Extracts from the Lectures of the 32nd Nordic Congress of Dermato-Venereology, Tampere, Finland
STD & Genital Dermatology
Anne Olaug Olsen: Anal dysplasia and cancer. Anal dysplasia
(anal intraepithelial neoplasia) is a precancerous condition
induced by human papillomavirus (HPV), which may progress
to invasive cancer. The worldwide incidence of anal cancer
in the general population although low, has increased over
the past three decades. The increase has been alarmingly
high among HIV positive men who have sex with men. Immunocompromised individuals and those previously treated
for HPV-related premalignant disease also represent high-risk
groups for the development of anal dysplasia and cancer. It
is however noteworthy that the majority of cases of anal and
perianal cancer continuously are diagnosed in heterosexual
and otherwise healthy men and women. There are numbers
of challenges to be addressed as long as there is no consensus
about the optimal management of HPV-induced anal intraepithelial neoplasia. Screening algorithms and follow-up routines
are in demand. A wide range of treatment modalities, including topical and ablative therapy, is available. Optimal regimes
for screening, intervention and follow-up of anal dysplasia in
high-risk groups, is a priority.
Eija Hiltunen Back: Ulcus Vulvae Acutum Lipschütz. Lipschütz
ulcer (acute genital ulcer, AGU) is an underdiagnosed disorder
that presents as an acute painful necrotic vulvar ulcers in prepubertal or pubertal girls without any history of sexual contact.
The onset is preceded by an acute systemic illness. Primary
Ebstein-Barr virus infection is the most frequently reported
aetiology. The diagnosis is established clinically after ruling
out STIs, trauma, autoimmune causes, drug reactions and local
manifestations of systemic illness. The histological ?ndings
are nonspeci?c. The management consists of symptomatic
treatment like oral and topical antibiotic and corticosteroid
therapy. Lesions heal spontaneously in a few weeks with no
sequelae. It is important to keep AGU in mind as a differential
diagnosis of vulval ulceration to avoid misdiagnoses and unnecessary invasive investigations.
Harald Moi: IUSTI Guidelines on Gonorrhoea Treatment. Neisseria
gonorrhoeae has shown a remarkable capacity to develop resistance to multiple classes of antibiotics. After a steady rise in
minimum inhibitory concentrations in recent years, resistance
and even clinical failures to extended-spectrum cephalosporins
(ceftriaxone and ce?xime) have been con?rmed. As a consequence, combination antimicrobial therapy is recommended.
The ?rst line treatment according to recent European IUSTI
guidelines is 500 mg ceftriaxone i.m. and 2 g azithromycin
p.o. as direct observed therapy. If treatment after susceptibility testing, antibiotics are given according to the test results.
Erika Wikström: Overtime Chlamydia Trachomatis Serotype
Distributions in Fertile-aged Finnish females. While the occurrence of Chlamydia trachomatis has been high in the af?uent
countries for several decades little is known about the ecology of C. trachomatis serotypes. We studied the distribution
of C. trachomatis serotypes in Finnish women from the 1980s
to the 2000s. 1,169 healthy subjects testing positive for C.
Forum for Nord Derm Ven 2013, Vol. 18, No. 4
trachomatis-speci?c IgG antibodies were available from a large
subcohort of 11,067 15–29-years old women belonging to the
Finnish Maternity Cohort of the National Institute for Health
& Welfare. The temporary C. trachomatis serotype replacement
among females parallels changes in the sexually active population in the 1990s in Finland.
EIJA HILTUNEN-BACK
AND
HARALD MOI
Dept of Dermatology and
Venereology, Helsinki University Hospital, and Dept
of Rheumatology, Dermatology and Infectious
Diseases,
Ola?a Clinic, Oslo
eija.hiltunen-back@ hus.?
haraldmoi@yahoo.no
Atopic Dermatitis
See separate Meeting Report from Louise Lönndahl on page
139–140.
Paediatric Dermatology
Katariina Hannula-Jouppi, Helsinki, Finland: Netherton Syndrome.
Netherton syndrome (NS) is a rare autosomal recessive genodermatosis characterized by severe skin in?ammation, erythema
and scaling, multiple atopic manifestations and trichorrhexis
invaginata, a hair shaft defect causing brittle ”bamboo” hair.
Mutations in the SPINK5 gene cause NS by loss of LEKTI, a serine protease inhibitor in the epidermis. Loss of LEKTI disrupts
normal skin homeostasis and leads to unopposed KLK activity and ELA2 activation, which initiate proin?ammatory and
proallergic cascades. We have studied 10 Finnish NS patients
and identi?ed a novel Finnish founder mutation in exon 8 of
SPINK5, in 7 NS patients originating in the Ostrobothnia region. All NS patients had typical NS features and we saw a rapid
increase in IgE sensitization to multiple during the ?rst years.
Nicolas Kluger, Helsinki, Finland: Congenital Linear Streaks of the
Face and Neck and Microphthalmia in an Infant Girl. A newborn
girl presented with atrophic unilateral facial lesions following
Blaschko’s lines, aplastic nails, ipsilateral microphthalmia,
aniridia and sclerocornea was diagnosed Microphthalmia with
Linear Skin defects (MLS) syndrome/MIDAS (MIcrophtalmia,
Nordic Dermato-Venereological Congress, Tampere
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