- Contact skin lesions may be the consequences of contact with various irritants or allergens, or due to other factors (e.g., UV radiation, microbials), intrinsic factors (e.g., in autoimmune ...responses), or even their combination. There are many substances related to irritant contact dermatitis (CD), causing irritant or toxic effects, e.g., chemical and physical agents, plants, phototoxic agents, airborne irritants, etc. Impaired barrier function (e.g., aberrancies in epidermal pH buffering capabilities) also participates by promoting bacterial biofilms and creating an environment favoring sensitization. Development of allergic CD skin lesions includes complex immune pathways and inflammatory mediators, influenced by both genetic (predominantly filaggrin mutations) and environmental triggers. In the pathogenesis of allergic CD, antimicrobial peptides play a prominent role; they are produced by various skin cells (e.g., keratinocytes, sebocytes) and move to inflamed lesions during an inflammation process. Also, in allergic CD skin lesions, the skin shows different types of immune responses to individual allergens, although clinical manifestations do not depend on the causative allergen type, e.g., nickel stimulates immune activation primarily of the Th1/Th17 and Th22 components. Also important are alarmins, proteases, immunoproteomes, lipids, natural moisturizing factors, tight junctions, smoking, etc. We expect that future perspectives may reveal new pathogenetic factors and scientific data important for the workup and treatment of patients with CD.
Pseudolymphoma is a benign, reversible, inflammatory, reactive, and polyclonal lymphocyte proliferation, which regresses spontaneously or heals after elimination of the causal factor. A female ...patient, aged 33, presented with a painful, erythematosus, radiant tumor formation on the skin in the temporal region. The patient had enlarged lymph nodes on the right side of the neck before the appearance of that tumor formation. The dermatoscopic finding was nonspecific. After the tumor biopsy was performed, the diagnosis of reactive lymphatic proliferation - pseudolymphoma or cutaneous lymphoma of B-cell immunophenotype - was established histologically. After we completely excised the skin change, the immunohistochemical finding indicated fluoride skin lymphocyte hyperplasia of B- and T-lymphocytes. The results of other findings were normal (serologic test for Borrelia burgdoferi, ultrasound of the cervical and supraclavicular lymph nodes, as well as ultrasound of the abdomen and axillary and inguinal regions). However, the etiology of the disease remains unknown. This case report confirms that the correlation between clinical presentation, dermatoscopic examination, histologic and immunohistochemical analysis, and the therapy response is crucial for diagnosis of pseudolymphoma and patient outcome.
Basal cell carcinoma (basalioma, BCC) is the most common skin cancer and the most common human malignancy in general, with a continuously increasing incidence. In most cases, BCC develops on ...chronically sun-exposed skin in elderly people, most commonly in the head and neck region. Besides chronic UV radiation, other risk factors for the development of BCC include sun bed use, family history of skin cancer, skin type 1 and 2, a tendency to freckle in childhood, immunosuppression, previous radiotherapy, and chronic exposure to certain toxic substances such as inorganic arsenic. There are numerous variations in clinical presentation of BCC, such as nodular BCC, ulcerating BCC, pigmented BCC, sclerosing BCC, superficial BCC, and fibroepithelioma of Pinkus. Each varies in terms of clinical presentation, histopathology and aggressive behavior. Treatment modalities for BCC include surgical excision, cryosurgery, curettage, electrodessication, radiotherapy, photodynamic therapy, topical cytostatics, and immunomodulators. If left untreated or inadequately treated, BCC may become invasive and locally destructive, although it very rarely metastasizes. Due to the extremely high incidence of BCC, medical professionals should be familiar with its manifold clinical presentations.
Kontaktne reakcije kože mogu biti posljedice kontakta s različitim iritansima ili alergenima ili mogu nastati zbog drugih čimbenika (npr. UV zračenja, mikroorganizama), unutarnjih čimbenika (npr. kod ...autoimunih reakcija) ili njihovom kombinacijom. Postoje mnoge tvari koje su povezane s pojavom iritativnog kontaktnog dermatitisa (KD) te uzrokuju iritativne ili toksične učinke: kemijske i fizikalne tvari, biljke, fototoksične tvari, okolišni čimbenici itd. Također oštećena funkcija kožne barijere (npr. odstupanja u epidermalnim pH puferskim sposobnostima) sudjeluje u tome promicanjem bakterijskih biofilmova i stvaranjem okruženja koja pogoduju senzibilizaciji. Razvoj kožnih oštećenja kod alergijskog KD-a obuhvaća kompleksne imunosne puteve i upalne medijatore koji su pod utjecajem i genetskih čimbenika (pretežno mutacija filagrina) i okidača iz okoliša. U patogenezi alergijskog KD-a istaknuta je uloga antimikrobnih peptida koji nastaju kao proizvod različitih kožnih stanica (npr. keratinociti, sebociti) i potom prelaze u kožne lezije tijekom procesa upale. Također, kod kožnih lezija u alergijskom KD-u koža pokazuje različite tipove imunosnih odgovora na pojedine alergene, iako kliničke manifestacije ne ovise o vrsti uzročnog alergena; npr. nikal stimulira imunosnu aktivaciju prvenstveno Th1/Th17 i Th22 komponenata. Također su važni alarmini, proteaze, imunoproteomi, lipidi, prirodni hidratantni čimbenici, međustanične veze, pušenje itd. Očekujemo da će se istraživanjima u budućnosti otkriti novi patogenetski čimbenici i znanstvene spoznaje važne za rad i liječenje bolesnika s KD-om.
Cutaneous pseudlolymphoma: A case report Stanić Duktaj, Sandra; Novak-Bilić, Gaby; Bradamante, Mirna ...
Acta dermatovenerologica Croatica,
07/2019, Letnik:
27, Številka:
2
Paper
Odprti dostop
Pseudolymphoma is a benign, reversible, inflammatory, reactive, and polyclonal lymphocyte proliferation, which regresses spontaneously or heals after elimination of the causal factor. A female ...patient, aged 33, presented with a painful, erythematosus, radiant tumor formation on the skin in the temporal region. The patient had enlarged lymph nodes on the right side of the neck before the appearance of that tumor formation. The dermatoscopic finding was nonspecific. After the tumor biopsy was performed, the diagnosis of reactive lymphatic proliferation – pseudolymphoma or cutaneous lymphoma of B-cell immunophenotype – was established histologically. After we completely excised the skin change, the immunohistochemical finding indicated fluoride skin lymphocyte hyperplasia of B- and T-lymphocytes. The results of other findings were normal (serologic test forBorrelia burgdoferi, ultrasound of the cervical and supraclavicular lymph nodes, as well as ultrasound of the abdomen and axillary and inguinal regions). However, the etiology of the disease remains unknown. This case report confirms that the correlation between clinical presentation, dermatoscopic examination, histologic and immunohistochemical analysis, and the therapy response is crucial for diagnosis of pseudolymphoma and patient outcome.
Bazocelularni karcinom (bazaliom, BCC) je najčešći zloćudni tumor kože i najčešći zloćudni tumor u ljudi, a njegova učestalost u stalnom je porastu. U većini slučajeva BCC nastaje na kronično ...osunčanoj koži u odraslih osoba, najčešće u području glave i vrata. Uz kronično izlaganje UV zrakama u rizične čimbenike za nastanak BCC spadaju uporaba solarija, pozitivna obiteljska anamneza tumora kože, tip kože I i II, sklonost nastanku pjegavosti u djetinjstvu, imunosupresija, prethodna radioterapija i kronična izloženost toksičnim noksama poput anorganskog arsena. Postoje brojne raznolikosti kliničke slike BCC. Klinički oblici BCC uključuju: nodularni BCC, ulcerozni BCC, pigmentirani BCC, sklerozirajući BCC, superficijalni BCC i Pinkusov fibroepiteliom. Uz raznoliko kliničko očitovanje navedeni oblici BCC razlikuju se u histološkoj slici te po stupnju lokalne agresivnosti. Metode liječenja BCC uključuju: kirurško odstranjenje novotvorine u cijelosti uz patohistološku analizu, krioterapiju, kiretažu i elektrodisekciju, radioterapiju, fotodinamsku terapiju, te lokalnu primjenu citostatika i imunomodulatora. Neliječen ili neodgovarajuće liječen BCC može postati invazivan i lokalno agresivan, iako vrlo rijetko metastazira. S obzirom na vrlo visoku učestalost BCC liječnici bi trebali poznavati mnogobrojne raznolikosti u kliničkom očitovanju ovog tumora kako bi se dijagnoza postavila u ranoj fazi kada su i mogućnosti liječenja veće, a prognoza bolja.
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