References1 Hajjeh RA, Conn LA, Stephens DS et al. Cryptococcosis in the United States: population-based multistate active surveillance and risk factors in HIV-infected persons. J Infect Dis 1999; 179 : 449 -454. 2 Gaddoni D, Resta F, Baldassari L et al. Criptococcosi cutanea in corso di AIDS. G Ital Dermatol Venereol 1993; 128 : 129 -132. 3 Vandersmissen G, Meuleman L, Tits G et al. Cutaneous cryptococcosis in corticosteroid-treated patients without AIDS. Acta Clin Belg 1996; 51 (2): 111 -117. 4 Nampoory MR, Khan ZU, Johny KV et al. Invasive fungal infections in renal transplant recipients. J Infect 1996; 33 (2): 95 -101. 5 Krcmery V Jr, Kunova A, Mardiak J. Nosocomial Cryptococcus laurentii fungemia in a bone marrow transplant patient after prophylaxis with ketoconazole successfully treated with oral fluconazole. Infection 1997; 25 (2): 130. 6 Bangert RL, Cho BR, Widders PR et al. A survey of aerobic bacteria and fungi in the feces of healthy psittacine birds. Avian Dis 1988; 32 : 46 -52. 7 Slavikova E, Vadkertiova R. Yeasts and yeast-like organisms isolated from fish-pond waters. Acta Microbiol Pol 1995; 44 (2): 181-189. 8 Bellosta M, Gaviglio MR, Mosconi M et al. Primary cutaneous cryptococcosis in an HIV-negative patient. Eur J Dermatol 1999; 9 (3): 224 -226. 9 Dimino-Emme L, Gurevitch AW. Cutaneous manifestations of disseminated cryptococcosis. J Am Acad Dermatol 1995; 32 (5, Part 2): 844 -850. 10 Kordossis T, Avlami A, Velegraki A et al. First report of Cryptococcus laurentii meningitis and a fatal case of Cryptococcus albidus cryptococcaemia in AIDS patients. Med Mycol 1998; 36 (5): 335 -339. 11 Johnson LB, Bradley SF, Kauffman CA. Fungaemia due to Cryptococcus laurentii and a review of non-neoformans cryptococcaemia. References 1 Carlson JA, Murphy M. Androgen receptors and lichen sclerosus (letter). J Am Acad Dermatol 2000; 43: 559. 2 Clifton M, Smoller B. Androgen receptors and lichen sclerosus (reply). J Am Acad Dermatol 2000; 43: 559. 3 Kohlberger PD, Joura EA, Bancher D, Gitsch G, Breitenecker G, Kieback DG. Evidence of androgen receptor expression in lichen sclerosus: an immunohistochemical study. J Soc Gynecol Invest 1998; 5: 331-333. 4 Powell JJ, Wojnarowska F. Lichen sclerosus. Lancet 1999; 353: 1777-1783. 5 Carlson JA, Ambros R, Malfetano J et al. Vulvar lichen sclerosus and squamous cell carcinoma: a cohort, case control, and investigational study with historical perspective; implications for chronic inflammation and sclerosis in the development of neoplasia. J Am Board Fam Pract 1999; 12: 473 -476. 6 Tidy JA, Soutter WP, Luesley DM, MacLean AB, Buckley CH, Ridley CM. Management of lichen sclerosus and intraepithelial neoplasia of the vulva in the UK.
Aim.To present and compare 10-year clinical experience of human brucellosis in Republic of Macedonia with data presented in the literature about the frequency of cutaneous manifestations of brucellosis. To estimate the percent of underdiagnosed / misdiagnosed skin lesions related to brucellosis and to raise awareness of cutaneous manifestations of brucellosis in our clinical practice. Methods.Clinical records and experience of the Infectious Diseases Clinic and Dermatology Clinic, Faculty of Medicine, Skopje, and a review of the recent literature data about cutaneous manifestations of brucellosis relevant for dermatologists, infectologists and general practitioners. Results.Cutaneous manifestations or complications have been reported rarely, less than 5% (3.8 % -17 %) in different published studies. A variety of skin lesions have been reported in patients with brucellosis, including rashes (25%), nodules, papules, erythema nodosum (25%), eczematous lesions (12.5%), psoriasiform lesions (12.5%), petechiae, purpura and others.
Apart from the time-proven, gold standard treatment of many topical conditions with corticosteroids, the phobia of using topical corticosteroids (TCs) is a phenomenon unveiled among groups of patients, parents, as well as health professionals. Health professionals’ attitude to TCs could have a significant impact on the trend of TCs-phobia among patients. Therefore, it is essential to address this issue as TCs-phobia is something which could also have important implications in medication adherence and compliance to prescribed treatment. Bearing in mind that no survey had been conducted to investigate this matter in Republic of Macedonia (RM), a self-completed questionnaire has been created to assess attitudes and their prevalence associated with TCs-phobia among patients and health professionals with aim to describe the attitude, explore the reasons behind revealed phenomenon and define directions for future interventions needed to advance the healthcare in this field. Our findings show that the TCs-phobia is present among surveyed population (21.6 and 34.22% of all responders expressed negative attitudes or fear of TCs use, respectively). It is also concluded that ~27% of patients on TCs-therapy admitted that they feared of using the medication. However, there is a higher frequency of negative attitudes regarding the use of TCs among the health professionals (~39%) than among patients, where the TCs-phobia is more prominent among non-dermatologists than dermatologists. Moreover, negative attitude and fear of TCs use is universal among paediatricians (73.91%). Portrayed interventions needed to identify and manage the TCs-phobia can lead to improvement of adherence and predicted responsiveness of TCs-therapy.
Ciclopirox olamine is a synthetic hydroxypiridone derived, broad spectrum, antifungal agent which has been used effectively to treat seborrheic dermatitis. Seborrheic dermatitis is a chronic dermatosis, more common in men than women, which usually occurs in sites dense with sebaceous glands in the form of mild inflammatory desquamate erythema. Treatment modalities for seborrheic dermatitis include keratolytic agents, corticosteroids and antifungal agents. Due to its antimycotic and anti-inflammatory activities, ciclopirox olamine is established as an effective treatment for this condition.
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