The spectrum of mucocutaneous manifestations in Adamantiades‐Behçet’s disease in Greece

Background This is the largest specific demographic and clinical study performed until now in Greece. Objectives To analyse the spectrum of mucocutaneous manifestations in 202 patients with Adamantiades‐Behçet’s disease (ABD) in Greece. Methods Any mucocutaneous symptom at disease onset and during the follow‐up was recorded in a particular questionnaire that included 58 items. All patients fulfilled the International Study Group Criteria for BD. Results Consecutive patients (130 men and 72 women) were included in this study. Their mean age was 42.03 ± 12.41 and 44.96 ± 11.99 years for male and female patients respectively. Pathergy test was positive in 38%, whereas HLA‐B5 (51) positivity was evident in 76% of patients. Onset signs: oral aphthous ulcers were found in 64.36%, genital ulcers in 6.93%, skin lesions in 8.91%, erythema nodosum in 7.42% and pseudofolliculitis in 1.5%. One patient had leg ulcers. During the follow‐up, oral aphthous ulcers were found in 100%, genital ulcers in 65.4% and in 51.4%, erythema nodosum in 42.9% and in 78.1%, whereas pseudofolliculitis in 57.1% and in 21.9% in men and women respectively. Significant differences pointing to a different course of mucocutaneous disease were found between men and women. Conclusions The nature and frequency of mucocutaneous manifestations at presentation are important for the diagnosis of ABD, whereas significant differences were found between genders in this Greek patient cohort. Significant differences were also observed when our results were compared with those of four other series, probably explained by genetic and environmental factors.     

Cutaneous borreliosis in Northern Greece

Our study is the first international report on cutaneous Lyme disease in Greece. Our purpose was, firstly, to assess the advisability of carrying out specific serological testing in the case of skin conditions certainly or possibly related to Borrelia burgadorferi (Bb) and, secondly, to evaluate the necessity and efficacy of treatment. Our research was carried out between 1988 and 1991 on 68 patients suffering from cutaneous diseases generally related to Bb and 57 control subjects. Specific IgM and IgG antibodies were detected by indirect immunofluorescence assay (IFA) and titers > 1/256 were considered as positive. All 57 control subjects were negative. Eighteen out of the 68 patients (26.5%) were positive. Five out of the eight patients (62.5%) with cutaneous diseases certainly related to Bb, and 13 out of the 60 patients (21.6%) with skin diseases possibly related to Bb, were positive. The high percentage (26.5%) in skin diseases generally related to Bb suggests that patients with all these diseases should be tested by IFA. Negative results in control patients confirm the specificity of IFA and indicate that it is unnecessary to perform this investigation in the absence of specific clinical manifestations. Even though we regard scleroderma to be a late form of cutaneous borreliosis, it shows a favorable response to therapy, whereas granuloma annulare, even after liter elimination, remains clinically unchanged. Treatment should be administered not only to patients with high titers, but must he regarded as essential in all seropositive cases with dermatoses generally related to borreliosis, in view of the possibility of a late manifestation of the disease     

Assessing the secular trends in the transmission of HIV in Greece

OBJECTIVE: To evaluate the current trends in HIV transmission in Greece. METHODS: A retrospective study of HIV infected individuals reported to the Hellenic Center for Infectious Diseases Control (HCIDC) was conducted. RESULTS: Since the beginning of the epidemic in Greece and until early 1990s most cases concerned men who have sex with men (MSM). After the mid-1990s the proportion of homosexual males among HIV positive individuals decreased slightly, then was stabilised but they still remain the dominant population among HIV positive people. On the other hand, heterosexual transmission increased steadily and has become a frequent route for the spread of HIV/AIDS in recent years. Individuals originating from or travelling to countries where this mode of transmission prevails were the most frequent cases in this category. A significant proportion of cases classified as "undetermined" were also recorded and were partially attributed to the increased heterosexual transmission among people (especially women) without obvious high risk behaviours. CONCLUSIONS: The HIV/AIDS surveillance system must evolve in order to find the new unreported risk information and identify the population groups at higher risk. This will help to implement preventive policies and information campaigns addressed to target populations with special attention paid to immigrants, women, and marginalized communities.     

Epidemiology of onychomycosis in southern Greece

Background Onychomycosis appears to be a variable entity: it presents in different forms in different parts of the world. It is probable that every country has its own particularities of presentation and it is also probable that different regions of the same country, with either different or equivalent environmental conditions, present with different levels of incidence. Large-scale epidemiological studies performed worldwide have demonstrated different epidemiological results. Objective This study was undertaken to determine the epidemiology of onychomycosis in the population of southern Greece. Methods Direct microscopic examination and culture were performed on samples from patients with clinical suspected onychomycosis. Results The most frequently isolated fungus was Candida (52.44%), followed by dermatophytes (41.04%) and saprophytic molds (6.51%). Finger nails were infected more than toe nails in both sexes. The most frequently isolated fungus in finger nails was Candida (76%), followed by dermatophytes (23%), and molds (1%); toe nails were most often infected by dermatophytes (71%), Candida (13%) and molds (16%). Among the infected women patients, the most frequently isolated fungus was Candida (64%), followed by dermatophytes (30.58%); 5.33% were infected by saprophytic molds. Of the 101 men infected, dermatophytes were most frequently isolated (62.37%), followed by Candida (28.71%) and saprophytic molds (8.91%). Conclusions Comparison of the results of epidemiological studies of onychomycosis worldwide show great differences, not only between different countries and different climate zones, but also between studies performed in the same country. In our opinion such epidemiological studies should be performed in every country in order to determine the major fungal species responsible; such information is extremely useful in the treatment of nail onychomycosis.     

Epidemiology of Cutaneous Leishmaniasis in Greece

ABSTRACT: Cutaneous leishmaniasis is a disease endemic in Greece. Cases collected between the years 1975 and 1979 are analyzed from a clinco-epidemiologic point of view. Prevalence is highest in the Ionian islands and Crete. The disease most commonly affects individuals 10 to 20 years of age. The exposed parts of the body are most commonly involved, particularly the face. The period of highest incidence is mid-winter.     

Changing landscape in living kidney donation in Greece

Patients with end-stage renal disease in Greece are facing long waiting times to receive a kidney transplant from a deceased donor. Living kidney donation offers a valuable alternative that provides optimal outcomes and significantly expands the donor pool but still remains relatively underutilised. Developments around the world in the field of kidney transplantation mandate a change in current practice to include additional options for living donation through paired exchange, antibody-incompatible transplantation and other strategies, following careful consideration of the cultural and ethical factors involved in these complex clinical decisions. An increase in living donation rates may be achieved in several ways, including targeted campaigning to overcome potential barriers. Educating clinicians on transplantation will prove as equally important as informing patients and prospective donors but requires training and resources. Adoption of established practices and implementation of new strategies must be tailored to the needs of the Greek donor and recipient population. Local beliefs about donation, perception of associated risk and other social characteristics must be considered in the design of future strategies. Facilitating living donation in a safe environment with appropriate donor and recipient education will form the solid foundation of a new era of kidney transplantation in Greece.     

Parental attitudes towards head lice infestation in Greece

Background Pediculosis capitis constitutes a growing problem worldwide and is usually considered as an inconvenience. Parents often handle this infestation on their own initiative. Objective We conducted a survey in order to depict the parental attitudes towards head lice infestation in Greece. Methods Parents of children aged 3–14 years, attending a dermatology outpatient clinic at a children’s hospital, were given a questionnaire regarding head lice. Demographic data, management, and prevention strategies were included in the questionnaire. Results Three‐hundred and seventy‐two complete questionnaires were analyzed (response rate: 89%). Pediculosis capitis was more prevalent in the age groups 3–5 years and 6–8 years. The percentage of parents of infested children who sought advice on treatment from the pharmacist was 73%, and only 15% consulted their doctor. Chemical agents to treat head lice were used by 59% of them, products containing natural oils by 38%, and wet combing in parallel was employed by 79% of them. Preventive measures were employed by 66% of the respondents, and 54% applied botanical and synthetic products commercially available for this purpose. Conclusion There is a trend towards the use of natural oils for either prevention or treatment. More needs to be done to promote public education and rational use of either pediculicides or non‐pharmacological agents for pediculosis capitis infestation.