Dermatology practical & conceptual最新文献

Introduction: Whole blood cells and derived indices can be used as a read-out of the inflammatory pathogenic processes in many human diseases, including psoriasis. Indeed, systemic treatments with special regard to anti-IL-23 agents could exert anti-inflammatory and disease modifying effects; however, there is still a lack of conclusive data.

Objectives: We aimed to assess the therapeutic effect of risankizumab on whole blood cells and inflammatory indices in psoriatic patients.

Methods: We performed a prospective multicenter observational study on adult patients with moderate-to-severe psoriasis who underwent risankizumab therapy for at least 52 weeks. Blood cell count, CRP, and ESR were prospectively recorded for each patient included in the study, at routine visits up to week 52. The ratio between peripheral cells, namely NLR, PLR, MLR, SII, and PIV, were calculated and compared at time 0 and at weeks 12, 24, and 52 of treatment. At different timepoints, modulation of laboratory values and derived indices and their correlation with disease severity and response to treatment were analyzed. Subanalysis of very early responders and late responders was performed as well.

Results: We observed a progressive reduction in inflammatory indices such as CRP, ESR, NLR, and SII during treatment, with prominent modification involving SIRI as well, in patients who had a very early and almost complete response to risankizumab. Reduction in neutrophils and MPV, a transient increase in eosinophils at week 12, and a progressive increase in peripheral basophils were associated with therapeutic response.

Conclusion: Risankizumab promotes a progressive anti-inflammatory effect, more prominent in patients with a faster response in the early phases of treatment.

Introduction: Previous studies have independently linked chondrodermatitis nodularis (CN) with vascular injury, tobacco smoking, and diabetes, particularly in adult patients with early onset lesions.

Objectives: To build on previous research by investigating survival and frequency of comorbidities in adult patients diagnosed with premature CN lesions (<61 years).

Methods: We conducted a retrospective multicenter case-control observational study focused on individuals diagnosed with CN before the age of 61. Participants were further categorized into those diagnosed before 46 years and those diagnosed between ages 46 and 60 years. We evaluated the frequency of cancer, chronic obstructive lung disease, severe liver disease, diabetes mellitus, HIV infection, arterial disease, hypertension, dyslipidemia, multimorbidity, and tobacco smoking as well as survival rates. Statistical analysis included univariate analysis (including Holm-Bonferroni test), Kaplan-Meier plot estimation with log-rank test, and multivariate Cox analysis.

Results: Patients diagnosed with CN between ages 46 and <61 years showed significantly greater multimorbidity (Holm-Bonferroni test, P=0.00007 < 0.00122) and higher mortality rates compared to controls (log-rank test, P=0.006). Multivariate Cox analysis revealed an adjusted HR of 2.75 (95% CI: 1.36-5.54, P=0.005).

Conclusions: The novel finding of this retrospective multicenter study is that a diagnosis of CN in middle-aged patients could be a marker of elevated risk of systemic comorbidity and mortality. These results highlight the need for prospective studies to confirm these associations. Meanwhile, clinicians should be aware that emphasizing healthy lifestyle choices of patients with CN may have an important preventive value.

Introduction: Considering its visible nature, facial dermatosis may result in more prominent psychosocial effects.

Objectives: We aimed to compare quality of life, anxiety, depression, perceived stress, stress coping strategies, and body image in individuals with facial and trunk dermatosis.

Methods: A total of 120 patients (60 with facial dermatosis, 60 with trunk dermatosis) and 60 healthy volunteers were included in the study. Demographic and clinical features were recorded, and participants were evaluated with Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Stress Coping Attitudes Inventory (SCAI), and Body Image Scale (BIS).

Results: In trunk dermatosis patient group, the DLQI, HADS, and PSS scores were significantly higher, while the BIS scores were significantly lower than in the facial dermatosis group and the controls. Avoidance subscores of the SCAI were significantly higher in the trunk dermatosis group compared to the facial dermatosis group. Acceptance/Cognitive Restructuring subscore of the SCAI was found to be higher in the facial dermatosis than the trunk dermatosis group (P=0.037). Linear regression analysis revealed that the most important determinant of DLQI was HADS-Anxiety score (β=0.271, P=0.023) and one of the most important determinant of the PSS score was HADS-Anxiety score (β= 0.426, P<0.001).

Conclusion: Patients with trunk dermatosis experienced more stress, anxiety, depression, and distortion of body perception, and the impact on quality of life was more pronounced. This situation was thought to be related to the fact that patients with facial dermatosis used positive coping strategies, while negative strategies were more common in patients with trunk dermatosis.

Introduction: Rosacea is a chronic inflammatory skin disorder distinguished by recurrent episodes of inflammatory papules, persistent erythema, facial flushing, pustules, and telangiectasia. Any disturbance in the gut microbiome could influence the immune system equilibrium in rosacea by releasing zonulin, leading to increased intestinal permeability and the passage of many microbes into the circulation, causing inflammation.

Objectives: We aimed to estimate the serum zonulin levels in cases with rosacea compared with healthy controls. Some fecal bacteria were investigated in an attempt to find a relationship between gut microbiome and rosacea.

Methods: This case-control study was performed on 42 participants aged above 18 years: 21 patients with a clinical diagnosis of rosacea approved by dermoscopy and 21 healthy individuals as controls. The serum zonulin level was estimated by the enzyme-linked immunosorbent assay technique, and some gut microbiomes were investigated using real-time quantitative PCR.

Results: There was a statistically significantly higher serum zonulin level in rosacea cases than in controls. There was a statistically significant elevation in Bacteroides and Lactobacillus gut microbiomes in rosacea patients compared to controls, while there was no statistically significant increase in Fusobacterium microbiome in patients. Zonulin levels did not show a significant correlation with gut microbiome.

Conclusions: Serum zonulin measurement can be used as a discriminating marker between rosacea and healthy controls, due to getting a specific cut-off point in ROC analysis with the highest specificity and sensitivity (100% and 100%, respectively). Gut microbial dysbiosis could play a valuable role in the disease pathogenesis.