Mollusca Contagiosa

Mollusca contagiosa (MC) definiramo kao čestu virusnu infekciju kože uzrokovanu Molluscipox virusom (MCV) koja se viđa u djece i odraslih. Klinički se manifestira u obliku malih, umbiliciranih papula voštana sjaja. Dok su MC relativno česta u djece od 1. do 5. godine i mogu biti smještene bilo gdje na tijelu, njihova pojavnost u odraslih uglavnom se smatra spolno prenosivom infekcijom (engl. sexually transmitted infection, STI). MCV se može prenositi direktno s osobe na osobu ili autoinokulacijom. MCV u odraslih karakteristično zahvaća genitalnu regiju. Međutim, ekstragenitalni smještaj kod odraslih tipično se viđa u imunosuprimiranih bolesnika, osobito u bolesnika s HIV-om/AIDS-om. Prema novijim literaturnim podacima, pojava MC u HIV-pozitivnih bolesnika, smatra se dijelom sindroma imunosnog oporavka (engl. immune reconstitution inflammatory syndrome, IRIS). MC, stoga, u djece zahvaća podjednako oba spola, no, čini se da je incidencija u odrasloj populaciji veća kod muškaraca. Liječenje, koje nije uvijek nužno, može biti korisno u prevenciji daljnjeg prijenosa infekcije ili autoinokulacije. Nažalost, ne postoji etiološko liječenje MC, a većina postupaka koji se primjenjuju mehanička je, što katkad uzrokuje određeni stupanj nelagode ili boli. Osobitu pažnju treba posvetiti ekstragenitalno smještenim MC kod odraslih, kada bi svakako trebalo preporučiti obradu na HIV. I djecu i odrasle s MC trebalo bi podučiti da izbjegavaju češanje kože, kao i kontakte s drugom osobom (uglavnom spolni kontakti kod odraslih), kako bi se spriječio daljnji prijenos infekcije i/ili autoinokulacija. Osim toga, kod odraslih bolesnika s MC treba učiniti pažljiv probirna ostale STI te ih savjetovati o eventualnom liječenju i daljim postupcima.Mollusca contagiosa (MC) are defi ned as a common cutaneous viral infection caused by the Molluscipox virus (MCV) and affecting both children and adults. MC are clinically characterized by small, waxy, dome-shaped umbilicated papules. Whereas mollusca contagiosa are rather frequent in 1-5 year-old children and can be localized almost anywhere on the body, their appearance in adults is mostly regarded as a sexually transmitted infection (STI). MCV might be transmitted directly from person to person or by autoinoculation. MC in adults characteristically involve the genital area. However, the extragenital appearance of MC in adults is more typically seen in patients with immunosuppressive conditions, especially in HIV/AIDS patients. The onset of MC in HIV-positive individuals can be, according to the current literature data, regarded as a part of the immune reconstitution inflammatory syndrome (IRIS). It is most probable that MC affect both sexes equally in children’s age, whereas in adults they seem to be more frequent in men. Therapy may be beneficial in preventing transmission or autoinoculation. Unfortunately, there has been no etiological treatment of MC so far, and the majority of treatment options are mechanical, causing sometimes a certain degree of discomfort, or are not enough "evidence-based". Special attention should be given to the extragenital site of MC involvement in adults, and HIV serology testing should certainly be recommended in such patients. Both children and adults with MC should be educated to avoid scratching and skin contact with others to prevent transmission and autoinoculation. Besides, adult patients with MC should be carefully screened for other STIs and counseled appropriately

Food Allergy in Children with Atopic Dermatitis

Alergija na hranu čest je problem u bolesnika s atopijskim dermatitisom, osobito u djece. S obzirom na kliničke spoznaje u posljednjih nekoliko desetljeća, jasno je da hrana, kao kravlje mlijeko i kokošje jaje, može direktno dovesti do pogoršanja atopijskog dermatitisa, osobito u senzibilizirane djece. Budući da su uloga, kao i imunosna zbivanja alergije na hranu kod atopijskog dermatitisa još nedovoljno potpuno razjašnjeni, mi ćemo se upravo osvrnuti na utjecaj alergije na hranu kod djece s atopijskim dermatitisom.Food allergy is a common problem in patients with atopic dermatitis, particularly in children. Based on clinical data from the past few decades, it is clear that food as cow’s milk and hen eggs can directly provoke fl ares of atopic dermatitis, particularly in sensitized infants. Because the role and immunology of food allergy in atopic dermatitis remain controversial, here we review data that mainly focus on food allergy in children with atopic dermatitis

Pyogenic Granuloma of the Proximal Part of a Nail Unit in a Child

We present a case of proximal pyogenic granuloma in 4-year-old child. The patient presented to our Department due to a fast-growing lesion on the proximal part of the nail unit. The lesion had appeared over several weeks, and it was extremely painful for the child. On the day of the 1st visit, the lesion was not bleeding but was very painful during examination and photo-documentation. Clinically, it presented as an exogenous tumoral lesion of the proximal 1/3 of the nail, partially exulcerated with one part exhibiting coagulated hemorrhage and with uneven coloration (Figure 1). The lesion was not sharply demarcated. Dermoscopically, the majority of the lesion presented an unspecific dermoscopic structure, orange background color, and matched the criteria for a vascular lesion: few unspecific vessels and hemorrhage. The “sticky fiber” sign was also present (Figure 2). Since the lesion was fast-growing and due to the unspecific dermoscopic appearance, the child was referred to a pediatric surgeon and a complete excisional biopsy of the lesion was performed. The dermoscopy of pyogenic granuloma has been already described (1). The histology report confirmed pyogenic granulom

Pyogenic Granuloma of the Proximal Part of a Nail Unit in a Child

We present a case of proximal pyogenic granuloma in 4-year-old child. The patient presented to our Department due to a fast-growing lesion on the proximal part of the nail unit. The lesion had appeared over several weeks, and it was extremely painful for the child. On the day of the 1st visit, the lesion was not bleeding but was very painful during examination and photo-documentation. Clinically, it presented as an exogenous tumoral lesion of the proximal 1/3 of the nail, partially exulcerated with one part exhibiting coagulated hemorrhage and with uneven coloration (Figure 1). The lesion was not sharply demarcated. Dermoscopically, the majority of the lesion presented an unspecific dermoscopic structure, orange background color, and matched the criteria for a vascular lesion: few unspecific vessels and hemorrhage. The “sticky fiber” sign was also present (Figure 2). Since the lesion was fast-growing and due to the unspecific dermoscopic appearance, the child was referred to a pediatric surgeon and a complete excisional biopsy of the lesion was performed. The dermoscopy of pyogenic granuloma has been already described (1). The histology report confirmed pyogenic granulom

Kerion Celsi due to Microsporum canis with dermatophytide reaction

Microsporum (M.) canis is the most common fungus to cause tinea capitis in Europe, especially in the Mediterranean region and South and Central Europe. Fungal scalp infections caused by M. canis tend to be non-inflammatory. Recently, a growing number of cases of tinea capitis characterized by inflammatory infection caused by M. canis and M. gypseum have been registered. We present a case of highly inflammatory tinea capitis, also known as kerion celsi, caused by M. canis in a 6-year-old-patient. Scalp infections due to M. canis are a growing problem in dermatological practice. Changes in epidemiology, etiology, and clinical patterns of fungal infections due to M. canis are significant. Greater awareness of this problem is needed in order to establish proper diagnosis and successful treatment strategy for these patients. </p