Magdalena Czarnecka-Operacz

Bacteria inhabiting the digestive tract are responsible for our health. The microbiome is essential for the development of the immune system and homeostasis of the body. Maintaining homeostasis is very important, but also extremely complicated. The gut microbiome is related to the skin microbiome. It can therefore be assumed that changes in the microbes inhabiting the skin are greatly influenced by the bacteria living in the intestines. Changes in the composition and function of microbes (dysbiosis in the skin and intestines) have recently been linked to changes in the immune response and the development of skin diseases, including atopic dermatitis (AD). This review was compiled by collaborating Dermatologists specializing in atopic dermatitis and psoriasis. A comprehensive review of the current literature was performed using PubMed and limited to relevant case reports and original papers on the skin microbiome in atopic dermatitis. The inclusion criterion was that the paper was published in a peer-reviewed journal in the last 10 years (2012–2022). No limitations on the language of the publication or the type of study were made. It has been shown that any rapid changes in the composition of the microflora may be associated with the appearance of clinical signs and symptoms of the disease. Various studies have proven that the microbiome of many systems (including the intestines) may have a significant impact on the development of the inflammatory process within the skin in the course of AD. It has been shown that an early interaction between the microbiome and immune system may result in a noticeable delay in the onset of atopic diseases. It seems to be of high importance for physicians to understand the role of the microbiome in AD, not only from the pathophysiological standpoint but also in terms of the complex treatment that is required. Perhaps young children diagnosed with AD present specific characteristics of the intestinal microflora. This might be related to the early introduction of antibiotics and dietary manipulations in breastfeeding mothers in the early childhood of AD patients. It is most likely related to the abuse of antibiotics from the first days of life.

Tertiary syphilis is a large diagnostic challenge. It is rarely the case that it affects the skin, bone tissue and the eyes at the same time. The presented case shows that extensive symptomatology of syphilis poses a challenge in making a proper diagnosis in patients whose history does not suspect STDs. The study aims to present the case of a young woman hospitalized with a suspected autoimmune disease, diagnosed with symptomatic late syphilis with involvement of the skin, bones and eyes.

HIV data for 2020 show a decline in the number and rate of new HIV cases diagnosed in the EU during the last decade. The COVID-19 pandemic has paralyzed the functioning of healthcare facilities in Poland and worldwide, also impacting the detection of HIV infection. Early diagnosis of HIV and implementation of antiretroviral treatment limit HIV transmission. A woman with HIV diagnosed during pregnancy should be under the care of a specialist in infectious diseases experienced in antiretroviral treatment. In this way, she will be properly protected during the delivery, and relevant medications can be implemented for the newborn baby. Taking these aspects into account, the medical team should consist of: A specialist in infectious diseases, an obstetrician, a neonatologist and pediatrician, a midwife, and a dermato-venereologist. Every effort should be made to increase the scope and quality of monitoring of the spread of the epidemic in Poland, with special emphasis on diagnostics based on specific tests among populations particularly exposed to HIV infections cooperating with non-governmental organizations.

Aim. The aim of this paper is to analyse and review the currently available evidence and research with regard to allergy to the iodinated contrast media, which still remains an important, albeit rare, clinical complication. Material and Methods. We performed our research using the PubMed search engine provided by the National Centre for Biotechnology Information, having inserted ‘iodinated contrast media’, ‘allergy’, ‘adverse reactions’ as the keywords. Results. Even though the modern iodinated contrast media are much safer than those used in the past, adverse reactions still occur in up to 1–3% of patients undergoing radiological procedures. Their range varies from skin changes, such as a macular rash, prurigo or urticarial, to the more severe multisystemic reactions including anaphylactic shock. The underlying mechanisms are still investigated and are not fully comprehended, although the most frequently accepted explanations include a systemic inflammatory reaction associated with increased histamine and tryptase levels, activation of memory T cells and both direct and indirect damage to the vascular epithelium. The significance of classic allergy tests has not yet been fully established. The associated known risk factors are of various character and researchers have come with different, occasionally contradicting results regarding patients’ age and gender, however, other factors have been more clearly described, and include concomitant conditions and medications. Conclusions. The aforementioned data emphasizes the importance of clinical aspects of allergy to the iodinated contrast media for every practicing physician, as more and more medical specialties benefit from the advantages of modern vascular imaging.

Actinic keratosis (AK) is a common skin disease caused by long-term sun exposure and typically forms on the face, neck, balding scalp, chest and shoulders. AK is characterized by the formation of keratotic macules, papules, or plaques with superficial scales on a red base. Treatment options for actinic keratosis include destructive therapies (eg, surgery, cryotherapy, photodynamic therapy [PDT], dermabrasion), topical medications (eg, diclofenac, topical fluorouracil, imiquimod, ingenol mebutate), and field ablation treatments (eg, chemical peels, laser resurfacing). The aim of this paper was to present a case of patient with AK and the allergic reaction to the 3% diclofenac sodium topical gel ( DSTG) treatment. After a few days of therapy an acute, eczematous reaction on the face was observed. The symptoms have subsided within a week after discontinuing the treatment. The patch test with 3% diclofenac sodium topical gel was performed and evaluated as positive suggesting a delayed type hypersensitivity reaction to active medication or its inactive ingredients. In case of contact allergy confirmed with PT, it is important to inform the patient on the need of future medication avoidance.

Hereditary angioedema (HAE) is a genetically determined disease characterized by recurrent episodes of subcutaneous or submucosal tissue oedema. Failure to respond to the classical treatment of angioedema with antihistamines, glucocorticosteroids as well as adrenaline is highly characteristic...

Atopic dermatitis (AD) is a chronic and recurrent disease with an inflammatory background. Genetic and environmental factors are responsible for the occurrence and development of this dermatosis. The aim of the study was to assess the frequency of colonisation of the nasal vestibule and apparently healthy skin by S. aureus, and to assess dermal lesions for superinfection with S. aureus in AD patients. The research was performed on a population of 100 AD patients. Three smears were collected for microbiological investigations: from the anterior nares, from apparently healthy skin and from lesioned skin. On collection, the material was cultured on mediums provided by the bioMerieux and Argenta companies. The strains were identified and their sensitivity to antibiotics assessed by means of the Vitek2 system (bioMerieux). S. aureus was present in at least one location in 90%. 44% presented S. aureus colonization of apparently healthy skin and within skin lesions. In the case of 23%, this particular pathogen was detected only in skin lesions, whereas 6% had a positive result within the area of apparently healthy skin. In total, S. aureus was detected in the skin of 73%. In 61%, apparently healthy skin had been colonized with S. aureus, whereas in 81% colonization was proved within the skin lesions. S. aureus was detected in the nasal vestibule of 85%. Among the group with S. aureus in their anterior nares, the pathogen was also found on the skin surface of 77%. S. aureus colonises skin in most AD patients. Most AD patients carry S. aureus in their nasal vestibules. S. aureus does not seem to colonise healthy skin as often as skin lesions in young people. The vast majority of S. aureus strains were sensitive to local antibiotics. Most S. aureus strains produced penicillinase.

Pokrzywka to jedna z najbardziej rozpowszechnionych chorób skóry i częsta przyczyna konsultacji dermatologicznych. Stanowi wyzwanie diagnostyczne dla lekarza klinicysty. Szacuje się, że choruje na nią 8,8-20% populacji, częściej dotyka kobiet niż mężczyzn (3:2). W artykule omówiono możliwości diagnostyczne i terapeutyczne stosowane w pokrzywce. W szczegółowy sposób przedstawiono pokrzywkę fizykalną z zimna na podstawie opisu przypadku klinicznego 23-letniego pacjenta, u którego przy użyciu nowych metod diagnostycznych (Threshold TempTest) wyjaśniono etiologię nagłego pojawienia się obrzęku naczynioruchowego oraz bąbli pokrzywkowych.