1
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Rybak-d’Obyrn J, Placek W, Owczarczyk-Saczonek A, Derkaczew M, Joniec E, Hofman R, Stompór M. Cutaneous Eruptions in the Course of COVID-19 Among Geriatric Patients in a Nursing Home in Poland. Clin Cosmet Investig Dermatol 2022; 15:2117-2127. [PMID: 36217410 PMCID: PMC9547623 DOI: 10.2147/ccid.s371630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/17/2022] [Indexed: 01/08/2023]
Abstract
Purpose The aim of this study was to assess the incidence and characteristics of COVID-19 cutaneous manifestations among geriatric patients infected with the SARS-CoV-2 virus. Patients and Methods Sixty-four nursing home residents in Dobre Miasto, Poland (mean age: 79 years) infected with SARS-CoV-2 were monitored for skin lesions during the epidemic outbreak in 2020. Only five of them presented COVID-19 dermatological manifestation: vesicular (4 cases) and erythematous (1 case) skin lesions, which appeared after the remaining symptoms of the disease had resolved. Results The average time between COVID-19 onset and cutaneous manifestation was 22 days. Skin lesions persisted in five cases 112, 17, 21,19 and 27 days, respectively, and were often accompanied by pruritus and neuropathic pain. Conclusion Skin manifestations of SARS-CoV-2 infection might be misdiagnosed or overlooked, particularly among elderly patients with chronic diseases. The recognition of skin lesions due to COVID-19 might improve patients' quality of life by reducing the intensity of symptoms such as pruritus or neuropathic pain.
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Affiliation(s)
- Joanna Rybak-d’Obyrn
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Waldemar Placek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Agnieszka Owczarczyk-Saczonek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Maria Derkaczew
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland,Correspondence: Maria Derkaczew, Tel +48 607654914, Email
| | - Ewelina Joniec
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Robert Hofman
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Małgorzata Stompór
- Department of Family Medicine and Infectious Diseases, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
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2
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Petersen J, Garbe C, Wolf S, Stephan B, Augustin M, Hagenström K. Medicinal Treatment of Elderly Psoriasis Patients before and after Entering a Nursing Home. Healthcare (Basel) 2022; 10:1730. [PMID: 36141342 PMCID: PMC9498407 DOI: 10.3390/healthcare10091730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 12/05/2022] Open
Abstract
Psoriasis (PS) is a chronic inflammatory skin disease, and it increasingly appears also in the elderly population. There is a rising interest in drug therapy for PS, especially for people receiving care in nursing homes (NH). Which PS-related drugs are prescribed in the time before nursing home admission (NHA), and to what extent does the supply of drugs change after NHA? Which specialties prescribe PS-related drugs? Statutory health insurance data were examined for people with PS, aged ≥ 65 years, who were newly admitted to a NH in the period 2011-2014 and observed for one year before and after NHA. Changes in prescription prevalence (pre-post comparison) were examined for significant differences. Prescriptions of PS-relevant drugs were measured by defined daily dose and stratified according to the prescribing specialist group. The analysis included 718 insured persons with PS (76.2% female, mean age 83.3 years). Systemic therapeutics played a minor role (pre: 2.6% vs. post: 2.1%) in drug therapy. Topical steroids had a high share of about 40% in the pre-post comparison. Overall, the proportion of people with PS who received treatment remained at a comparable level before and after NHA. A structured assessment of the skin is crucial, specifically in people with cognitive impairment.
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Affiliation(s)
- Jana Petersen
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
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3
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Nwabudike LC, Oproiu AM, Dogaru IM, Costache M, Tatu AL. Clinical, Dermoscopic and Microscopic Features of a "Collision Tumour" Ultimately Confirmed as a Regressing Melanoma - Lessons Learnt from a Chance Diagnosis. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1325-1331. [PMID: 35860608 PMCID: PMC9289571 DOI: 10.2147/ccid.s361793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/30/2022] [Indexed: 11/23/2022]
Abstract
Spontaneous regression of malignant melanoma was first reported over a century ago. Clinically, areas of blue or grey colouration in lesions may be indicative of regression. Dermoscopy is a very useful tool for diagnosing regression. An important criterion is the blue-white scar. About 10–35% of excised melanomas show features of regression histopathologically. We present a case of regressing melanoma, with clinical and dermoscopic features suggesting a collision tumour, diagnosed histopathologically. This case might improve our knowledge of the potential clinical manifestations, and the biology, of regressing melanoma.
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Affiliation(s)
| | - Ana Maria Oproiu
- Department of Plastic Surgery, Emergency University Hospital, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioana Mihaela Dogaru
- Department of Plastic Surgery, Emergency University Hospital, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mariana Costache
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Pathology, Emergency University Hospital, Bucharest, Romania
| | - Alin Laurentiu Tatu
- Clinical Medicine Department, Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, Galati, Romania.,Dermatology Department, St Parascheva Clinical Hospital of Infectious Diseases, Galati, Romania.,Multidisciplinary Integrated Center for Dermatologic Interface Research (MIC-DIR), Galati, Romania
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4
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Baroiu L, Anghel L, Tatu A, Iancu A, Dumitru C, Leșe AC, Drăgănescu M, Năstase F, Niculeț E, Fotea S, Nechita A, Voinescu D, Stefanopol A. Risk of hepatitis B reactivation: From biologic therapies for psoriasis to immunosuppressive therapies for COVID‑19 (Review). Exp Ther Med 2022; 23:385. [PMID: 35495599 PMCID: PMC9019722 DOI: 10.3892/etm.2022.11312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/28/2021] [Indexed: 12/15/2022] Open
Abstract
The cytokine storm from the evolution of severe cases of COVID-19, requiring strong immunosuppressive therapies, has raised the issue of reactivation of hepatitis B virus (HBV) infections in these patients. An analysis of the first observational studies in patients with COVID-19 and immunosuppressive therapy and HBV infection along with special clinical cases was presented, as well as personal experience on a series of cases (a group of 958 patients with COVID-19), compared with the analysis of studies performed on patients with HBV infection that underwent biological therapies for psoriasis and personal experience (a group of 81 psoriasis patients treated with biological therapies). Clinical studies have revealed that HBV reactivation in patients undergoing biological therapies for psoriasis, can be prevented with monitoring and treatment protocols and thus, these therapies have been demonstrated to be safe and effective. In COVID-19, immunosuppressive therapies are short-lived but in high doses, and the conclusions of clinical trials are contradictory, but there are published cases of HBV reactivation, which requires a unitary attitude in the prevention of HBV reactivation in these patients. An algorithm was presented for monitoring and treatment of HBV infection for patients with psoriasis treated with biological therapy and the conditions when this protocol can be used for patients with COVID-19 and immunosuppressive therapy.
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Affiliation(s)
- Liliana Baroiu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Lucreția Anghel
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Alin Tatu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Alina Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Caterina Dumitru
- Department of Laboratory Medicine, ‘Sf. Cuv. Parascheva’ Clinical Infectious Diseases Hospital, 800179 Galati, Romania
| | - Ana-Cristina Leșe
- Faculty of Visual Arts and Design, ‘George Enescu’ National University of Arts, 700451 Iasi, Romania
| | - Miruna Drăgănescu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Florentina Năstase
- Department of Neuropsychomotor Rehabilitation, ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Elena Niculeț
- Multidisciplinary Integrated Center of Dermatological Interface Research, ‘Dunărea de Jos’ University, 800008 Galați, Romania
| | - Silvia Fotea
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Aurel Nechita
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Doina Voinescu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Anca Stefanopol
- Multidisciplinary Integrated Center of Dermatological Interface Research, ‘Dunărea de Jos’ University, 800008 Galați, Romania
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5
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Anghel L, Baroiu L, Popazu CR, Pătraș D, Fotea S, Nechifor A, Ciubara A, Nechita L, Mușat CL, Stefanopol IA, Tatu AL, Ciubara AB. Benefits and adverse events of melatonin use in the elderly (Review). Exp Ther Med 2022; 23:219. [PMID: 35126722 PMCID: PMC8796282 DOI: 10.3892/etm.2022.11142] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 12/11/2022] Open
Abstract
Melatonin is a hormone secreted by the pineal gland in accordance with the circadian rhythm when the light level decreases. Reduction of melatonin secretion with age may be associated with physiological aging in neurodegenerative diseases by affecting the suprachiasmatic nucleus or of the neuronal pathways of transmission to the pineal gland. A significant decrease in melatonin synthesis has been reported in various disorders and diseases, including cardiovascular diseases, metabolic disorders (particularly diabetes type 2), cancer and endocrine diseases. In addition to the fact, that melatonin is a sleep inducer, it also exerts cytoprotective properties as an antioxidant and free radical scavenger. The therapeutic role of melatonin has been demonstrated in sleep disorders, eye damage and cardiovascular disease. The association between melatonin and β-blockers has had a positive impact on sleep disorders in clinical trials. Previous studies have reported the anti-inflammatory effect of melatonin by adjusting levels of pro-inflammatory cytokines, including interleukin (IL)-6, IL-1β and tumor necrosis factor-α. Melatonin treatment has been demonstrated to decrease IL-6 and IL-10 expression levels and efficiently attenuate T-cell proliferation. Currently, there is an inconsistency of scientific data regarding the lowest optimal dose and safety of melatonin for long-term use. The aim of the present review was to summarize the evidence on the role of melatonin in various clinical conditions and highlight the future research in this area.
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Affiliation(s)
- Lucreția Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Corina Rișcă Popazu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Diana Pătraș
- Internal Medicine Department, St. Andrew The Apostle Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Anamaria Ciubara
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Carmina Liana Mușat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Ioana Anca Stefanopol
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Alin Laurențiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research, 'Dunărea de Jos' University, 800008 Galați, Romania.,Research Center in The Field of Medical and Pharmaceutical Sciences, 'Dunărea de Jos' University, 800008 Galați, Romania
| | - Alexandru Bogdan Ciubara
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galați, Romania
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6
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Jicman Stan D, Niculet E, Lungu M, Onisor C, Rebegea L, Vesa D, Bezman L, Bujoreanu FC, Sarbu MI, Mihailov R, Fotea S, Tatu AL. Nasopharyngeal carcinoma: A new synthesis of literature data (Review). Exp Ther Med 2022; 23:136. [PMID: 35069817 PMCID: PMC8756428 DOI: 10.3892/etm.2021.11059] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 02/07/2023] Open
Abstract
Nasopharyngeal carcinoma (NPC) is an epithelial tumor, which develops most frequently from the lateral pharyngeal recess and holds some complex epidemiological characteristics. Its unusual race and geographic distribution suggests that not only the environmental factors are a contributing factor to the development of this rare cancer type, but also the genetic traits play an important role, along with nitrosamine-containing food consumption and Epstein-Barr virus infection. The signs and symptoms which a patient can present and suffer from are various and include nasal, otic, neurological as well as general ones; the way this tumor manifests being dependent on the stage of the tumor. The therapeutic management applicable in NPC needs to be established according to the case of the patient and include radiotherapy, chemotherapy, surgery, immune therapy, targeted therapy or combined treatment. The main objective of the treatment is local and regional tumor control; relapse is an important factor for future development of distant metastases. New therapeutic concepts are always sought of, current research focusing on precision medicine, meaning systemic treatment with a personalized radiotherapy approach according to the characteristics of the tumor.
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Affiliation(s)
- Daniela Jicman Stan
- Department of Otorhinolaryngology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Biomedical Doctoral School, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galați, 800010 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galați, 800010 Galati, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Mihaela Lungu
- Department of Neurology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galați, 800010 Galati, Romania
| | - Laura Rebegea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Doinita Vesa
- Department of Otorhinolaryngology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Clinical Surgical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Laura Bezman
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galați, 800010 Galati, Romania.,Department of Ophthalmology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
| | - Florin Ciprian Bujoreanu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 'Dunarea de Jos' University, 800010 Galati, Romania.,Department of Dermatology, 'Sfanta Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Mihaela Ionela Sarbu
- Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Raul Mihailov
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Silvia Fotea
- Department of Neurology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Department of Pediatrics, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galati, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 'Dunarea de Jos' University, 800010 Galati, Romania.,Department of Neurology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Department of Ophthalmology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
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7
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Brihan I, Fekete G, Turda C, Tica O, Venter A, Ianosi S, Neagoe CD, Branisteanu D. Clinicopathological correlation of transient acantholytic dermatosis: A case report. Exp Ther Med 2021; 23:173. [PMID: 35069854 PMCID: PMC8764573 DOI: 10.3892/etm.2021.11096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/13/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ilarie Brihan
- Dermatology Department, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Gyula Fekete
- Dermatology Department, Dermatology Clinic, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540530 Targu Mureș, Romania
| | - Constanta Turda
- Department of Psycho‑Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Ovidiu Tica
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Alina Venter
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Simona Ianosi
- Department of Dermatology, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Carmen-Daniela Neagoe
- Department of Internal Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Daciana Branisteanu
- Department of Dermatology, University of Medicine and Pharmacy ‘Grigore T. Popa’, 700115 Iasi, Romania
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8
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Bobeica C, Rebegea L, Murariu G, Dobre M, Nechita A, Tatu AL, Niculet E, Anghel L, Fotea S, Craescu M. Cutaneous adverse reactions in a lung cancer patient treated with pembrolizumab: A case report. Exp Ther Med 2021; 23:15. [PMID: 34815767 PMCID: PMC8593923 DOI: 10.3892/etm.2021.10937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/05/2022] Open
Abstract
Lung cancer is the main cause of oncological death in the US and worldwide, constituting a significant public health problem. The incidence of lung cancer is on the increase. In the present study, the diagnostic process was carried out and treatment options were considered to determine the therapeutic response of a patient diagnosed with lung cancer. The case of an early stage lung cancer patient who benefited from surgical treatment was presented. The pathology report stated the complete diagnosis to be pleomorphic lung cancer with an adenocarcinoma component, pT2aN0M0, with focal positivity for thyroid transcription factor 1 (TTF1), without epidermal growth factor receptor (EGFR) mutations and ALK recombinations, having an initial clinical stage of IB and programmed death ligand-1 (PD-L1) positivity with a tumor proportion score of over 70%. The patient underwent radiotherapy treatment and was administered osteoclast inhibitors and immunotherapy, with no favorable therapeutic effect and with the presence of secondary cutaneous adverse effects to pembrolizumab. As a main cause of death, lung cancer registers a low general survival rate even in patients with targeted therapies or immunotherapy. By better identifying the patients at risk, one can establish a more efficient personalized treatment; the future objective of scientific studies is the follow-up of adverse effects of new therapies.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Laura Rebegea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Gabriel Murariu
- Department of Chemistry, Physics and Environment, Faculty of Sciences and Environment, 'Dunarea de Jos' University, 800201 Galati, Romania
| | - Michaela Dobre
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
| | - Lucretia Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
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9
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Matveev AV, Egorova EA, Konyaeva EI, Dormidor AG, Bekirova EY. Peculiarities of Adverse Events Manifested by Injury of Skin and Skin Derivatives and Associated with Beta-blockers Use. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-10-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
More than 50 years after Propranolol was introduced to the pharmaceutical market as a drug that can lower the heart rate, beta-blockers (BAB) are still widely used in the pharmacotherapy of cardiovascular diseases. However, the use of BAB has a number of limitations, first of all, due to adverse drug events (AE) that develop during their use. The purpose of our review was to study the features of the BAB AE manifested by injuries of the skin and its appendages. The clinical manifestations of them are the development or exacerbation of psoriasis, lichen planus, contact dermatitis, acrocyanosis, Raynaud's disease, alopecia, hyperhidrosis, vitiligo, anaphylaxis, and allergic skin reactions. True medicinal psoriasis occurs in patients taking BAB with no family or previous history and most often mimics erythrodermic psoriasis and palmar-plantar pustular psoriasis. Systemic use of BAB can also be accompanied by exacerbation of vitiligo. In patients with segmental vitiligo, the results of Doppler flowmetry and iontophoresis showed increased blood flow in vitiligo foci compared with normal skin. The development of anaphylactic reactions against the background of BAB therapy may be due to the modulation of adenylate cyclase, which can affect the release of anaphylactogenic mediators, as well as a decrease in the severity of cardiovascular compensatory changes. The peculiarities of the development of such reactions may be the resistance of patients to traditional treatment, which is due to the development of paradoxical reflex vagotonic effects when using adrenaline. Some of the mentioned AE may pose a potential threat to the life and health of the patient and therefore require additional discussion.
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Affiliation(s)
- A. V. Matveev
- Medical Academy named after S. I. Georgievsky, V.I. Vernadsky Crimean Federal University; Russian Medical Academy of Continuing Professional Education
| | - E. A. Egorova
- Medical Academy named after S. I. Georgievsky, V.I. Vernadsky Crimean Federal University
| | - E. I. Konyaeva
- Medical Academy named after S. I. Georgievsky, V.I. Vernadsky Crimean Federal University
| | | | - E. Yu. Bekirova
- Medical Academy named after S. I. Georgievsky, V.I. Vernadsky Crimean Federal University
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10
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Jicman Stan D, Niculet E, Lungu M, Onisor C, Rebegea L, Bobeica C, Elisei AM, Anghel L, Tatu AL. Rare case of metachronous tumor: Nasopharyngeal and colorectal carcinoma. Exp Ther Med 2021; 22:1417. [PMID: 34707699 PMCID: PMC8543177 DOI: 10.3892/etm.2021.10852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
The study presents an unusual case of a patient with a personal history of a rectal malignant tumor in 2013, who after a period of 6 years, was diagnosed with an advanced nasopharyngeal carcinoma, locally and regionally invasive. It is possible that the colorectal malignant tumor affected the development of the nasopharyngeal carcinoma, or the other way around, depending on the presence of genetic instabilities. These two types of malignant tumors share a series of genes that can influence their progression, i.e., SPINK-6 and Bcl-2. The particularity of this case stems from the development of a metachronous tumor, a rectal adenocarcinoma and nasopharyngeal carcinoma, two malignant tumors with different patient prognosis and disease progression. Research needs to be continued on the multidisciplinary therapeutic management of nasopharyngeal cancer and the ways of identifying this cancer type in its early stages, considering that most patients come from a rural environment, have poor medical education, a number of comorbidities, and who frequently ignore the signs, symptoms and sometimes the treatment offered.
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Affiliation(s)
- Daniela Jicman Stan
- Department of Otorhinolaringology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Biomedical Doctoral School, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
| | - Mihaela Lungu
- Department of Neurology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Laura Rebegea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Alina Mihaela Elisei
- Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG, 800010 Galati, Romania.,Research Centre in The Field of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Department of Pharmaceutical Sciences, 'Dunărea de Jos' University of Galați, 800010 Galati, Romania
| | - Lucretia Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG, 800010 Galati, Romania.,Department of Dermatology, 'Sfanta Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
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11
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Bujoreanu FC, Bezman L, Radaschin DS, Niculet E, Bobeica C, Craescu M, Nadasdy T, Jicman DS, Ardeleanu V, Nwabudike LC, Marinescu SA, Tatu AL. Nevi, biologics for psoriasis and the risk for skin cancer: A real concern? (Case presentation and short review). Exp Ther Med 2021; 22:1354. [PMID: 34659500 PMCID: PMC8515562 DOI: 10.3892/etm.2021.10789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/02/2021] [Indexed: 11/06/2022] Open
Abstract
Psoriasis is a systemic inflammatory cutaneous disease that affects approximately 2% of the world's population. Systemic treatments and biologic treatment therapies are a powerful option for patients with moderate to severe psoriasis. Some studies from the literature indicate an overall small, but increased, risk of neoplasia in patients with psoriasis treated with phototherapy or systemic medication. The relationship between psoriasis and malignancy is not very well established; there are few studies with conflicting results. We present the case of a 31-year-old male patient, diagnosed with psoriasis, who was deemed eligible for systemic therapy. Treatment with methotrexate was initiated, but without a satisfactory outcome. Given the patient's resistant disease involving 15% of his body surface, his desire to have a clear skin, besides his being naïve to biologic therapy, he was proposed to start treatment with secukinumab 300 mg monthly. The patient experienced complete clearance of lesions and was followed-up on the basis of clinical and biological parameters. There are limited data concerning the relationship between melanocytic lesions, psoriasis and melanoma. Immunologic pathways implicated in psoriasis induce a reduction in the number of melanocytic nevi. Nevertheless, little is known concerning the association of melanocytic nevi with psoriasis. Thorough skin examination, meaning clinical and dermoscopic evaluation of melanocytic lesions, must be encouraged in patients treated with systemic therapies such as biologic agents.
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Affiliation(s)
- Florin Ciprian Bujoreanu
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania.,Department of Dermatology, Doctoral School of Biological and Medical Sciences, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Laura Bezman
- Ophthalmology Department, 'Sf. Apostol Andrei' Clinical Emergency Hospital, 800578 Galați, Romania.,Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Diana Sabina Radaschin
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania
| | - Thomas Nadasdy
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania
| | - Daniela Stan Jicman
- ENT Department, 'Sf. Apostol Andrei' Clinical Emergency Hospital, 800578 Galați, Romania
| | - Valeriu Ardeleanu
- Surgery Department, Arestetic Plastic Surgery Clinic, 800098 Galați, Romania.,Faculty of Medicine, Doctoral School, 'Ovidius' University, 900533 Constanța, Romania.,Surgery Department, CFR General Hospital, 800223 Galați, Romania
| | - Lawrence Chukwudi Nwabudike
- Outpatient Dermatology Department, 'Prof. N. Paulescu' National Institute of Diabetes, 011233 Bucharest, Romania
| | - Silviu Adrian Marinescu
- Department of Plastic and Reconstructive Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alin Laurentiu Tatu
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galați, 800010 Galați, Romania.,Research Center of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 800010 Galați, Romania
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12
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Zhang J, Chen R, Wen L, Fan Z, Guo Y, Hu Z, Miao Y. Recent Progress in the Understanding of the Effect of Sympathetic Nerves on Hair Follicle Growth. Front Cell Dev Biol 2021; 9:736738. [PMID: 34513851 PMCID: PMC8427189 DOI: 10.3389/fcell.2021.736738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/02/2021] [Indexed: 11/15/2022] Open
Abstract
Clinical observation and experimental studies have long suggested that the perifollicular nerves have nutritional and regulatory effects on the growth, development, and physiological cycle of hair follicles (HFs), even though the concrete mechanism remains obscure. Recently, with the progress of immunohistochemistry and molecular biology techniques, more innovation has been made in the study of the follicular sympathetic nerves and its nerve-effect factor norepinephrine affecting hair follicle stem cells. This review highlights the progress in the regulation of the sympathetic nervous system toward the growth of HFs.
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Affiliation(s)
- Jiarui Zhang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruosi Chen
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lihong Wen
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhexiang Fan
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yilong Guo
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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13
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Bobeica C, Niculet E, Halip AI, Gheuca-Solovastru L, Draganescu ML, Popescu IA, Onisor C, Chirobocea S, Lungu M, Craescu M. Predictive value of immunological markers in systemic sclerosis. Exp Ther Med 2021; 22:994. [PMID: 34345276 PMCID: PMC8311248 DOI: 10.3892/etm.2021.10426] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022] Open
Abstract
Systemic sclerosis (SSc) is a collagenosis characterized by excessive deposition of collagen in the skin and viscera, in a background of immune disorder. The immunological profile of SSc often shows elevated levels of antinuclear antibodies (ANAs). However, many authors have identified cases of SSc having normal ANA levels, framed as paraneoplastic SSc. Among patients with negative ANAs in our group, we did not identify any neoplastic process that could support this hypothesis. The extended detection of autoantibodies is extremely useful in establishing the subset of SSc. Thus, anti-Scl70 antibodies are specific for the diffuse subset of SSc, while anticentromere antibodies (ACAs) have specificity for a limited subset. However, studies have shown the existence of cases of diffuse SSc having high titers of ACAs and cases of limited SSc with high titers of anti-Scl70 antibodies. This indicates an inconsistent association between the disease subset and the autoantibodies specific to each subset. Our study found a more balanced consistency between disease subsets and autoantibodies specific for each subset. Therefore, the percentages of patients having an immunological profile inconsistent with the subset of SSc, are lower than those found by other authors. This observation opens the perspective of larger studies on the immunological profile in SSc.
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Affiliation(s)
- Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Alina Ioana Halip
- Department of Dermato-Venereology, Doctoral School of ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Laura Gheuca-Solovastru
- Department of Clinical Dermato-Venereology, Faculty of Medicine and Pharmacy, ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Miruna Luminita Draganescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Ioana Adriana Popescu
- Department of Dermato-Venereology, Doctoral School of ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Silvia Chirobocea
- Department of Neurology, Municipal Emergency Hospital, 605400 Moinești, Romania
| | - Mihaela Lungu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800216 Galați, Romania
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14
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Chioncel V, Andrei CL, Brezeanu R, Sinescu C, Avram A, Tatu AL. Some Perspectives on Hypersensitivity to Coronary Stents. Int J Gen Med 2021; 14:4327-4336. [PMID: 34408475 PMCID: PMC8364397 DOI: 10.2147/ijgm.s326679] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/22/2021] [Indexed: 11/23/2022] Open
Abstract
The development of coronary stents has represented a revolution in the treatment of coronary heart disease. Beyond their many advantages, stents also have their limitations and complications. Allergic reactions to coronary stents are more common than acknowledged. These stented patients are exposed to foreign substances inserted in direct contact with the coronary intima. Hypersensitivity to stent components and drugs prescribed after stent insertion together with any environmental exposure seem to contribute to these adverse reactions. Patients can present to the hospital with a wide range of symptoms and multiple complications, the most important ones being instent restenosis and stent thrombosis. Although not very common (and not always easy to identify), allergic reactions after coronary or peripheral stents should be taken into account. Careful selection of patients (for elective stent implantation) depending on the propensity to allergies, although hard to achieve, represents a key factor in reducing the number of these complications.
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Affiliation(s)
- Valentin Chioncel
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, 050474, Romania
| | - Catalina Liliana Andrei
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, 050474, Romania
| | - Radu Brezeanu
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, 050474, Romania
| | - Crina Sinescu
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, 050474, Romania
| | - Anamaria Avram
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, 050474, Romania
| | - Alin Laurentiu Tatu
- Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform "Dunărea de Jos", ReForm-UDJG, Research Centre in the Field of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Clinical Medical Department, "Dunărea de Jos" University of Galati, Galati, 800010, Romania
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15
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Arbune M, Gurau G, Niculet E, Iancu AV, Lupasteanu G, Fotea S, Vasile MC, Tatu AL. Prevalence of Antibiotic Resistance of ESKAPE Pathogens Over Five Years in an Infectious Diseases Hospital from South-East of Romania. Infect Drug Resist 2021; 14:2369-2378. [PMID: 34194233 PMCID: PMC8238535 DOI: 10.2147/idr.s312231] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/26/2021] [Indexed: 01/31/2023] Open
Abstract
PURPOSE This study aimed at identifying the main antimicrobial resistance of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli) pathogens in a Romanian infectious diseases hospital. This antimicrobial resistance is a global threat, having high rates of multidrug resistance and limited treatment options. PATIENTS AND METHODS This retrospective study (2016-2020) assessed the antimicrobial resistance of ESKAPE pathogens isolated from the patient's biological samples. The microbiological diagnosis was performed by classical culture methods. The antimicrobial susceptibility analysis used the Kirby-Bauer disk-diffusion method and the method of minimum inhibiting concentration with the automated Vitek, according to the CLSI (Clinical and Laboratory Standards Institute) standards. RESULTS Included in this study were 4293 bacterial isolates: 67% Gram-negative bacilli, 31% Gram-positive cocci and 2% other morphotinctorial bacteria. ESKAPE pathogens were found in 97% of the bacterial isolates strains; E. coli (38.26%) and Staphylococcus aureus (26%) were the most prevalent. Most bacterial strains were isolated from urine cultures (45.6%), skin and soft tissue secretions/collections (35.9%) and also blood cultures (4.2%). Increased antimicrobial resistance was observed for methicillin-resistant Staphylococcus aureus (MRSA)s, extended spectrum beta-lactamase producing (ESBL) Enterobacterales, carbapenem-resistant (CR) Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae. No vancomycin resistance was found for Enterococcus faecium. The highest prevalence rates of multidrug resistance were found in methicillin-resistant Staphylococcus aureus (86.6%), Acinetobacter baumannii (36.8%), Pseudomonas aeruginosa (29.1%) and Klebsiella pneumoniae (24.4%). CONCLUSION ESKAPE pathogens are frequently isolated in the infectious diseases hospital, with main antimicrobial resistance: ESBL, MRSA and CR. The local antimicrobial resistance pattern is essential in updating the local protocols and for appropriately prescribing antibiotics. Streamlining microbiological diagnosis and aligning with the European standards for antimicrobial susceptibility testing are necessary steps in harmonizing the regional network for good antimicrobial resistance control practices.
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Affiliation(s)
- Manuela Arbune
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Infectious Diseases Department, Clinical Hospital of Infectious Diseases “Sf. Cuvioasa Parascheva”, Galati, Romania
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Department of Pathology, “Sf. Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
| | - Alina Viorica Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Medical Laboratory Department, Clinical Hospital of Infectious Diseases “Sf. Cuvioasa Parascheva”, Galati, Romania
| | - Gabriela Lupasteanu
- Infectious Diseases Department, Clinical Hospital of Infectious Diseases “Sf. Cuvioasa Parascheva”, Galati, Romania
- Medical Doctoral School, “Ovidius” University, Constanta, Romania
| | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Mihaela Camelia Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Infectious Diseases Department, Clinical Hospital of Infectious Diseases “Sf. Cuvioasa Parascheva”, Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, Galati, Romania
- Dermatology Department, Clinical Hospital of Infectious Diseases “Sf. Cuvioasa Parascheva”, Galati, Romania
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16
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Tatu AL, Baroiu L, Fotea S, Anghel L, Drima Polea E, Nadasdy T, Chioncel V, Nwabudike LC. A Working Hypothesis on Vesicular Lesions Related to COVID-19 Infection, Koebner Phenomena Type V, and a Short Review of Related Data. Clin Cosmet Investig Dermatol 2021; 14:419-423. [PMID: 33958887 PMCID: PMC8096633 DOI: 10.2147/ccid.s307846] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/07/2021] [Indexed: 01/19/2023]
Abstract
SARS-CoV-2 has recently been associated with the reactivation of varicella zoster virus in patients. This is potentially an observation of a local susceptibility of the skin in areas of vesicle formation. This article explores the dermatologic manifestations that have been linked to the SARS-CoV-2 virus, their infectious risk, as well as potential confounding factors. An isotopic response may be occurring due to the occurrence of an immunocompromised district incited by sustained inflammation mediated by inflammatory cytokines.
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Affiliation(s)
- Alin Laurentiu Tatu
- Dermatology Department, “St. Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania
- Faculty of Medicine and Pharmacy, Clinical Medical Department, Dermatology, Medical and Pharmaceutical Research Unit, Competitive, Interdisciplinary Research Integrated Platform, ReForm-UDJG “Dunărea de Jos” University, Galati, Romania
| | - Liliana Baroiu
- Infectious Diseases Department, “St. Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania
- Faculty of Medicine and Pharmacy, Clinical Medical Department, “Dunărea de Jos” University, Galati, 800010, Romania
| | - Silvia Fotea
- Faculty of Medicine and Pharmacy, Clinical Medical Department, “Dunărea de Jos” University, Galati, 800010, Romania
- Sf Ioan Clinical Hospital of Pediatrics, Galati, Romania
| | - Lucretia Anghel
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800010, Romania
- Internal Medicine Department, Sf Andrei Clinical Emergency Hospital, Galati, Romania
| | - Eduard Drima Polea
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800010, Romania
- Elisabeta Doamna Clinical Hospital of Psychiatry, Galati, Romania
| | - Thomas Nadasdy
- Dermatology Department, “St. Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania
| | - Valentin Chioncel
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Phamacy, Bucharest, 050474, Romania
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17
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Niculet E, Bobeica C, Tatu AL. Glucocorticoid-Induced Skin Atrophy: The Old and the New. Clin Cosmet Investig Dermatol 2020; 13:1041-1050. [PMID: 33408495 PMCID: PMC7779293 DOI: 10.2147/ccid.s224211] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022]
Abstract
Glucocorticoids are major therapeutic agents highly used in the medical field. Topical glucocorticoids have biologic activities which make them useful in dermatology – anti-inflammatory, vasoconstrictive, immune suppressive and antiproliferative, in treating inflammatory skin disorders (allergic contact eczema, atopic hand eczema, nummular eczema, psoriasis vulgaris or toxic-irritative eczema). Unfortunately, the beneficial effects of topical glucocorticoids are shadowed by their potential for adverse effects – muscle or skin atrophy, striae distensae, rubeosis or acne. Skin atrophy is one of the most prevalent side-effects, with changes found in all skin compartments – marked hypoplasia, elasticity loss with tearing, increased fragility, telangiectasia, bruising, cutaneous transparency, or a dysfunctional skin barrier. The structure and function of the epidermis is altered even in the short-term topical glucocorticoid treatment; it affects stratum corneum components, subsequently affecting skin barrier integrity. The dermis is altered by directly inhibiting fibroblast proliferation, reducing mast cell numbers, and loss of support; there is depletion of mucopolysaccharides, elastin fibers, matrix metalloproteases and inhibition of collagen synthesis. Atrophogenic changes can be found also in hair follicles, sebaceous glands or dermal adipose tissue. Attention should be paid to topical glucocorticoid treatment prescription, to the beneficial/adverse effects ratio of the chosen agent, and studies should be oriented on the development of newer, innovative targeted (gene or receptor) therapies.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania
| | - Carmen Bobeica
- Department of Dermato-Venereology, Doctoral School, University of Medicine and Pharmacy "Gr. T. Popa", Iași, Romania
| | - Alin L Tatu
- Clinical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Galati, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, Galati, Romania.,Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania
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18
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Lozzi F, Di Raimondo C, Lanna C, Diluvio L, Mazzilli S, Garofalo V, Dika E, Dellambra E, Coniglione F, Bianchi L, Campione E. Latest Evidence Regarding the Effects of Photosensitive Drugs on the Skin: Pathogenetic Mechanisms and Clinical Manifestations. Pharmaceutics 2020; 12:E1104. [PMID: 33213076 PMCID: PMC7698592 DOI: 10.3390/pharmaceutics12111104] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 12/27/2022] Open
Abstract
Photosensitivity induced by drugs is a widely experienced problem, concerning both molecule design and clinical practice. Indeed, photo-induced cutaneous eruptions represent one of the most common drug adverse events and are frequently an important issue to consider in the therapeutic management of patients. Phototoxicity and photoallergy are the two different pathogenic mechanisms involved in photosensitization. Related cutaneous manifestations are heterogeneous, depending on the culprit drug and subject susceptibility. Here we report an updated review of the literature with respect to pathogenic mechanisms of photosensitivity, clinical manifestations, patient management, and prediction and evaluation of drug-induced photosensitivity. We present and discuss principal groups of photosensitizing drugs (antimicrobials, nonsteroidal anti-inflammatory drugs, anti-hypertensives, anti-arrhythmics, cholesterol, and glycemia-lowering agents, psychotropic drugs, chemotherapeutics, etc.) and their main damage mechanisms according to recent evidence. The link between the drug and the cutaneous manifestation is not always clear; more investigations would be helpful to better predict drug photosensitizing potential, prevent and manage cutaneous adverse events and find the most appropriate alternative therapeutic strategy.
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Affiliation(s)
- Flavia Lozzi
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Caterina Lanna
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Laura Diluvio
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Sara Mazzilli
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Virginia Garofalo
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Emi Dika
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Via Massarenti, 1-40138 Bologna, Italy;
| | - Elena Dellambra
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata–Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), via dei Monti di Creta 104, 00167 Rome, Italy;
| | - Filadelfo Coniglione
- Department of Clinical Science and Translational Medicine, Tor Vergata University, 00133 Rome, Italy;
| | - Luca Bianchi
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Elena Campione
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
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19
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Brihan I, Hălmăjan A, Boda D, Ianoși SL, Fekete GL, Zdrîncă M. Role of osteodensitometry in osteoporosis and osteopenia in psoriatic arthritis. Exp Ther Med 2020; 20:188. [PMID: 33101478 DOI: 10.3892/etm.2020.9318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/07/2020] [Indexed: 01/13/2023] Open
Abstract
Dual-energy X-ray Absorptiometry (DEXA) determines the mineral contents for the spine, the proximal femur and the entire body. A group of 36 patients with psoriatic arthritis were chosen, with different types of arthropathy, from the total 82 patients with psoriatic arthritis in the study group, for which bone mineral density (BMD) was measured, using the DEXA technique. The chosen study group comprised 12 men, 12 premenopausal women and 12 menopausal women, with psoriatic joint damage and a group of 36 healthy individuals, divided based on the same criteria: Men, premenopausal and menopausal women. This study did not emphasize an association between the patient type and the presented bone demineralization type (χ2 (2)=4.473, P=0.107) in men. In premenopausal women, there was a significant association between the patient type and the presented bone demineralization type (χ2 (2)=8.778, P=0.012), as the female patients with psoriatic arthritis presented total and partial demineralization to a larger degree, compared with healthy individuals. In menopausal women, this study did not highlight an association between the patient type and the presented bone demineralization type (χ2 (2)=4.523, P=0.104). Bone demineralization was significant in all three patient groups, both total and partial, in patients with psoriatic arthritis compared with healthy patients. Bone demineralization manifested as osteopenia, with T-scores ranging from -2.5 to -1, and not as osteoporosis. Determining B MD by DEXA technique revealed osteopenia to a higher degree within the group of patients with psoriatic arthritis compared with the healthy patients, as well as the absence of osteoporosis in psoriatic arthritis.
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Affiliation(s)
- Ilarie Brihan
- Dermatology Department, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Angelica Hălmăjan
- Psychology Department, Faculty of Social-Humanistic Sciences, University of Oradea, 410073 Oradea, Romania
| | - Daniel Boda
- Dermatologic Research Laboratory - National Institute of Diabetes Nutrition and Metabolic Diseases 'N.C. Paulescu', 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Simona Laura Ianoși
- Dermatology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Gyula László Fekete
- Dermatology Discipline, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540530 Targu Mures, Romania
| | - Mihaela Zdrîncă
- Preclinical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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20
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Brihan I, Ianoși SL, Boda D, Hălmăjan A, Zdrîncă M, Fekete LG. Implications of self-esteem in the quality of life in patients with psoriasis. Exp Ther Med 2020; 20:202. [PMID: 33123231 DOI: 10.3892/etm.2020.9332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/26/2020] [Indexed: 01/22/2023] Open
Abstract
Skin has an integrative role in daily life, being a communication organ between the patient and the world. Skin affection in psoriasis has consequences on the patient's self-esteem, with direct implications on the quality of life. This study focused on the impairment of self-esteem in a group of 110 patients: Patients with severe cutaneous and psoriasis arthritis and patients with mild types of psoriasis, using the Rosenberg Self-Esteem Scale. Patients with severe cutaneous and psoriasis arthritis have a lower self-esteem compared with patients with mild psoriasis. The statistical data of two groups regarding the degree of education (secondary and higher education), in the male patients with severe cutaneous and psoriasis arthritis with higher education showed a lower self-esteem, compared with male patients with severe cutaneous and psoriasis arthritis with secondary education. In mild forms of psoriasis, the self-esteem of women and men is relatively equal, but below the general population average. Male patients with psoriasis arthritis have a much lower self-esteem compared with that of women, looking at life prospects more negatively. Psoriasis has a major impact on self-esteem, which correlates with quality of life in patients with psoriasis arthritis, depending on the skin condition that creates a major visual impact in society.
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Affiliation(s)
- Ilarie Brihan
- Dermatology Department, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Simona Laura Ianoși
- Dermatology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Daniel Boda
- Dermatologic Research Laboratory - 'N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Angelica Hălmăjan
- Psychology Department, Faculty of Social Humanistic Sciences, University of Oradea, 410073 Oradea, Romania
| | - Mihaela Zdrîncă
- Preclinical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - László Gyula Fekete
- Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Targu Mures, Romania
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21
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Branisteanu DC, Stoleriu G, Branisteanu DE, Boda D, Branisteanu CI, Maranduca MA, Moraru A, Stanca HT, Zemba M, Balta F. Ocular cicatricial pemphigoid (Review). Exp Ther Med 2020; 20:3379-3382. [PMID: 32905166 PMCID: PMC7465597 DOI: 10.3892/etm.2020.8972] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/06/2020] [Indexed: 01/07/2023] Open
Abstract
Ocular cicatricial pemphigoid is a particular form of mucous membrane pemphigoid and it is characterized by a chronic bilateral conjunctivitis with relapsing-remitting periods. Without therapy 75% of the cases develop visual loss due to major ocular complications (e.g. severe dry-eye syndrome, corneal erosions, corneal keratinization, entropion, symblepharon). Pathogenesis remains uncertain and probably linked to an autoimmune type II hypersensitivity response in patients with a genetic predisposition and exposure to different environmental triggers. With a worldwide distribution, no racial predilection and an estimated incidence that largely varies from 1/10,000-1/60,000, ocular cicatricial pemphigoid predominantly affects women aged ~60 years. Conjunctival biopsy with direct immunofluorescence is the gold standard in diagnosis confirmation, but up to 40% of the patients have a negative biopsy result that does not rule out the diagnosis. The skin and many other mucous membranes (e.g. oral, trachea, esophagus, pharynx, larynx, urethra, vagina and anus) may be involved. The disease grading relies on Foster staging system (based on clinical signs) and Mondino and Brown system (based on the inferior fornix depth loss). The differential diagnosis includes atopy, allergies, trauma, chemical burns, radiation, neoplasia, infectious, inflammatory and autoimmune etiologies. The main goals of the treatment are to stop disease progression, to relieve symptoms and to prevent complications. With long-term systemic therapy 90% of the cases can be efficiently controlled. While Dapsone is the first-line treatment in mild to moderate disease in patients without G6PD deficiency, more severe cases require immunosuppressant therapy with azathioprine, mycophenolate mofetil, methotrexate or cyclosporine. Cyclophosphamide, biologics (etanercept or rituximab) and intravenous immunoglobulin therapy are usually reserved for recalcitrant disease and unsatisfactory results to conventional therapy. Dry eye syndrome requires constant lubricating medication and topical steroids, cyclosporine-A and tacrolimus. Surgery should be planed only in quiescent phase as minor conjunctival trauma can significantly worsen the disease.
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Affiliation(s)
| | - Gabriela Stoleriu
- Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galaţi, 800008 Galaţi, Romania
| | - Daciana Elena Branisteanu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Minela Aida Maranduca
- Department of Physiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Moraru
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Horia Tudor Stanca
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihail Zemba
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Florian Balta
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
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22
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Ciobotaru OR, Stoleriu G, Ciobotaru OC, Grigorovici A, Voinescu DC, Matei MN, Cobzaru RG, Manolache N, Lupu MN. Postanesthetic skin erythema due to succinylcholine versus atracurium. Exp Ther Med 2020; 20:2368-2372. [PMID: 32765716 PMCID: PMC7401908 DOI: 10.3892/etm.2020.8792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/14/2020] [Indexed: 12/28/2022] Open
Abstract
Intraoperative anaphylactic reactions may range from mild, erythema-like to anaphylactic shock, with tension crash and bronchospasm. The substances considered to be most responsible for the occurrence of intraoperative allergic reactions are neuromuscular blocking agents, antibiotics and latex. Recent studies have identified a new receptor, Mas-Related G-Protein-coupled Receptor X2 (MRGPRX2), considered as a target for some neuromuscular blockers such as atracurium, rocuronium or fluoroquinolone, resulting in pseudoallergic or anaphylactoid reactions. Induction of anesthesia can use both depolarizing myorelaxants, useful especially in emergency situations, in the patient with gastric plenitude or at high risk of intubation, and non-depolarizing myorelaxants such as atracurium, cisatracurium and rocuronium. Succinylcholine has a short time of action and it is rapidly metabolized. Atracurium, although having a slightly longer time to action, has the benefit of a low risk of increased levels of potassium in blood, which is extremely important in patients with cardiac pathology or associated kidney diseases. The present study compared the side effects of systemic anesthesia with succinylcholine vs. atracurium.
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Affiliation(s)
- Oana Roxana Ciobotaru
- Clinical Department, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800008 Galati, Romania
| | - Gabriela Stoleriu
- Clinical Department, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800008 Galati, Romania
| | - Octavian Catalin Ciobotaru
- Department of Surgery, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800008 Galati, Romania
| | - Alexandru Grigorovici
- Department of Surgery, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Doina Carina Voinescu
- Clinical Department, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800008 Galati, Romania
| | - Madalina Nicoleta Matei
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800008 Galati, Romania
| | - Roxana Gabriela Cobzaru
- Department of Preventive Medicine and Interdisciplinarity, Discipline Microbiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Nicuta Manolache
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800008 Galati, Romania
| | - Mary-Nicoleta Lupu
- Department of Surgery, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800008 Galati, Romania
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23
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Fekete GL, Fekete L, Ancuceanu R, Ianoși SL, Drăgănescu M, Brihan I. Acyclovir-induced immune thrombocytopenia: Case report and review of the literature. Exp Ther Med 2020; 20:3417-3420. [PMID: 32905113 DOI: 10.3892/etm.2020.8971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022] Open
Abstract
There are a number of medications which can serve as catalysts for drug-induced immune thrombocytopenia (DIPT). A minimum of six different mechanisms have been put forward as the means by which drug-induced antibodies can encourage platelet destruction, thus emphasising the complexity of the pathogenesis of DITP. Acyclovir, has been widely used because of its highly potent prohibitive properties for infections caused by HSV and VZV. The common adverse effects of this drug are well known, the severe adverse reactions are mostly related to high dose intravenous administrations. The immune thrombocytopenia induced by acyclovir is unusual. The authors present a rare clinical case of acyclovir-induced immune thrombocytopenia in a 72-year-old female patient with typical herpes zoster treated with acyclovir. The clinical and laboratory findings, taken together with the transitory relationship between acycolvir and the start of thrombocytopenia, combined with the elimination of the other know sources of thrombocytopenia, allowed us to reach the diagnosis of acyclovir-induced immune thrombocytopenia. An international database search was employed to complete an extensive review of the current literature. Contemporary information on acyclovir-induced immune thrombocytopenia was collected by the analysis of present day review articles and accessible case reports. The authors found five published cases of acyclovir-induced immune thrombocytopenia. Analyzing these articles it was concluded that immune thrombocytopenia induced by acyclovir is rare, and an unusual side effect, with good prognosis. Prompt diagnosis is vital to appropriate management, therefore clinicians need to be cognisant of this rare potential adverse reaction.
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Affiliation(s)
- Gyula László Fekete
- Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureş, Romania
| | - László Fekete
- Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureş, Romania
| | - Robert Ancuceanu
- Department of Pharmaceutical Botany and Cell Biology, Faculty of Pharmacy, 'Carol Davila' University of Medicine and Pharmacy, 020956 Bucharest, Romania
| | - Simona Laura Ianoși
- Department of Dermatology, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Miruna Drăgănescu
- Medical Department, Faculty of Medicine and Pharmacy, University 'Dunărea de Jos', 800010 Galati, Romania
| | - Ilarie Brihan
- Department of Dermatology, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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24
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Dinu A, Bucur S, Olteanu R, Constantin T, Raducan A, Baetu M, Constantin MM. Psoriatic arthritis: A permanent new challenge for dermatologists (Review). Exp Ther Med 2020; 20:47-51. [PMID: 32508992 PMCID: PMC7271732 DOI: 10.3892/etm.2019.8322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 10/30/2019] [Indexed: 12/25/2022] Open
Abstract
Considering that most of the patients (>2/3) are diagnosed with psoriasis in the cutaneous form long before the joint damage occurs and, in these conditions, a significant proportion of them is found in the dermatologist's initial records, a question must be asked: when is it necessary to send these patients to a rheumatology consultation? The recognition of psoriatic arthritis in patients with vulgar psoriasis and the dermatologist's ability to differentiate it from other arthritis, offers the opportunity to improve patient prognosis by prompt intervention and close collaboration with the rheumatologist. Diagnosis of early psoriatic arthropathy should be considered when a patient with psoriasis or family history of psoriasis has peripheral inflammatory arthritis (oligoarthritis or distal interphalangeal joints damage), enthesitis, dactylitis, spinal pain of inflammatory type. Given that patients with psoriasis are included in the dermatologists' medical records, it is very important to recognize psoriatic arthritis in patients with cutaneous psoriasis, to differentiate it from other possible arthritis, thus having the possibility to improve patient prognosis by prompt intervention and through collaboration with the rheumatologist.
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Affiliation(s)
- Alina Dinu
- Second Department of Dermatology, Colentina Clinical Hospital, 20125 Bucharest, Romania
| | - Stefana Bucur
- Second Department of Dermatology, Colentina Clinical Hospital, 20125 Bucharest, Romania
| | - Rodica Olteanu
- Second Department of Dermatology, Colentina Clinical Hospital, 20125 Bucharest, Romania
| | - Traian Constantin
- Department of Urology, ‘Th. Burghele’ Hospital, 50652 Bucharest, Romania
- General Medicine, University of Medicine and Pharmacy ‘Carol Davila’, 050474 Bucharest, Romania
| | - Anca Raducan
- Dr. Anca Răducan Anti-Aging Dermatology Clinic, 900705 Constanta, Romania
| | - Mara Baetu
- ‘C.I. Parhon’ National Institute of Endocrinology, 011863 Bucharest, Romania
| | - Maria-Magdalena Constantin
- Second Department of Dermatology, Colentina Clinical Hospital, 20125 Bucharest, Romania
- General Medicine, University of Medicine and Pharmacy ‘Carol Davila’, 050474 Bucharest, Romania
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25
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Bobeică C, Tatu AL, Crăescu M, Solovăstru L. Dynamics of digital ulcers in systemic sclerosis. Exp Ther Med 2020; 20:61-67. [PMID: 32508995 PMCID: PMC7271728 DOI: 10.3892/etm.2020.8572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/11/2020] [Indexed: 12/22/2022] Open
Abstract
Systemic sclerosis (SSc) is a collagenosis with insufficiently known etiopathogenesis,
characterized by microvasculopathy and excessive fibrosis in the context of an autoimmune
disorder. The incompletely elucidated pathogenesis and limited therapeutic options,
disabling aspects, skin lesions and pain determine important functional and psychological
deficiencies which affect the quality of life. It is imperative to observe and correlate
individual clinical and paraclinical data to optimize disease management. A group of 22
patients diagnosed with SSc, hospitalized in a university clinic in Bucharest was included
in an observational study. The evolution of digital ulcers was evaluated as an indicator
of vasculopathy and their status and dynamics were correlated with clinical elements
reflecting the fibrotic aspect of the disease. The present study shows that the Raynaud
phenomenon is almost always present during the course of the disease, but its presence is
not always associated with digital ulcers. The existing data in the literature show that
fibrosis is subsequent to vasculopathy, but this study did not reveal causality between
these two aspects of pathogenesis. The presence of microstomia and digital contracture was
identified in the presence of digital ulcers, but also in their absence. The
etiopathogenic mechanisms with multiple unknown involved factors open the opportunity to
investigate many aspects of SSc for optimal aiming of therapeutic interventions.
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Affiliation(s)
- Carmen Bobeică
- Department of Dermato-Venereology, Doctoral School, University of Medicine and Pharmacy 'Gr. T. Popa' Iaşi, 700115 Iaşi, Romania.,Department of Morphological and Functional Sciences, 'Dunărea de Jos' University of Galaţi, Faculty of Medicine and Pharmacy, 800216 Galaţi, Romania
| | - Alin Laurențiu Tatu
- Department of Clinical Dermato-Venereology, 'Dunărea de Jos' University of Galaţi, Faculty of Medicine and Pharmacy, ReForm UDJ, 800216 Galaţi, Romania.,Department of Clinical Dermato-Venereology, University of Medicine and Pharmacy 'Gr. T. Popa', Faculty of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Mihaela Crăescu
- Department of Morphological and Functional Sciences, 'Dunărea de Jos' University of Galaţi, Faculty of Medicine and Pharmacy, 800216 Galaţi, Romania.,Department of Clinical Radiotherapy, 'Sf. Ap. Andrei' Emergency Clinical Hospital of Galaţi, 800578 Galaţi; , Romania
| | - Laura Solovăstru
- Department of Clinical Dermato-Venereology, University of Medicine and Pharmacy 'Gr. T. Popa', Faculty of Medicine and Pharmacy, 700115 Iaşi, Romania.,Department of Clinical Dermato-Venereology, 'Sf. Spiridon' Emergency Clinical Hospital of Iaşi, 700111 Iaşi, Romania
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26
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Boda D, Dehelean C. Immuno-dermatological processes involved in chronic skin diseases: Highlights of the Second Conference of the Romanian Society for Immuno-Dermatology, Bucharest, September, 2018. Exp Ther Med 2019; 18:873-874. [PMID: 31384316 PMCID: PMC6639975 DOI: 10.3892/etm.2019.7690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/19/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristina Dehelean
- Faculty of Farmacy, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
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