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Introduction: Hidradenitis suppurativa is a chronic inflammatory skin disease with a typical formation of inflamed nodules, abscesses, and sinus tracts usually in the axillary, inguinal, and anogenital region. We decided to investigate the possible association of hidradenitis suppurativa and total IgE elevation and to explore the patients' characteristics which can be related to high IgE levels. Methods: We performed a retrospective observational study which included 67 patients with moderate-to-severe stage of hidradenitis suppurativa followed up in our outpatient dermatology department. Total IgE, IgA, IgG, IgM, and CRP serum levels were measured. A personal and family history was taken. We asked them about allergic diseases and cigarette smoking and determined the basic parameters such as the weight and height of the patients. Results: Elevated total IgE levels were noticed in 21 patients (31.3%), of which 6 had a history of allergic disorder. Three of them had allergic rhinoconjunctivitis and the other three were suffering from atopic dermatitis. The mean total IgE level was 203.0 IU/ml with a maximum value of 1,954 IU/ml. Analysis of the factors, such as cigarette smoking, sex, elevated CRP, body mass index, and the number of affected areas, did not show an association with increased IgE levels. Conclusion: Our study showed a higher mean value of total IgE in patients with moderate to severe hidradenitis suppurativa than in the general population. However, we did not confirm an association with any characteristics of the patients. Limitations of this work include a small number of patients and a lack of the control group, therefore further and more extensive studies are needed to support these results. [ABSTRACT FROM AUTHOR]

Internal malignancy may be presented in the form of paraneoplastic syndromes, which may indicate either formation or recurrence of a previously treated malignancy. Furthermore cutaneous paraneoplastic disorders often precede a diagnosis of cancer. We present 2 unique case reports with cutaneous paraneoplastic manifestations. The first one describes a patient with sudden progression of long-term stabilized morphea in connection with newly diagnosed hepatocellular carcinoma (HCC). The second one describes female patient with breast cancer preceded by the development of extragenital lichen sclerosus (LS) with typical sclerotic lesions and hemorrhagic bullae. [ABSTRACT FROM AUTHOR]

Burning, itching and dyspareunia are typical symptoms of many genital diseases. These subjective complaints can be misdiagnosed because of different clinical presentations. We present a case report of a postmenopausal woman treated for genital warts over a period of three years followed by the development of leukoplastic lesions in the whitish area clinical classified as Lichen sclerosus (LS). Histology of this lesion revealed carcinoma in situ. After radical surgical removal, vulvar Paget's disease was histologically verified. LS and extramammary Paget's disease (EMPD) belong to a group of uncommon dermatoses which mainly affect the skin of the genitals in postmenopausal women. Ulceration, erosions and leukoplastic lesions can signalize the development of squamous cell carcinoma in association of lichen sclerosus, on the other hand, they can be the sign of EMPD after a long period of time using different topical agents. The importance of reaching the correct diagnosis is essential and can influence current patient investigations and invasive or non-invasive treatment. [ABSTRACT FROM AUTHOR]

The introduction of new pharmacotherapy entities in the last decade accentuate the necessity to set up treatment guidelines based on real life evidence. Randomized controlled trials remain golden standard of a research. Data derived from studies aiming on daily clinical practice should bring needed, added value. Disease prevalence growth, due to increased life expectancy, better diagnostic procedures and earlier medical intervention, as well as ever growing demand for highly priced, sophistically produced drugs put stress on healthcare budgets even in developed countries. Large databases commonly called - therapy registries are implemented to collect data on therapy effectivity in terms of effectiveness, safety and patient long-term on therapy survival. Registries importance rose together with biological therapies introduction. New in class molecules entered the market conditionally being obliged to provide additional e.g. safety data. Such procedures require involvement of many different professionals, e.g. physicians, professional medical bodies, IT experts, database administrators, statisticians and government institutions. Paper based, followed by computer based forms were distributed among physicians to collect these data. eHealth technologies provide physicians with centralized, more intuitive applications. The particularities of different diagnosis caused great variations within each specific registry launched. Important information was missing since they were pointed out as optional and many were redundant causing frustration among physicians due to inadequate administrative workload. The main objective of this work was to set up the therapy registry standards and procedures. Methodology of 'ideal' moderate to severe plaque psoriasis biology therapy registry development, introduction, administration and evaluation was prepared to assist any government institution or professional body when planning registry deployment. Electronic application based on widely used MS Excel platform was developed and installed in the biological therapy centers as a standalone application for the pilot use. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about the treatment of dermal and subcutaneous pheohyphomycosis, a rare fungal infection.

Juvenile hyaline fibromatosis is a rare autosomal recessive hereditary disease with a male to female ratio of 6: 4. A case of a 28-year-old immobile man with disproportional nanism is considered who was admitted to the hospital with chronic pyodermia of the skin. Skeletal scintigraphy showed centres of increased osteoblastic activity in regions of large joints and active deposits of ectopic ossification in the head, trunk and neck tumors. Fingers were deformed and thickened with flexural contractures with enlargement of the distal portions. Treatment of chronic bacteriological and candidomycetical infections were done.

A case of phaeohyphomycosis caused by strains of both Alternaria spp. and Phaeosclera dematioides is presented. First clinical signs of mycosis appeared on the patient's face, after an injury with a straw stalk during the wheat harvest in Germany in 1942. Further signs developed in 1955 at one forearm, and again in 1968 in the mouth, leading to perforation of the palate. After treatment with amphotericin B (1973-75) she went into a 13-year-long, clinically asymptomatic remission. She relapsed in 1988, when eight foci of the disease developed, mostly on both forearms. Diabetes mellitus and asthma developed at this time. After pulse therapy with itraconazole the patient remains in a good clinical condition. [ABSTRACT FROM AUTHOR]

A patient with primary malignant melanoma localized to the right gluteal region is described. Four years later and after intercurrent influenza, disseminated metastases of malignant melanoma to the skin occurred. After a further 6 months melanodermia developed and lasted until the death of the patient (6 months later). Autopsy revealed melanosis of the visceral organs. Histology taken from internal organs using S-100 protein and HMB-45 melanoma methods confirmed metastases of malignant melanoma to the skin, oral cavity, palatal tonsils, nasal and nasopharyngeal mucosae, lungs, myocardium and brain. The authors discuss the mechanism of melanosis—a rare sign in patients with metastasizing malignant melanoma. [ABSTRACT FROM AUTHOR]