Correlation between serum reactivity to Demodex-associated Bacillus oleronius proteins, and altered sebum levels and Demodex populations in erythematotelangiectatic rosacea patients.

Rosacea is a chronic inflammatory condition that affects the skin of the face and the eyes. The aetiology of rosacea is not clearly established but increasing evidence suggests a potential role for bacteria in the induction of the condition. A role for Bacillus oleronius, originally isolated from within a Demodex folliculorum mite, in the aetiology of the condition has been suggested. The aim of the study was to determine whether a correlation existed between the level of sebum and the density of D. folliculorum in the skin of erythematotelangiectatic rosacea patients, and the reactivity of these patients' sera to proteins of B. oleronius. Serum reactivity to the 62 and 83 kDa B. oleronius proteins was found in 82.6 % (62/75) of the rosacea patients and in 26.9 % (14/52) of controls (P = 0.0016). In the group of rosacea patients whose sera reacted to B. oleronius proteins, the level of sebum was statistically lower than in controls (P = 0.01). The density of D. folliculorum on the face of Bacillus positive rosacea patients was statistically higher than controls (P = 0.0001). Rosacea patients demonstrated increased Demodex populations on their faces and reduced sebum levels. Their sera also showed reactivity to B. oleronius proteins, suggesting a potential role for this bacterium in the aetiology of rosacea.

Tinea cutis glabrae: causes of diagnostic challenge.

Dermatophytoses belong to the most common disease entities encountered in everyday dermatological practice. Despite the fact that their clinical presentation, course and treatment response remain rather typical, they often present a considerable diagnostic and therapeutic challenge. We present a case of a 54-year-old male who presented to the outpatient clinic of the Department of Dermatology in December 2012 with the diagnosis of erythema gyratum repens for further diagnosis and treatment of skin lesions gradually intensifying in the previous 2 years. The skin changes presented as spreading annular erythematous lesions, with papules and plaques located peripherally, and accompanying pruritus. Due to the clinical presentation and anamnesis, working conditions (poultry farm), and lack of response to previous treatment, mycological culture was performed. Epithelial scrapings of the trunk and the groins proved to be positive. After 3 weeks, Trichophyton mentagrophytes var mentagrophytes was identified by epithelial cell culture.

Scleromyxedema: a rare disorder and its treatment difficulties.

Scleromyxedema is a rare progressive cutaneous mucinosis, usually associated with a systemic involvement and paraproteinemia. Its aetiology remains unknown. The therapeutic options include numerous treatment modalities, however, no standard treatment exists as the rarity of this disease prevents the execution of controlled therapeutic trials. This paper reports a case of a 38-year-old male with progressive scleromyxedema associated with gammopathy. Initially, the patient was treated with prednisolone and later etretinate was added to the therapeutic schedule with quite good clinical improvement. However, after 6 months of treatment, several adverse effects were observed: hypercholesterolemia, hypertriglyceridaemia and cataract of the right eye. The patient was consulted by dermatologists in Warsaw and Gdansk as well as by a haematologist. The patient was excluded from oncological treatment. Melphalan therapy was not recommended as it is associated with very toxic side effects. IVIG treatment (intravenous immunoglobulin) was not initiated because of financial issues. As the disease progressed, treatment with plasmapheresis was introduced. The patient received 4 cycles of the therapy. It was well-tolerated by the patient and gave satisfactory, but temporary results. In order to obtain long-lasting improvement the patient was treated with IVIG (21.0 g/dose for 5 consecutive days). This treatment modality seems to have resulted in a more stable improvement.

Disease-induced level of shame in patients with acne, psoriasis and syphilis.

INTRODUCTION: A prolonged feeling of shame leads to particularly negative consequences and it accompanies, as well as triggers, any kind of stigma. AIM: AS EMPIRICAL WORKS ON SHAME DUE TO STIGMATIZING DISEASES ARE SCARCE, THE AUTHORS AIMED TO INVESTIGATE THE FOLLOWING: 1) which diseases are perceived as the most embarrassing, and 2) what level of shame is attributed to the embarrassing diseases by affected patients. Additionally, the authors assumed that the differentiation variable for the second aim would be the level of infectiousness (or non-infectiousness) of a given disease. MATERIAL AND METHODS: A two-stage study was carried out in 2011-2013. Three groups of patients affected by various diseases were included into the actual study: 1) people suffering from non-infectious (42 psoriasis and 42 acne subjects) and 2) infectious (25 syphilis cases) diseases. The patients filled in an original questionnaire, designed especially for the purpose of the study. RESULTS: As the most shameful acne patients consider syphilis, but patients with syphilis - AIDS. Patients with syphilis assigned to their disease the greatest shame (average 75%), and the lowest - acne patients (average 30%). Patients with psoriasis assessed on 52% shame experienced because of the disease. CONCLUSIONS: The conducted study confirmed the accuracy of the empirical assumptions which may be applicable in prevention as well as therapy of negative consequences of shame.

Selected aspects of the living situation of persons suffering from syphilis - Poznan study.

In the last years, a considerable increase in syphilis incidence was observed in Poland. This is a condition with serious health and psychosocial consequences. The research demonstrates that one of the events which significantly modify the course of human life is the somatic disease experience; hence, it was decided to examine selected aspects of the living situation of persons suffering from syphilis, which refer to the social position held by these persons. Materials for the research were collected based on the anonymous authors' survey composed of 16 questions. The research lasted for two years and covered a group of 42 syphilitic patients (35 males and 7 females). The mean age of male patients was 35.7 and of female patients 37.0 years. Among the participants, 8 persons had been subjected to treatment for a few years, 11 for about a year, and 22 persons had recently become ill. Patients assessed the attitude toward themselves mostly as invariable, followed by unstable; 45.2% of subjects considered their position in the family as average and 42.9% as high; 28.6% of patients assessed their occupational position as average and the same number admitted to be currently out of work. Most frequently, unemployed were patients who had been affected by the disease for several years (62.5%), whereas their social position was assessed either as high (47.6%) or average (45.2%). Irrespective of the duration of the disease, patients (during hospitalization) usually met a lot of people. It has been proven that most of the syphilitic patients do not have negative attitude toward themselves and do not assess their social position as inferior, regardless of the duration of the disease. Such a picture of the living situation may be a manifestation of the compensation for the negative mental state, activation of other defense mechanisms or proper strategy of coping with the stressor. The generally optimistic image of the studied group of syphilitic patients may constitute a warning against an increased risk from the infected persons.

Potential role of Demodex mites and bacteria in the induction of rosacea.

Rosacea is a common dermatological condition that predominantly affects the central regions of the face. Rosacea affects up to 3 % of the world's population and a number of subtypes are recognized. Rosacea can be treated with a variety of antibiotics (e.g. tetracycline or metronidazole) yet no role for bacteria or microbes in its aetiology has been conclusively established. The density of Demodex mites in the skin of rosacea patients is higher than in controls, suggesting a possible role for these mites in the induction of this condition. In addition, Bacillus oleronius, known to be sensitive to the antibiotics used to treat rosacea, has been isolated from a Demodex mite from a patient with papulopustular rosacea and a potential role for this bacterium in the induction of rosacea has been proposed. Staphylococcus epidermidis has been isolated predominantly from the pustules of rosacea patients but not from unaffected skin and may be transported around the face by Demodex mites. These findings raise the possibility that rosacea is fundamentally a bacterial disease resulting from the over-proliferation of Demodex mites living in skin damaged as a result of adverse weathering, age or the production of sebum with an altered fatty acid content. This review surveys the literature relating to the role of Demodex mites and their associated bacteria in the induction and persistence of rosacea and highlights possible therapeutic options.

Heracleum Sosnowskyi Manden.

Heracleum Sosnowskyi was discovered in 1772 and described as a separate species in 1944 by I. P. Mandenova. Its name is derived from the surname of a botanist studying Caucasian flora, Prof. D.I. Sosnowski. In the area of the Caucasus foothills, the plant reaches approximately 1-1,5 m in height, whereas in Poland its size is significantly larger, up to 3-3.5 m. Heracleum blooms from mid-June to the end of July. The flowers are arranged in umbels and last for 2-3 weeks. In Central Europe, the species colonizes mostly neglected green areas, ruins and riversides. Heracleum poses a serious threat to the human population due to its photoallergic properties, resulting from the presence of intensely toxic furanocoumarin in its sap. Furanocoumarins are found in small hairs that cover the leaves and stem, and are the components of the essential oil. They may penetrate the skin through the epithelial layer, posing a direct threat to human health. Contact with the plant, followed by sun exposure, may lead to the development of large blisters and symptoms of burns. Heracleum, in the event of consumption, is also harmful to farm animals, causing, among others, internal bleeding and diarrhea. Although the toxic properties of Heracleum have been known for many years, every summer people who had contact with the plant present at physicians of different medical specialties.