Title Autoimmune skin diseases and the face Title (croatian) Autoimune kožne bolesti i lice Author Lea Klapan Mentor Branka Marinović (mentor)Committee member Branka Marinović (predsjednik povjerenstva)Committee member Zrinka Bukvić Mokos (član povjerenstva)Committee member Romana Čeović (član povjerenstva)Granter University of Zagreb Defense date and country 2020-07-17, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract The prevalence of autoimmune diseases has increased in the last decade. In order to deal with the escalating figures, we need to know how to recognize them. One of the first indicators which can be noticed is when the condition appears on the skin, especially in the area of the face, due to its obvious and easily accessible location. This thesis deals with four important autoimmune diseases that, among other areas on and in the body, affects the face. They have been chosen due to their prevalence, deleterious effects imposed on the body and quality of life, but also, due to the convenient early symptoms developing on the skin; possibility for the early recognition, diagnosis and treatment. The autoimmune disorders which are about to be discussed in this thesis are: dermatomyositis, lupus erythematosus, morphea and pemphigus vulgaris. Dermatomyositis is a rare inflammatory disease. It belongs to the group of inflammatory myopathies. It commonly affects the muscles with preceding skin symptoms. The rash that appears is red to purple in color and is usually found on the face (commonly on the eyelids, nose and cheeks) and on the knuckles of the hands. Dermatomyositis can affect adults as well as children. Lupus erythematosus has a potential to affect many systems in the body, however skin involvement has been perceived as an isolated condition and therefore subjected to different handling. Cutaneous lupus erythematosus is a skin disease which may occur independent of or as an accompanying expression of systemic lupus erythematosus. It is divided into three main subtypes; acute cutaneous lupus erythematosus (ACLE), subacute cutaneous lupus erythematosus (SCLE), and chronic cutaneous lupus erythematosus (CCLE). The types are characterized by photosensitivity and have a predilection to affect the face and sun exposed areas of the skin.
Morphea, a designated term for localized scleroderma, is a chronic condition of unknown etiology. It is the most common form of scleroderma, characterized by thickening of the skin. It can be further divided into subtypes, each with a different clinical manifestation and level of connective tissue involved. Each of the subtypes can affect the face. Pemphigus vulgaris is the most common type in the group of pemphigus diseases. It is rare and causes painful blistering on the skin and mucous membranes. Blisters have tendency to spread widely and when ruptured, may become infected. Diagnosis is made on the basis of clinical picture and laboratory tests, among which direct immunofluorescence represents the golden standard. Treatment includes systemic corticosteroids and adjuvant therapy, most often azathioprine. Rituximab has been used more often in recent years.
Abstract (croatian) Prevalencija autoimunih bolesti je u porastu, što ukazuje na veliku potrebu što brže i pouzdanije dijagnostike. Jedan od prvih indikatora koji pomaže u dijagnozi aktivne bolesti je pojava promjena na koži, ponajviše na koži lica s obzirom na dostupnost i vidljivost područja. U ovom radu opisati ćemo četiri važne autoimune bolesti, koje uz regiju kože lica zahvaćaju i druge organe. Obzirom na njihovu veliku prevalentnost, štetni učinak koji imaju na tijelo te kvalitetu života, no također zbog ranih promjena koje izazivaju na koži; što omogućuje rano prepoznavanje, uspostavljanje dijagnoze i terapije, odlučili smo se opisati dermatomiozitis, lupus eritematozus, morfeu i obični pemfigus. Dermatomiozitis ubrajamo u skupinu bolesti zvane upalne miopatije autoimunog podrijetla. Karakterizira ga tipični osip na koži koji prethodi progresivnoj slabosti misića. Osip je crvenkasto do ljubičaste boje, najčešće na očnim kapcima, nosu i obrazima, te na zglobovima ruku. Javlja se u odraslih i djece. Kožni lupus eritematozus može se pojaviti neovisno o ili u sklopu sistemskog lupusa. Razlikujemo tri tipa: akutni, subakutni te kronični kožni lupus eritematozus. Fotosenzitivnost je karakteristična za ovu bolest, kao i sklonost zahvaćanja lica te ostalih dijelova tijela izloženih suncu. Morfea, lokalizirana sklerodermija, je rijetka kronična bolest nepoznate etiologije. Najčešći oblik sklerodermije karakteriziraju tipična zadebljanja kože. Razlikujemo nekoliko podtipova, svaki sa određenim kliničkim manifestacijama i različitim utjecajem na tkiva. Svaki podtip se može pojaviti na licu. Vulgarni pemfigus najčešći je oblik unutar grupe pemfigusa. Rjedak je oblik, obilježen bolnim mjehurima na koži i sluznicama. Nastali mjehuri imaju tendenciju širenja te ukoliko dođe do njihovog pucanja, postoji mogućnost suprinfekcije. Dijagnoza se postavlja na temelju kliničke slike i laboratorijskih nalaza među kojima nalaz direktne imunofluorescencije predstavja zlatni standard za dijagnostiku. Liječenje uključuje sistemske kortikosteroide te adjuvantnu terapiju, najčešće azatioprin. Posljednjih godina sve se češće u terapiji primjenjuje rituksimab.
Keywords
autoimmunity
disease
face
dermatomyositis
lupus erythematosus
morphea
pemphigus vulgaris
Keywords (croatian)
autoimunost
bolest
lice
lupus eritematozus
dermatomiozitis
morfea
vulgarni pemfigus
Language english URN:NBN urn:nbn:hr:105:862591 Study programme Title: Medicine (in English language) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-10-06 09:57:19
