<abstract xmlns="http://www.w3.org/1999/xhtml">Systemic scleroderma (SSc) is a multisystem disease with microvascular abnormalities, autoimmune disorders, excessive collagen production and deposition, and fibrosis of the skin and internal organs. According to the simplest, though incomplete classification, there are two forms of SSc: diffuse and limited (formerly acrosclerosis). CREST syndrome is a subtype of limited SSc, characterized by: calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia. We present a patient with all the features of the CREST syndrome, which appeared at the age of 43 and lasted for 23 years. The patient presented with a gradual development of symptoms during the first ten years, from Raynaud’s phenomenon, skin sclerosis, calcinosis, telangiectasia, and esophageal dysmotility. The diagnosis was based on clinical findings and relevant diagnostic procedures. The article presents a literature review on the epidemiology, etiology, pathophysiology, clinical manifestations, various attempts at classification, diagnostic criteria, and therapeutic modalities.When classifying systemic scleroderma into two main types — diffuse and limited, with CREST syndrome as a variant of the latter, it should be pointed out that both types represent clinical forms of systemic sclerosis, share similar visceral involvement, laboratory abnormalities and course which is variable, as was the case in our patient.</abstract>

Medical Faculty, University of Niš, Serbia

Clinic of Skin and Venereal Diseases, Clinical Center of Niš, Serbia2

CREST Syndrome - a Limited Form of Systemic Scleroderma: a Case Report and Literature Review

<abstract xmlns="http://www.w3.org/1999/xhtml">The World Health Organization (WHO) estimated that in 2008 there were 106.1 million newly registered cases of gonorrhea among adults worldwide. Of these cases, 3.4 million were in the WHO European Region. In the European Union and European Economic Area, the overall incidence of reported cases was 15.3 per 100.000 population in 2012; the highest rate (45.4 per 100.000) was observed in the United Kingdom, while low rates (&lt;5 per 100.000) were generally reported in the Central and Eastern Europe. In 2012, low incidence of gonorrhea (1.49/100.000) was reported in Serbia, as well.The purpose of this study was to report on the epidemiology of gonorrhea in a Belgrade population (about 1.5 million inhabitants) during the period 2010 - 2014, and to discuss data on gonorrhea rates in the European Union.In Serbia it is mandatory to report gonorrhea, and all reports of culture-proved gonorrhea are sent to the City Institute for Public Health in Belgrade. These reports were used as the source for data analysis of gonorrhea incidence. Incidence rates were calculated using data from the 2011 population census in Serbia for Belgrade population. Age-adjusted annual incidence rates were carried out by a direct method using the “world population” as a standard.During the 2010 - 2014 period, the average gonorrhea incidence in Belgrade population was 9.2 per 100.000 in men, and 1.9 per 100.000 in women. The incidence was highest in men and women aged 20 - 29 years. In all age groups gonorrhea incidence was higher in men than in women, the average male/female ratio being 4.8. In both sexes, the incidence of gonorrhea was highest in persons who had never married, with secondary education and unemployed. Out of 357 men with gonorrhea, 92 (25.77%) were self-reported homosexuals.</abstract>

City Institute for Skin and Venereal Diseases, Belgrade, Serbia

Institute of Epidemiology, School of Medicine, University of Belgrade, Belgrade

City Institute for Public Health, Belgrade

The Incidence of Gonorrhea in Belgrade in the Period 2010 - 2014

<abstract xmlns="http://www.w3.org/1999/xhtml">Human immunodeficiency virus type 1- infected patients with syphilis are among the most important transmitters of HIV-1 infection due to biological effects of genital ulcerations, and aggravation due to their continued risky behavior. The association between primary syphilis and acute HIV-1 co-infection is not well documented, and reports on isolated cases are raising special interest and indicate that this double primary co-infection may occur. We present a case of a 31-year-old man with no past medical history who presented with fever, papular rash on the face which lasted for a few days, and a single genital ulcer. He was diagnosed with primary syphilis and primary HIV-1 infection after a single exposure with an infected female sex worker. Male-to-female HIV transmission during vaginal intercourse is significantly more likely than female-to-male HIV transmission. However, high prevalence of sexually transmitted diseases among female sex workers contributed to high HIV transmission probability, as in our case.As far as the available world literature is concerned, this is the first case of co-infection of primary syphilis and HIV.</abstract>

Co-infection of Primary Syphilis and HIV after a Single Exposure - a Case Report

<abstract xmlns="http://www.w3.org/1999/xhtml">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 face involving only eyebrows and eyelashes, but affects predominantly the scalp, leading to severe progressive cicatricial alopecia. Both conditions tend to progress until puberty.The authors present a case of an otherwise healthy 19-year-old male patient, with absence of lateral eyebrows since childhood, which spread symmetrically and medially, until puberty affecting the entire eyebrows, whereas the eyelashes were completely spared. On examination, skin findings on the face, trunk and extremities pointed to ulerythema ophryogenes: apart from hair loss, the lateral eyebrows were highly erythematous; a great number of disseminated follicular, slightly keratotic papules (keratosis pilaris) pin- or match-head sized, were seen on the trunk, extensor surface of the arms and legs, as well as the buttock, and on palpation the skin felt like a “nutmeg grater”. However, follicle-based erythematous papules (focal patchy alopecia) were found not only along the eyebrows but also partly in the parietal capillitium forming focal patchy alopecia, which is a finding characteristic for keratosis follicularis spinulosa decalvans; the histopathological analysis of the biopsy specimens taken from the parietal capillitium has confirmed the clinical diagnosis.Cytogenetic analysis showed no karyotypic abnormalities. Family history showed that the patient’s mother and maternal grandfather also suffered from hair loss especially of the lateral eyebrows.This paper presents an overlap between two rare follicular genokeratoses in a young male with a positive family history, who presented with ulerythema ophryogenes involving not only the eyebrows, but also the scalp, in the form of parietal, focal cicatricial patchy alopecia.</abstract>

Faculty of Medicine, University of Novi Sad, Serbia

Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Republic of Serbia

Center of Pathology and Histology, Clinical Center of Vojvodina, Novi Sad, Republic of Serbia

Overlap Between Ulerythema Ophryogenes and Keratosis Follicularis Spinulosa Decalvans: a Case Report

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Serbian Journal of Dermatology and Venereology

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