antifungal agent taken by the patient; the time between drug intake and occurrence of the flare-up; the approach to management; and the outcome were documented for each patient. A PubMed literature search was also conducted, focusing on inflammatory exacerbations induced by griseofulvin, ketoconazole, itraconazole, fluconazole, and terbinafine. The patients were four farmers and one veterinarian (all male). All primary lesions were inflammatory dermatophytoses, including one kerion. Inflammatory exacerbation of the skin lesions started 12-24 hours after the intake of oral antifungals. Mild systemic changes, including slight fever and malaise, occurred in two cases. Itraconazole 400 mg/day was implicated as the causative agent in four cases and terbinafine 250 mg/day in one case. Mycologic cultures grew Trichophyton verrucosum in four cases. Antifungal treatment was discontinued in all patients. Oral and topical corticosteroids were administered to the two patients with systemic changes; the other three patients were treated with topical corticosteroids only. Two days after the onset of corticosteroids, lower doses of itraconazole (100 mg/day) and terbinafine (125 mg/day) were reintroduced. All lesions healed after 4-5 weeks. The PubMed search did not identify any articles that described inflammatory exacerbations of dermatomycoses induced by oral antifungals. Inflammatory flare-up of der-matomycoses is a rare but potentially severe cutaneous complication of oral antifungal use. Occupational contact with animals, inflammatory dermatomycoses, and zoophilic fungi represent common features in these patients. Although evidence-based data are not available, clinical experience shows that, in addition to antifungal therapy, topical and/or systemic corticosteroids are helpful to reduce the inflammatory reactions. The cases described in this article represent the first published report of oral antifungal-exacerbated inflammatory flare-up reactions of dermatomycosis in patients taking itraconazole or terbinafine

Breaking the Relentless Course of Hallopeau's Acrodermatitis by Dapsone

We report the case of a 74-year-old man who suffered for four years from recurrent generalized pustular eruptions associated with acrodermatitis continua of Hallopeau (ACH). Initial therapy using topical corticosteroids, tars and PUVA failed to improve the acral lesions. The disease was also unresponsive to systemic therapy using corticosteroids, methotrexate, etretinate, acitretine and cyclosporin A. Serious side-effects were experienced with these drugs. A marked improvement of the generalized pustules was observed under treatment combining etretinate and methotrexate, without having any effect on the acropustulosis. During hospitalization, a topical tar therapy cleared the pustular rash. Again no effect was observed on the acral lesions. Disulone (DDS) therapy, initiated at a dose of 200 mg/day, completely cleared ACH after 4 weeks. The disease relapsed when the dose was reduced to 100 mg/day. Increasing the DDS to 150 mg/day was rapidly followed by a new clearance of the acral lesions. After a 3-month treatment, the patient has remained lesion free and no DDS-related side-effects have occurred. In conclusion, sulfones may be considered as an alternative therapeutic option in drug-resistant ACH

Cutaneous adverse reactions following anti-infective vaccinations.

Although widely administered, anti-infective vaccinations are rarely responsible for cutaneous adverse effects. In this context, hepatitis B and bacillus Calmette-Guerin vaccines are the most frequently incriminated products. Cutaneous adverse effects are less frequently encountered following administration of vaccines against varicella, diphtheria/tetanus/pertussis (primary and booster doses), measles, poliomyelitis, rubella, pneumococcus, tick-borne encephalitis, smallpox, Meningococcus and influenza. The adverse effects can occur at the site of or at a distance from the injection. The patho-mechanisms of local adverse cutaneous reactions include predominantly nonspecific lymphoid or granulomatous reactions. Allergic reactions to the vaccine strain, adjuvants, conservatives or other components are less frequently involved in local vaccine adverse effects. Systemic reactions are mainly mediated by immediate type or immune complex-related allergic reactions to toxoid-, ovalbumin-, gelatin- or pneumococcal-containing vaccines. Systemic reactions are sometimes related to a specific vaccine strain. Other cutaneous reactions may also occur through unknown patho-mechanisms. No vaccine type or strain is specifically associated with a particular type of cutaneous adverse effect. This article presents seven case reports of cutaneous adverse effects following anti-infective vaccination then reviews the relevant literature on this subject

The HLA dermatosis connection

A number of dermatological diseases are associated with distinct HLA types. These associations vary in different populations and ethnic groups. HLA determination can be related to different diseases courses, various anatomical predilection sites and can be used as a diagnostic tool. However, the pathogenic role of HLA in susceptibility to specific dermatological diseases often remains unclear

Cutaneous neuropeptides

The neuropeptides act as mediators in the transmission of nervous influx and as messengers between the nervous system and other cell populations. The skin contains numerous neuropeptides which are involved in the regulation of inflammation, immunomodulation, and thermoregulation. Cutaneous trophicity, pigmentation, and to a lesser extent sebaccous secretions are also influenced by neuropeptides. This review describes the functions of the most important neuropeptides encountered at the level of the skin.Les neuropeptides agissent comme médiateurs de la transmission des influx nerveux et comme messagers entre le système nerveux et d'autres populations cellulaires. La peau contient de nombreux neuropeptides qui interviennent dans la régulation de l'inflammtion, de l'immunomodulation et de la thermorégulation. La trophicité cutanée, la pigmentation et, dans une moindre mesure, la sécrétion sébacée sont également influencées par les neuropeptides. Cette revue présente les fonctions des neuropeptides les plus importants rencontrés au niveau de la peau