Background/Aim. Treatment of psoriasis is very complex and there are no still universal, nor unique treatment modalities. Apart from conventional treatment, which includes topical calcipotriol (vitamin D3 analogue), balneotherapy is drawing increased attention worldwide. Being part of climatotherapy, balneotherapy is defined as the use of natural environmental factors in the treatment of health conditions, whereas in the treatment of psoriasis it means the use of mineral baths and peloids. The aim of this study was to examine the therapeutic efficacy of mineral waters and peloids of the Rusanda Spa on plaque psoriasis in patients also treated with calcipotriol. Methods. The study included 60 patients divided into two groups. The first group included patients treated with mineral waters, peloids and calcipotriol in the Rusanda Spa, while the second one included those treated only with calcipotriol. The study took 21 days, and each patient was followed up for at least one month after ending the treatment. The treatment efficacy was measured by psoriasis area severity index (PASI) scores on the days 0, 7, 14 and 21 during the treatment and 30 after the end of the therapy. Results. After a 3-week treatment in the Rusanda Spa, the first group showed a decrease in PASI score by 59.45%, whereas in the group of outpatients treated by calcipotriol it was 39.34%. On the day 30 following the treatment, the first group presented with the PASI score reduction of 58.44%, and the second group of 34.78%. The therapeutic efficacy of mineral waters and peloids combined with calcipotriol showed to be significantly higher in regard to monotherapy with calcipotriol (p < 0.05). In regard to clinical symptoms, the best results were obtained in the reduction of desquamation (p < 0.001). Conclusion. The results of our study show that in the treatment of plaque-type psoriasis, topical calcipotriol combined with Spa Rusanda balneotherapy is more effective than topical calcipotriol alone. Randomized controlled trials are needed to confirm the effects of balneotherapy as monotherapy in treatment of this type of psoriasis.

Background/Objectives: Chronic spontaneous urticaria (CSU) is an immune-mediated skin disorder, with increasing evidence suggesting its association with autoimmune thyroid diseases. The presence of antithyroid antibodies (anti-TPO and anti-TG) and autoimmune thyroid disease indicates shared immunological mechanisms in the pathogenesis of both conditions. This study examines the prevalence of autoimmune thyroid changes in patients with CSU. Methods: The study was conducted as a combined retrospective-prospective observational analysis. It included 43 patients with CSU and 50 healthy participants in the control group. Thyroid hormone levels (TSH, T3, T4), anti-TPO and anti-TG antibodies, as well as ultrasound characteristics of the thyroid gland, were analyzed. Results: In patients with CSU, a higher prevalence of hypothyroidism (27.9% vs. 4% in the control group), hypertension, asthma, and diabetes were observed. Elevated levels of anti-TPO antibodies were found in 51.2% of CSU patients, compared to only 6% in the control group (p < 0.001). Similarly, anti-TG antibodies were increased in 41.9% of CSU patients, compared to 4% in the control group. Additionally, ultrasound analysis revealed significant differences in thyroid morphology, with a heterogeneous structure observed in 72.1% of CSU patients, compared to only 14% in the control group (p < 0.001). Nodular changes were present in 34.88% of CSU patients, whereas the prevalence in the control group was only 6% (p < 0.001). Conclusions: Our results confirm a significant association between CSU and autoimmune thyroid diseases, including a high prevalence of anti-TPO and anti-TG antibodies, hypothyroidism, diffuse heterogeneity, and nodular changes. Additionally, elevated T3 hormone levels were common among CSU patients, while T4 levels did not differ significantly from those in the control group.

Hyperkeratosis follicularis et parafollicularis in cuten penetrans known as Kyrle's disease is a recessive hereditary genodermatosis. Generally, Kyrle's disease appears between 30 to 50 years of age and women are affected more than men. Case report We report a case of a 40-year-old man, a worker in a cement factory, who noticed the first skin lesions six years ago. Those were follicular papules on the left leg. He had been in good health beforehand although an alcoholic for many years. Based on laboratory and other findings, chronic hepatitis was diagnosed. Histopathological analysis of skin lesions showed presence of hyperkeratosis and partial parakeratosis with acanthosis of the epidermis. Discussion Kyrle's disease is classified among the perforating dermatoses with perforating folliculitis, perforating serpiginous elastosis and perforating reactive collagenosis. Kyrle's disease is often associated with hepatic, renal or diabetic disorders, and may be a paraneoplastic disease. Conclusion The course of this disease is chronic. If the associated diseases are treated, patients may have a better prognosis.

Background/Objectives: Adequate knowledge and correct attitudes about the HPV vaccine influence awareness of the importance of preventing HPV-related diseases, which is particularly important for future healthcare professionals. We aim to examine the share of correct answers and the prevalence of different attitudes about the HPV vaccine among active regular students of the Faculty of Medicine in Novi Sad. Methods: A cross-sectional study was conducted from 1 to 30 November 2023 using a structured survey questionnaire. Results: A total of 1760 students were included, of which 78% were female, with an average age of 21 years. Students who participated in prior HPV education) demonstrated significantly higher knowledge (81.92% vs. 65.60%, p < 0.001) and were more likely to recommend the vaccine to patients (89.91% vs. 82.99%, p < 0.001). Almost all vaccinated students (99.41%) would recommend the vaccine, compared to 82.91% of unvaccinated students (p < 0.001). Students who actively sought HPV information also showed a higher likelihood of recommending the vaccine (93.05% vs. 83.02%, p < 0.001). Moreover, those with sufficient self-assessed knowledge were more inclined to recommend the vaccine (89.88%) than those with insufficient knowledge (81.66%, p < 0.001). The analysis demonstrated that an increase in the number of correct answers in the knowledge evaluation corresponds to higher odds of recommending the HPV vaccine to patients (OR = 1.23, 95% CI 1.17–1.28). Positive attitudes prevailed, with 68.89% supporting more education on HPV vaccination. Conclusions: Students who previously attended education on HPV infection/vaccination and those who would recommend the vaccine have significantly higher levels of knowledge. The study highlights the importance of HPV-related education in shaping future healthcare professionals’ attitudes and knowledge.

It is estimated that more than 80% of people are infected with human papilloma virus (HPV) at some point in their lives. Knowledge about HPV infection and methods of its prevention is important for society as a whole. Medical students as future healthcare workers must be thoroughly informed about HPV infection in order to properly participate in the promotion of its prevention. The aim was to examine the knowledge and attitudes in relation to previous education about HPV infection and prevention methods. A cross-sectional study was conducted among undergraduate students at the Faculty of Medicine in Novi Sad (MFNS). The study covered all study programs and was conducted in the period from 1 to 30 November 2023, using a specially created survey questionnaire for the purposes of this research. 1760 surveys were collected, representing 70.4% of the total number of MFNS students. In the past year, only 26% of respondents attended some kind of education about HPV infection/vaccine. Statistical significance was observed in the difference between the responses of students who attended education in comparison to those who did not attend education in the past year (75.5% versus 63.3%, p < 0.001). Students who stated that they plan to get vaccinated in the following period answered the questions correctly in a higher percentage (87.5% versus 80.1%, p = 0.01). Students of the Faculty of Medicine in Novi Sad, as future healthcare workers, demonstrated certain knowledge and demonstrated right attitudes. Students who attended education about HPV infection and methods of prevention had more correct answers, as did students who plan to get vaccinated in the future.

Radiation dermatitis is one of the commonest side effects of ionizing radiation which is applied in radiotherapy of carcinoma of all localizations, most frequently of tumors of breast, head and neck region, lungs and soft tissue sarcomas. It usually occurs as a complication of breast radiotherapy and thus it is more often recorded in female patients on the skin in the region of breast subjected to radiation. Clinical manifestations of radiation dermatitis can be divided into four phases: acute phase (erythema, dry desquamation, moist desquamation, ulceration and necrosis with resulting re-epithelialization, residual post-inflammatory hyperpigmentation, reduction and suppression of sebaceous and sweat glands and epilation); subacute phase (hyperpigmentation and hypopigmentation, telangiectasia, skin atrophy, even ulceration); chronic phase (skin atrophy, dermal fibrosis and permanent skin epilation) and late phase (increased risk of skin cancer). In order to prevent radiation dermatitis, skin care products should be applied throughout radiotherapy that will decrease the frequency of skin reactions or block them and thus improve life quality. Although the therapy includes not only topical corticosteroids but numerous other products with active ingredients such as aloe vera, calendula, hyaluronic acid, sucralfat, sorbolene, mineral and olive oil, honey, vitamin C, zinc, antimicrobials and silver, common therapeutic consensus has not been reached on their application in radiation dermatitis. Therefore, the treatment should be conducted according to the basic guidelines but tailor-made for each individual patient.