Long-term drug survival and predictor analysis of the whole psoriatic patient population on biological therapy in Hungary.

Persistence is an important component of therapeutic success, which depends on a variety of factors. Persistence measured under optimal conditions during clinical trials does not necessarily coincide with persistence observed in the real-world settings. The aim of the present study was to compare persistence rate of TNF-alpha inhibitors and interleukin 12/23 inhibitor in all psoriasis patients in Hungary, as well as to analyze the predictors of persistence.

Histopathological aspects and differential diagnosis of CD8 positive lymphomatoid papulosis.

Lymphomatoid papulosis (LyP) belongs to CD30+ lymphoproliferative disorders with indolent clinical course. Classic histological subtypes, A, B and C are characterized by the CD4+ phenotype, while CD8+ variants, most commonly classified as type D, were reported in recent years. We present 14 cases of CD8+ LyP.

Long-term results of the Sauvé-Kapandji procedure in the rheumatoid wrist.

This retrospective long-term study evaluates the clinical and radiological results of the Sauvé-Kapandji procedure in rheumatoid wrists. Fourteen patients with rheumatoid arthritis who had undergone a Sauvé-Kapandji procedure were examined 10 to 16.5 years after surgery.

[Dermatoses of pregnancy].

Pregnancy is associated with hormonal, metabolic, immunologic, haemodynamic and vascular changes which produce physiological and pathological cutaneous manifestations. Most skin disorders during pregnancy represent physiological changes. The specific dermatoses of pregnancy are disease entities almost exclusively related to the pregnancy or the postpartum period.

[The pathomechanism of polycystic ovary syndrome in the light of recent research findings].

The author summarizes the factors which play a role in the development of polycystic ovary syndrome highlighting the impact of intrauterine genetic programming and the importance of the maternal steroid environment. Environmental effects, steroid receptor modulators, endocrine disruptor compounds, and the role of obesity in the development of polycystic ovary syndrome are also discussed.

[Management of the common European viper's bite--a case report].

The common European viper is widespread throughout Europe. In Hungary it can be found mainly in the Zemplén Mountains, on the upper course of the Tisza River, and Zala and Somogy counties. Viper's bite is one of the rarest injuries that requires emergency medical care.

[Adverse events during biological therapy -- focusing on dermatological side-effects].

Unlabelled: Biological response modifiers, especially tumour necrosis factor inhibitors have been proved to be very effective in the treatment of various immune mediated rheumatological, gastroenterological and dermatological diseases in the last 15 years. With their increasing use, the incidence of their adverse effects are more precisely defined. The aim of this cohort study was to analyse the adverse effects occurred within the study period in patients receiving biological therapy for rheumatological and dermatological autoimmune diseases.

Combined high tibial osteotomy decreases biomechanical changes radiologically detectable in the sagittal plane compared with closing-wedge osteotomy.

Purpose: The purpose of this randomized, prospective study was to compare radiologic changes in the sagittal plane after closing-wedge and combined high tibial osteotomies (HTOs) performed in patients with medial knee arthrosis associated with a varus deformity and requiring a 10 degrees correction.

Methods: The patellar height, determined by the Insall-Salvati index (ISI), and tibial slope (TS) angle, measured by the Dejour-Bonnin method, were compared after 45 closing-wedge osteotomy (CWO) and 46 combined osteotomy (CO) procedures. CO is a relatively new technique effectively being the combination of closing-wedge and opening-wedge HTOs.

Once weekly administration of etanercept 50 mg is efficacious and well tolerated in patients with moderate-to-severe plaque psoriasis: a randomized controlled trial with open-label extension.

Background: In previous studies, etanercept 25 mg twice weekly (BIW) or 50 mg BIW significantly reduced disease severity in patients with plaque psoriasis and demonstrated a favourable safety profile.

Objectives: To assess the efficacy and safety of etanercept 50 mg administered once weekly (QW) compared with placebo in patients with moderate-to-severe plaque psoriasis over 24 weeks.

Methods: This study was conducted in two parts: (i) a 12-week, double-blind, placebo-controlled phase, in which patients received etanercept 50 mg QW or placebo QW; and (ii) a 12-week, open-label extension phase, in which all patients received etanercept 50 mg QW.

Clinical, histopathological, immunophenotypic and molecular analysis of 60 patients with cutaneous T-cell infiltrates with follow up of indeterminate cases to identify T-cell lymphoma.

Diagnosis of primary cutaneous T-cell lymphomas, especially of mycosis fungoides could be difficult in early stage due to clinical and histopathological similarity to reactive inflammatory dermatoses. To assess diagnostic value of complex histological, immunophenotypic and T-cell receptor gamma gene rearrangement analysis, skin biopsy specimen and peripheral blood samples of 60 patients with suspected cutaneous T-cell lymphoma were analyzed. Our results indicate clear distinction between reactive dermatoses (benign cases, n = 31) and cutaneous T-cell lymphomas (lymphoma cases, n = 17).

The patella and tibial condyle position after combined and after closing wedge high tibial osteotomy.

High tibial osteotomy changes the patella and tibial condyle position, which makes the subsequent total knee replacement technically demanding. From 1 January 1993 to 31 December 2000, combined osteotomy [After the first osteotomy made 2 cm distally to the joint line, a bone wedge is removed based laterally. Its tip ends at the center of the tibial condyle (half bone wedge).

[Urticaria and Quincke's edema].

Urticaria and Quincke's edema is the most common cutaneous disease encountered in general medicine and dermatology. The symptoms are caused by vasoactive mediators released by mast cells following immunological or nonimmunological stimuli. Diagnosing the disease can be difficult, especially if the symptoms are chronically present and only barely react to treatment.

Bilateral blepharochalasis.

Blepharochalasis is a rare disorder characterized by recurrent painless periorbital oedema, which leads to atrophy of the periorbital skin. Pathomechanism of the disease is probably immunological with a nearly complete loss of elastic fibres. The authors describe a 17-year-old woman, who was followed for 7 years.

[Diagnosis, care, and therapeutic possibilities in intravascular B-cell lymphoma--a case report].

The cutaneous angiotropic lymphoma has a poor prognosis. The diagnosis and the treatment are usually late. The mortality rate is over 80% and the majority of patients die within a year because of the tumorous infiltration of parenchymal organs.

[Complex histologic, immunophenotypic and molecular genetic investigation in cutaneous T-cell lymphoproliferative diseases].

Diagnosis of cutaneous T-cell lymphomas, especially of mycosis fungoides is often difficult in the early stage of the disease, as well as their differentiation from other reactive inflammatory dermatoses. The diagnostic exactness could be improved by the simultaneous histological, immunophenotypic and gene rearrangement analysis of the skin biopsy specimen, and these results together with the clinical findings could help to establish the early diagnosis. Using this complex analysis effective treatment can be started in time and repeated skin biopsies are not always necessary.

Large B-cell lymphoma of the leg in a patient with multiple malignant tumours.

A patient who had primary gastric B-cell non-Hodgkin's lymphoma, invasive ductal breast cancer and a basocellular carcinoma of the forehead in her medical history was studied. Three years after polychemotherapy and irradiation of the breast cancer, a rapidly enlarging, ulcerated violaceous tumour developed on the patient's left leg. The tumour was identified by the histopathological, immunohistochemical and immunoglobulin gene rearrangement analyses as a cutaneous large B-cell lymphoma.

Intravascular B-cell lymphoma.

Intravascular (angiotropic) lymphoma is a unique and rare cutaneous lymphoma in which the malignant T or B lymphoid cells proliferate within the lumens of small blood vessels, primarily in the skin and central nervous system. Erythematous, tender nodules, tumors, and telangiectases are the most common skin symptoms in addition to various neurologic signs. Progression of the disease produces secondary organ involvement with variable symptoms and can be fatal.

[Paraneoplastic dermatoses].

Paraneoplastic dermatoses are important cutaneous markers of internal malignancies. They form a heterogenous group of skin diseases, where tumor induced immunologic factors, hormones, metabolic disorders and epidermal growth factor may play a role in the onset of the symptoms. The paraneoplastic skin disorder frequently refers to the type, localization and prognosis of the underlying tumor.

[Angioneurotic edema induced by angiotensin converting enzyme inhibitors].

Angioneurotic oedema is one of rare side effects of angiotensin converting enzyme inhibitors, its incidence is around 0.1-0.2%.

[Dermatologic aspects of SAPHO-syndrome].

SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis) as a new disease entity was first described in 1987. The syndrome is characterized by the presence of pustular dermatoses together with aseptic osteoarticular lesions. The bone involvement includes hyperostosis, aseptic osteomyelitis or arthritis of the anterior chest wall, sacroiliac joints or long bones.

[New aspects in the classification of cutaneous lymphomas].

Authors discuss the classification of primary cutaneous lymphomas created by the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer (EORTC) in 1996, which is based on the clinical, histological, immunohistochemical and genetic features of cutaneous lymphomas. Unlike the previous histologic classifications it contains well-defined disease entities characterized by their clinical and histological picture, clinical outcome, behaviour and therapeutic response. This classification does not use the term of low grade or high grade lymphoma, but introduces the indolent, aggressive and provisional subgroups in the T-cell lymphomas, and indolent, intermediate and provisional subgroups in the B-cell group.

[Cutaneous and mucosal manifestations of inflammatory bowel diseases].

The rheumatological, ophthalmological- and dermatological complications are the most common ones among the extraintestinal manifestations of inflammatory bowel diseases (IBD). The incidence of skin manifestations is estimated to be 15-20% in case of Crohn's disease and 10% in case of ulcerative colitis. The so called specific lesions (perianal fissures, metastatic Crohn's disease), which are part of the skin symptoms associated with IBD, show a intimate connections with the bowel disease itself, as they histologically show granulomatous inflammation with epitheloid cells, similar to the ones seen in the intestines.

[Cutaneous manifestations of strongyloidosis].

Strongyloidiasis is a parasitic disease, caused by Strongyloides stercoralis, an intestinal nematode, which is mainly endemic in tropical and subtropical regions. It can be sporadically found in the temperate zone, especially in closed communities and among people living under bad social conditions. Gastrointestinal, pulmonary and cutaneous symptoms may arise during the migration of the larvae.