[Primary cutaneous infections due to Staphylococcus and Streptococcus]

The multifactorial complexities of autoimmune development in Pemphigus vulgaris: Critical evaluation of the role of environmental and lifestyle "exposome" factors

Pemphigus vulgaris (PV) is a potentially life-threatening blistering disorder characterized by autoantibodies directed against cell-cell adhesion molecules that serves as an excellent model to study human autoimmune development. Numerous studies have identified specific Human Leukocyte Antigen (HLA) genes, in particular DRB1*0402 and DQB1*0503, that confer disease risk. Although HLA is required, it is not sufficient for the initiation of disease. As with all autoimmune diseases, the etio-pathogenesis of PV is complex, meaning it is multifactorial. Susceptibility is polygenic, and the search for non-HLA disease-linked genes continues. Moreover, twin studies across autoimmune conditions indicate that non-genetic environmental and lifestyle factors, which can be collectively grouped under the term "exposome", are also major contributors to disease development. The literature presents evidence for the potential role of multiple triggers such as medications, infections, stress, diet, immunizations, and sleep to influence the etiology, pathophysiology, and prognosis of PV. However, a clear understanding of the degree to which specific factors impact PV is lacking. In this investigation, we comprehensively review the environmental elements listed above and consider the strength of evidence for these factors. The overall goals of this work are to provide greater insights into the factors that influence disease susceptibility, disease development and disease course and ultimately help to better guide clinicians and inform patients in the management of PV.

Nodular Lymphangitis (Sporotrichoid Lymphocutaneous Infections). Clues to Differential Diagnosis

Nodular lymphangitis, also known as sporotrichoid lymphocutaneous infections, is characterized by suppurative inflammatory nodules along the lymphatic vessels. This manifestation is classic of sporotrichosis, however, other infections such as nocardiosis, atypical mycobacteriosis, leishmaniasis, among others, can also express this clinical pattern. Sporotrichosis, which often occurs in gardeners, remains the most recognized cause of nodular lymphangitis. The histopathological studies, as well as the culture are diagnostic standards of lesions that do not respond to empirical treatment. In this article, we will review the main causes of nodular lymphangitis or lymphocutaneous sporotrichoid infections.

Reasonable antimicrobial therapy in patients with pyodermatosis

The data are given about the history of the invention and development of antimicrobial therapy in the XX-th and the beginning of the XXI-th centuries. There are presented data on the pharmacological effects of antibacterial agents from different groups that are used for the treatment of patients with pyodermatosis, dose schedules, pharmacokinetics, adverse effects, contraindications, and medicine interactions. The main causes leading to the formation of resistant microorganism strains are pointed. Advances of broad-spectrum antibacterial antibiotics for treatment the pyodermic patients are demonstrated on the example of amoxicillin+clavulinic acid, josamycin and doxycycline monohydrate. The arguments justifying the need to refuse empiric administration of antibacterial therapy are presented. To select a rational causal initial therapy of patients with pyoderma it is necessary to use the results of microbiological study of etiology and pathogenic microflora sensitivity to antimicrobial preparations.