The corresponding author of the manuscript was inadvertently omitted the author name Marija Kaštelan from the author group of the published article. The revised author group is given below.
Basal cell carcinoma and squamous cell carcinoma, collectively termed non-melanoma skin cancers are the most common malignant tumors in humans. Basal cell carcinoma grows slowly and metastatic spread ...is very rare. Squamous cell carcinoma is characterized by infiltrative, destructive growth and metastasis. Long-term exposure of skin to UV light has a great impact on development of these epidermal malignancies. UV light induces cascade of events like well known DNA damage of keratinocytes as well as still completely undetermined influence on apoptotic process through expression of proapoptotic and antiapoptotic molecules. The major role in development of skin cancer is given to proapoptotic p53 molecule or tumor suppressor gene which mutation due to UV exposure leads to resistance of DNA-damaged cell to apoptosis. Other proapoptotic molecules such as Fas ligand (FasL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) are strongly expressed in basal cell carcinoma and squamous cell carcinoma that could be explained by the ability of tumor to escape the attack of immune system.
Lichen planus is recognized as a T-cell-mediated disease. Histologically, it is characterized by the formation of colloid bodies representing apoptotic keratinocytes. The apoptotic process mediated ...by CD8(+) cytotoxic T lymphocytes (CTLs) and NK cells mainly involves two distinct pathways: the perforin/granzyme pathway and the Fas/FasL pathway. So far, little is known regarding the role of perforin-mediated apoptosis in lichen planus. In the present study, the expression and distribution of perforin, T and NK cell subsets in the epidermis and dermis of lesional and nonlesional lichen planus skin were studied. Skin biopsy specimens from lesional and nonlesional skin of ten patients with lichen planus and eight healthy persons were analysed by immunohistochemistry. Significant accumulation of T cells, particularly of CD4(+) and CD8(+) subsets, was found in both epidermis and dermis of lichen planus lesions compared with nonlesional and healthy skin. There were no significant differences in the incidence of NK cells (CD16(+) and CD56(+)) between lesional, nonlesional and healthy skin. Perforin expression was significantly upregulated in the epidermis of lichen planus lesions. In conclusion, accumulation of perforin(+) cells in the epidermis of lichen planus lesions suggest a potential role of perforin in the apoptosis of basal keratinocytes.
ULOGA PROTEINA PORODICE BCL-2 U PSORIJAZI KAŠTELAN, MARIJA; PRPIĆ MASSARI, LARISA; BRAJAC, INES
Liječnički vjesnik,
02/2010, Letnik:
132, Številka:
1-2
Journal Article
Recenzirano
Odprti dostop
Apoptoza je fiziološki proces programirane smrti stanica odgovoran za održavanje homeostaze u organizmu. U koži se procesom apoptoze nadzire proliferacija i diferencijacija keratinocita te tako ...održava homeostaza unutar epidermisa. Proces programirane stanične smrti nadziru proteini porodice Bcl-2 uključujući više proapoptotskih (Bax, Bak, Bad) i protuapoptotskih molekula (Bcl-2, Bcl-xl). Danas se smatra da poremećaj procesa apoptoze ima važnu ulogu u razvoju mnogih kožnih bolesti. Psorijaza je kroničnorecidivirajuća upalna bolest kože obilježena poremećajem diferencijacije i proliferacije keratinocita te sniženom apoptozom keratinocita unutar epidermisa. Na temelju dosadašnjih spoznaja o ulozi programirane stanične smrti u nastanku psorijaze, čini se da apoptoza ima važnu ulogu u razvoju epidermalne hiperproliferacije psorijatične lezije. Budući da proteini porodice Bcl-2 nadziru proces apoptoze, važno je razjasniti njihovu ulogu u patogenezi psorijaze. Naime, uočena povećana ekspresija protuapoptotskih, a sniženo izražavanje proapoptotskih molekula porodice Bcl-2 u psorijatičnoj koži upućuju na njihovu važnost u razvoju bolesti.
Bowel-associated dermatosis-arthritis syndrome (BADAS) is defined by the presence of pustular vasculitic skin lesions usually associated with blind loops of the bowel, either after Billroth II or ...ileojejunal bypass surgery or caused by a chronic inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
A 50-year-old patient is presented with an unusual case of pustulo hemorrhagic vasculitis over the lower arms and legs that appeared ten days before the first symptoms of appendicitis, partially regressed, and reappeared five days after appendectomy. Laboratory tests showed anemia, an elevated erythrocyte sedimentation rate, and C-reactive protein as well as a polyclonal increase in IgG and IgA levels, erythrocyturia and proteinuria. Histopathological examination of a skin biopsy indicated the suspected diagnosis. During hospitalization the patient developed arthropathy with swelling of the metacarpophalangeal and interphalangeal joints and ankles. The patient was treated with systemic antibiotics and corticosteroids, which caused resolution of the symptoms.
This report speculates that appendicitis was the possible cause of BADAS in this case.
Summary Current research in pathogenesis of psoriasis vulgaris suggests that the inflammatory mechanisms are immune based and most likely initiated and maintained by T cells. However, the question of ...lymphocyte being an initiator of psoriatic events remains open so far. Clinical observations such as plaque symmetry, stress-induced onset or exacerbations, pruritus, and possibility of generalization, suggest a role of the nervous system and neurogenic inflammation in pathogenesis. A key to understanding the role of melanocyte in psoriasis is their ability to act as regulatory cell in maintaining epidermal homeostasis. In suggested hypothetic event, melanocyte, acting as a local “stress sensor”, provide communicatory link between CNS and skin. The disease probably begins with so far unknown signal directed through neuronal network to the melanocyte, placed in the center of epidermal unit. That signal governs keratinocyte cellular activities and lead to reactive abnormal epidermal differentiation and hyperproliferation. Increased proliferation of basal keratinocytes and high metabolic demands creates angiogenesis in papillary dermis and elongation of dermal papillae. Stimulated melanocytes and basal keratinocytes become an important source of proinflammatory cytokines that attract lymphocytes in dermis. In conclusion, according to our hypothesis, lymphocyte infiltrate in psoriasis is secondary event rather than vice versa as presented in the literature.
Tinea incognito is a dermatophyte infection modified by inappropriate and often prolonged use of topical steroids. We present a case of tinea incognito in a 72-year-old woman, referred by her family ...physician who had unsuccessfully treated the lesions for 3 weeks with topical steroid cream. Physical examination revealed multiple nummular scaly papules and plaques which spread over her arms and trunk. The lesions were circular, erythematous, sharply demarcated with raised scaly edge some coalescing to form moderately infiltrated areas. Direct microscopy was positive for fungal hyphae. Fungal culture on Sabouraud's agar grew Trichophyton rubrum. The patient was successfully treated with oral terbinafine 250 mg daily and 1% clotrimazole cream twice daily. The present case highlights the importance of considering a dermatophytosis when clinical presentation of dermatosis is atypical. Disseminated scaly infiltrate lesions should be investigated for fungal infection in patients previously treated with steroids, as to avoid misdiagnosis and spread of infection.
Photocarcinogenesis--molecular mechanisms Gruber, Franjo; Zamolo, Gordana; Kastelan, Marija ...
Collegium antropologicum
31 Suppl 1, Številka:
Supp. 1
Journal Article
Recenzirano
The carcinogenicity (photocarcinogenicity) of sunlight to human skin has been recognized more than a century ago. Last decades numerous experimental studies show that UV rays damage DNA, cause gene ...mutations leading to the development of malignant tumors such basal cell carcinomas, squamous cell carcinomas and melanomas. The tumors occur most frequently in fair skinned people, and the mutations typically are found at dipyrimidine sites with C-T or / and CC-TT tandem double mutations. The authors briefly summarize their investigation of the p53 suppressor gene, and expose their hypothesis of hTERT involvement in cancerogenesis. Also their underline the importance of UV induced immunosuppression in photocarcinogenesis. Psoriatic patients are exposed to numerous cancerogens in their treatment. A better understanding of the mechanisms of photocarcinogenesis could provide new ways in the treatment of skin tumors.
Infliximab is an anti-tumor necrosis factor-monoclonal antibody shown to be effective in the treatment of moderate-to-severe psoriasis and psoriatic arthritis. We report on the first two patients in ...Croatia in which the efficacy of infliximab therapy was monitored and evaluated primarily on the basis of cutaneous manifestations of psoriasis. Both patients had severe, treatment-resistant chronic plaque psoriasis and psoriatic arthritis and were on methotrexate therapy before the initiation and throughout the course of infliximab treatment. Infliximab was administered intravenously at a dose of 4 or 5 mg/kg at week 0, 2, 6 and every 8 weeks thereafter. Disease severity was measured before each infusion by means of Psoriasis Area and Severity Index (PASI) score. A remarkable clinical response was achieved in both patients with a 50% or greater improvement in baseline PASI at week 2 after therapy initiation and a 90% or greater improvement at week 6 in one patient and at week 14 in the other. Both patients also reported a significant decline in their arthritis symptoms shortly after the introduction of infliximab. The concomitant use of infliximab and methotrexate in these two patients resulted in rapid and sustained remission of psoriasis with no major adverse effects detected.
UV radiation is present in sunlight and can be emitted from numerous artificial sources. Outdoor workers are exposed to sunlight in a wide variety of occupations like sailors, fishers, construction ...workers, farmers, and other. Presented are the skin diseases caused by sunlight exposure. They may be of little medical importance such as stigmata or create problems like photoaging, skin carcinoma, melanoma, phototoxic and photoallergic reactions. Shown are briefly data on skin cancer in the Rijeka region in outdoor occupations, the legislation and necessity for prevention. Psoriatic patients need particular caution because they are exposed to UVR, tars, and immunosuppressive drugs during the treatment.
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