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Lupus erythematosus is an autoimmune connective tissue disorder showing a broad spectrum of clinical manifestations.

Erythema multiforme (EM) is an acute immune-mediated disease with multifactor etiology, which presents with symmetric target-like lesions on the skin. Probably the most common etiological factor of EM is viral infections, particularly herpes simplex virus (HSV). Herpes-associated erythema multiforme (HAEM) is an acute exudative dermatosis, caused mostly by HSV-1 and much rarely by HSV-2. A 44-year-old female patient with herpes associated erythema multiforme was consulted with initial appearance of typical target lesions on the dorsal surface of both hands, after long history of labial herpes episodes. The diagnostic algorithm included routine laboratory tests, histological examination and serologic test for HSV-1 and 2. Our first choice of treatment was acyclovir 5 x 200 mg/24 h and dexamethasone 4 mg/24 h, however due to increased anxiety and tachycardia reported by patient the corticosteroid therapy was discontinued and promethazine was initiated. The patient responded well to the therapeutic regimen and at the follow-up visit was in clinical remission. In conclusion, the diagnosis of HAEM is mainly clinical, when the patient develops target lesions and coexisting HSV infection is detected.

Graham-Little-Piccardi-Lassueur syndrome (GLPLS) is a rare syndrome characterized by the triad of cicatricial alopecia of the scalp, non-cicatricial alopecia of the axilla and groin and follicular lichen planus eruptions on the trunk and extremities. GLPLS is considered to be a variant of lichen planopilaris. We report two cases that have fulfilled all of the criteria for GLPLS. The first case was a 71-year-old woman, admitted to the Department of Dermatology for pruritic perifollicullar erythema and scaling of the scalp, cicatricial scalp alopecia and hair loss of the axilla and pubic region for five months. Subsequently, follicular hyperkeratotic eruptions and hyperpigmented macules on the skin of the chest and abdomen appeared. The second case was a 48-year-old man with pruritic follicular papules on the face, trunk and extremities for four months. All of the laboratory examinations in both patients were within normal limits. No alternation in the general condition of the patients was observed. Histological examinations in both patients confirmed the diagnosis GLPLS. The patients were treated with systemic and local corticosteroid resulting in marked improvement of the skin lesions; however, cicatricial scalp alopecia showed no response to the treatment.

Neurofibromatosis type I is an autosomal dominant genetic disorder with an incidence of about 1 in 3000 births. Apart from the typical skin involvement NF1 may affect multiple organs with ocular, neurological, skeletal and cardiovascular manifestations. We present a case of a 38-year-old man with multiple café-au-lait macules and hundreds of neurofibromas disseminated on the trunk and extremities dating from childhood. To establish the diagnosis and to exclude any complications we performed multiple examinations, including skin biopsy, laboratory investigations, ophthalmologic assessment, consultations with a neurologist, internist and orthopedist, etc. The treatment of cutaneous NF1 is mainly symptomatic. Surgical excision aims to achieve cosmetic results. Recently novel and perspective conservative therapies have been investigated. In order to ensure better outcome for the patients with NF1 long-term multi-disciplinary approach is advised.

The group of congenital limb overgrowth syndromes associated with vascular malformations include various disorders, often with variable clinical expression. Klippel-Trenaunay syndrome is the most common syndrome in this group, compared to other similar disorders such as Proteus, Parkes-Weber, Sturge-Weber, Cobb, Maffucii and CLOVES syndromes. We present a case of a 55-year-old male who presented with swelling, pain, heaviness, numbness and increased local temperature, involving the right upper extremity and the right side of the chest wall and associated with a livid erythema. The patient had several comorbidities including arterial hypertension and ischemic heart disease. He also had a family history of diabetes mellitus. A multidisciplinary team-based treatment approach, including physicians with expertise in various medical and surgical specialties was applied with the patient being “the unifying focus” of all these experts and their efforts. A personal approach tailored to the patient’s preferences was the key to a successful treatment.

The aim of the study was to develop a molecular diagnosis protocol of monocytic ehrlichiosis and granulocytic anaplasmosis in dogs by conventional polymerase chain reaction (PCR) and to compare the results from PCR and a rapid serological test. One hundred and six blood samples from dogs were tested by the rapid serological test SNAP 4Dx Plus (IDEXX Laboratories, Westbrook, ME) and by conventional PCR. Sixty-two of them (58.49%) were positive for antibodies to Ehrlichia canis/Ehrlichia ewingii and 14 (13.21%) for antibodies to Anaplasma phagocytophilum/Anaplasma platys. In 24 (22.64%) blood samples, antibodies against both pathogens were simultaneously detected. Six (5.66%) samples were seronegative. Fourty-six of the 106 tested samples (43.4%) were positive for a 345 bp segment of the ribosomal gene of family Anaplasmataceae. In 28 of them the presence of a 444 bp fragment of the ankA gene of A. phagocytophilum was detected, and in 26: a 409 bp fragment of the gene of E. canis. Nine samples were simultaneously positive for genetic sequences of E. canis and A. phagocytophilum. The target DNA fragments specific for the two studied pathogens were not detected in one of the Anaplasmataceae-positive samples. In the remaining 60 cases (56.6%), the presence of a 345 bp segment of the ribosomal gene was not detected. In the present study, the DNA of E. canis and of A. phagocytophilum was detected for the first time in Bulgarian dogs by the conventional PCR. [ABSTRACT FROM AUTHOR]

The changes in cognitive functions that occur with aging and in various pathological conditions are a subject of growing interest. Experimental and clinical data justify the hypothesis about the influence the immune system exerts on cognitive processes. The balance between pro-inflammatory and anti-inflammatory cytokines has been established as a necessary factor for normal cognitive functioning. Cytokine production is under strong genetic control and various single nucleotide polymorphisms (SNPs) in cytokine genes have been described. As cytokine SNPs have been demonstrated to affect the gene expression or the functional activity of the immune protein this logically led to the suggestion about the role of these polymorphisms in cognitive functioning. Studies exploring the association between different genetic variants of cytokine gene polymorphisms and cognitive abilities in healthy subjects and in demented patients show divergent results. The review of relevant literature suggests that SNPs implement their effect on cognition in large interactions with each other, as well as with many other factors, some of which still remain to be identified. This article summarizes the contemporary knowledge about the correlations between SNPs in cytokine genes and cognitive status in humans. Further research is needed to determine the precise role and the molecular mechanisms of action of the SNPs in cognitive processes.

Pathogenetic-based topical treatment with statins that target the mevalonate pathway and cholesterol biosynthesis was recently shown to be effective in disseminated porokeratosis.8 Here we performed molecular genetic analysis of skin samples of eight patients with disseminated porokeratosis. (a) Before treatment, the patient presented porokeratotic lesions on the arms and legs. Two novel SSH1 mutations in Chinese patients with disseminated superficial actinic porokeratosis and immunohistochemical analysis of anti-Slingshot homolog 1 antibody in one typical patient. [Extracted from the article]

Tuberculosis verrucosa cutis (TBVC) is a paucibacillary form of cutaneous tuberculosis which develops after an exogenous infection in a subject with a high degree of immunity after previous sensitization with Mycobacterium tuberculosis complex. It is rare in developed countries, but remains a concern in Asia and in professionals such as pathologists and butchers. We present a 17-year old boy, working as a butcher assistant, referred to our clinic with several verrucous papules and plaques on the extremities of 2-year duration. Mantoux tuberculin test and T-spot test were positive for Mycobacterium tuberculosis. Treatment with a standard anti-tuberculous combination resulted in complete remission. [ABSTRACT FROM AUTHOR]

Because of their unique tolerance to desiccation, the so-called resurrection plants can be considered as excellent models for extensive research on plant reactions to environmental stresses. The vegetative tissues of these species are able to withstand long dry periods and to recover very rapidly upon re-watering. This study follows the dynamics of key components involved in leaf tissue antioxidant systems under desiccation in the resurrection plant Haberlea rhodopensis and the related non-resurrection species Chirita eberhardtii. In H. rhodopensis these parameters were also followed during recovery after full drying. A well-defined test system was developed to characterise the different responses of the two species under drought stress. Results show that levels of H2O2 decreased significantly both in H. rhodopensis and C. eberhardtii, but that accumulation of malondialdehyde was much more pronounced in the desiccation-tolerant H. rhodopensis than in the non-resurrection C. eberhardtii. A putative protective role could be attributed to accumulation of total phenols in H. rhodopensis during the late stages of drying. The total glutathione concentration and GSSG/GSH ratio increased upon complete dehydration of H. rhodopensis. Our data on soluble sugars suggest that sugar ratios might be important for plant desiccation tolerance. An array of different adaptations could thus be responsible for the resurrection phenotype of H. rhodopensis. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the correlation between tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-12p40-containing cytokines, in silicosis patients and healthy donors exposed to silica dust, in an attempt to clarify the reason for variety of clinical outcomes between humans with similar exposure history. Serum levels of TNF-α, IL-12p40, IL-12p70 and IL-23 in total group of 62 silicosis patients, 24 healthy donors with similar exposure history like patients and 19 healthy donors without exposure were determined by enzyme-linked-immunosorbent assay (ELISA) method. The serum level of TNF-α was significantly higher in healthy donors exposed to SiO2 (22.4 ± 11.1 pg/mL) in comparison with non-exposed healthy donors (14.8 ± 8.8 pg/mL; p = 0.022) and similar to that in silicosis patients. In total, group of silicosis patients significantly elevated levels of TNF-α (20.9 ± 12.9 vs. 14.8 ± 8.8 pg/mL; p = 0.047) and IL-12p40 (94.5 ± 51.6 pg/mL vs. 68.7 ± 26.2 pg/mL; p = 0.029) compared to non-exposed healthy donors were observed. In addition, a strong positive correlation between TNF-α and IL-23 levels (r = 0.678; p = 0.022) and between TNF-α and IL-12p70 levels (r = 0.75; p = 0.0003) was detected in the group of exposed healthy donors, while in the group of silicosis patients, a significant positive correlation was observed only between TNF-α and IL-12p40 (r = 0.434; p = 0.00048), in contrast to other IL-12p40 containing cytokines. In conclusion, we could assume that the elevated serum levels of TNF-α are associated with exposition to silica particles, while the elevation of both TNF-α and IL-12p40 is associated with silicosis development and severity. Additionally, the balance between IL-12p40-containing cytokines may also contribute to the silicosis progression. [ABSTRACT FROM AUTHOR]

PURPOSE: Atopic dermatitis (AD) is an immune-mediated disease which usually begins during the childhood. The major regulators of Th1/Th2 balance are cytokines and T-regulatory cells. The aim of the present study was to compare gene expression profiles in children and adults with AD. METHODS: Total RNA was isolated from blood samples of 19 AD patients composed of 6 children and 13 adult AD patients. We analyzed the gene expression of IL12A, IL12B, IL23A, IL10 and Foxp3 mRNA in patients' blood, by quantitative real-time PCR. Relative quantitative evaluation of mRNAs was performed by the comparative ΔΔCt method. RESULTS: The gene expression, on mRNA level, of all investigated genes was higher in children than in adult AD patients. However, the major result from this study is that IL12A (RQ=4.14; p=0.0029), IL23A (RQ=3.53; p=0.006), and Foxp3 (RQ=3.51;p=0.023) mRNAs are significantly increased in children's blood compared to adult AD patients, in contrast to IL12B and IL10 mRNAs. CONCLUSION: On the basis of these preliminary results, we could conclude that the altered Th1/Th2 cytokine balance in AD depends on the age of patients. Our results demonstrated that IL- 12p70, IL-23 and Treg cells could play different roles in pathogenesis of atopic dermatitis in younger compared to older ages. [ABSTRACT FROM AUTHOR]

The present study investigates the association between IL12Bpro and +16974A/C in 3' -untranslated region (UTR) polymorphisms of IL12B and IL-12p40 serum level related to development of colorectal cancer (CRC). Our results showed similar distribution of both the investigated polymorphisms among CRC patients and healthy donors, which suggests that these polymorphisms in IL12B were not associated with the development of CRC. However, we found an increased IL-12p40 level in sera from patients compared to healthy donors and the highest level was observed in stage I compared to more advanced stages of CRC. These findings demonstrated that IL-12p40 serum level has an association with the progression of CRC. [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of type 1 diabetes (T1D), as an autoimmune and multifactorial disease, depends on both environmental and genetic factors.Methods: This study investigates the distribution of the 3'UTR polymorphism of IL12B in 51 diabetic Bulgarian children stratified by age of diagnosis and its influence on IL-12p40 serum levels. The quantity of serum IL-12p40 was detected by ELISA and the genotyping was performed by PCR-RFLP.Results: Significantly-higher frequency of C allele was observed in patients diagnosed at greater than 12 years of age (0.50) compared with patients with early onset of T1D (0.22 and 0.25) and controls (0.24). Strongly-elevated serum IL-12p40 was observed in patients (245.6 +/- 100 pg/mL) than in healthy children (58.5 +/- 17.3pg/mL; p=0.0001) and adults (72.2 +/- 31 pg/mL; p=0.0001), independently of 3'UTR polymorphism in IL12B and age of diagnosis.Conclusion: Our data suggests that 3'UTR polymorphism in IL12B was not associated with Ti D susceptibility or IL-12p40 serum level, but carrying of variant allele may contribute to late onset of disease. [ABSTRACT FROM AUTHOR]

Examines the ability of ornithine decarboxylase inhibitor, diflouromethylornithine to inhibit casein kinase II activity. Proliferation of c-Myc expression and normal human keratinocyte; Analysis of the casein kinase II, ubiquitous second messenger independent serine and theorine protein kinase found in all eukaryotic cells; Role of polyamines in the regulation of proliferative cells; Contribution of CK II to the pathogenesis of psoriasis.

Multiple sclerosis (MS) is a socially significant immune-mediated disease, characterized by demyelination, axonal transection and oligodendropathy in the central nervous system. Inflammatory demyelination and neurodegeneration lead to brain atrophy and cognitive deficit in up to 75% of the patients. Cognitive dysfunctions impact significantly patients’ quality of life, independently from the course and phase of the disease.

Keratinocytes, a key cellular component both for homeostasis and pathophysiologic processes of the skin, secrete a number of cytokines and their proliferation and differentiation are stimulated by a variety of biological factors. The major mechanism by which cells (keratinocytes) respond to extracellular signals, is changing in protein phosphorylation. The protein phosphorylation is a consequence of the ligand/receptor binding which leads to activation of several transduction systems. In this review we emphasize on different signal transduction pathways in keratinocytes (tyrosine kinases. PKA. PKC, MAPK, casein kinase 2 etc.). [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on the case of nodular fibrosis and granuloma formation in a woman.

The complex interactions between the central nervous system (CNS) and the immune system in normal and pathological conditions have long been a subject of investigations, and a large amount of data have been accumulated in this field. The immune system communicates with the CNS mainly via synthesis and secretion of cytokines. Receptors for cytokines are expressed on cells of hippocampus, which is responsible for the memory functions. Changes in cytokine profile are registered in patients with neurodegenerative dementia of Alzheimer type and increased production of pro-inflammatory cytokines in systemic inflammatory diseases is associated with typical neuropsychological and behavioral signs in experimental and clinical conditions. These and many other evidence confirm the role of the cytokines and immune system respectively in modulation of cognitive functions but the precise mechanisms and targets of their action in normal status and in various diseases are still not fully clarified. This review aims to summarize the discovered effects and consequences of immune-CNS interactions in the field of cognitive functioning and to outline the missing gaps and perspectives for future investigations. [ABSTRACT FROM AUTHOR]

Background. Psoriasis impairs the quality of life (QoL) of patients as is in such severe diseases as cardiac failure or some malignant diseases. The aim of the study was to assess the QoL of Bulgarian psoriasis patients and its dynamics after different treatment approaches. Material and methods. The study was conducted in 93 patients (55 men and 38 women), mean age 45 years. The patients were divided in 3 groups: group of patients with psoriasis placata and group of patients with psoriasis palmoplantaris, both undergoing combined climatotherapy and a control group of patients with psoriasis placata undergoing Narrow Band Ultraviolet B phototherapy (NB UVB). The combined climatotherapy was performed in the "Tuzlata" rehabilitation hospital, Balchik, Bulgaria and included thalassotherapy, peloidotherapy and balneotherapy. We used the Dermatology Quality of Life Index (DQLI) questionnaire to assess the QoL of the patients before and after the treatment. Results. The improvement of the QoL in patients with psoriasis placata undergoing combined climatotherapy was statistically higher compared to the patients undergoing NB UVB phototherapy. The improvement in the QoL of the patients with psoriasis placata undergoing combined climatotherapy was statistically significant compared to the patients with psoriasis palmoplantaris undergoing the same treatment. There was no statistically significant difference in the improvement of the QoL between the patients with and without comorbidities. Conclusion. Our results suggest that the combined climatotherapy has better beneficial effect on the QoL of the patients with psoriasis. [ABSTRACT FROM AUTHOR]

Hyperimmunoglobulin E syndrome (HIES) is a rare immunodeficiency presenting with a triad of recurrent skin and pulmonary infections, elevated IgE and eczematous reaction. Two forms of HIES are currently recognized -- autosomal-dominant and autosomal-recessive --. Treatment is symptomatic and the main therapeutic targets for HIES patients are prevention and management of infections. Systemic antistaphylococcal antibiotics are the mainstay of treatment. We report a case of HIES seen and followed up at our clinic and review the current literature. In our patient systemic acitretin and multiple courses of antibiotics led to a remarkable improvement and a remission period that has so far been maintained. [ABSTRACT FROM AUTHOR]

La sindrome di Down è una condizione congenita caratterizzata da ritardo mentale e tipici dismorfismi: ad essa la ricerca scientifica ha dedicato molti studi. La sua associazione con la psoriasi è rara, ma i pazienti che ne sono affetti presentano una malattia grave con placche spesse e cattiva prognosi. Le anomalie biochimiche con ridotto rapporto cAMP/cGMP sono correlate all'inizio precoce della psoriasi, oltre che all'invecchiamento prematuro. Si descrive un caso di psoriasi a placche spesse con inizio precoce in un paziente portatore di trisomia 21 e si sottolinea la necessità di ulteriori studi che mettano in rapporto genotipo e fenotipo nei soggetti psoriasici. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the association between serum levels of IL-12p40 and IL-10 and progression of the colorectal cancer (CRC). An association between severity of CRC and serum levels of investigated cytokines was observed. IL-12p40 was in the highest level in stage-I (423.6±224.7pg/ml) compared to more severe stages. In the opposite direction were the data for immunosuppressive cytokine, IL-10. Patients with stage-IV had the highest level of IL-10 (36.02±9.5pg/ml). On the basis of our results we could conclude that IL-12p40 and IL-10 serum levels were inversely associated with tumour progression. More severe stages of CRC are characterized by low IL-12p40 and high IL-10 serum levels. [ABSTRACT FROM AUTHOR]