Postepy Dermatologii I Alergologii最新文献

Introduction: Vitiligo is a chronic skin disorder characterized by melanocyte loss, with treatment aiming to induce repigmentation and maintain disease stability. Microneedling enhances transdermal drug delivery, potentially improving treatment outcomes when combined with topical agents.

Aim: This study evaluates and compares the efficacy and safety of microneedling combined with 5-fluorouracil (5-FU), trichloroacetic acid (TCA), and botulinum toxin-A (BTX-A) in vitiligo treatment.

Material and methods: This interventional comparative clinical trial included 60 patients with stable non-segmental vitiligo, randomly assigned into three groups: group I (5-FU, n = 20), group II (TCA, n = 20), and group III (BTX-A, n = 20). Microneedling was performed before applying the respective agents. Treatments were administered biweekly for six sessions, with efficacy assessed using the VASI, VIDA, and PGA scores, as well as patient satisfaction.

Results: Baseline characteristics were comparable across groups (p > 0.05). Post-treatment VASI scores showed a significant improvement in all groups (p < 0.001), with the highest reduction in group I (50%), followed by group II (29%) and group III (5%) (p < 0.001). PGA revealed significantly higher repigmentation in group I (40% good, 35% moderate, 10% excellent) than in group II (p = 0.021) and group III (p < 0.001). Patient satisfaction was the highest in group I (50% very satisfied), followed by group II (45% satisfied), and 75% of group III reporting dissatisfaction (p < 0.001).

Conclusions: Microneedling combined with 5-FU showed the highest efficacy, followed by TCA, while BTX-A was the least effective. This approach offers a safe and promising adjunct for vitiligo treatment, achieving faster repigmentation and improving patient adherence.

Introduction: The incidence of newly diagnosed melanoma patients has significantly increased over the past few decades. In recent years, in addition to developing new diagnostic and preventive strategies, cancer centres have prioritized the establishment of highly specialised melanoma units (MUs), offering the implementation of an adequate follow-up plan, along with the evaluation of overall patient satisfaction and patient-reported outcome measures (PROMs).

Aim: The aim of this study was to evaluate the patient satisfaction of treatment and clinical care provided in multidisciplinary MUs.

Material and methods: The study was based on the analysis of results from a survey administered to all melanoma patients treated at the Lower Silesian Oncology, Pulmonology and Haematology Centre (LSOPHC) in Wroclaw. The questionnaire was a part of a pilot program for melanoma patients in the Lower Silesian Voivodeship (inhabited by approximately 2.9 million people).

Results: A total of 432 patients diagnosed with melanoma between May 2020 and February 2023 participated in the study. The study successfully gathered results concerning four key aspects outlined in the developed questionnaire: 1) infrastructure and organisation of treatment, 2) quality of medical care, 3) scope of information provided to patients, and 4) overall satisfaction with the pilot program.

Conclusions: Detailed questions in the survey yielded specific data highlighting both strengths and weaknesses of care provided to patients enrolled in the pilot program. The results of the patient satisfaction assessment may offer valuable insights for other MUs.

Introduction: Some diseases, including primary immunodeficiencies (PID), require treatment with intravenous immunoglobulin (IVIG). IVIG is an effective treatment and is generally well tolerated. IVIG can cause side effects ranging from mild reactions to, in rare cases, serious complications such as anaphylaxis.

Aim: We aimed to assess the frequency, types, and severity of adverse effects in adults receiving IVIG for PID, and to examine associated risk factors and the impact of premedication.

Material and methods: This retrospective cohort study analysed 90 patients and 6246 IVIG infusions administered at the Gülhane Training and Research Hospital between 2016 and 2024. Demographic data, comorbidities, IVIG-related side effects, and treatment processes of the patients were examined.

Results: A total of 6246 IVIG infusions were evaluated, 363 (5.8%) of which had side effects. Side effects mostly occurred within the first 6 h of infusion (early reaction) (75.2%). The most frequently preferred intervention was to reduce the infusion rate (37.5%), followed by stopping the treatment (27.5%) and using antihistamines (22.5%). Serious cases such as anaphylaxis were rare (0.12%) and could be controlled with appropriate interventions. The rate of side effects was significantly lower in patients who received premedication.

Conclusions: Our study highlights that side effects associated with IVIG treatment are generally mild and manageable, but careful monitoring and individualized premedication protocols are important for preventing side effects and patient safety.

Introduction: Hirsutism is excessive hair growth in women, typically in male-pattern areas like the face, chest, and back. It is important to address this condition and effective treatment is necessary for those affected.

Aim: To determine the etiology of hirsutism, its treatment based on the etiology, and after treatment improvement.

Material and methods: This prospective study, included 135 women with hirsutism, of reproductive age, who were checked for hair growth in androgen-sensitive areas, menstrual cycle disorders, or infertility. The Ferriman-Gallwey test was done to evaluate hirsutism and the RIA method was used for the hormone serum level determination.

Results: Oral contraceptives were prescribed to 33.3% of women, dexamethasone to 30.4% (alone or in combination with other medications), and metformin to 28.1% of cases. For face hair removal laser was used by 21.4% of women, tweezers by 20.7%, depilatory cream by 16%, while other methods were less represented.

Conclusions: Treating hirsutism requires a multifaceted approach that takes into account the underlying cause, the severity of the condition, and the patient's preferences. While medical and physical treatments can provide relief, a holistic approach that includes lifestyle changes and mental health support is crucial. Early intervention and regular monitoring can prevent progression and provide significant relief. Ongoing research continues to offer hope for more effective, tailored therapies in the future.

Introduction: Atopic dermatitis (AD) is the non-fatal skin disease with the highest global disease burden.

Aim: This study investigates the factors influencing AD incidence and aims to construct a predictive risk nomogram model.

Material and methods: A total of 469 patients with dermatitis and eczema who were treated at the Dermatology Department of the Fourth Affiliated Hospital of Soochow University from January 2021 to May 2025 were included, and categorized into an AD group (n = 216) and a non-AD group (n = 253). Differences between the two groups were analysed through univariate analyses, followed by multivariate logistic regression. A predictive model was then constructed. The diagnostic performance of the model was evaluated using calibration curve, Hosmer-Lemeshow (H-L) test, receiver operating characteristic (ROC) curve, and clinical decision curve analysis (DCA) approaches.

Results: Significant differences were observed between the AD and non-AD groups in terms of age, history of allergic diseases, family history of allergy, infantile onset history, number of medical visits, blood eosinophil count, and serum total immunoglobulin E levels (p < 0.001). Logistic regression analysis showed that the number of medical visits (OR = 1.16, 95% CI: 1.08-1.24), history of allergic diseases (OR = 2.68, 95% CI: 1.44-5.00), family history of allergy (OR = 2.30, 95% CI: 1.27-4.17), and infantile onset history (OR = 23.80, 95% CI: 2.92-193.62) were significant factors influencing AD incidence. Calibration curve, H-L test (χ² = 6.68, p = 0.57 in the training set and χ² = 7.96, p = 0.44 in the validation set) and area under the ROC curve tests (0.808 in the training set and 0.812 in the validation set) demonstrated that the model exhibited good fit and predictive accuracy. The DCA results indicated that the model provided certain net clinical benefits in predicting AD.

Conclusions: Factors including frequent hospital visits, history of allergic diseases, family history of allergy, and infantile onset are closely associated with the occurrence of AD. The model based on these risk factors developed herein offers significant value as a potential tool for predicting the occurrence of AD.

Introduction: Inhaled corticosteroids (ICS) are the cornerstone of asthma and allergic rhinitis management, but concerns regarding their potential systemic effects, including suppression of skin reactivity and hypothalamic-pituitary-adrenal (HPA) axis function.

Aim: To evaluate the impact of ICS on skin prick test (SPT) results and endogenous cortisol levels in adults with allergic conditions.

Material and methods: This pilot observational study included 24 adults with allergic conditions. Clinical data, ICS therapy parameters, SPT with histamine control, and salivary and serum cortisol levels were collected and analysed.

Results: ICS use was not associated with significant alterations in histamine-induced skin reactivity. A borderline inverse correlation was observed between ICS duration and salivary cortisol levels (r = -0.405, p = 0.05), while serum cortisol remained unaffected. Salivary and serum cortisol levels were strongly correlated (r = 0.719, p < 0.001). Participants using additional corticosteroid-containing medications had significantly lower salivary cortisol (p = 0.049).

Conclusions: ICS at standard doses do not appear to suppress skin reactivity on SPT, supporting their continued use during allergy evaluation. However, prolonged ICS use may lead to subtle HPA axis suppression, highlighting the utility of salivary cortisol as a noninvasive monitoring tool.

Introduction: Acne vulgaris (AV) affects over 85% of adolescents and often persists into adulthood.

Aim: This study aimed to evaluate the impact of mild to moderate acne on body image, self-esteem, depression, and potential body dysmorphic disorder (BDD) in adolescents.

Material and methods: 170 acne patients and 79 healthy controls, aged 12-17, were recruited. Acne severity was assessed using the Global Acne Grading System (GAGS) and Visual Analogue Scale (VAS). Participants completed the Children's Depression Inventory (CDI), Body Image Questionnaire (BIQ), Rosenberg Self-Esteem Scale (RSES), and Turkish Acne Quality of Life Index (TAQoLI).

Results: Significant negative correlations were found between acne severity and both quality of life (r = -0.372, p < 0.05) and body image scores (r = -0.586, p < 0.05). Depression scores were higher in the patient group (13.36 ±7.30, p < 0.001), showing a positive correlation with acne severity (r = 0.560). Social appearance anxiety emerged as the strongest predictor of quality of life. No significant differences in self-esteem were noted between groups.

Conclusions: Mild to moderate acne negatively impacts psychological well-being in adolescents, emphasising the importance of addressing not only physical symptoms but also psychosocial effects. Multidisciplinary approaches integrating dermatological and psychological care are recommended.

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the mucous membrane of the nose and adjacent cavities. In the treatment of the condition, glucocorticoids are considered a traditional and effective therapeutic drug. Monoclonal antibodies are a promising therapeutic option because they can block specific chemokines.

Aim: The aim of the presented study is to assess the comparative efficacy of CRSwNP therapy with combined use of steroids and a biologic agent, omalizumab.

Material and methods: One hundred and four participants diagnosed with chronic rhinosinusitis who underwent excision of polyps were involved in two interventional groups of the study. The first group (ST-group) included 56 patients who received 2 injections of Diprospan, while the other group (STO-group) received combined therapy with omalizumab and Diprospan. Sino-Nasal Outcome Test 22 (SNOT-22), assessment of skin functional properties, Modified Lund-Mackay Postoperative Endoscopy Score (MLMES) and computed tomography of nasal sinuses were used to comparatively evaluate the treatment efficacy.

Results: The STO-group showed statistically significant improvements across all measured parameters. This suggests that omalizumab may enhance the therapeutic effect of corticosteroids, potentially by stabilizing mast cells and decreasing allergic inflammatory responses more broadly.

Conclusions: While more research is necessary to evaluate the cost-effectiveness and long-term safety of this approach, current evidence supports its potential as a more effective treatment modality for severe or refractory cases of CRS. The addition of omalizumab allows for lower cumulative steroid exposure, reducing long-term side effects while maintaining or improving efficacy.

Introduction: Drug hypersensitivity reactions pose a considerable clinical challenge due to their unpredictable nature and potential severity.

Aim: To determine the risk factors linked to drug allergies.

Material and methods: This case-control study examined patients with drug allergies. Analysed parameters included age, sex, height, weight, body mass index (BMI), atopy history, family history of drug allergies, frequent antibiotic use, and the presence of kidney disease, liver disease, asthma, nasal polyps, or chronic urticaria. Additional data for the study group included the relationship between reactions and viral infections, presence of urticaria/angioedema or anaphylaxis, implicated drug groups, reactions to multiple drug groups, and routes of drug administration.

Results: The study included 136 patients in the study group and 87 controls. The study group was significantly older (p = 0.010), with no significant sex difference (p = 0.079). The study group had higher mean BMI (p = 0.043). Atopy history, kidney disease, asthma, and chronic urticaria were significantly more common in the control group. In the study group, 69.40% experienced urticaria/angioedema, 30.60% had anaphylaxis. Nonsteroidal anti-inflammatory drugs (NSAIDs) (61.76%) and antibiotics (41.91%) were the most common triggers, with penicillins (20.59%) and cephalosporins (11.76%) being the most common antibiotics. The oral route was the most frequent mode of administration leading to allergies (88.24%), followed by intravenous route (8.09%).

Conclusions: Our study revealed that higher age and BMI are associated with drug allergies, with NSAIDs and antibiotics, particularly penicillin, being the most common triggers, and oral administration as the predominant route of administration.