[Collagen based dressings in the treatment of wound healing]

Collagen is the fundamental protein forming the connective tissues matrix, improves the ability of keratinocytes to migrate to sites that require rebuilding of the damaged epidermis, is one of the component of dressings used to accelerate wound healing. Because of the potential risk of the presence of pathogenic prions in bovine collagen, part of collagen dressings is formed on the basis of porcine collagen. Currently, a least of an immunogenic form of collagen is atelocollagen, which is subjected to enzyme-treated collagen, in which the terminal amino acids are removed from the collagen. It is assumed that in the near future atelocollagen will be used also as a carrier for drugs which support the healing processes.

[Photoaging of a skin]

Photoaging is a skin aging caused by long-term exposure to the ultraviolet radiations of the sun. Ultraviolet activates activating protein-1 and generate reactive oxygen species which play a substantial role in collagen degradation. Clinically, photoaged skin appears as a coarse with deep wrinkles. Presently there are available several agents to reverse the photodamage. There is conclusive evidence that synthetic vitamin A derivatives are the most effective in the treatment of photoaging. Erythema and scaling may be experienced initially.

Can atopy patch tests with aeroallergens be an additional diagnostic criterion for atopic dermatitis?

The complex pathomechanisms underlying skin lesions in atopic dermatitis (AD) result in variations of the clinical picture and frequent diagnostic difficulties. The purpose of this study was to evaluate the usefulness of atopy patch tests (APT) for aeroallergens in the diagnosis of AD. The study involved 115 adult patients with AD and 98 healthy volunteers (the control group). APTs for cat dander allergens, birch pollen, a mixture of house dust mite species and a mixture of 5 grass pollen allergens were applied for both groups. Positive reaction to at least one test allergen was found in 53.9% patients compared to 6.2% in the control group (p<0.001). The most frequent hypersensitivity (45.2%) observed was to house dust mite allergens. Polyvalent allergy to 2-4 allergens was found in 56.5% patients. The specificity of tests exceeded 75%, whereas the sensitivity varied from 18 to 66%.

CONCLUSIONS

1. Atopy patch tests, which are characterised by considerable specificity, confirm the role of polyvalent contact hypersensitivity to aeroallergens in the development of atopic dermatitis. 2. Positive aeroallergen ATP results are observed in the majority of patients and can thus be regarded as an additional diagnostic criterion in atopic dermatitis.

[Prevalence of antibodies against Anaplasma phagocytophilum, Babesia microti i Borrelia burgdorferi in adults in North-Eastern Poland]

THE AIM

of the study was to evaluate the seroprevalance of antibodies against Anaplasma phagocytophilum and Babesia Microti in healthy north-eastern Poland, adult population.

MATERIAL AND METHODS

The study was conducted in a group of 142 healthy adults (mean age 19-22), bitten by ticks within last 2 years. The control group consisted of 50 adults from central Poland (nonendemic area). The antibody levels for A. phagocytophilum (IgG/Ap-Ab) and B. microti (IgM/Bm-Ab) were evaluated in two series of samples from the same persons (interval 5-6 months) by immunoenzymatic tests (Borrelia Biomedica, Austria), immunofluorescence test (Human Granulotic Ehrlichiosis IFA IgG and Babesia microti IFA IgG from MRL Diagnostics).

RESULTS

Positive results for A. phagocytophilum were defined as titres > or =1:256 and for B. microti > or =1:64 and B. burgdorferi > or = 11 BBU/ml. Positive results for IgG B. burgdorferi during the first collection were revealed in 16% (n=24/142) of individuals from endemic area and in 4% (n=2/50) of the control group, which was statistically relevant (p<0,05). IgG A. phagocytophilum antibodies were present in 3,5% (n=5/142) of individuals from the endemic area, but for IgG B. microti antibodies (IgG/Bm-Ab) no positive results were found. No IgG antibodies against A. phagocytophilum and B.microti, were found in individuals from non-endemic area. During the second collection, in individuals from the endemic area, the antibodies against B. burgdorferi were found in 9,8% (n=14/142), IgG A. phagocytophilum antibodies (IgG/Ap-Ab) in 4,9% (n=7/142) and against B. microti (IgG/ Bm-Ab) in 1,4% (n=2/142). The antibodies against B. Burgdorferi were found in 2% (n=1/150) of the control group during the second collection, and no IgG against A. phagocytophilum and B. microti were found.

CONCLUSION

[corrected] Evaluating the seroprevalance of the studied antibodies in both collections, a conclusion was drawn that there was no significant increase of antibodies levels directly after the highest exposition to tick bites. None of individuals showed 4-fold antibody level increase between the first and second collection. The seroconversion for IgG/Bm-Ab antibodies was present in 1,4% (n=2/142) of individuals, in those 2 cases a 2-fold antibodies level increase was observed. As far as IgG/Ap-Ab antibodies are concerned the seroconversion was observed in 2,1% (n-3/142), but only one case shown a 3-fold antibodies level increase. No seroconversion of B. burgdorferi antibodies were found in the second collection.

[Total and specific IgE and immediate skin tests in the prognosis of atopic dermatitis]

The possibility of forecasting of atopic dermatitis (AD) course is limited. The aim of the study was to determine the prognostic usefulness of determination of total and specific IgE concentrations and the results of immediate skin tests in AD patients. The study included 480 adult patients with AD. Immediate skin tests with extracts of 18 aeroallergens and 10 food allergens were performed by PRICK method. Total IgE concentration and concentration of specific IgE (sIgE) against 13 aeroallergens and 12 food allergens were determined by the FAST method. For the assessment of the degree of pathologic process intensity the occurrence was determined of selected AD features according to Hanifin and Rajka exerting direct effect on the severity of the disease, urticaria, extensive cutaneous lesions and remission of the disease. The results were subjected to statistical analysis. In patients in whom total IgE concentration was significantly increased and/or hypersensitivity was found to aeroallergens, coexistence of atopic diseases of the airways, ectodermal defect, urticaria and extensive skin lesions was more frequently observed. Extensive skin lesions were also more frequent in patients with hypersensitivity to food allergens. The studies performed demonstrated that the diagnostic tests discussed are useful for prognostication of AD course. The presence of SIgE, positive results of immediate skin tests and high total IgE concentration prognosticate a more severe course of the disease.

[Neoplastic skin infiltration in chronic myelomonocytic leukemia]

Chronic myelomonocytic leukemia has been associated with various nonspecific cutaneous manifestations. Rarely has the leucaemia been reported to directly affect the skin. We present a case of 53-year old man with CMML who showed neoplastic cutaneous lesions. The occurrence of these lesions may be the presenting feature of the disease or may herald its progression to acute leukemia. Early diagnosis have therapeutic and prognostic significance.

Prognostic value of Hanifin and Rajka's feature sets in adult atopic dermatitis patients

Prognostication of the course of atopic dermatitis (AD) is of special importance in prophylaxis of this disease. The aim of the study was to describe the AD minor feature sets, according to Hanifin and Rajka, on the basis of which one can predict the occurrence of extensive skin lesions, allergic rhinitis, atopic bronchial asthma, cataracts, hand and/or foot dermatitis, food intolerance, urticaria and elevated IgE serum in AD patients. Two-hundred-fifty-four patients were included in the study. Minor feature sets of prognostic value were selected using the MANOVA method in conjunction with the discriminant analysis. On the basis of the above sets, one can predict: involvement of more than 60% of body surface, occurrence of allergic rhinitis, elevated serum IgE, cataracts, atopic bronchial asthma, food intolerance and urticaria with the probability ratio of 90.8%, 82.8%, 79.9%, 78.4%, 77.3%, 77.1% and 76.1% respectively. In the examined group, no association was found between hand and/or foot dermatitis and the tendency towards skin infection.

[IgE levels and hypersensitivity to certain inhaled and food allergens in acute and chronic urticaria]

In 79 males aged 19-21 years with acute and chronic urticaria living under similar conditions the levels were determined of total IgE (FIST test) and specific IgE (FAST test) against the most frequent inhaled and food allergens. Statistically significant rise of the mean value of total IgE was noted in both groups of patients. In acute urticaria increased concentration of specific IgE against inhaled allergens was significantly more common.