[Anaplastic large-cell lymphoma CD30(+) ALK(+)]. / Anaplastisch großzelliges Lymphom CD30(+) ALK(+).

We present a case of primary systemic anaplastic large-cell lymphoma, which manifested itself through skin involvement in a 32-year-old man. Only the third histological investigation with immunophenotyping resulted in the correct diagnosis of CD30(+) ALK(+) anaplastic large cell lymphoma. After combined chemotherapy and adjuvant radiotherapy, complete remission of the disease was achieved and one year after completion of therapy no relapse occurred. The diagnostic pitfalls and therapeutic options are discussed.

[Clinical and microbiological characteristics of severe infections caused by group A streptococci]. / Klinická a mikrobiologická charakteristika závazných infekcii sposobených streptokokmi skupiny A.

AIM OF THE STUDY: Analysis of data on the occurrence of severe infections caused by group A streptococci, emm typing of the isolated strains, and survey of resistance to the selected antibiotics. MATERIAL AND METHODS: In 2012 and 2013, 43 S. pyogenes strains were isolated from severe infections. The isolates were most often recovered from wounds and abscesses (36 patients), followed by blood culture (5 patients), sputum (1 patient), and autopsy samples (1 patient). Antimicrobial susceptibility to selected antibiotics ( penicillin, erythromycin, clindamycin, spiramycin, and tetracycline) was tested by the disk-diffusion method and the minimal inhibitory concentrations (MICs) were determined. RESULTS: In 2012 and 2013, an increase in severe streptococcal infections was observed, with 27 and 16 cases reported, respectively. Resistance to macrolides was detected in 18.5% and 12.5% of isolates, respectively, and resistance to tetracycline in 25.9% and 20% of isolates, respectively. The isolated S. pyogenes strains were most often assigned to emm type 1. Risk factors for streptococcal infection were analyzed, with injury being most often identified as a risk factor- in seven and two patients, respectively. The patients were most frequently treated by beta-lactam antibiotics (penicillin and ampicillin). In 2012, two cases were fatal. CONCLUSION: This study reports cases of invasive group A streptococcal (GAS) infection as seen in clinical practice. An increased occurrence of S. pyogenes was observed in the hospital, with the isolates exhibiting elevated resistance to erythromycin and tetracycline. It is necessary to monitor the trends of antimicrobial resistance and the distribution of emm types among group A streptococcal isolates. Cooperation of the laboratory and clinical professionals in the prevention and therapy of streptococcal infections, invasive in particular, is crucial for risk reduction.

Hidradenitis suppurativa treated with combination of infliximab and dapsone.

Hidradenitis suppurativa (HS) is chronic inflammatory disease characterized by recurrent painful nodules, which leads to forming an abscess and sinus tracts, together with pustulation and hypertrophic scarring in the areas of apocrine sweat glands. Systemic and local antibiotic therapy, together with corticoid therapy, sulphonates, retinoids and surgical treatment with incisions and drainage belongs to actual treatment possibilities. Biological therapy represents the absolute peak in the treatment last years, mostly TNFα-inhibitors. Even though their very good short term effect is described, long term keeping up the good long effect of the treatment is not achieved with satisfaction. This is the reason to reach for traditional therapeutic possibilities combined with biological treatment in cases of torpid and resistive disease. In the following article a case report of a patient with hidradenitis suppurativa treated subsequently with combination of TNFα-inhibitors and dapson (Fig. 6, Ref. 19).

Systemic therapy of psoriasis: methotrexate.

Methotrexate is the first line therapy for the treatment of moderate to severe psoriasis and psoriatic arthritis all over the world. It has immunosupressive and anti-inflammatory effects. If we want to use it, we have to know its mechanism of action and also its possible toxicity and how to cope with it (Tab. 3, Fig. 1, Ref. 14).

[Superficial thrombophlebitis--diagnostics and treatment]. / Povrchová tromboflebitída--diagnostika a liecba.

Superficial thrombophlebitis (ST) is a common disease, usually considered benign. However, the practice of systemic duplex ultrasonography has revealed a large number of deep-vein thromboses concomitant with ST. In contrast with extensive information on the management of deep vein thrombosis, little is known about the most appropriate treatment of the ST. Systematic duplex ultrasonography investigation has been proposed in the initial management of ST, to detect the presence of any underlying deep vein thrombosis. Because ST may extend into the deep venous system and potentially engender pulmonary embolism, treatment with low-molecular-weight-heparins might be the best choice. In our work diagnostic and therapeutic procedures for ST, proposed by Slovak angiological society, Slovak society for vascular surgeons, Slovak dermatological society, Slovak society for haemostasis and thrombosis, Slovak surgical society and Slovak internistic society are discussed.

Dermatitis herpetiformis in siblings.

Two Caucasian sisters, XZ and YZ, suffered from DH. However, the clinical course of their diseases was different; patient XZ, contrary to her sister YZ, suffered besides dermatitis herpetiformis (DH) also from coeliac disease (CD) and an autoimmune thyroid disease. The sisters were ordered to adhere to gluten-free diet and dapsone was prescribed, however, patient XZ developed a hypersensitivity to dapsone. The HLA typing disclosed that they were homozygous and that they shared HLA alleles DQB1*0201. Our results confirm the known association of DH to other autoimmune disorders and its well established association the HLA-DQB1*0201 allele. Although DH is generally not regarded as a familial disease our case report suggests its familial character (Fig. 3, Ref. 10). Full Text (Free, PDF) www.bmj.sk.

[Yeasts and fungi isolated at the mycology laboratory of the First Dermatovenerology Clinic of the Medical Faculty Hospital of Comenius University in Bratislava 1995-2000]. / Kvasinkovité mikroorganizmy a plesne izolované v mykologickom laboratóriu I. Dermatovenerologickej kliniky LFUK a FN v Bratislave v rokoch 1995-2000.

In 1995-2000 we examined in the mycological laboratory 8663 specimens for fungal infection by microscopical examination cultivation. The species was identified by the germ-tube test, fermentation and assimilation of carbohydrates. We examined 3421 specimens of faeces and found fungal infection in 37%, the most common was Candida albicans and Geotrichum candidum. In 1736 specimens of sputum and bronchial lavage, yeast microorganisms were isolated in 48%, mostly Candida albicans. In 2697 specimens of skin and mucous membranes in 26% we found fungal microorganisms. We examined 550 samples from the external ear, 40% was mycologically positive, the most common infectious agent of otomycosis was Aspergillus sp. Among 87 specimens from eyes we isolated molds. Acremonium sp., Fusarium sp. and Penicillium sp. Among 123 samples of urine, 41% were mycologically positive, most common was Candida albicans. In 49 blood samples yeasts were found only three times.

[Epidemiology of dermatomycoses in Slovakia]. / Epidemiologická situácia výskytu dermatomykóz v Slovenskej republike.

The authors analyze the incidence of dermatomycoses in the Slovak Republic in 1994-1999. They found an increase of these infections in particular epidermophytoses, trichophytoses and candidoses. From 25,762 examined subjects with suspicion of dermatomycosis they isolated in 1990 till 1999 8,237 cultures of dermatophytes. The most frequent causal agent was Trichophyton rubrum (81.61%). In the conclusion the authors draw attention to the inevitability of introduction of effective preventive measures.

[Zoonotic dermatomycoses in urban populations]. / Zooantroponózne dermatomykózy u mestského obyvatel'stva.

The authors analyzed epidemiologically two cases of trichophytosis caused by zoophilic dermatophytes in persons living in the city. The first case was a male aged 43, suffering from trichophytosis on the right side of his neck. The patient was infected at work from guinea pigs. Trichophyton mentagrophytes varietas granulosum was the etiological agent. The second case occurred in a female aged 29, suffering from trichophytosis on her left arm. Trichophyton verrucosum was the causal agent. A horse was the source of infection.

The occurrence of dermatophytes in Slovakia.

We have compared the epidemiology of dermatophytoses in Slovakia during the periods 1956-85 and 1986-92. Infections caused by Trichophyton rubrum gradually increased while infections due to Trichophyton verrucosum and Microsporum canis decreased.

[Lyme borreliosis--diagnosis, clinical aspects and therapy of the cutaneous form]. / Lymská borelióza--diagnostika, klinika a terapia kozných foriem.

Occurrence of Lyme borreliosis and namely its skin forms have a rising tendency. Thick population of ticks and their relatively high contamination with borrelia (app. 9% in Slovakia), increased presence of man in nature and frequent professional exposition create good conditions for the spreading of the disease. During the period of 20 months in 1993-1994 19 cases of borreliosis were recorded among 2,187 patients hospitalized at the Bratislava Dermatologic Clinic--17 cases of erythema chronicum migrans and two cases of acrodermatitis chronica atrophicans. All patients stated that they came into contact with ticks 24 hours--12 months prior to the origin of dermatologic alterations. 14 cases of erythema chronicum migrans being IFT examined by means of B. burgdorferi antigen included 10 patients who yielded the titre of antibodies higher than 1:256; 6 patients being examined by means of ELISA test included 2 positive findings. The IFT values varied also in cases of classical clinical picture of erythema chronicum migrans and a discrepancy was observed between IFT and ELISA results. Two cases of acrodermatitis chronica atrophica had positive serologic test. The serologic tests were performed also in 4 cases of scleroderma with positive results. Into their analysis the authors included also other studies on the basis of which they present schemes of diagnostic examination and therapeutic interventions in Lyme borreliosis. (Tab. 2, Ref. 4.)

[Mycotic infections in childhood]. / Mykotické infekcie v detskom veku.

The occurrence of mycotic infections has a rising tendency. Epidemiologic studies investigate this problem in adults. The problem is still insufficiently analyzed in children. The study is aimed at gaining information about the occurrence of mycoses evoked by dermatophytes and yeasts in children living in Slovakia, namely on the basis of the analysis of results for the mycological laboratory. From 1992 to 1993 6,511 samples which included 556 samples from children were processed on the basis of suspective dermatophytoses, the children being at the age of 1 to 15 years. 6,896 samples suspective of yeast infections included 3,620 mycologically positive samples. 279 samples were taken from 265 children at the age of 3 months to 15 years. 556 children with dermatophytosis included 116 mycologically positive cases, 64 boys and 52 girls. Microscopic examination was positive in 90 children and cultivation examination was positive in 85 children. Trichophytosis was confirmed in 38 children (32.8%) microsporiasis in 9 (7.8%), epidermophytosis in 50 (43.1%) and onychomycosis in 19 children (16.3%). Isolated antropophilic dermatophytes were represented most frequently by Trichophyton rubrum, 26 times, isolated zoophylic species included T. verrucosum, 15 times and T. mentagrophytes var. granulosum 13 times. 29 children (25%) had epidermophytosis and onychomycosis of feet. The group of 265 children with yeast infections included 123 with primary skin disease and 134 with internal disease. The most frequently monitored materials were stools, 147 times, and scrapings of the oral cavity, 78 times. The total number of isolated species of yeasts was 17. Candida albicans was isolated 218 times (78.2%). The total number of examinations included 7.1-8.5% of samples from children.(ABSTRACT TRUNCATED AT 250 WORDS)

[Treatment of mycotic skin infections]. / Liecba mykotických infekcií koze.

Mycotic infections of the skin remain still to represent a therapeutic problem. The development of new antimycotics widens the possibilities of therapy. One of them is oxiconasolnitrate which is a derivate of of imadazole. It is available on our market as Myfungar cream. The clinical postregistration study verified the effectivity of this preperation. The examined group was constituted of 30 patients. 24 patients were afflicted with epidermophytia inguinalis, 1 patient with epidermophytia cruris, 1 patient with epidermophytia manuum, 1 patient with trichophytia corporis and 2 with candidosis submammaris. Cultivation examination revealed 20 time Trichophyton rubrum, one time Trichophyton mentagrophytes var. interdigitale, one time Trichophyton mentagrophytes var. granulosum, one time Epidermophyton floccosum, and 2 time Candida albicans. Therapy lasted 21-42 days. All patients were treated for a period of 6 weeks. 24 treated cases after the therapy included 10 wit persistent squamming, 4 cases with erythema, 3 cases with infiltration, and 1 case with persistent vesiculation. 4 patients suffered from itch irritation, and 1 from pain. 4 patients were not evaluated for their therapy was interrupted. Cultivation examinations in 5 cases revealed the presence of T. rubrum. Microscopic examinations were positive in 10 patients. Following 6 weeks of therapy 20% of patients remained to yield positive cultivation findings and 40% of patients were microscopically positive. 2 patients with candidosis were clinically cured and their laboratory findings were negative in 5-6 weeks. Myfungar creme is a preparation which had in 80% of patients a ver y good or good therapeutic effect. Its low sensibilization abilities and application once per day are advantageous. (tab. 6, Ref. 6.)

[Microsporum canis infection in rabbits and its transmission to humans]. / Microsporum canis-Infektion beim Kaninchen mit Ubertragung auf den Menschen.

The infection of the capillitium of an 8-year old child due to Microsporum canis is described. The child occasionally visited its mother working at an animal farm. The focus of the infection was found in farm rabbits infected by M. canis. A contamination of the environment (cages and floors) by the above mentioned dermatophyte could also be demonstrated. The infection was transferred to an animal feeder as well. The infection focus was eliminated by strict disinfection and sanitary measures. The importance of the mycological examination of animals with focal loss of hair is stressed.