Biomedical subjects

Visnja Milavec-Puretić

Publications and source records attributed to Visnja Milavec-Puretić.

9 recordsLinked to original sources

PubMed2006

Pyoderma gangrenosum associated with ulcerative colitis.

We report the case of a 45-year old man with non-healing ulcers located on his chest, lumbal, sacral, retroauricular areas and forehead. Both clinical and histopathological examinations suggested pyoderma gangrenosum (PG). For six months the diagnosis of ulcerative colitis was established. PG in our patient was presented as a rapidly enlarging, painful ulcer with purple, undermined edges and a necrotic, haemorrhagic base. Initially, he was treated with a high dosage of peroral glucocorticosteroid, sulfasalazine, and systemic antibiotics, together with daily wound care. Ulceration partially regressed. Total colonoscopy showed pancolitis. When the dose of glucocorticosteroids was tapered down to 35 mg, new ulcerations on his right thigh and abdomen were formed. He also developed E. coli sepsis and flare up of bowel disease. Azathioprine, together with two pulse doses of glucocorticosteroids and antibiotics, were administered. He was scheduled for a total colectomy. The management of PG continues to be a therapeutic challenge.

Colitis, Ulcerative↗

PubMed2006

Atopy patch test with Dermatophagoides pteronyssinus (Dp 1) in atopic dermatitis patients.

The aim of this study was to evaluate the role of Dermatophagoides pteronyssinus (Dp) in atopic dermatitis patients, using atopy patch test (APT) with Dp (extract 1). Twenty patients (males (m) = 9, females (f) = 11, mean age = 46.0 years, range = 19-78 years) with atopic dermatitis were involved in this study. The control group consisted of seventeen healthy subjects (m = 7, f = 10, mean age = 48.3, range = 24-64 years), with no personal or family history and no signs of atopy. Total IgE, specific IgE and a skin prick test were done for all subjects involved in this study. The atopy patch tests were performed with Dp (extract 1) in: 3,000, 10,000, 20,000 and 30,000 biological units per ml (BU/ml) concentrations using glycerol as medium. The total IgE was significantly higher in atopic dermatitis (AD) patients than in a control group with (p < 0.05). After the tests six of twenty patients (30%) had positive APT results in the last two concentrations (20,000 and 30,000 BU/ml). However, all the results were positive after 48 h (and 72 hours), while no positive results were recorded in the control subjects. According to our study, APT with Dp 1 in 20,000 BU/ml and reading time 48 h and 72 hours is to be recommended. The results suggest that APT may detect the trigger factor (Dp) in AD patients.

Adult↗

PubMed2005

Clinical usefulness of cellular antigen stimulation test in detection of aspirin allergy.

Acetylsalicylic acid, commonly known as aspirin, can induce some hypersensitive reactions with clinical symptoms such as urticaria, angioedema, acute bronchospasm, and rarely anaphylactic shock. At present, detection of aspirin allergy is still rather difficult and requires an adequate clinical history and sensitive in vivo and in vitro tests. The aim of the study was to evaluate the diagnostic utility of cellular antigen stimulation test (CAST) in the detection of allergic reaction mediated by aspirin. Fifty patients (39 women and 11 men) with a history of hypersensitivity reaction to aspirin were included in the study. Positive scratch test to aspirin was found in 72% (36/50) and positive CAST in 58% (29/50) of patients. Both skin scratch test and CAST positive results were recorded in 48% (24/50%) and negative results in 20% (9/45) of patients. The level of agreement between skin scratch test and CAST was fair with Cohen's kappa of 0.269 (0.95% CI 0.004-0.533). The observed between-test agreement was 66%. It is concluded that CAST-ELISA might be of value as an additional test for the detection of aspirin nonallergic hypersensitivity in suspected individuals.

Adolescent↗

PubMed2005

Caustic reaction caused by cement.

A case is reported of a patient who developed full thickness chemical burns of the skin after a prolonged contact while working with wet cement. The history, course of disease, and therapy are described. Cement is an alkaline substance (pH >12) leading to colliquative necrosis. Tissue damage is due to the exothermic reaction of calcium oxide and water forming calcium hydroxide. Patch test was performed to test sensitization to chromium, chromate and cobalt, the usual cement ingredients. In our opinion, such lesions may not be rare because cement is widely used in construction, but are rarely described or under-recognized.

Adult↗

PubMed2004

Allergy to endoprostheses.

This paper describes a study of hypersensitivity and tissue reaction to loosened metal implants in 40 patients who underwent repeated hip arthroplasty. Metal sensitivity was tested using a standard cutaneous patch test. Nine patients were positive for chromium, nickel, cobalt, metal rust, endoprosthesis scrapings or combinations of these allergens. Patients with positive or negative patch test did not differ in terms of their age, sex, primary diagnosis, number of endoprosthesis revisions, length of implant function, presence of other metal parts around the implant, circulating immunocomplexes, and histological appearance of the tissue around the implant. In conclusion, stainless steel endoprostheses are safe for revised hip arthroplasty, and hypersensitivity to metals probably does not play a significant role in the loosening of endoprosthesis.

Female↗

PubMed2004

Correlation among skin prick test, total and specific IgE UniCAP tests in atopic patients from Zagreb, Croatia.

The correlation of pollen allergens, Dermatophagoides pteronyssinus and animal dender was assessed during a two-year period. Results of skin prick test, total and specific IgE UniCAP tests were compared in atopic patients (AP) with the following diagnoses: atopic dermatitis, allergic rhinitis, allergic conjunctivitis, allergic bronchitis or asthma, allergic urticaria and angioedema. The study included total and specific IgE (in vitro) tests to allergen mixtures (grass, tree, weed) or to single allergens of Dermatophagoides pteronyssinus (Der p), cat and dog fur, feather, etc. Comparison of skin prick test with total and specific IgE UniCAP immunoassay was done in 173 patients, i.e. 107 female and 66 male atopic patients aged 9-76 years. Allergies were most commonly recorded in the 25-35 age group. Total IgE ranged from 8.63 kU/l to >4000 kU/l, with specific IgE ranging from class 1 to class 5. Skin prick test showed high correlation with specific IgE for grass and weed pollen in patients with repiratory allergy (50.28%). Good correlation among all three tests was quite frequently observed. The results suggest that the study should be continued using these three tests in further cases of atopic dermatitis.

Adolescent↗

PubMed2004

Retrospective survey of patch testing at department of dermatology and venerology, zagreb university hospital center in zagreb, croatia.

Epicutaneous (patch) test is a standard test to confirm contact allergy. During a six-year period (1998-2003), contact allergic dermatitis was diagnosed in 4132 (65%) of 6341 patients using standard patch test with a Croatian series of allergens according to the International Contact Dermatitis Research Group (ICDRG). The most common clinical diagnoses related to contact allergy (male; female) were contact allergic dermatitis (65.4%; 72.2%); atopic dermatitis (15.9%; 11.7%); contact irritant dermatitis (7.0%; 6.6%) and nummular eczematoid dermatitis (4.2%; 2.4%). According to occupation, positive patch test reaction was most commonly observed in workers, whereas 65% of patients showed positive reactions to one or more substances. There was an increased frequency of positive patch test reactions to potassium dichromate, nickel sulfate, thimerosal and neomycine sulfate, along with a significant decrease in the frequency of positive patch test reactions to cobalt chloride, carba mix, wood tars, detergents, parabens mixture, urushiol and rubber mixture. We strongly recommend keeping up-to-date with the epidemiology of contact allergy in Croatia.

Adult↗

PubMed2003

Clinical case of acral hemorrhagic Darier's disease is not caused by mutations in exon 15 of the ATP2A2 gene.

Darier's disease (Dyskeratosis follicularis, DD) is a genetic disorder characterized by pathogenetic changes of keratinization with variant forms of cutaneous phenotype. Recently, it has been showed that Darier's disease cause mutations in the ATP2A2 gene, at 12q24.1. The gene encodes sarco-endoplasmic reticulum calcium ATPase type 2 (SERCA2). Mutations in exon 15 are reported to be the most consistent mutations associated with the acral hemorrhagic type of Darier's disease. By direct sequencing we investigated exon 15 of the ATP2A2 gene in a Croation family in which one member had a hemorrhagic Darier's disease, but did not record any mutation in the family we investigated. Our results show that mutations in exon 15 of the ATP2A2 gene are not a necessary prerequisite for acral hemorrhagic type of Darier's disease. Our finding support the variability of clinical manifestations of Darier's disease and lack of genotype/phenotype consistency.

Adult↗

PubMedDate not supplied

[What should we know about contact hypersensitivity to local glucocorticoids?].

Local glucocorticoids are still the most frequently used drugs in dermatology. In recent years there have been an increasing number of reports on contact allergic reactions to glucocorticoid. Patients with contact allergy to glucocorticoid generally present with chronic dermatitis that is exacerbated by and fails to respond to glucocorticoid therapy. Most patients react in patch test to more than one glucocorticoid, but mostly to tixocortol pivalate and budesonide. In patients with prolonged eczematous skin disease and other chronic inflammatory disease who do not improve, or who deteriorate during topical glucocorticoid therapy, contact allergy should be suspected and patch test should be preformed.

Administration, Topical↗