Stojanović and colleagues examined the sensitivity of KIM-1 and cystatin-C, two biomarkers of ren... more Stojanović and colleagues examined the sensitivity of KIM-1 and cystatin-C, two biomarkers of renal injury, and investigated whether erythropoietin protects the kidneys of rat pups exposed to global ischemia in utero. As measured by both biomarkers, absolute injury scores were significantly lower in pups that received darbepoetin-α. See page 11
BACKGROUND: The serious nature of potentially malignant oral lesions (PMOL) demands that the fina... more BACKGROUND: The serious nature of potentially malignant oral lesions (PMOL) demands that the final diagnosis be made on both clinical and histopathologic grounds. The aim of the present study was to determine the correlation between clinical and histopathologic diagnoses of PMOL using a discrepancy index (DI). METHODS: Fifty-one patients with PMOL were examined clinically, and a biopsy was taken from each one. The results of histopathologic diagnosis were compared with the clinical diagnosis. We established that the histopathologic diagnosis was incompatible when the clinical diagnosis was not confirmed. On the basis of the incompatible diagnosis, we calculated a discrepancy index between the clinical and histopathologic diagnosis. RESULTS: Clinically, the homogeneous leukoplakia was the most frequent lesion followed by erosive lichen planus and reticular lichen planus. No cases of erythroplakia were observed. Lesions were most frequently seen at the buccal mucosa, followed by the gingiva (alveolar mucosa) and tongue. The histopathologic diagnosis showed that the majority of the lesions were benign keratoses followed by lichen planus. Three cases of epithelial dysplasia were mild. The DI between clinical and histopathologic diagnosis was 17.6 %. The higher DI was found in erosive lichen planus. CONCLUSION: The obtained findings show that in 90% of leukoplakias, clinical diagnosis was confirmed by histopathologic examination. The discrepancy between clinical and histopathologic diagnoses in 17.6 % of cases suggests that all PMOLs should be submitted to histological analysis.
The paper presents two cases of familial hemophagocytic lymphohistiocytosis in one family. The fi... more The paper presents two cases of familial hemophagocytic lymphohistiocytosis in one family. The first case is the first-born female child with symptoms of an abrupt onset of hepatic failure and encephalopathy at the age of 2.5 months, and the second case is the third-born male child from the fourth pregnancy who died in his first month with a similar clinical manifestation. By means of histological examination, a diffuse proliferation of histiocytes of benign appearance with numerous phagocytized erythrocytes in the cytoplasm was found in both patients. These infiltrates existed in numerous organs and tissues of the body, but they were mostly visible in the spleen, liver, lymph nodes and in the bone marrow. The course of the disease is rapidly progressive with an up to now insufficiently explained etiology of the disease, with the existence of an autosomal recessive type of inheritance and defects in cellular and humoral immunity.
Introduction. Evaluation of the prognostic factors and the survival rate in oral squamous cell ca... more Introduction. Evaluation of the prognostic factors and the survival rate in oral squamous cell carcinoma is extremely important, because patients in the same tumor-node-metastasis stage may have a different survival rate. Numerous studies have been conducted on various clinical and pathological prognostic factors in order to develop a prognostic model for the survival rate of patients with oral cancer. Material and Methods. The study was designed as a prospective study including 65 consecutive patients (n = 65) of both sexes who underwent surgical treatment of oral cancer. The diagnosis of oral cancer was based on the medical history, physical examination, and biopsy. The clinical tumor-node-metastasis staging was determined based on clinical examination. The radiological tumor-node-metastasis staging was done by computed tomography of the head, neck, and chest. The tumor thickness was determined by computed tomography and histopathological analysis of surgical specimens. Results. T...
Background: In vivo confocal microscopy is an imaging technique that has been applied to the stud... more Background: In vivo confocal microscopy is an imaging technique that has been applied to the study of the ocular surface. However, confocal microscopes dedicated to eye examination are routinely adopted only in ophthalmology reference centres and do not allow an examination of periocular tissue, nor a fluorescence examination. Methods: We applied for the first time the two in vivo confocal microscopes commonly used in dermatology (VivaScope ® 1500 and 3000, CALIBER, distributed in Europe by Mavig GmbH, Munich, Germany) to observe the cornea, the bulbar and tarsal conjunctiva, the eyelid margin, the lacrimal punctum and the palpebral skin of healthy volunteers. Tumoral, inflammatory and infectious diseases of the ocular mucosa and periocular skin from more than 200 patients were observed under the same microscopes. Both microscopes have a reflectance mode. VivaScope ® 1500 allows an additional fluorescent examination and its placement on the ocular surface was made possible by the creation of a special interface between the microscope and the ocular apparatus. Results: Thanks to its compact and flexible configuration, the handheld camera VivaScope ® 3000 allowed to access more easily to the ocular and periocular tissues. Diagnosis of benign and malignant tumors (melanoma, squamous cell carcinoma and basal cell carcinoma), as well as infectious and genetic disease (storage diseases), could be evocated. The detection of parasites (Demodex folliculorum) on eyelids was possible. Confocal images correlated well with conventional histopathology. The fluorescence examination of corneal squamous cell carcinoma by VivaScope 1500 was characterized by extravasation of fluorescein after intravenous injection. Conclusions: Confocal microscopes dedicated to the skin offer new perspectives for the diagnosis, optimization of treatments, and follow-up of the ocular diseases. They will allow dermatologists to examine conjunctival and eyelid tumors, as it is for skin or genital mucosa. In addition, thanks to some adaptations of the dermatological device VivaScope ® 1500, it is possible for the first time to perform a fluorsecnte examination of the ocular and peri-ocular tissue, opening a new era in the clinical imaging of the ocular surface. A new semiology remains to be learned.
-Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infectio... more -Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infection in humans. immunocompetent and immunocompromised patients both can be affected and Nocardia cyriacigeorgica was reported as a pathogen isolated in patients worldwide. in most cases, nocardiosis is present as pulmonary infection because inhalation is the primary way of bacterial exposure. Nocardial brain abscess occurs usually secondary to a septic focus elsewhere in the body. Considering the facts that the elderly population is growing, such as the number of immunocompromised patients together with high mortality rate in patients with nocardial infection of the central nervous system, we have to raise awareness of the possibility for this rare but potentially fatal condition. we present a case where nocardial abscesses of lung and brain were initially suspected as lung cancer with brain metastases. The patient was treated with a combination of surgical resection and antimicrobial therapy with good outcome.
Serbian Journal of Dermatology and Venereology, 2015
Ulerythema ophryogenes and keratosis follicularis spinulosa decalvans are rare folliculocentric k... more Ulerythema ophryogenes and keratosis follicularis spinulosa decalvans are rare folliculocentric keratotic disorders, from the group of follicular genokeratoses, characterized by keratosis pilaris atrophicans: follicular keratotic papules, sometimes with surrounding erythema, which eventually result in fibrosis, atrophy, progressive scarring and permanent hair loss. Ulerythema ophryogenes begins at birth or soon thereafter; it involves the lateral eyebrows, spreads medially and eventually affects the entire eyebrows, cheeks, and less frequently, forehead and asjecebt scalp. Involvement of the scalp has apparently not been reported in cases in which the eyebrows were predominantly involved. In addition to sporadic cases, ulerythema ophryogenes has been reported among relatives. Keratosis follicularis spinulosa decalvans is also a genetically heterogeneous syndrome which begins in infancy or childhood by involving hair bearing skin, especially the scalp; rarely it is confined to the fa...
Serbian Journal of Dermatology and Venerology, 2013
The authors present a case of a patient with extramammary Paget’s disease in the pubic region tre... more The authors present a case of a patient with extramammary Paget’s disease in the pubic region treated by a dermatologist with a private practice for almost 4 years before incisional biopsy was performed. A thorough examination showed no evidence of malignancies of internal organs, whereas definite diagnosis was made by excision of the entire skin lesion and histopathological analysis. With regard to multiple criteria, findings in our patient were consistent with current literature data, but interestingly, the primary extramammary Paget’s disease has not spread into deeper tissues.
Background: The best time to initiate concurrent chemoradioation (ChRT) with temozolamide after s... more Background: The best time to initiate concurrent chemoradioation (ChRT) with temozolamide after surgery in glioblastoma multiform (GBM) patients has not been clearly established. Our aim was to investigate whether survival is influenced by the time to ChRT in patients with different types of surgery. Methods: We conducted a retrospective study of all the patients treated in our centre from January 2005 to December 2017, with a histological diagnosed GBM, which underwent surgery and completed concurrent ChRT with temozolamide. The time to ChRT was grouped in 4 quartiles, and early ChRT was defined as happening during the first quartile. Surgery type was divided into resection (R) and biopsy (B). Survival at 12 months (OS12m), median progression free survival (mPFS) and overall survival (mOS) were calculated. Other relevant clinical factors were also analyzed. Results: From a total of 160 patients, 119 who completed ChRT were included. The median time to ChRT was 37 days, (Q1¼26, Q2¼37, Q3¼45); 35 (30%) received early ChRT (26 days). Patients who underwent R were 101 (85%) and 18 (15%) B. The mean age was 62y, 94 patients (79%) had PS 0-1, MGMT methylation was positive in 23 (19%). There were no significant differences between groups regarding Age, PS and MGMT status; but more patients treated with B received early ChRT (31% vs 8%). The OS12m was shorter for patients who underwent R and received early vs no-early ChRT (35% vs 73%, p ¼ 0.002). No differences in OS12m were found for B patients (0% vs 18%, p ¼ 0.4) according to time to ChRT. For patients who received early ChRT, the mOS was similar despite surgery type (9.9, 95% CI 9.6-11 vs 12.9, 95% CI 6.5-19.3, p ¼ 0.8, for R and B, respectively). But for patients who did not receive early ChRT, longer survival was achieved in the R vs B subgroup (16.2, 95%CI 14.1-17.8 vs 11.1, 95% CI 4.5-17.7, p ¼ 0.024, for R and B, respectively) and resection type remained significant in the multivariate analysis (HR ¼ 1.2, p ¼ 0.02). Conclusions: We have found that patients with GBM who underwent resection had a worse prognosis if they received early chemoradiation (26 days). No differences were found for biopsied patients. A no-early chemoradation approach for patients who underwent resection may be safe. Prospective studies are encouraged.
INTRODUCTION ecently, interest in the study of oral candidiasis has markedly increased mainly bec... more INTRODUCTION ecently, interest in the study of oral candidiasis has markedly increased mainly because of its association with human immunodeficiency virus (HIV) infection, but also due to its relation with potentially malignant lesions of oral mucosal. Many authors have studied the characteristics of oral mucosa in immunocompromised patients in order to find the differences in immunologic reactions to the development of candidiasis. There are a number of oral lesions that are clearly associated, more often than others, with either candidial infestation or frank invasion (1). The yeast-like fungus Candida albicans and a few other Candida species are capable of producing skin, mucous membrane, and internal infections. The organism lives with the normal flora of the mouth, vaginal tract, and gut, so the results of culture analysis must be interpreted carefully. Pregnancy, oral contraception, antibiotic therapy, diabetes, skin maceration, topical steroid therapy, certain endocrinopathies, and factors related to depression of cell-mediated immunity may allow the yeast to become pathogenic and produce budding spores and elongated cells (pseudohyphae) or true hyphae with septate walls. The yeast infects only the outer layers of the epithelium of mucous membrane and skin (the stratum corneum). The primary lesion is a pustule, the contents of which dissects horizontally under the stratum corneum
Benign osteoblastoma is an uncommon osteoblastic tumor with osteoid and bone deposition, characte... more Benign osteoblastoma is an uncommon osteoblastic tumor with osteoid and bone deposition, characterized cytologically by the abundant presence of osteoblasts. A 54-year-old man presented with a chief complaint of a painless swelling beneath the mandible, which was growing during the past 3 years.The clinical examination revealed the presence of a palpable tumor mass, which was fused by its one side to the left angle of the mandible, and its remainder was situated beneath the body of the mandible. Radiologic picture disclosed a well-circumscribed lesion ih which some parts were heavily calcified. After the surgial extirpation, the pathohistological diagnosis was a benign osteoblastoma of the mandible. The major problem for pathologists is the correct differentiation between benign osteoblasoma and a number of lesions that may have similar characteristics.
Serbian Journal of Dermatology and Venereology, 2020
Introduction. Nevus sebaceous is a rare congenital hamartoma, composed of epidermis, sebaceous gl... more Introduction. Nevus sebaceous is a rare congenital hamartoma, composed of epidermis, sebaceous glands, sweat glands and hair follicles. It is possible to develop secondary tumors in the area of nevus sebaceous during the lifetime, most often after puberty. Secondary lesions are most often benign, while malignant lesions may occur but significantly less frequently. Case report. We present the case of a 21-year-old patient who came for an examination due to the appearance of a nodule in the area of a yellowish lesion on the head. The yellowish lesion was present since birth, and the nodule appeared about a year before. The dermoscopic examination of the lesion was nonspecific. The final diagnosis of eccrine poroma as a secondary lesion in nevus sebaceous was made by pathohisto-logical analysis. Conclusion. Every secondary tumor in nevus sebaceous deserves full attention, with either close follow up, or excision with pathohistological analysis.
We report a case of congenital cytomegalovirus and Herpes simplex virus infection suspected via u... more We report a case of congenital cytomegalovirus and Herpes simplex virus infection suspected via ultrasound indicated by the presence of fetal cerebral abnormalities. The pregnancy was electively terminated at 31 weeks of gestation. The postmortem examination of the foetus showed brain with lissencephaly. The histopathological examination revealed numerous enlarged cells containing cytomegalic inclusions and multinucleated giant cells in multiple fetal organs and placenta. Documented evidence of histopathological detection of cytomegalovirus inclusions in multiple organs are very sparse in literature. This case highlights the causal relationship of viral infections in early pregnancy and abnormalities of the central nervous system.
Introduction. Congenital anomalies of the epididymis, detected either during orchiopexy or routin... more Introduction. Congenital anomalies of the epididymis, detected either during orchiopexy or routine herniectomy, as well as their importance in male fertility, have been described in many papers in clinical surgery. Clinical Considerations. The aim of this study was to report various types of epididymal congenital abnormalities registered in the clinical practice of pediatric surgery, to describe their basic characteristics and to classify them into three groups: (I) fusional anomalies of the epididymis and testis; (II) anatomic forms of anomalies; (III) congenital epididymal cysts. Conclusion. The clinical experience of pediatric surgeons indicates that during these surgical procedures, it is necessary to carefully examine the epididymis to detect anomalies, and it is of utmost importance to inform the patient and/or his parents. It is also recommended to follow the patients up to the age of fertility.
Introduction. Hypertensive ischemic leg ulcer, also known as Martorell ulcer, is not very rare, b... more Introduction. Hypertensive ischemic leg ulcer, also known as Martorell ulcer, is not very rare, but an under-recognized type of leg ulcer. It has specific clinical and histopathological characteristics. It occurs almost exclusively in patients with arterial hypertension. It is more common in women and in patients with type 2 diabetes. It is localized particularly in the laterodorsal distal third of the lower leg. This ulcer is extremely painful. Its clinical features may very much resemble pyoderma gangrenosum. Case Report. We are presenting a case of a 40-year-old obese male, who suffered from arterial hypertension during the past 26 years. His ulcer appeared spontaneously on the lateral aspect of the right lower leg and progressed gradually. From the very onset, the ulcer was extremely painful. At first, it was diagnosed as pyoderma gangrenosum and treated with systemic corticosteroids and immunosuppressants. Since the response to therapy was not satisfactory, the histopathology w...
Introduction: Pachydermodactyly is a very rare type of macrodactyly. It clinically resembles juve... more Introduction: Pachydermodactyly is a very rare type of macrodactyly. It clinically resembles juvenile rheumatoid arthritis, but it has a non-inflammatory etiology without bone, articular, or synovial involvement. Case Presentation: In this study, we report the case of a 15-year-old boy with repetitive behavior diagnosed with a pachydermodactyly after evaluation of bilateral swelling of the proximal interphalangeal joints. Histologic examination revealed epidermal hyperorthokeratosis, thickening of the dermis with increased dermal collagen and absence of inflammatory cells. Pachydermodactyly is a very rare condition associated with compulsive behavior and results from repetitive minor trauma that causes localized proliferation of fibrous tissue. Conclusions: Pachydermodactyly is a dermatological sign of compulsive behavior and repetitive minor trauma, and it should be distinguished from other forms of joint enlargement to avoid unnecessary medicamentous treatment. Control examinations did not reveal clinically relevant worsening even without any treatment applied.
At the end of the Second World War, the General State Hospital had seven departments, the same fa... more At the end of the Second World War, the General State Hospital had seven departments, the same facilities, and the same bed capacity as in the pre-war period. In the newly formed state of Yugoslavia, intensive growth and modernization of the hospital began, despite the great financial difficulties. The hospital became the Main Provincial Hospital and new departments and services were established. Mainly during the 1960s and 1970s, ten new surgery departments were established, which later became independent clinics. The surgery departments occupied pavilions 1, 2, 3 and 4. Complex and contemporary abdominal and thoracic surgeries were performed. The Department of Internal Diseases became the Clinic of Internal Diseases and in 1964 it was moved to a newly equipped four-story building. The Clinic of Gynecology and Obstetrics was founded and it was moved into a modern, purpose-built facility with a 230 bed capacity for adult patients and 105 for newborns. Rapid progress has also been ma...
Serbian Journal of Dermatology and Venereology, 2018
Syringoma is a benign adnexal tumor derived from intraepidermal eccrine ducts. The usual presenta... more Syringoma is a benign adnexal tumor derived from intraepidermal eccrine ducts. The usual presentation of syringoma is a small smooth skin-colored, yellowish or brownish papule with flattened or rounded top. Eruptive syringoma is a rarely reported form, where lesions are numerous and occur in successive crops. A case of a 57-year-old Caucasian male with a twenty four-year history of multiple asymptomatic, erythematous and brownish papules, predominantly over the anterior aspect of the trunk is presented. All lesions appeared after prolonged sun exposures within a few days and persisted without further changes afterwards. Contact non-polarized dermoscopy showed a fine light brown, regular pigment network on a light pink background, being the same in all lesions. History of the disease, clinical finding and dermoscopy were inconclusive, and biopsy was performed. Histopathology revealed signs of syringoma. Dermoscopic finding was thought to be intriguing and therefore is discussed in th...
Stojanović and colleagues examined the sensitivity of KIM-1 and cystatin-C, two biomarkers of ren... more Stojanović and colleagues examined the sensitivity of KIM-1 and cystatin-C, two biomarkers of renal injury, and investigated whether erythropoietin protects the kidneys of rat pups exposed to global ischemia in utero. As measured by both biomarkers, absolute injury scores were significantly lower in pups that received darbepoetin-α. See page 11
BACKGROUND: The serious nature of potentially malignant oral lesions (PMOL) demands that the fina... more BACKGROUND: The serious nature of potentially malignant oral lesions (PMOL) demands that the final diagnosis be made on both clinical and histopathologic grounds. The aim of the present study was to determine the correlation between clinical and histopathologic diagnoses of PMOL using a discrepancy index (DI). METHODS: Fifty-one patients with PMOL were examined clinically, and a biopsy was taken from each one. The results of histopathologic diagnosis were compared with the clinical diagnosis. We established that the histopathologic diagnosis was incompatible when the clinical diagnosis was not confirmed. On the basis of the incompatible diagnosis, we calculated a discrepancy index between the clinical and histopathologic diagnosis. RESULTS: Clinically, the homogeneous leukoplakia was the most frequent lesion followed by erosive lichen planus and reticular lichen planus. No cases of erythroplakia were observed. Lesions were most frequently seen at the buccal mucosa, followed by the gingiva (alveolar mucosa) and tongue. The histopathologic diagnosis showed that the majority of the lesions were benign keratoses followed by lichen planus. Three cases of epithelial dysplasia were mild. The DI between clinical and histopathologic diagnosis was 17.6 %. The higher DI was found in erosive lichen planus. CONCLUSION: The obtained findings show that in 90% of leukoplakias, clinical diagnosis was confirmed by histopathologic examination. The discrepancy between clinical and histopathologic diagnoses in 17.6 % of cases suggests that all PMOLs should be submitted to histological analysis.
The paper presents two cases of familial hemophagocytic lymphohistiocytosis in one family. The fi... more The paper presents two cases of familial hemophagocytic lymphohistiocytosis in one family. The first case is the first-born female child with symptoms of an abrupt onset of hepatic failure and encephalopathy at the age of 2.5 months, and the second case is the third-born male child from the fourth pregnancy who died in his first month with a similar clinical manifestation. By means of histological examination, a diffuse proliferation of histiocytes of benign appearance with numerous phagocytized erythrocytes in the cytoplasm was found in both patients. These infiltrates existed in numerous organs and tissues of the body, but they were mostly visible in the spleen, liver, lymph nodes and in the bone marrow. The course of the disease is rapidly progressive with an up to now insufficiently explained etiology of the disease, with the existence of an autosomal recessive type of inheritance and defects in cellular and humoral immunity.
Introduction. Evaluation of the prognostic factors and the survival rate in oral squamous cell ca... more Introduction. Evaluation of the prognostic factors and the survival rate in oral squamous cell carcinoma is extremely important, because patients in the same tumor-node-metastasis stage may have a different survival rate. Numerous studies have been conducted on various clinical and pathological prognostic factors in order to develop a prognostic model for the survival rate of patients with oral cancer. Material and Methods. The study was designed as a prospective study including 65 consecutive patients (n = 65) of both sexes who underwent surgical treatment of oral cancer. The diagnosis of oral cancer was based on the medical history, physical examination, and biopsy. The clinical tumor-node-metastasis staging was determined based on clinical examination. The radiological tumor-node-metastasis staging was done by computed tomography of the head, neck, and chest. The tumor thickness was determined by computed tomography and histopathological analysis of surgical specimens. Results. T...
Background: In vivo confocal microscopy is an imaging technique that has been applied to the stud... more Background: In vivo confocal microscopy is an imaging technique that has been applied to the study of the ocular surface. However, confocal microscopes dedicated to eye examination are routinely adopted only in ophthalmology reference centres and do not allow an examination of periocular tissue, nor a fluorescence examination. Methods: We applied for the first time the two in vivo confocal microscopes commonly used in dermatology (VivaScope ® 1500 and 3000, CALIBER, distributed in Europe by Mavig GmbH, Munich, Germany) to observe the cornea, the bulbar and tarsal conjunctiva, the eyelid margin, the lacrimal punctum and the palpebral skin of healthy volunteers. Tumoral, inflammatory and infectious diseases of the ocular mucosa and periocular skin from more than 200 patients were observed under the same microscopes. Both microscopes have a reflectance mode. VivaScope ® 1500 allows an additional fluorescent examination and its placement on the ocular surface was made possible by the creation of a special interface between the microscope and the ocular apparatus. Results: Thanks to its compact and flexible configuration, the handheld camera VivaScope ® 3000 allowed to access more easily to the ocular and periocular tissues. Diagnosis of benign and malignant tumors (melanoma, squamous cell carcinoma and basal cell carcinoma), as well as infectious and genetic disease (storage diseases), could be evocated. The detection of parasites (Demodex folliculorum) on eyelids was possible. Confocal images correlated well with conventional histopathology. The fluorescence examination of corneal squamous cell carcinoma by VivaScope 1500 was characterized by extravasation of fluorescein after intravenous injection. Conclusions: Confocal microscopes dedicated to the skin offer new perspectives for the diagnosis, optimization of treatments, and follow-up of the ocular diseases. They will allow dermatologists to examine conjunctival and eyelid tumors, as it is for skin or genital mucosa. In addition, thanks to some adaptations of the dermatological device VivaScope ® 1500, it is possible for the first time to perform a fluorsecnte examination of the ocular and peri-ocular tissue, opening a new era in the clinical imaging of the ocular surface. A new semiology remains to be learned.
-Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infectio... more -Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infection in humans. immunocompetent and immunocompromised patients both can be affected and Nocardia cyriacigeorgica was reported as a pathogen isolated in patients worldwide. in most cases, nocardiosis is present as pulmonary infection because inhalation is the primary way of bacterial exposure. Nocardial brain abscess occurs usually secondary to a septic focus elsewhere in the body. Considering the facts that the elderly population is growing, such as the number of immunocompromised patients together with high mortality rate in patients with nocardial infection of the central nervous system, we have to raise awareness of the possibility for this rare but potentially fatal condition. we present a case where nocardial abscesses of lung and brain were initially suspected as lung cancer with brain metastases. The patient was treated with a combination of surgical resection and antimicrobial therapy with good outcome.
Serbian Journal of Dermatology and Venereology, 2015
Ulerythema ophryogenes and keratosis follicularis spinulosa decalvans are rare folliculocentric k... more Ulerythema ophryogenes and keratosis follicularis spinulosa decalvans are rare folliculocentric keratotic disorders, from the group of follicular genokeratoses, characterized by keratosis pilaris atrophicans: follicular keratotic papules, sometimes with surrounding erythema, which eventually result in fibrosis, atrophy, progressive scarring and permanent hair loss. Ulerythema ophryogenes begins at birth or soon thereafter; it involves the lateral eyebrows, spreads medially and eventually affects the entire eyebrows, cheeks, and less frequently, forehead and asjecebt scalp. Involvement of the scalp has apparently not been reported in cases in which the eyebrows were predominantly involved. In addition to sporadic cases, ulerythema ophryogenes has been reported among relatives. Keratosis follicularis spinulosa decalvans is also a genetically heterogeneous syndrome which begins in infancy or childhood by involving hair bearing skin, especially the scalp; rarely it is confined to the fa...
Serbian Journal of Dermatology and Venerology, 2013
The authors present a case of a patient with extramammary Paget’s disease in the pubic region tre... more The authors present a case of a patient with extramammary Paget’s disease in the pubic region treated by a dermatologist with a private practice for almost 4 years before incisional biopsy was performed. A thorough examination showed no evidence of malignancies of internal organs, whereas definite diagnosis was made by excision of the entire skin lesion and histopathological analysis. With regard to multiple criteria, findings in our patient were consistent with current literature data, but interestingly, the primary extramammary Paget’s disease has not spread into deeper tissues.
Background: The best time to initiate concurrent chemoradioation (ChRT) with temozolamide after s... more Background: The best time to initiate concurrent chemoradioation (ChRT) with temozolamide after surgery in glioblastoma multiform (GBM) patients has not been clearly established. Our aim was to investigate whether survival is influenced by the time to ChRT in patients with different types of surgery. Methods: We conducted a retrospective study of all the patients treated in our centre from January 2005 to December 2017, with a histological diagnosed GBM, which underwent surgery and completed concurrent ChRT with temozolamide. The time to ChRT was grouped in 4 quartiles, and early ChRT was defined as happening during the first quartile. Surgery type was divided into resection (R) and biopsy (B). Survival at 12 months (OS12m), median progression free survival (mPFS) and overall survival (mOS) were calculated. Other relevant clinical factors were also analyzed. Results: From a total of 160 patients, 119 who completed ChRT were included. The median time to ChRT was 37 days, (Q1¼26, Q2¼37, Q3¼45); 35 (30%) received early ChRT (26 days). Patients who underwent R were 101 (85%) and 18 (15%) B. The mean age was 62y, 94 patients (79%) had PS 0-1, MGMT methylation was positive in 23 (19%). There were no significant differences between groups regarding Age, PS and MGMT status; but more patients treated with B received early ChRT (31% vs 8%). The OS12m was shorter for patients who underwent R and received early vs no-early ChRT (35% vs 73%, p ¼ 0.002). No differences in OS12m were found for B patients (0% vs 18%, p ¼ 0.4) according to time to ChRT. For patients who received early ChRT, the mOS was similar despite surgery type (9.9, 95% CI 9.6-11 vs 12.9, 95% CI 6.5-19.3, p ¼ 0.8, for R and B, respectively). But for patients who did not receive early ChRT, longer survival was achieved in the R vs B subgroup (16.2, 95%CI 14.1-17.8 vs 11.1, 95% CI 4.5-17.7, p ¼ 0.024, for R and B, respectively) and resection type remained significant in the multivariate analysis (HR ¼ 1.2, p ¼ 0.02). Conclusions: We have found that patients with GBM who underwent resection had a worse prognosis if they received early chemoradiation (26 days). No differences were found for biopsied patients. A no-early chemoradation approach for patients who underwent resection may be safe. Prospective studies are encouraged.
INTRODUCTION ecently, interest in the study of oral candidiasis has markedly increased mainly bec... more INTRODUCTION ecently, interest in the study of oral candidiasis has markedly increased mainly because of its association with human immunodeficiency virus (HIV) infection, but also due to its relation with potentially malignant lesions of oral mucosal. Many authors have studied the characteristics of oral mucosa in immunocompromised patients in order to find the differences in immunologic reactions to the development of candidiasis. There are a number of oral lesions that are clearly associated, more often than others, with either candidial infestation or frank invasion (1). The yeast-like fungus Candida albicans and a few other Candida species are capable of producing skin, mucous membrane, and internal infections. The organism lives with the normal flora of the mouth, vaginal tract, and gut, so the results of culture analysis must be interpreted carefully. Pregnancy, oral contraception, antibiotic therapy, diabetes, skin maceration, topical steroid therapy, certain endocrinopathies, and factors related to depression of cell-mediated immunity may allow the yeast to become pathogenic and produce budding spores and elongated cells (pseudohyphae) or true hyphae with septate walls. The yeast infects only the outer layers of the epithelium of mucous membrane and skin (the stratum corneum). The primary lesion is a pustule, the contents of which dissects horizontally under the stratum corneum
Benign osteoblastoma is an uncommon osteoblastic tumor with osteoid and bone deposition, characte... more Benign osteoblastoma is an uncommon osteoblastic tumor with osteoid and bone deposition, characterized cytologically by the abundant presence of osteoblasts. A 54-year-old man presented with a chief complaint of a painless swelling beneath the mandible, which was growing during the past 3 years.The clinical examination revealed the presence of a palpable tumor mass, which was fused by its one side to the left angle of the mandible, and its remainder was situated beneath the body of the mandible. Radiologic picture disclosed a well-circumscribed lesion ih which some parts were heavily calcified. After the surgial extirpation, the pathohistological diagnosis was a benign osteoblastoma of the mandible. The major problem for pathologists is the correct differentiation between benign osteoblasoma and a number of lesions that may have similar characteristics.
Serbian Journal of Dermatology and Venereology, 2020
Introduction. Nevus sebaceous is a rare congenital hamartoma, composed of epidermis, sebaceous gl... more Introduction. Nevus sebaceous is a rare congenital hamartoma, composed of epidermis, sebaceous glands, sweat glands and hair follicles. It is possible to develop secondary tumors in the area of nevus sebaceous during the lifetime, most often after puberty. Secondary lesions are most often benign, while malignant lesions may occur but significantly less frequently. Case report. We present the case of a 21-year-old patient who came for an examination due to the appearance of a nodule in the area of a yellowish lesion on the head. The yellowish lesion was present since birth, and the nodule appeared about a year before. The dermoscopic examination of the lesion was nonspecific. The final diagnosis of eccrine poroma as a secondary lesion in nevus sebaceous was made by pathohisto-logical analysis. Conclusion. Every secondary tumor in nevus sebaceous deserves full attention, with either close follow up, or excision with pathohistological analysis.
We report a case of congenital cytomegalovirus and Herpes simplex virus infection suspected via u... more We report a case of congenital cytomegalovirus and Herpes simplex virus infection suspected via ultrasound indicated by the presence of fetal cerebral abnormalities. The pregnancy was electively terminated at 31 weeks of gestation. The postmortem examination of the foetus showed brain with lissencephaly. The histopathological examination revealed numerous enlarged cells containing cytomegalic inclusions and multinucleated giant cells in multiple fetal organs and placenta. Documented evidence of histopathological detection of cytomegalovirus inclusions in multiple organs are very sparse in literature. This case highlights the causal relationship of viral infections in early pregnancy and abnormalities of the central nervous system.
Introduction. Congenital anomalies of the epididymis, detected either during orchiopexy or routin... more Introduction. Congenital anomalies of the epididymis, detected either during orchiopexy or routine herniectomy, as well as their importance in male fertility, have been described in many papers in clinical surgery. Clinical Considerations. The aim of this study was to report various types of epididymal congenital abnormalities registered in the clinical practice of pediatric surgery, to describe their basic characteristics and to classify them into three groups: (I) fusional anomalies of the epididymis and testis; (II) anatomic forms of anomalies; (III) congenital epididymal cysts. Conclusion. The clinical experience of pediatric surgeons indicates that during these surgical procedures, it is necessary to carefully examine the epididymis to detect anomalies, and it is of utmost importance to inform the patient and/or his parents. It is also recommended to follow the patients up to the age of fertility.
Introduction. Hypertensive ischemic leg ulcer, also known as Martorell ulcer, is not very rare, b... more Introduction. Hypertensive ischemic leg ulcer, also known as Martorell ulcer, is not very rare, but an under-recognized type of leg ulcer. It has specific clinical and histopathological characteristics. It occurs almost exclusively in patients with arterial hypertension. It is more common in women and in patients with type 2 diabetes. It is localized particularly in the laterodorsal distal third of the lower leg. This ulcer is extremely painful. Its clinical features may very much resemble pyoderma gangrenosum. Case Report. We are presenting a case of a 40-year-old obese male, who suffered from arterial hypertension during the past 26 years. His ulcer appeared spontaneously on the lateral aspect of the right lower leg and progressed gradually. From the very onset, the ulcer was extremely painful. At first, it was diagnosed as pyoderma gangrenosum and treated with systemic corticosteroids and immunosuppressants. Since the response to therapy was not satisfactory, the histopathology w...
Introduction: Pachydermodactyly is a very rare type of macrodactyly. It clinically resembles juve... more Introduction: Pachydermodactyly is a very rare type of macrodactyly. It clinically resembles juvenile rheumatoid arthritis, but it has a non-inflammatory etiology without bone, articular, or synovial involvement. Case Presentation: In this study, we report the case of a 15-year-old boy with repetitive behavior diagnosed with a pachydermodactyly after evaluation of bilateral swelling of the proximal interphalangeal joints. Histologic examination revealed epidermal hyperorthokeratosis, thickening of the dermis with increased dermal collagen and absence of inflammatory cells. Pachydermodactyly is a very rare condition associated with compulsive behavior and results from repetitive minor trauma that causes localized proliferation of fibrous tissue. Conclusions: Pachydermodactyly is a dermatological sign of compulsive behavior and repetitive minor trauma, and it should be distinguished from other forms of joint enlargement to avoid unnecessary medicamentous treatment. Control examinations did not reveal clinically relevant worsening even without any treatment applied.
At the end of the Second World War, the General State Hospital had seven departments, the same fa... more At the end of the Second World War, the General State Hospital had seven departments, the same facilities, and the same bed capacity as in the pre-war period. In the newly formed state of Yugoslavia, intensive growth and modernization of the hospital began, despite the great financial difficulties. The hospital became the Main Provincial Hospital and new departments and services were established. Mainly during the 1960s and 1970s, ten new surgery departments were established, which later became independent clinics. The surgery departments occupied pavilions 1, 2, 3 and 4. Complex and contemporary abdominal and thoracic surgeries were performed. The Department of Internal Diseases became the Clinic of Internal Diseases and in 1964 it was moved to a newly equipped four-story building. The Clinic of Gynecology and Obstetrics was founded and it was moved into a modern, purpose-built facility with a 230 bed capacity for adult patients and 105 for newborns. Rapid progress has also been ma...
Serbian Journal of Dermatology and Venereology, 2018
Syringoma is a benign adnexal tumor derived from intraepidermal eccrine ducts. The usual presenta... more Syringoma is a benign adnexal tumor derived from intraepidermal eccrine ducts. The usual presentation of syringoma is a small smooth skin-colored, yellowish or brownish papule with flattened or rounded top. Eruptive syringoma is a rarely reported form, where lesions are numerous and occur in successive crops. A case of a 57-year-old Caucasian male with a twenty four-year history of multiple asymptomatic, erythematous and brownish papules, predominantly over the anterior aspect of the trunk is presented. All lesions appeared after prolonged sun exposures within a few days and persisted without further changes afterwards. Contact non-polarized dermoscopy showed a fine light brown, regular pigment network on a light pink background, being the same in all lesions. History of the disease, clinical finding and dermoscopy were inconclusive, and biopsy was performed. Histopathology revealed signs of syringoma. Dermoscopic finding was thought to be intriguing and therefore is discussed in th...
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Papers by Nada Vuckovic