Serbian Journal of Dermatology and Venereology

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1/19/22, 11:26 AM Serbian Journal of Dermatology and Venereology

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Journal

Serbian Journal of Dermatology and Venereology

The Journal of Serbian Association of Dermatovenereologists (SAD)

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Editor-in-Chief

Professor LIDIJA KANDOLF SEKULOVIĆ MD PhD, Clinic of

Dermatovenereology, Medical Faculty, Military Medical Academy, Belgrade, Serbia

Editorial Board President

Asistant Professor DUŠAN ŠKILJEVIĆ MD PhD, Faculty of Medicine, University of Belgrade, Clinic of Dermatovenereology, Clinical Center of Serbia. Belgrade, Serbia

Secretary

Professor MILAN MATIĆ MD PhD, Faculty of Medicine, University of Novi Sad, Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia

Members

Associate Professor MILAN BJEKIĆ MD PhD, Belgrade, Serbia

Professor MILOŠ NIKOLIĆ MD PhD, Faculty of Medicine, University of

Belgrade, Clinic of Dermatovenereology, Clinical Center of Serbia. Belgrade, Serbia

Professor MARINA JOVANOVIĆ MD PhD, Faculty of Medicine, University of Novi Sad, Clinic of Dermatovenereology, Clinical Center of Vojvodina, Novi Sad, Serbia

Assistant Professor ZORAN GOLUŠIN MP PhD, Faculty of Medicine, University of Novi Sad, Clinic of Dermatovenereology, Clinical Center of Vojvodina, Novi Sad, Serbia

Professor DRAGAN JOVANOVIĆ MD PhD, Faculty of Medicine, University of Niš, Clinic of Skin and Venereal Diseases, Clinical Centre Niš, Serbia

Professor SONJA PRĆIĆ MP PhD, Faculty of Medicine, University of Novi Sad, Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia Professor ROBERT A. SCHWARTZ MD PhD, Dermatology and Pathology, New Jersey Medical School, University of New Jersey, Newark, New Jersey, USA

Professor JACEK C. SZEPIETOWSKI MD PhD, Department of Dermatology, Venereology and Allergology, Wroclaw, University of Medicine, Poland Professor NADA VUČKOVIĆ MD PhD, Faculty of Medicine, University of Novi

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

Professor ŽELJKO MIJUŠKOVIĆ MD PhD, Clinic of Dermatovenereology, Medical faculty, Military Medical Academy, Belgrade, Serbia

Associate professor SVETLANA POPADIĆ MD PhD, , Faculty of Medicine, University of Belgrade, Clinic of Dermatovenereology, Clinical Center of Serbia. Belgrade, Serbia

Associate professor DANICA TIODOROVIĆ MD PhD, Faculty of Medicine, University of Niš, Clinic of Skin and Venereal Diseases, Clinical Centre Niš, Serbia

Professor JANA KAZANDIJEVA MD PhD, Medical University of So a, University Department of Dermatology and Venereology, Bulgaria

Associate Professor VESNA PETRONIĆ ROSIĆ MD, MSc, The University of Chicago, Department of Medicine, USA

JENNIFER L. PARISH, Philadelphia, USA

Professor ALEXANDER STRATIGOS MD PhD, Department of Dermatology, University of Athens, Andreas Sygros Hospital, Athens, Greece

Professor IRIS ZALAUDEK MD PhD, Department of Dermatology, Medical University of Graz, Austria

Editor

SERBIAN ASSOCIATION OF DERMATOVENEREOLOGISTS, Pasterova 2, 11 000 Belgrade, Serbia

Language Editors English Proofreading Jasminka Anojčić Serbian Proofreading

Dragica Pantić, Faculty of Medicine, University of Novi Sad, Serbia Technical Editors

Technical editor

Pavle Bajazet Novi Sad, Serbia Technical Assistant

Vesna Šaranović Novi Sad, Serbia UDC Selection

Zorica Đokić Faculty of Medicine, University of Novi Sad, Serbia Reference Checking

Silvija Brkić Faculty of Medicine, University of Novi Sad, Serbia Contact

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1/19/22, 11:28 AM Volume 11 (2019): Issue 3 (September 2019)

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Volume 11 (2019): Issue 3 (September 2019)

5 Articles

Open Access

Glucocorticoids in Leprosy Reversal reaction

Renni Yuniati andMatthew Brian Khrisna Published Online: 20 Feb 2020

Page range: 77 - 83

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Open Access

Acne Keloidalis Nuchae – Case Report

Dejan Ogorelica,Zorica Gajinov,Ljubinka Matović,Branislava Gajić, Zoran Golušin andSanja Jakovljević

Published Online: 20 Feb 2020 Page range: 85 - 88

Article Preview

Open Access

Alternative Leprosy Treatment Using Rifampicin Oﬂoxacin Minocycline (ROM) Regimen – Two Case Reports

Yohanes Widjaja,Khairuddin Djawad,Saffruddin Amin, Widyawati Djamaluddin,Dirmawati Kadir andSri V. Muchtar Published Online: 20 Feb 2020

Page range: 89 - 93

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1/19/22, 11:28 AM Volume 11 (2019): Issue 3 (September 2019)

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Open Access

Acne Necrotica (Varioliformis) – Case Report

Marija Nikolić,Jelena Perić andDušan Škiljević Published Online: 20 Feb 2020

Page range: 94 - 97

Article Preview

Open Access

Balloon Cell Nevus – Report of Three Cases

Andrija Jović,Danijela Popović,Slađana Cekić,Zorana Zlatanović, Hristina Kocić andDanica Tiodorović

Published Online: 20 Feb 2020 Page range: 99 - 102

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Serbian Journal of Dermatology and Venereology 2019; 11 (2): 50-52

Successful Management of Treatment-Resistant Alopecia Areata with Platelet Rich Plasma: A Case Series

Sanjeewani FONSEKA, Y.M.D.M BANDARA, Brabaharan SUBHANI

Department of Pharmacology, University of Peradeniya, and Skin Center, Mulgampola, Kandy, Sri Lanka

*Correspondence: Sanjeewani Fonseka, E-mail: [email protected] UDC 616.594.1-085

Abstract

Introduction. Alopecia areata (AA) is an autoimmune disease-causing non-scarring alopecia. It is usually treated with immunosuppressive agents, to which some patients fail to respond adequately. Material and Methods. Three patients with AA refractory to standard therapy were treated with intra-dermal injection of autologous platelet rich plasma (PRP) every four weeks. Results. All three patients showed remarkable improvement after multiple sessions of PRP treatment. Conclusion. Autologous PRP is safe and effective in treatment-resistant forms of AA demon- strated in many case reports; therefore it deserves further study with randomized, placebo-controlled trials.

Key words: Alopecia Areata; Platelet-Rich Plasma; Treatment Outcome; Case Reports

Introduction

Alopecia areata (AA) is an autoimmune disease ranging from a single patch of alopecia to alopecia universalis (1). It is usually treated with topical, intralesional and system- ic immunosuppressive drugs (2). Since AA does not always respond to standard treatment, alternative therapies are required.

Platelet rich plasma (PRP) is a concentrate of autologous platelets widely used in various clinical disciplines to promote tissue regen- eration. It is now emerging as a treatment for AA with minimal adverse effects (2).

We report the successful treatment of three challenging clinical presentations of alopecia areata with PRP.

Case Reports Case 1

A 25-year-old female presented with AA (area of scalp hair loss approximately 75%), which has lasted for three years. She had been previously treated with topical steroids, 2%

minoxidil lotion, dithranol paste, 0.1% tacrolimus ointment, intralesional triamcinolone and several courses of oral prednisolone, dexamethasone, azathioprine and sulfasalazine without success.

Case 2

A 23-year old female presented with alopecia totalis lasting for 6 years. She had un- dergone topical treatments with steroids, 2%

minoxidil lotion, dithranol paste, 0.1% tacrolimus ointment, intralesional triamcinolone, intravenous dexamethasone pulses, oral prednisolone, and sulfasalazine. By the time she presented to us there was no progression of the hair loss but there was no new hair growth.

Case 3

A 55-year-old female presented with alo- pecial totalis lasting for 4 years. She was treated with topical steroids, dithranol paste, 0.1%

tacrolimus ointment, intralesional triamcinolone acetonide injections, oral prednisolone, intravenous dexamethasone pulses, sulfasalazine and oral methotrexate.

As stated above a fair trial of the available treatment protocols was attempted; however, in spite of it there was continued progression and despite ore-growth of hair it was followed by a relapse of symptoms. We treated these three patients with autologous PRP as men- tioned below.

S. Fonseka et al.

Alopecia areata and platelet-rich plasma treatment

DOI: 10.2478/sjdv-2019-0007

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CASE REPORT Serbian Journal of Dermatology and Venereology 2019; 11 (3): 85-88

DOI: 10.2478/sjdv-2019-0012

Acne Keloidalis Nuchae – Case Report

Dejan OGORELICA^1,2, Zorica GAJINOV^1,2, Ljubinka MATOVIĆ¹, Branislava GAJIĆ^1,2, Zoran GOLUŠIN^1,2, Sanja JAKOVLJEVIĆ^1,2

1Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia

2Faculty of Medicine, University of Novi Sad, Serbia

*Correspondence: Dejan Ogorelica, E-mail: [email protected] UDC 616.594.1-002

Abstract

Acne keloidalis nuchae (AKN) / folliculitis keloidalis nuchae (FKN) is a chronic inflammatory condition which involves hair follicles localized predominantly in occipital scalp and posterior neck area leading to hypertrophic scarring alopecia. We present a 59-year-old factory worker, Caucasian male with a whitish alopecic oval plaque about 10 cm in diameter in the occipital region. The peripheral part of plaque was mildly inflammated, with groups of tufted terminal hairs, while the central part showed cicatricial alopecia and discrete non-adherent dry scales. Skin changes firstly occurred 6 years earlier, as itchy papules and pustules that sometimes healed with scarring. The applied relevant diagnostic and therapeutical measures are discussed in this report.

Key words: Acne Keloid; Folliculitis; Diagnosis; Alopecia; Cicatrix; Case Reports; Therapeutics

Introduction

Acne keloidalis nuchae (AKN) /folliculitis keloidalis nuchae (FKN) is a chronic inflammatory condition which involves hair follicles predominantly localized in occipital scalp and posterior neck area leading to hypertrophic scarring alopecia. The disorder was first described in 1869 by Kaposi, who called it “dermatitis papillaris capillitii“ (1). The term “acne keloidalis nuchae“ was coined by Bazini in 1872 (2).

AKN is the most prevalent in Afican American population, but it is also frequently observed among Hispanic and Asian men. However, it is rarely observed among Caucasian men (3, 4).

AKN usually occurs in people aged 14-25 years and mostly affects males, with male-female ra- tio of approximately 20:1 (5, 6).

Case report

We present a 59-year-old, factory worker, Caucasian male with a whitish alopetic oval plaque about 10 cm in diameter in the occipital region. The peripheral part of plaque was mildly inflammated, with groups of tufted terminal hairs, while the central part showed cicatricial alopecia and discrete non-adherent

dry scales (Figure 1). Skin changes started Figure 1. Clinical presentation of alopecic oval plaque in occipitial region