|
|
Prognostic factors in malignant melanoma
Třešková, Inka ; Topolčan, Ondřej (advisor) ; Pizinger, Karel (referee) ; Nekulová, Miroslava (referee)
Background: Malignant melanoma is one of the most malignant types of skin cancer. Incidences are on the rise worldwide and in the Czech Republic an increase of 5% in diagnosed cases is noted each year. Early detection and early surgical removal are associated with reduced mortality. The strong aggressiveness of this malignant disease is caused by its local invasive growth and tendency to metastasize early. Aim of the study: The malignant melanoma is highly metabolically active tumor that releases a number of enzymes, cytokines, growth hormones and other molecules. The aim of this work was to determine the usability of preoperative and postoperative serum and plasma levels of biomarkers in primary diagnosis of tumor activity and in the postoperative follow-up care. These findings would be of clinical relevance for the patient's prognosis, modification of multimodal treatment and follow-up of patients with malignant melanoma. Methods: We measured circulating levels of several biomarkers in a group of 77 patients with malignant melanoma and cohort of 34 patients without cancer as a control group. Using routine immunoassays and novel multiplex xMAP technology, we measured: thymidine kinase, tissue polypeptide specific antigen, protein S100A, osteoprotegerin, osteopontin , insulin-like growth factor 1...
|
|
|
Epidemiology of hypersensitivity in patients with atopic dermatitis and its clinical relevance
Liška, Martin ; Panzner, Petr (advisor) ; Pizinger, Karel (referee) ; Petrů, Vít (referee)
Epidemiology of hypersensitivity in patiens with atopic dermatitis and its clinical relevance MUDr. Martin Liška Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease which is often accompanied by hypersensitivity to various allergens. While food allergens have been considered to play a major role in AD pathogenesis, there is also increasing evidence that aeroallergens are involved. The clinical relevance of detected hypersensitivity was also intensively investigated in last decades. Aims of the study: Our aim was to find out the frequency of hypersensitivity to airborne allergens in AD patients and its clinical relevance using various evaluation standards. Methods: We tested 71 patients (median age 5 years) with AD for hypersensitivity to grass and birch pollen, Dermatophagoides pteronyssinus and Dermatophagoides farinae using atopy patch test (APT), skin prick test (SPT) and specific IgE measurement. The sensitivity (SE) and specificity (SP) of the tests were calculated on the basis of personal history of AD exacerbation, SCORAD changes and the number of days with need for topical anti- inflammatory treatment (AITD) in relation to exposure to the allergens being tested. Results: APT was positive in 45 patients, mostly to Der.farinae (n = 37). SPT and/or specific IgE were positive in 42...
|
|
|
Assesment of diagnostic methods for immunologically based skin diseases
Brodská, Petra ; Pizinger, Karel (advisor) ; Arenberger, Petr (referee) ; Skořepová, Magdalena (referee)
Background: Atopic dermatitis is a common chronic inflammatory skin disease. Numerous IgE-inducing allergens play role in the pathogenesis of atopic dermatitis. Malassezia, the predominant skin microbiota fungus, is considered to exacerbate atopic dermatitis, especially in a subset of patients with head and neck type. In the present study the relationship between atopic dermatitis and sensitization to Malassezia antigens was investigated. Methods: We assessed 240 patients with atopic dermatitis seen at the Department of Dermatology, University Hospital in Zürich, Switzerland and at the Department of Dermatovenereology, University Hospital in Pilsen, Czech Republic. The subgroup of patients with primarily head, neck and upper torso pattern of atopic dermatitis was considered as HNAD type. Severity of eczema was assessed with EASI in Switzerland and with SCORAD in the Czech Republic. Total serum IgE and specific IgE to Malassezia were determined and correlated with clinical picture of atopic dermatitis, gender, age and severity of eczema. Results: Total IgE was elevated in 72.5% of patients. Specific IgE to Malassezia was positive (≥ 0.35 kU/l) in 54.2% of patients. Men were significantly more often sensitized to Malassezia antigen (63.5% of men versus 47.1% of women, p-value 0.013). Concurrently, patients...
|
|
|
Photodynamic therapy and diagnostic in dermatology
Kacerovská, Denisa ; Pizinger, Karel (advisor) ; Arenberger, Petr (referee) ; Ettler, Karel (referee) ; Vašků, Vladimír (referee)
Background Based on news about hypericin (HYP) as a potent photosensitizer with promising photobiological activities, we decided to try it as a topically applied photosensitizer in photodynamic therapy (PDT). Objective The aim of this single-centre, prospective study was to investigate the effectiveness of topical HYP-PDT treatment for non melanoma skin cancer. Methods The study was carried out on 34 patients (20 male and 14 women in the 32 to 83 years age range) with actinic keratoses (AK), basal cell carcinoma (BCC) and Bowen's disease. The patients were treated once a week with HYP in a glycerol solution and a red light dose of 75 J/cm2 for 6 weeks on average. Results The percentage of complete clinical response was 50% for AKs, 24% in patients with superficial BCC and 40% in patients with Bowen's disease. Complete clinical response did not occur in the group with nodular BCCs. A complete histological response rate was found out in 12% of patients with superficial BCCs and 80% in the patients with Bowen's disease. No control biopsies were performed after the treatment of AKs. All patients complained of burning and pain sensations during irradiation. Conclusion The topical HYP-PDT is a promising treatment for non melanoma skin cancer although the results of our study were less successful in...
|
|
| |
|
|
Assesment of diagnostic methods for immunologically based skin diseases
Brodská, Petra ; Pizinger, Karel (advisor) ; Arenberger, Petr (referee) ; Skořepová, Magdalena (referee)
Background: Atopic dermatitis is a common chronic inflammatory skin disease. Numerous IgE-inducing allergens play role in the pathogenesis of atopic dermatitis. Malassezia, the predominant skin microbiota fungus, is considered to exacerbate atopic dermatitis, especially in a subset of patients with head and neck type. In the present study the relationship between atopic dermatitis and sensitization to Malassezia antigens was investigated. Methods: We assessed 240 patients with atopic dermatitis seen at the Department of Dermatology, University Hospital in Zürich, Switzerland and at the Department of Dermatovenereology, University Hospital in Pilsen, Czech Republic. The subgroup of patients with primarily head, neck and upper torso pattern of atopic dermatitis was considered as HNAD type. Severity of eczema was assessed with EASI in Switzerland and with SCORAD in the Czech Republic. Total serum IgE and specific IgE to Malassezia were determined and correlated with clinical picture of atopic dermatitis, gender, age and severity of eczema. Results: Total IgE was elevated in 72.5% of patients. Specific IgE to Malassezia was positive (≥ 0.35 kU/l) in 54.2% of patients. Men were significantly more often sensitized to Malassezia antigen (63.5% of men versus 47.1% of women, p-value 0.013). Concurrently, patients...
|
|
|
Epidemiology of hypersensitivity in patients with atopic dermatitis and its clinical relevance
Liška, Martin ; Panzner, Petr (advisor) ; Pizinger, Karel (referee) ; Petrů, Vít (referee)
Epidemiology of hypersensitivity in patiens with atopic dermatitis and its clinical relevance MUDr. Martin Liška Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease which is often accompanied by hypersensitivity to various allergens. While food allergens have been considered to play a major role in AD pathogenesis, there is also increasing evidence that aeroallergens are involved. The clinical relevance of detected hypersensitivity was also intensively investigated in last decades. Aims of the study: Our aim was to find out the frequency of hypersensitivity to airborne allergens in AD patients and its clinical relevance using various evaluation standards. Methods: We tested 71 patients (median age 5 years) with AD for hypersensitivity to grass and birch pollen, Dermatophagoides pteronyssinus and Dermatophagoides farinae using atopy patch test (APT), skin prick test (SPT) and specific IgE measurement. The sensitivity (SE) and specificity (SP) of the tests were calculated on the basis of personal history of AD exacerbation, SCORAD changes and the number of days with need for topical anti- inflammatory treatment (AITD) in relation to exposure to the allergens being tested. Results: APT was positive in 45 patients, mostly to Der.farinae (n = 37). SPT and/or specific IgE were positive in 42...
|
|
|
Prognostic factors in malignant melanoma
Třešková, Inka ; Topolčan, Ondřej (advisor) ; Pizinger, Karel (referee) ; Nekulová, Miroslava (referee)
Background: Malignant melanoma is one of the most malignant types of skin cancer. Incidences are on the rise worldwide and in the Czech Republic an increase of 5% in diagnosed cases is noted each year. Early detection and early surgical removal are associated with reduced mortality. The strong aggressiveness of this malignant disease is caused by its local invasive growth and tendency to metastasize early. Aim of the study: The malignant melanoma is highly metabolically active tumor that releases a number of enzymes, cytokines, growth hormones and other molecules. The aim of this work was to determine the usability of preoperative and postoperative serum and plasma levels of biomarkers in primary diagnosis of tumor activity and in the postoperative follow-up care. These findings would be of clinical relevance for the patient's prognosis, modification of multimodal treatment and follow-up of patients with malignant melanoma. Methods: We measured circulating levels of several biomarkers in a group of 77 patients with malignant melanoma and cohort of 34 patients without cancer as a control group. Using routine immunoassays and novel multiplex xMAP technology, we measured: thymidine kinase, tissue polypeptide specific antigen, protein S100A, osteoprotegerin, osteopontin , insulin-like growth factor 1...
|
|
|
Photodynamic therapy and diagnostic in dermatology
Kacerovská, Denisa ; Pizinger, Karel (advisor) ; Arenberger, Petr (referee) ; Ettler, Karel (referee) ; Vašků, Vladimír (referee)
Background Based on news about hypericin (HYP) as a potent photosensitizer with promising photobiological activities, we decided to try it as a topically applied photosensitizer in photodynamic therapy (PDT). Objective The aim of this single-centre, prospective study was to investigate the effectiveness of topical HYP-PDT treatment for non melanoma skin cancer. Methods The study was carried out on 34 patients (20 male and 14 women in the 32 to 83 years age range) with actinic keratoses (AK), basal cell carcinoma (BCC) and Bowen's disease. The patients were treated once a week with HYP in a glycerol solution and a red light dose of 75 J/cm2 for 6 weeks on average. Results The percentage of complete clinical response was 50% for AKs, 24% in patients with superficial BCC and 40% in patients with Bowen's disease. Complete clinical response did not occur in the group with nodular BCCs. A complete histological response rate was found out in 12% of patients with superficial BCCs and 80% in the patients with Bowen's disease. No control biopsies were performed after the treatment of AKs. All patients complained of burning and pain sensations during irradiation. Conclusion The topical HYP-PDT is a promising treatment for non melanoma skin cancer although the results of our study were less successful in...
|
|
| |
guest ::
