Psorijaza je kronična kožna bolest koja se manifestira eritematoznim plakovima prekrivenim bjeličastim ljuskama. Pretpostavlja se da od psorijaze u svijetu boluje 120-180 milijuna ljudi (1). Etiologija je nepoznata, ali se smatra da je psorijaza multifaktorski uzrokovana bolest koja nastaje složenom i dinamičnom interakcijom genetskih, okolinskih i imunoloških faktora. Stres se smatra najvažnijim i najjačim provocirajućim faktorom, koji utječe na pojavu, kao i na pogoršanje postojeće psorijaze. Istraživanja su pokazala da je psihološki stres prethodio pojavi psorijaze u 44 %, a doveo do pogoršanja psorijaze u 88 % bolesnika (2,3). Saznanje da boluju od psorijaze, njena neizliječivost, kronicitet i nepredvidljivost, praćena pogoršanjima, raširenost i prisutnost promjena na vidljivim dijelovima tijela, mogućnost pojave psorijaze i u mlađih osoba, kao i razvoj pridruženih bolesti utječu na i zičko i psihičko zdravlje, radnu sposobnost i produktivnost, društvene aktivnosti i uopće na kvalitetu i način života oboljelih (4). Psorijaza se, osim sa svojim dobro poznatim i najčešćim pratiteljem, psorijatičnim artritisom, često pojavljuje udružena i s drugim bolesnim stanjima, tzv. komorbiditetima, od kojih su najprominentniji kardiovaskularni i metabolički komorbiditet koji su najčešći faktori pogoršanja kvalitete života i skraćenja životnog vijeka pacijenata sa psorijazom (5). U odnosu na opću populaciju oboljeli od psorijaze imaju veću učestalost metaboličkog sindroma, a bolesnici s težim oblikom psorijaze imaju veći izgled za razvoj metaboličkog sindroma u odnosu na one s blažim oblikom KVALITETA ŽIVOTA OBOLJELIH OD PSORIJAZE U ODNOSU NA TEŽINU KLINIČKE SLIKE I PRISUTNOST KOMORBIDITETA

By the quantitative dermatoglyphic analysis we have made research in 25 variables in number of epidermal ridges on palms and fingers in forty male patients with primary hypertophic osteoarthorpathy: on all ten fingers, on five fingers separately and their sum all to gether, between triradii a-b, b-c and c-d on one hand and both palms, their sum on one and both palms and atd angles on one and both hands and their sum all together. Obtained data were compared with control group of 200 healthy men from the Zagreb region in Croatia. Statistically significant differences to control by t-test we have found in 13 variables in the sense of increasing of number of epidermal ridges on second right finger their sum on five and both hands, then first, second, third,  foruth and fifth finger left hand, then between triradii a-b of left hand. Decreased were atd angles on right and left palm, and both in degrees. Accordingly a polygenic system identical in some loci to polygenic system predisposing to male patients with primary hypertrophic osteoarthropathy might be found responsible for dermatoglyphic pattern development

: By the quantitative dermatoglyhic analysis we have made research in 25 variables in number of epidermal ridges on palms and fingers in fifty female psoriatic monoarthritis patients: on all ten fingers, on five fingers separately and their sum all together, between triradii a-b, b-c and c-d on one and both palms, their sum on one and both palms and atd angles on one and both  hands and their sum all together in degrees. Obtained date were compared with control group of 200 healthy women from the Zagreb area in Croatia. Statistically significant difference to control by t-test, we have found in 15 variables in the sense of increasing number of epidermal ridges: on each  of ten fingers, their sum on five and all together both , then between triradius b-c of both palms and all together between triradii a-b, b-c and c-d on right palm then decreasing atd angle on left palm in degrees. Accordingly a polygenetic system identical in some loci to polygenetic system predisposing to female psoriatic monoarthritis susceptibility might be found responsible for dermatoglyphic pattern development.

By the quantitative dermatoglyphic analysis, which is one the genetic method, was performed research in seventy male psoriatic patients to evaluation of genetic factors in the disease. Twenty five variables were determined: ridge count on each of ten fingers, their sum on five and ten fingers, four traits on each palm, i.e. ridge count between a-b, b-c and a-d triradii, their sum on each and both palm and atd angle on both palm and their bilateral sum in degrees. The data thus obtained were compared with digitopalmar prints of 200 phenotypically healthy men in Zagreb area, which are kept at Institute of Anthropology in Zagreb, who served as a control group. The statistically significant differences to control group, by the Student’s t-test, were found in sixteen variables. Ridge count was increased on the first, second, third, fourth and fifth finger bilaterally, and their sum on  each, and both fists. The atd angle of both palm was reduced and in overall sum. Accordingly, a polygenic system – a few major genes with a lot of modification genes – are identical in some loci in predisposing to male psoriasis patients susceptibility, and might be found responsible for the dermatoglyphic pattern development.

Introduction: Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including the metabolic syndrome. Examinees and methods: A prospective study has been conducted which included 70 patients affected by psoriasis, both genders, older than 18 years. Average age being 47,14 (SD=±15,41) years, from that there were 36 men or 51,43 and 34 women or 48,57%. The average duration of psoriasis was 15,52 (SD= ±12,54) years. For purposes of diagnosing the metabolic syndrome, the criteria of National Cholesterol Education Program Adult Treatment Panel III, (NCEP ATP III) were used. For purposes of detecting the severity and spread of psoriasis, Psoriasis Area and Severity Index (PASI) was used. Results: The incidence of metabolic syndrome in patients with psoriasis was 38,57%. Average values of PASI score were 16,65. The increase in values of PASI score and metabolic syndrome were statistically highly connected. (r=0,3, p=0,0001). Conclusion: Psoriasis is connected with metabolic syndrome, there is a positive correlation between the severity of psoriasis and frequency of metabolic syndrome.

Introduction: Psoriasis is a chronic skin ailment, which can be connected with other ailments including dyslipidemia. Examinees and methods: Research included 70 patients affected by psoriasis. Both genders, above 18 years of age. Average age of the respondents was 47.14 (SD= ±15.41), which consisted of 36 men (51.43%) and 34 women (48.57%). The average duration of psoriasis was 15.52 (SD= ±12.54) years. Results: Frequency of dyslipidemia on those affected by psoriasis was 62.85%. Most often it was hypertriglyceridemia (39%) and hypertriglyceridemia with a lowered value of HDL (36%), average age of those affected by psoriasis with dyslipidemia was 48.76 years (SD= ±14.72), and the average duration of the basic disease was 16.15 years (SD= ±12.63), the average values of the PASI score were 16.65. Increase in values of PASI score and dyslipidemia were statistically significantly connected (r=0.41; p=0.0001). Conclusion: Psoriasis is connected with dyslipidemia.

Introduction: Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including high blood pressure. Examinees and methods: A prospective study has been conducted which included 70 patients affected by psoriasis, both genders, older than 18 years. Average age being 47,14 (SD= ±15,41) years, from that there were 36 men or 51,43 and 34 women or 48,57%. Average duration of psoriasis was 15,52 (SD=±12,54) years. Results: Frequency of high blood pressure in those affected by psoriasis was 54,28%. Average age of the patients with psoriasis and high blood pressure was 53,79 year (SD=±14,15) and average duration of psoriasis was 17,19 years (SD=±13,51). Average values of PASI score were 16,65. Increase in values of PASI score and high blood pressure were statistically highly related (r=0,36, p=0,0001). Conclusion: Psoriasis was related to high blood pressure and there was a correlation between the severity of psoriasis and high blood pressure.

Incidence rate of skin tumours, both, non-melanoma and melanoma, is increasing nowadays. Various etiological factors are of relevance for the occurrence of the diseases. The solar radiation, as well, long-term exposure to ultraviolet (UV) radiation, have the greatest impact on development of these skin tumours. Non-melanoma skin tumours, Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), are the most common skin tumours in humans, and usually develop on the chronically photo-exposed areas. As for the Malignant Melanoma (MM), one of the most aggressive skin tumours, the exposure to solar radiation also plays an important role. This study investigates the correlation between the skin tumours and UV radiation in the area of West Herzegovina, on the sample of 1676 patients. It presents the occurrence of skin tumours in the period from 1997 to 2003. The study investigates the incidence and the risk factors separately for every skin tumour which can be etiologically related to the occurrence of skin tumours and UV radiation: occupation, exposure to UV radiation, skin type, and family history on malignan tumours within the patient's family. The exact incidence rate of non-melanoma and melanoma skin tumours in Bosnia and Herzegovina is still unknown, for the reason that the united National Cancer Register does not exist yet.

OBJECTIVE To determine the quality of life in adolescents with acne vulgaris in relation to the severity of clinical picture and sex using the Skindex-29 general questionnaire. PATIENTS AND METHODS Using a sectional study, the quality of life was analyzed in 90 adolescents of both sexes, aged 16 to 21 years, who were suffering from acne vulgaris. The study was conducted between January 1, 2008 and January 31, 2009, at Department of Dermatovenereology, Dr. Irfan Ljubijankić Cantonal Hospital in Biha6. According to the type of efflorescence, its localization and severity of clinical features, respondents were classified in three groups: group 1 consisted of adolescents with acne comedonica, group 2 with acne papulopustulosa, and group 3 with acne conglobata. The quality of life in these adolescents suffering from acne vulgaris was evaluated by using the general Skindex-29 questionnaire consisting of 30 questions grouped into three scales (scale of emotions, symptom scale, and scale of social and physical functioning) about the psychological impact of acne on the quality of life. RESULTS In the study group, there were 54 (60%) female and 36 (40%) male respondents, mean age 17.5 (range 15.6-20.6) years. Of the total number of patients with acne vulgaris, nine (4 female and 5 male; 10%) had acne comedonica (group 1), 72 (46 female and 26 male; 80%) acne papulopustulosa (group 2) and nine (4 female and 5 male; 10%) acne conglobata (group 3) (p > 0.95). Skindex-29 values expressed as mean +/- SD or median (range) in groups 1,2 and 3 were as follows: on the scale of emotions 43.1 +/- 22.2, 60.4 +/- 20.1 and 52.5 +/- 28.7 (p = 0.084); on the scale of symptoms 26.5 +/- 15.4, 49.0 +/- 20.5 and 42.95 +/- 26.1 (p = 0.039); and on the scale of functioning 23.4 +/- 24.6, 36.0 +/- 23.2 and 34.8 +/- 30.9 (p = 0.341), with cumulative score of 31.0 +/- 10.5, 47.5 +/- 12.0 and 43.44 +/- 8.8 (p = 0.069), respectively. Skindex-29 values were expressed as median (range) in women and men in all three groups, as follows: women, scale of emotions 44.0 (27.5-60), 64.0 (10-90) and 62.5 (5-83) (p = 0.25); scale of symptoms 32.7 (21.5-42.4), 54.2 (17.6-90) and 63.5 (17.8-92) (p = 0.17); scale of functioning 22.2 (2-46.5), 39.2 (0-90) and 51.6 (0-83) (p = 0.31); and men, scale of emotions 30.0 (22.5-90), 55.5 (7.5-100) and 40.2 (30-97.5) (p = 0.26); scale of symptoms 11.9 (4-50), 54.0 (0-75) and 28.5 (17.8-42.8) (p = 0.003); and scale of functioning 13.0 (5-77), 31.7 (0-84) and 14.6 (4.5-72.9) (p = 0.58). CONCLUSION Acne vulgaris affects the quality of life in adolescents involved regardless of the severity of the clinical picture, with a pronounced impact in women.

Objective. To determine anxiety and depression levels inadolescents with acne vulgaris in relation to clinical severityand gender. Patients and methods. Using a sectional study,the anxiety and depression level was analyzed of 90 adolescentsof both sexes, aged 16 to 21 years, who were sufferingfrom acne vulgaris. The study was conducted between February1st 2008 and January 31st 2009 at the Dermatovenerologydepartment of the Cantonal Hospital “Dr. Irfan Ljubijankic”,Bihac. According to the type of efflorescence, its localizationand severity of clinical features, respondents were classifiedin three groups: the first group consisted of adolescents withmild forms of acne, the second group had moderate formsof acne and the third had severe forms of acne. Evaluationof anxiety levels in patients with acne vulgaris was made usingSTAI questionnaire (Spielberger’s state and trait AnxietyInventory) that consists of 20 questions about the essentialcharacteristics of anxiety as the condition, and the level ofdepression was determined using the BDS-scale (Back DepressionInventory) which consists of 18 items that were usedby the respondents to perform self-evaluation of depressionlevel. Results. In the study group there were 54 (60%) femalerespondents and 36 (40%) male, mean age 17.5 years (range15.6-20.6). Of the total number of patients with acne vulgaris,nine of them or 10% (4 female and 5 male) had a mild form ofacne (first group), 72 of them or 80% (46 female and 26 male)a moderate form of acne (second group) and 9 of them or 10% (4 female and 5 male) a severe form of acne (third group)(p > 0.95). 1.1% of the respondents had an exceptionally lowanxiety level, 13.3% had low level, moderate 76.8% and 8.8%had a high level. 37.8% had distinct signs of depression, therisk group consisted of 44.4%, and a normal value was foundin 17.7%. The values of the STAI questionnaire expressed asmedian (range) in the first, second and third groups were 58.7(39-70), 57.7 (20-70) and 60.2 (40-70) (p = 0.36), while thevalues of the BDS scale within the same groups were 13.4 (8-16), 15.1 (3-29) and 14.4 (7-24) (p = 0.367). Conclusion. Thelevel of depression and anxiety in patients with acne vulgarisis not related to severity and patient sex.

Objective. To determine anxiety and depression levels inadolescents with acne vulgaris in relation to clinical severityand gender. Patients and methods. Using a sectional study,the anxiety and depression level was analyzed of 90 adolescentsof both sexes, aged 16 to 21 years, who were sufferingfrom acne vulgaris. The study was conducted between February1st 2008 and January 31st 2009 at the Dermatovenerologydepartment of the Cantonal Hospital “Dr. Irfan Ljubijankic”,Bihac. According to the type of efflorescence, its localizationand severity of clinical features, respondents were classifiedin three groups: the first group consisted of adolescents withmild forms of acne, the second group had moderate formsof acne and the third had severe forms of acne. Evaluationof anxiety levels in patients with acne vulgaris was made usingSTAI questionnaire (Spielberger’s state and trait AnxietyInventory) that consists of 20 questions about the essentialcharacteristics of anxiety as the condition, and the level ofdepression was determined using the BDS-scale (Back DepressionInventory) which consists of 18 items that were usedby the respondents to perform self-evaluation of depressionlevel. Results. In the study group there were 54 (60%) femalerespondents and 36 (40%) male, mean age 17.5 years (range15.6-20.6). Of the total number of patients with acne vulgaris,nine of them or 10% (4 female and 5 male) had a mild form ofacne (first group), 72 of them or 80% (46 female and 26 male)a moderate form of acne (second group) and 9 of them or 10% (4 female and 5 male) a severe form of acne (third group)(p > 0.95). 1.1% of the respondents had an exceptionally lowanxiety level, 13.3% had low level, moderate 76.8% and 8.8%had a high level. 37.8% had distinct signs of depression, therisk group consisted of 44.4%, and a normal value was foundin 17.7%. The values of the STAI questionnaire expressed asmedian (range) in the first, second and third groups were 58.7(39-70), 57.7 (20-70) and 60.2 (40-70) (p = 0.36), while thevalues of the BDS scale within the same groups were 13.4 (8-16), 15.1 (3-29) and 14.4 (7-24) (p = 0.367). Conclusion. Thelevel of depression and anxiety in patients with acne vulgarisis not related to severity and patient sex.

Introduction: Melanoma is a malignant tumor of melanocytes and it is the most malignant tumor of skin and mucous membranes. We do not have any data about incidence and characteristics of skin melanoma in Bosnia and Herzegovina. Aim: We aimed to analyze hospital records on skin melanoma cases from the region of Tuzla during the 5-year period in order to obtain preliminary data about melanoma incidence and clinical characteristics. Patients and methods: This retrospective study included all patients surgically treated at the University Clinical Center Tuzla, from January 2001 to December 2005, who were initially diagnosed with skin melanoma. Results: Most of pathologically verified skin melanoma, disregarding primary tumor (T), were presented in both genders at stage T4 (41.67 %) and T2 (28.33 %). Histological analysis showed that the majority of observed skin melanoma were diagnosed in Clark level III (36.36 %) and Clark level IV (33.33 %) stage. The average tumor thickness of the examined sample, according to Breslow’s classification, was found to be over than 4.0 mm. Conclusion: Our findings are similar to those reported in other countries in the region. Further studies are necessary in order to asses the burden of the disease in the national level. A national melanoma register is of great importance for further surveilance.

Objective – To determine the quality of life for adolescents with acne vulgaris in relation to clinical severity and sex.  Patients and methods – Using a sectional study the quality of life has been analyzed for 90 adolescents of both sexes, aged 16 to 21 years, who were suffering from acne vulgaris. The study was conducted between January 1st 2008th and January 31st 2009th at the Dermatovenerology department of the Cantonal Hospital » Dr. Irfan LjubijankiA‡ « , Bihac. According to the type of efflorescence, its localization and severity of clinical features, respondents were classified in three groups: the first group were the adolescents with Acne comedonica, the second group had Acne papulopustulosa and the third one had Acne conglobata. Evaluation of quality of life in these adolescents suffering from acne vulgaris was conducted with a specific CAD index (Cardiff Acne Disability Index), consisting of five questions about the psychological impact of acne on the quality of life.  Results – In the study group there were 54 (60%) female respondents and 36 (40%) males, mean age 17.5 years (range 15.6-20.6). Of the total number of patients with acne vulgaris, nine of them or 10% (4 female and 5 male) had Acne comedonica (first group), 72 of them or 80% (46 female and 26 male) Acne papulopustulosa (second group) and 9 of them or 10% (4 female and 5 male) Acne conglobata (third group) (p>0.95). CAD index values that were expressed as mean ± SD or median (range), in the first, second and third groups were 48 ± 3.2, 9.1 ± 3.8, or 10.2 ± 5.4 (p = 0.008), where women had 6 (2-8), 9 (1-15) respectively 13.5 (5-15) (p = 0.04), and men had 3 (2-11), 9 (0-15) respectively 9 (1-15) (p = 0.36).  Conclusion – The impact of acne vulgaris on quality of life for adolescents was more pronounced for more serious clinical forms of acne, which was reflected in women but not men.

Objective To determine the quality of life for adolescents with acne vulgaris in relation to clinical severity and sex. Patients and methods Using a sectional study the quality of life has been analyzed for 90 adolescents of both sexes, aged 16 to 21 years, who were suffering from acne vulgaris. The study was conducted between January 1st 2008th and January 31st 2009th at the Dermatovenerology department of the Cantonal Hospital “Dr. Irfan Ljubijankic”, Bihac. According to the type of efflorescence, its localization and severity of clinical features, respondents were classified in three groups: the first group were the adolescents with Acne comedonica, the second group had Acne papulopustulosa and the third one had Acne conglobata. Evaluation of quality of life in these adolescents suffering from acne vulgaris was conducted with a specific CAD index (Cardiff Acne Disability Index), consisting of five questions about the psychological impact of acne on the quality of life. Results In the study group there were 54 (60%) female respondents and 36 (40%) males, mean age 17.5 years (range 15.6-20.6). Of the total number of patients with acne vulgaris, nine of them or 10% (4 female and 5 male) had Acne comedonica (first group), 72 of them or 80% (46 female and 26 male) Acne papulopustulosa (second group) and 9 of them or 10 % (4 female and 5 male) Acne conglobata (third group) (p>0.95). CAD index values that were expressed as mean ± SD or median (range), in the first, second and third groups were 8 ± 3.2, 9.1 ± 3.8, or 10.2 ± 5.4 (p = 0.008), where women had 6 (2-8), 9 (1-15) respectively 13.5 (5-15) (p = 0.04), and men had 3 (2-11), 9 (0-15) respectively 9 (115) (p = 0.36). Conclusion The impact of acne vulgaris on quality of life for adolescents was more pronounced for more serious clinical forms of acne, which was reflected in women but not men.

www.pedijatrijadanas.com A 2.4 year old girl was admitted to the Dermatology Clinic with diagnosed acute Urticaria. The examination revealed sharply limited erythema with vesicles arranged in the form of herpes on the skin of the left side of the trunk, along the thoracic dermatoma T10 (Figure A). The girl had itching in the affected area, but the itching soon disappeared. The girl’s behavior showed that she was not suffering from pain. The mother informed us that the girl had had a cold a week earlier, treated by antibiotic syrup, and when four months old, she had had a few vesicles, immediately after her elder brother and sister had suffered from varicella. On the basis of the history data and clinical findings, Herpes zoster was diagnosed (HZ). Therapy with a vitamin syrup was recommended, to keep the affected area dry, and apply Acyclovir cream. In the course of Acyclovir cream application, the skin changes paled and disappeared, so a pediatrician stopped Acyclovir application and prescribed local therapy with Pasta Zinci Oxydati until the skin changes were completely healed. Specific results found at the first examination were provided afterwards. The results of the ELISA-test for Herpes simplex virus IgM and IgG were negative, while the test for Varicella/Zoster virus (VZV) IgM and IgG were positive (234 IU/ml, i.e. < 1600 IU/ml). Control examination of the girl three months later showed her to be in good general condition, normal physical findings, except a discreet hyperpigmentation at the area of the postzosteric changes (Figure B). Herpes zoster (HZ) is an acute skin viral infection that appears as an outcome of VZV reactivation, occurring more frequently in adults even a few decades after they have experienced Varicella infection. In healthy children HZ occurs exceptionally at an early age, where children experienced Varicella infection in the first year of life, or if the mother was infected by HZV in pregnancy and in that way transmitted the virus to the fetus. Paediatrics Today 2010;6(1):87 ▪ Images in clinical pediatrics