Gabriela Stoleriu

CUTANEOUS MANIFESTATIONS ASSOCIATED WITH THYROID DISEASE (Ab-stract): Aim: To present the clinical and laboratory features of patients with dermatologic disorders associated with thyroid diseases, diagnostic criteria, type of administered treatment and its effectiveness. Material and methods: This study is a retrospective study based on the medical records of patients with thyroid diseases admitted to the Dermato venereology Clinic of the Iasi "Sf. Spiridon" University Emergency Hospital between January 1, 2012-December 31, 2013. Data on clinical manifestations, methods of investigation, therapeutic approach, and associated dermatologic and systemic diseases were reviewed. Results: A total of 38 patients were enrolled in this study of which 36 females and two males. An high i n-cidence of cases with autoimmune thyroiditis (63%), followed by polynodular goiter (26.3%) and hypothyroidism (10.7%) was found during the study. The identified dermatologic diso r-ders associated with thyroid diseases were in order of frequency alopecia areata (22%), followed by lichen planus (18%). Conclusions: This study demonstrates that there is a significant association between certain dermatologic disorders and thyroid diseases, requiring per i-odic thyroid function tests.

Herpes zoster (shingles) is a neurocutaneous viral disease, in recent years its incidence increasing throughout the world. Aim: To study the incidence of herpes zoster among Iasi county patients requi ring hospital admission and to analyze the clinical and epidemiologica l features and socioeconomic status of the study group. Material and methods: Retrospective study of 158 patients admitted to the largest clinical dermatology department in Northeastern Romania, the Clinical Dermatology Department of the Iasi "Sf. Spiridon" University Emergency Hospital. The study was conducted over a period of five years and included the analysis of epidemiological data, socioeconomic status, clinical forms of disease, associated diseases, pathology reports for skin biopsy fragments, admi nistered treatment, and disease course. Results: This study confirms that shingles is not a sex-specific disease, the female/male ratio being 1.22: 1. Most patients belonged to the age group 70-80 years, accounting for about 35% of all patients, followed by the age group 60-70 years (24.6% of cases). A slight increase in the number of cases was recorded in autumn and summer in patients living in rural areas. 1.3% of the cases were dia g-nosed both with the disseminated form of disease, and complications (ecze matization, bacterial superin-fection, skin necrosis). 7.6% of patients presented additional skin disorders (pityriasis versicolor, imp e-tigo, psoriasis vulgaris, mucocutaneous candidiasis), which raised the suspicion of an immune deficie n-cy predisposing to shingles. The absence or late initiation of specific antiviral therapy correlated with prolonged hospital stay up to 4-6 days. We found an association between the erythematous form of shingles and young age, while the hemorrhagic or necrotic forms were pre sent in the elderly and/or ill patients. The course was favorable and the length of illness was significantly shortened when the trea t-ment adequate to the clinical form was administered. Associated comorbidities (e ssential hypertension 38.6%, dyslipidemia 24.6%, diabetes, mellitus 9.49%, chronic venous disease, other skin diseases) represent a factor complicating the development of herpes zoster by the cumulative stress the body is exposed to. Conclusions: The main statistically significant epidemiological data in the study group are: older age (over 60 years), associated diseases (which by the marked imbalances induced in the body i n-crease the risk of varicella zoster virus reactivation) intense psychological stress. The fo llowing parameters did not change the risk of developing shingles: area of origin, sex, the season at disease onset, number of hospital days, and administered treatment. Early dia gnosis and treatment of this disease is important for maintaining a good quality of life, to avoid complicati ons, to limit the extent of the disease and its transmission to others.

CLINICO-EPIDEMIOLOGICAL FEATURES AND ANTIMICROBIAL RESISTANCE PATTERN IN GONOCOCCAL INFECTION (Abstract): Aim: To analyze clinical and epidemiological features in patients with gonococcal infection attended Dermato-Venerology Clinic in Iasi and regional dermato-venerology offices and to evaluate gonococcal antimicrobial resistance pattern. Methods: The study was carried out on 129 patients clinically diagnosed and bacteriologically confirmed with gonococcal infection who were subsequently submitted to a questionnaire. We studied their demographic characteristics (sex, age, nationality, marital status), clinical features (site of infection, symptoms, concurrent STI, previous history of gonorrhoea) and behavioral aspects (education, number and type of sexual partners, safe sexual practices). Results: We found in our patients a strong association of gonorrhoea with young male individual, poor educational level and with clinical symptoms of urethritis. The level of antimicrobial resistance is higher than in other European countries. Conclusions: The poor health-seeking behavior, symptoms not specific enough, resistance pattern, lack of accessible and sensitive diagnostic methods lead to undiagnosed and probably mistreated gonorrhoea.

The intracellular renin-angiotensin effectors (peptides, enzymes, receptors) and their effects are intriguing for a lot of systems. That's why we aimed the effects of intracellularly-administered angiotensins (angiotensin II, angiotensin III, angiotensin IV, angiotensin fragment 1-7), angiotensinogen, CGP-42112A, apelin, and angiotensin receptors blockers (losartan, PD123319), by the means of liposomes, on apoptosis of cultured isolated rat aortic vascular smooth muscle cells. We evidenced that CGP-42112A (a potent AT 2 angiotensin II receptor agonist), administered intracellularly, induced the apoptosis of the cultured isolated vascular smooth muscle cells in a much higher proportion than other agonists and antagonists of angiotensin system: CGP-42112A > angiotensin II> angiotensin III≅ angiotensinogen. Moreover, losartan (an AT 1 angiotensin II receptor antagonist), administered intracellularly, induced an important degree of apoptosis of cultured isolated vascular smooth muscle cells. Losartan, administered as concomitant treatment for other angiotensin peptides and CGP-42112A, did not significantly modified the apoptotic effects of these peptides. On the other hand, PD123319 (an AT 2 angiotensin II receptor antagonist) was able to significantly reduce the losartan effects when administered as co-treatment for 24 h. The same effects were obtained when LY294002, a PI3K/Akt signaling inhibitor, was administered as a co-treatment. We can conclude an involvement of an AT 2 angiotensin II receptor and PI3K/Akt signaling in these apoptotic effects induced by some angiotensin peptides and losartan on cultured isolated rat aortic vascular smooth muscle cells.

Our studies aimed the effects of some endoplasmic reticulum stress inducers (thapsigargin, a Ca2+-ATP-ase
inhibitor; tunicamycin, a protein N-glycosylation inhibitor; brefeldin A, a protein transport inhibitor; paraquat,
an enhancer of reactive oxygen species production; A23187, a Ca2+ ionophore), as well as some antioxidants
(N-acetylcysteine; dithiothreitol, a disulfide bond formation inhibitor) on apoptosis of cultured rat
mesenchymal stem cells. The analyze of obtained results evidenced that paraquat, a common and effective
herbicide, induced the apoptosis of the isolated rat mesenchymal stem cells in a larger proportion as
compared to other chemicals as follows: paraquat > thapsigargin > tunicamycin ≅A23187 > brefeldin A.
Dithiothreitol was effective as a reducer of mesenchymal stem cells apoptosis when was administered as
co-treatment for paraquat for 24 h. In contrast, N-acetylcysteine, another potent antioxidant, had no protective
effects against paraquat apoptotic effects.

The process of melanin synthesis and distribution is called melanogenesis, a process that is based on melanocytes present among the basal cells of the epidermis. Pigments formed in melanocyte melanosomes are then stored in the basal layer of epidermal cells, as well as in dermal macro-phages, which become melanophores. From the embryological point of view, melanocytes derive from the melanoblasts of the neural crest, from where they migrate during the first months of life into the skin, eye, cochlea, bone, peripheral nervous system, heart and adipose tissue. The melanic pigments, eumelanin and pheomelanin, are the final product of complex biochemical reactions starting from the amino acid L-tyrosine. Melanin has a major role in skin homeostasis through the photoprotection it offers from the harmful effect of ultraviolet radiation. Melanin absorbs and/or reflects ultraviolet radiation but is also involved in the neutralizing process of free radicals and reactive oxygen species. Pigmentogenesis is a dependent oxygen process and is controlled by intrinsic factors (genetic and hormonal) as well as extrinsic factors (ultraviolet radiation). Melanogenesis is stimulated by stimulant melanocytic hormone, adrenocorticotropin hormone, estrogens and proges-terone. The present review aimed to provide a summary of recent data about melanogenesis physiology.

Background The first dermatology-specific proxy health related quality of life (HRQoL)
instrument for children 0-4 years old with skin diseases, the Infants and Toddlers
Dermatology Quality of Life (InToDermQoL), was recently developed. In order to avoid the
problem of cross-cultural inequivalence focus groups work and pilot tests were organized
simultaneously in all national centres of the project. The InToDermQoL showed good
comprehensibility, clarity and acceptance.
Objective To validate the InToDermQoL questionnaire during international field tests.
Methods Internal consistency, test-retest reliability, convergent and discriminant validity of
the InToDermQoL questionnaire were checked during international field tests.
Results Parents of 473 children with skin diseases filled in national language versions of the
InToDermQoL questionnaire. All three age-specific versions of the InToDermQoL
questionnaire with 10, 12 and 15 items, respectively, showed high internal consistency
(Cronbach’s alpha 0.90-0.93), good test-retest reliability (correlation coefficients>0.9),
significant correlations with the most widely used atopic dermatitis-specific proxy
instrument, the Infants Dermatitis Quality of Life Index (correlation coefficients 0.68-0.79).
The InToDermQoL versions for children less than 3 years old well correlated with the atopic
dermatis severity measure SCORAD (correlation coefficients 0.66 and 0.86 for 10 and 12
items versions, respectively). The InToDermQoL questionnaire discriminated well among
different diagnoses and disease severity levels.
Conclusion Our field tests confirmed internal consistency, test-retest reliability, convergent
and discriminant validity of the InToDermQoL questionnaire. Development and validation of
the InToDermQoL questionnaire makes it possible to assess dermatology-specific aspects of
HRQoL in youngest children with skin diseases. There are many reasons to assess HRQoL in
dermatologic clinical practice and we hope that our new instrument will be used
internationally in pediatric dermatology for research and practical needs.