[The lipodystrophy syndrome and protease inhibitor therapy in HIV infection]. / Lipodistroficki sindrom i terapija inhibitorima proteaza kod HIV infekcije.

The accumulation of adipose tissue in the dorsocervical region is a typical finding in patients with intensive glycocorticoid function. This finding was described in numerous HIV infected patients. Combined antiretroviral therapy that included a protease inhibitor implied the suggestion that dorsocervical fat pad could be a consequence of protease inhibitor therapy. This is a case report of a patient who developed a similar changes a year after the beginning of protease inhibitor therapy.

[Treatment of eosinophilic fasciitis with cimetidine]. / Lecenje eozinofilnog fasciitisa cimetidinom.

A case of a female patient with clinical and histological manifestation of eosinophilic fascitis has been reported. After five months cimetidine therapy a significant improvement was achieved. During the therapy some adverse effects occurred and cimetidine therapy had to be ceased.

[Onychatrophy in a female patient with lichen planus]. / Onihatrofija kod bolesnice sa lichen planus-om.

A case of female patient with onychatrophy, as a single clinical manifestation of lichen planus is reported. Nail histopathologic and direct immunofluorescent findings confirmed the diagnosis.

[Modern treatment of keloids]. / Savremeno lecenje keloida.

Keloids are a benign proliferative growth of dermal fibrous tissue, usually resulting from an excessive tissue response to skin trauma or disease in predisposed individuals. The basic cause is unknown. Hypertrophic scars are similar lesions but they will, in time, show some degree of resolution. These lesions can be aesthetically disfiguring and cause functional disturbances. This paper reviews current knowledge of the treatment modalities for keloids and hypertrophic scars. Most physicians emphasize the importance of prevention. No single therapeutic modality is the best. Current various treatment options of keloids and hypertrophic scars are: surgical treatment, radiation, medicamentous treatment, treatment by mechanical pressure, and laser therapy, each alone and in various combinations. The published recurrence rates for keloid treatments vary widely, although they are the lowest for the combination of surgery and radiation, but other measures may be useful. Some keloids and hypertrophic scars may respond to intralesional triamcinolone and verapamil, but results were significantly better in early lesions. Clinical trials of intralesional administration of gamma-interferon, as well as topical application of retinoids have caused reductions in keloids. Pressure treatment is widely accepted. Laser therapy which selectively injures cutaneous microvessels without inducing scars may be successfully used in the treatment of keloids and hypertrophic scars.

[Skin changes in patients with Lyme borreliosis]. / Kozne promene u obolelih od Lyme borreliosis.

In introduction some clinical characteristics of Erythema migrans, Borrelia lymphocytoma and acrodermatitis chronica atrophica has been described. The importance of atypical forms of Erythema migrans and the difficulties in differential diagnosis of cutaneous manifestation has been stressed. In a prospective, and partly retrospective investigation of 1292 persons with tick bites, signs of Lyme borreliosis have been found in 18.96%. Number of such persons seen in dermatology wards is rising, and 18.2% of these are children less than 15 years of age. Patients seen in dermatology are mostly women (56.5%:43.5%). Nearly half of the patients with Erythema migrans did not known that they had a tick bite (42.5%). Lyme borreliosis was manifested mainly as Erythema migrans, 89% of patients. Borrelia lymphocytoma was encountered in 2%, and Acrodermatitis chronica atrophicans in 0.4% of patients, significantly less than in other reports. Sclerotic skin lesions were found in 4.1% of patients, and some macular and urticarial lesions were recorded. An incubation period generally less than three weeks preceded to skin manifestations, but in some patients this period could not be recorded. Skin lesions were located on lower extremities in 50.4% of patients, trunk in 25.5%, and upper extremities in 10.5% of patients. In 87% of patients skin lesions lasted less than three weeks. Symptoms were present in 62% of patients. Seropositivity to Borrelia burgdorferi has been found in 10.2% of patients, mostly three weeks after the tick bite.

[Pityriasis versicolor--modern views on etiology, pathogenesis and therapy]. / Pityriasis versicolor--savremeni pogledi na etiologiju, patogenezu i terapiju.

Pityriasis versicolor (Tinea versicolor) is a superficial chronic fungal infection caused by Pityrisporum species which are normal "inhabitants" of the cutaneous flora. The morphologic changes from yeast to mycelial hypha form are important in the development of clinical lesions. The onset and course of the disease are under the influence of genetic factors, age, sex, climate, local environmental factors, malnutrition, pregnancy, oral contraceptives, corticosteroid and immunosuppressive treatment. They favorize transformation of saphrophytic to pathogenic form, and are the cause of recurrences and chronicity of the disease. The ultrastructural and immunologic studies which are carried out today would significantly contribute to a better understanding of pathogenesis of the disease. The disease is limited to seborrheic areas of the skin and commonly has three clinical forms: papulosquamous, follicular and inverse. This can make great problems in differential diagnosis. In the treatment of these patients it should be kept in mind that Pityriasis versicolor is not a primary contagious disease and that conversion of Pityrisporum depends on the predisposing factors. Numerous medicaments with local and systemic effect which are used nowaday in the treatment and prevention of pityriasis are reported. Way of application, doses, duration of therapy, advantages and disadvantages are given in detail.