Monica Costescu

Background: Atopic dermatitis is a chronic inflammatory skin disease in children, frequently associated with skin barrier dysfunction, immune dysregulation, and dysbiosis. Infected, treatment-resistant lesions may increase disease severity and complicate management, particularly in the presence of Staphylococcus aureus colonization. Objectives: To characterize the microbiological profile of infected, non-responsive pediatric atopic dermatitis, evaluate short-term clinical outcomes following individualized treatment, and identify predictors of disease severity. Methods: This observational analytical study included 41 children with atopic dermatitis recruited at Saint Constantin Hospital, Brașov, Romania, between September 2025 and February 2026. Eligible patients fulfilled the Hanifin and Rajka criteria and presented with infected, treatment-resistant lesions. Skin cultures were subjected to an antibiogram and antifungigram. Disease severity was assessed using the Patient-Oriented Eczema Measure (POEM) and SCORAD at baseline, 7 days, and 30 days. Repeated-measures ANOVA, mixed ANOVA, and hierarchical linear regression were used for statistical analysis. Results: Staphylococcus aureus was the predominant pathogen, followed by other bacterial species. Both POEM and SCORAD scores improved significantly over the 30-day follow-up, with marked improvement after 7 days and further reduction by day 30. Although patients with S. aureus colonization and those receiving systemic therapy tended to have higher disease severity, neither factor significantly influenced the trajectory of clinical improvement. Baseline disease severity was the strongest predictor of 30-day POEM and SCORAD outcomes, whereas demographic and perinatal characteristics did not independently predict short-term clinical outcomes. Conclusions: Individualized management was associated with significant improvements in clinician-assessed disease severity and patient-reported symptoms during the 30-day follow-up. Staphylococcus aureus, particularly methicillin-sensitive S. aureus (MSSA), was the most frequently isolated pathogen. Baseline disease severity was the strongest predictor of short-term clinical outcomes, whereas the evaluated demographic and perinatal characteristics did not provide additional predictive value in this cohort. Larger prospective controlled studies are needed to confirm these findings.

Mastocytosis (M) represents a systemic pathology characterized by increased accumulation and clonal proliferation of mast cells in the skin and/or different organs. Broadly, M is classified into two categories: Cutaneous mastocytosis (CM) and systemic mastocytosis (SM). In children, CM is the most frequent form. Unfortunately, pathogenesis is still unclear. It is thought that genetic factors are involved, but further studies are necessary. As for features of CM, the lesions differ in clinical forms. The most important fact is evaluating a pediatric patient with CM. It must comprise laboratory exams (with baseline dosing of total serum tryptase), a skin biopsy (with a pathological exam and, if the diagnosis is unclear, immunohistochemical tests), and a complete clinical evaluation. It is also defining to distinguish between CM and other diseases with cutaneous involvement. As for the management of CM in children, the first intervention implies eliminating trigger factors. The available cures are oral H1 and/or H2 antihistamines, oral cromolyn sodium, oral methoxypsoralen therapy with long-wave psoralen plus ultraviolet A radiation, potent dermatocorticoid, and calcineurin inhibitors. In children, the prognosis of CM is excellent, especially if the disease’s onset is in the first or second years of life.

The purpose of this study was to evaluate the relationship between central corneal thickness (CCT) and optic disc morphology in normal tension glaucoma (NTG). Patients with NTG underwent eye examination, optic disc imaging with Heildelberg Retina Tomograph II (HRT II) and ultrasound corneal pachymetry. The morphological parameters of the optic discs were used to classify the eyes into four groups: generalized enlargement (GE) type, myopic glaucomatous (MY) type, focal ischemic (FI) type and senile sclerotic (SS) type. A correlation between CCT and optic disc morphology obtained by HRT II was calculated. Multiple comparison and post hoc tests were performed in order to determine the significance of the differences between the four groups. The strongest correlation was between CCT and the parameters of optic disc imaging obtained at HRT II in the GE type of optic disc.

Basal cell carcinoma (BCC) is the most common cutaneous cancer. It seems that the most important prognostic factor is exposure to ultraviolet radiation (solar and artificial), correlated with other factors as well. In this article, we aimed to review basal cell carcinoma located in the axilla, referring to cases from our hospital. Axillary location of BCC is rare, with a very low number of cases quoted in the literature, compared to the high prevalence of basal cell carcinoma in the general population. During a period of two years, we detected only four cases of axillary basal cell carcinoma out of a total number of 921 cases diagnosed as BCC. We were interested in identifying certain factors involved in causing BCC, post-excision clinical evolution, histological type and aggressiveness of axillary basal cell carcinoma. Therefore, we quantified objectively the tumor and stromal expression of some immunological markers like: metalloproteinases MMP1, 3, 11, Ber-EP4 and Ki67. Histological types of tumors investigated here belong to the category of non-aggressive BCC, namely as nodular and superficial, although Ki67 index is greater than the average reported in the literature for this type of tumor. MMPs exhibited increased expression in tumors and stromal compartments, especially at the tumor invasion front, and was not associated with tumor ulceration or surrounding tissue remodeling-related changes. Our results confirm the literature data concerning the involvement of MMPs in BCC progression, whatever the tumor location is.