Introduction. Psoriasis is a chronic, inflammatory, immune-mediated skin disease. In addition to standard therapeutic modalities (antibiotics, cytostatics, phototherapy, photochemotherapy and retinoids), nonstandard methods can be used in the treatment of psoriasis. This includes balneotherapy which is most commonly used in combination with therapeutic resources. The aim of this research was to determine the length of remission of psoriasis in patients treated with standard therapeutic modalities, balneotherapy, and combined treatment (standard therapeutic modalities and balneotherapy). Material and Methods. The study analyzed 60 adult patients, of both sexes, with different clinical forms of psoriasis, who were divided into three groups according to the applied therapeutic modalities: the first group (treated with standard therapeutic modalities), the second group (treated with balneotherapy) and the third group (treated with combined therapystandard methods therapy and balneotherapy). The Psoriasis Area and Severity Index was determined in first, third and sixth week of treatment for all patients. The following laboratory analysis were performed and monitored: C reactive protein, iron with total iron binding capacity, unsaturated iron binding capacity and ferritin, uric acid, rheumatoid factors and antibodies to streptolysin O in the first and sixth week of treatment. Results. The average length of remission in patients treated with standard therapeutic modalities and in those treated with balneotherapy was 1.77 ± 0.951 months and 1.79 ± 0.918 months, respectively. There was a statistically significant difference in the duration of remission between the patients treated with combination therapy and patients treated with standard therapeutic modalities (p=0.019) and balneotherapy (p=0.032). Conclusion. The best results have been achieved when the combination therapy was administered. SažetakUvod. Psorijaza je hronična, inflamatorna, imunoposredovana kožna bolest. Pored standardnih terapijskih modaliteta (antibiotici, citostatici, fototerapija, fotohemoterapija i retinoidi), u terapiji se primenjuju i nestandardne terapijske metode kao balneoterapija, ali najčešće kombinacija više terapijskih sredstava. Cilj rada bio je da se utvrdi dužina remisije psorijaze kod pacijenata lečenih standardnim terapijskim modalitetima, balneoterapijom i kombinovanim lečenjem (standardnim terapijskim modalitetima i balneoterapijom). Materijal i metode. Analizirano je 60 odraslih pacijenata oba pola, obolelih od različitih kliničkih oblika psorijaze, podeljenih u tri grupe prema primenjenim terapijskim modalitetima: grupa I (lečena standardnim terapijskim modalitetima), grupa II (lečena balneoterapijom) i grupa III (lečena kombinovanim terapijskim modalitetima − standardnim metodama i balneoterapijom). Svim pacijentima smo određivali indeks procene težine psorijaze u 1, 3. i 6. nedelji lečenja. Pratili smo laboratorijske analize: C-reaktivni protein, gvožđe, ukupni kapacitet vezanog gvožđa, kapacitet vezivanja nezasićenog gvožđa, fe...

We present a 46-year-old non-atopic HIV-negative woman from Doboj, Republic of Srpska, Bosnia and Herzegovina, who was referred to the Department of Dermatovenereology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina, with a 3-month long history of an erythematous, large indurated infl amed area on the upper arm. The condition was asymptomatic, immediately following surgical excision of a small tumor. After exlusion of pulmonary blastomycosis and other organ involvement, the diagnosis of primary inoculation cutaneous blastomycosis was made based on clinical presentation and histopathological fi ndings. Histopathology revealed thick-walled, rounded, budding yeasts with broad-based buds that stained pink with periodic acid-schiff (PAS) staining. Itraconazole therapy was initiated at a dose of 2x100 mg/day. After three months of therapy, the dose of itraconazole was increased to 2x200 mg/day during the next three months, and then the dose was reduced to 2x100 mg. Blastomycosis is an uncommon, chronic granulomatous and suppurative mycosis caused by Blastomyces dermatitidis, which belongs to the group of main endemic systemic mycoses and in the great majority of cases represents a primary pulmonary disease. Few sporadic cases have been reported in Europe. There are three forms of blastomycosis: primary cutaneous, pulmonary and disseminated. B. dermatitidis has rarely been isolated from the environment. Wood debris or land close to rivers or subject to fl ooding are considered to be the natural substrate. The fungus can grow in sterile soil in the laboratory, and it is believed that humans get infected by inhaling spores from a saprophytic source. Primary cutaneous blastomycosis is very rare and it is found in farmers and laboratory workers. Human to human transmission does not normally occur. The diagnosis of the skin lesions is made by direct microscopy of skin samples (e.g., pus, scrapings) with 10% potassium hydroxide mount and confi rmed by culture or biopsy. Histopathological analysis provides identifi cation of all the dimorphic fungi. However, this can be complicated by the fact that in some cases they can be morphologically atypical or sterile. In the tissues, B. dermatitidis produces characteristic thick-walled, rounded, refractile, and spherical budding yeasts with broad-based buds. Of the available antimycotic drugs, itraconazole 200 mg/day is probably the most effective, but at least 400 mg/day is redommended initially.

Psoriasis is a chronic, immune-mediated inflammatory skin disease. The condition greatly affects people’s quality of life to the extent that it could be life-ruining and stigmatizing. A better understanding of psoriasis pathophysiology allowed the development of targeted therapies, including biologics and biosimilars which are recommended as an option for moderate to severe plaque psoriasis. Our results have shown that administration of biologics (adalimumab and secukinumab) and adalimumab biosimilar led to a significant improvement in the PASI response after 16 weeks. Most patients who have been treated for more than a year have the same PASI response.

Kratak sadržajUvod. U liječenju hronične urtikarije, osim standardnih protokola, može biti efikasna i primjena autohemoterapije. Cilj rada je utvrditi uspješnost autohemoterapije u liječenju hronične autoimunske urtikarije na težinu bolesti i prosječnu dužinu trajanja hronične urtikarije kod pacijenata liječenih u našoj ustanovi.Metode. Ispitivana su 64 bolesnika sa hroničnom urtikarijom tokom šest nedjelja. Ispitanici su podijeljeni u dvije grupe: 28 bolesnika sa autoimunskom hroničnom urtikarijom kojima su ordinirane standardna i autohemoterapija i 36 bolesnika sa idiopatskom hroničnom urtikarijom kojima je ordinirana samo standardna terapija. Terapijski uspjeh primjene autohemoterapije u liječenju hronične urtikarije smo pratili pomoću skora težine urtikarije (engl. Urticaria Severity Score -USS). Takođe, odredili smo prosječnu dužinu trajanja urtikarije. Za statističku analizu korišćeni su Mann-Whitney i Friedman-ov test, za nivo značajnosti razlike manje od 5%.Rezultati. Poređenjem vrijednosti USS utvrđena je statistički značajna razlika u visini nedjeljnog USS na početku i na kraju ispitivanja kod obje grupe bolesnika: kod bolesnika sa autoimunskom hroničnom urtikarijom (χ 2 = 122,130, p< 0,001) i kod bolesnika sa idiopatskom hroničnom urtikarijom (χ 2 = 137,827, p<0,001). Poređenjem vrijednosti USS između grupa bolesnika tokom prvih pet nedjelja praćenja nije utvrđena statistički značajna razlika. Međutim, u šestoj nedjelji je nađena statistički značajna razlika u USS između ispitivanih grupa (p = 0,032). Kod bolesnika sa autoimunskom hroničnom urtikarijom i idiopatskom hroničnom urtikarijom prosječna dužina trajanja urtikarije približno je iznosila 20 mjeseci i nema statistički značajne razlike u dužini trajanja urtikarije između grupa (p = 0,978).Zaključak. Autohemoterapija se pokazala efikasnom i uspješnom u liječenju autoimunske hronične urtikarije u odnosu na standardne protokole liječenja hronične urtikarije, ali ne utiče na dužinu trajanja urtikarije.