Currently in Bulgaria the two messenger RNA vaccines used to vaccinate the population against COVID-19 are Pfizer-BioNTech COVID-19 Vaccine (COMIRNATY) and Moderna COVID-19 Vaccine. We present a case ...of a patient with palmoplantar form of psoriasis (in remission in the last 2 years), who has an attack of psoriasis of the nails, which began two weeks after the second dose of Pfizer-BioNTech COVID-19 Vaccine. Within the next two months, onychopathy of the nails of the ten fingers developed with the manifestation of almost all known psoriatic changes in the nail bed and nail matrix. The toenails are not affected. Topical therapy with calcipotriol/betamethasone ointment under occlusive dressings was prescribed for two months. The monitoring continues.
Purpose of the study: To investigate demographics, prevalence, risk factors and the different clinical forms and symptoms of syphilis in men who have sex with men (MSM). Material/Methods: 50 MSM with ...syphilis were registered at the Clinic of Dermatology and Venereology in the city of Pleven, Bulgaria, for the period 2008-2022. The diagnosis was confirmed by serological tests. Patients were distributed by their socio-demographic status. Risk factors and sexual behavior were studied, as well as clinical symptoms and co-morbidities of syphilis. Results: Of 50 MSM patients the most affected is the age between 20-29 years (54%). 34% of them are university graduates, 88% abused alcohol, nicotine and drugs in combination, 70% had sexual contacts with a casual partner, 26% of them had HIV co-infection. Secondary and early latent syphilis are the most common clinical forms of the disease (34%). The typical symptoms of primary and secondary syphilis were clinically manifested, 34% of them are localized in the genital. There is a significant correlation of the clinical form with the localization of the skin-mucosal lesions (p < 0.001). Antibiotic therapy is effective and leads to negative serological test results by the end of the second year of treatment. Conclusions: For 15 years (2008-2022), the number of registered MSM with syphilis in the Clinic of Dermatology and Venereology in Pleven increased after 2016 especialy in the time of the COVID-19 pandemic. Our results are close to the published data on the problem in the scientific literature for the last 10 years.
We describe a 47-year-old healthy man who, after an injury to the third finger of the right hand, developed a reddened papule that did not disappear. Over a period of three months, edema developed on ...the finger and dorsum of the right hand, followed by several variegated nodules along the 3rd finger, dorsum of the right hand, and right forearm. There are no subjective complaints. The patient has an aquarium at home, and the complaints coincide with a period of growth of the fish in it. The diagnosis of Mycobacterium marinum infection is made on the basis of history, clinical picture, histology and molecular genetic testing for mycobacteria. Treatment with numerous antibacterial agents was carried out, and the long-term (9 months) therapy with clarithromycin, rifampicin and ethambutol, appointed after the diagnostic clarification, led to the cure of the infection. A brief review of the literature on the issue is made.
Contact dermatitis is an acute or chronic inflammatory reaction in response to substances coming into contact with the skin. Differentiating between irritant contact dermatitis and allergic contact ...dermatitis in practice, as well as finding the exact causative agent from the environment, often pose a challenge to the clinician. We present a case of contact dermatitis in a 9-year-old child caused by modeling clay (plasticine) and slime. The treatment with local corticosteroids and emollients and the discontinuation of contact with the identified insulting agents lead to a goodherapeutic result.
Combination between Leucocytoclastic vasculitis and Subacute cutaneous lupus erythematosus has been only rarely reported in the literature. Pathological cutaneous lesions are presented by purpura, ...erythematous macules, urticarial, nodules and necroses.We present a 58-year-old woman with painful nodular lesions on the left thigh.The disease started in June 2015 with photosensitivity and psoriasiform rashes on the back. Pathological cutaneous changes affected lateral and dorsal surface of the left thigh. It was presented by painful, indurated in base, ulcerative plaques, with unclear borders and necrotic surface. There were no deviations from complete blood count and biochemistry. Immunological investigations revealed elevated levels of MPO(рАNCA) – 1.38 U/ml, antinuclear antibodies (ANA)- 134.1 U/ml, SS-A(Ro) antibodies – 233.7 U/ml CRP- 12.7mg/l. Urine analysis revealed positive protein results.Escherichia coli was isolated from microbiology testing. Histopathological result from ulcerative lesions from the left thigh of the patient revealed necrotizing leukocytoclastic vasculitis. The result from direct immunofluorescence microscopy of lesional skin corresponded to lupus erythematosus.The diagnosis lupus vasculitis was made. Systemic therapy with chloroquine phosphate, methylprednisolone, methotrexate was administered. Topical treatment included proteolytic enzyme in dressings and vacuum therapy with good effect.
The study aimed to investigate the relationship between the professional environment and hypersensitivity reactions to various contact allergens, the features of the clinical course, and the type of ...allergic contact dermatitis (ACD) in 35 hairdressers. The analysis was based on data on length of professional experience, localization of rashes, clinical diagnosis and allergens, and the cause of positive reactions in patch testing. Skin changes most often affect the hands, palms, face, and neck. The frequency of ACD diagnosed was 46%, followed by dyshidrotic eczema (DE) - 34%. The highest percentage of contact dermatitis (68%) was seen in the upper extremities, followed by dermatitis of the face and hands (26%). Of the patients investigated, 34% had a history of illness up to 3 years. A negative correlation was found between professional experience and “hand eczema” (p=0.005). Patch tests showed that the most frequent positive reactions were to Nickel (II) sulfate hexahydrate (Nickel, 15 times) and p-Phenylenediamine (PPD, 14 times). These contact allergens are directly correlated with hand eczema. We compared the results with those published in the literature.
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