Postepy Dermatologii I Alergologii最新文献

Micro-needling mesotherapy is one of the increasingly popular treatments in dermatology clinics due to its wide range of effects on the skin. During the procedure, "micro-channels" are created in the epidermis, which remain open for a short period, allowing for the deeper delivery of selected active substances tailored to the skin's needs. In addition, micro-needling induces micro-injuries that stimulate the skin's repair processes, which are essential for tissue regeneration. The aim of the review is to create a practical guide for applying this method in clinical practice. An extensive review of the literature from the past 10 years was conducted using the PubMed database. The database was searched using the following keywords: "micro-needling", "micro-needle", "percutaneous collagen induction", and "dermaroller". The article is based on previously conducted studies and does not include any new research involving humans or animals.

Introduction: Venous leg ulcers (VLUs) are one of the most common civilization-related diseases which constitute a serious therapeutic and medical problem.

Aim: The aim of the study was to compare treatment results in patients with chronic venous leg ulcers using comprehensive therapy including topical hyperbaric oxygen therapy (HBOT).

Material and methods: The study included 57 patients: 25 (43.8%) males and 32 (56.1%) females, aged between 41 and 88 years. The patients were divided into two study groups. Group 1 (n = 29) received routine pharmacological treatment, specialized medical dressings, compression therapy and topical HBOT procedures. Group 2 (n = 28) received pharmacological treatment, medical dressings, and compression therapy. The ulcer surface area assessed using the planimetric method was compared, and selected inflammatory markers (serum concentration of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC)), selected coagulation parameters (blood concentration of fibrinogen, serum concentration of D-dimer) were assessed.

Results: After treatment, the ulcer area in patients in group 1, in which local HBOT used, was statistically significantly smaller compared to group 2 (7.12 cm² (4.65-8.56) vs. 8.98 cm² (6.48-10.18); p = 0.019). Inflammatory markers showed statistically significantly (p = 0.036; effect size - 0.27) lower values of CRP concentration in group 1: 5.8 mg/l (2.27-12) compared to group 2: 8.53 mg/l (6.3-20.86).

Conclusions: Treatment results for patients with VLUs indicates a more effective anti-inflammatory effect of comprehensive therapy including topical HBOT, with no significant influence of this method on the parameters of blood coagulation.

Introduction: Psoriasis is caused by a systemic inflammatory process. In the adult population, it may be concomitant with many diseases, especially cardiovascular ones and metabolic disorders. The incidence of psoriasis-related comorbidities in children and adolescents is subjected to in clinical trials.

Aim: The analysis of cases of children diagnosed with psoriasis depending on sex, age and medical history data, determination of the frequency of comorbidities and their risk factors, assessment of the quality of life of the patients and their families, educating the patients about psoriasis, collecting data on the methods of psoriasis treatment in the paediatric population.

Material and methods: The study included 99 children with psoriasis (61 girls and 38 boys), hospitalized in 3 paediatric dermatology centres from March 2020 to March 2022.

Results: The Psoriasis Area and Severity Index (PASI) score ≥ 10, indicating moderate and severe psoriasis, was obtained in 56% of the subjects, while the PASI score < 10, indicating mild psoriasis, was obtained in 44% of the subjects. Body mass index (BMI) above the reference range for age and sex was found in 19% of the patients. Comorbidities other than obesity were observed in 27% of the patients. Laboratory tests revealed lipid disorders and other deviations that might indicate chronic diseases.

Conclusions: Psoriatic children and adolescents are often obese and with abnormal lipid profile, which may constitute a risk factor of cardiovascular diseases. Psoriasis has a negative impact on the quality of life of patients and their families.

Introduction: Connective tissue diseases (CTDs), which include systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjogren's syndrome (SS), and so on, represent a group of autoimmune disorders that predominantly affect the body's connective tissues.

Aim: This study aimed to investigate the clinical efficacy of sirolimus in patients with connective tissue disease complicated with refractory thrombocytopenia (CTD-RTP) and its effect on immune regulation.

Material and methods: A retrospective study was conducted on 13 patients diagnosed with CTD-RTP who were treated with oral sirolimus for 6 months, starting with a daily dose of 1 mg. Changes in platelet counts, T cell lymphocyte subsets, regulatory T cells (Tregs), B cells, and cytokine levels were assessed from baseline to the end of the 6-month treatment. From November 2020 to December 2023, 13 patients with CTD-RTP were consecutively enrolled and monitored.

Results: The treatment was well tolerated with no severe drug-related toxicities were reported. After 3 months of sirolimus treatment, 7 patients exhibited a positive response (PR), with 1 patient achieving complete response (CR), resulting in an overall response rate of 61.5%. Continued treatment for 6 months led to further improvements, with the total effective rate reaching 76.9%. Importantly, there was a significant increase in peripheral blood Tregs after treatment compared with the baseline level.

Conclusions: Sirolimus is an effective and safe treatment option for CTD-RTP patients, and its effect may be related to its ability to increase the level of regulatory T cells in peripheral blood.

Introduction: Public perceptions of skin diseases can cause stigma, leading to embarrassment, isolation, and poor quality of life. This may prevent treatment, delay diagnosis, and increase healthcare costs. To improve outcomes, healthcare policies should promote accurate perceptions and better patient care.

Aim: This review examines the impact of stereotypes, stigma, media influence, and cultural factors on the perception, knowledge and attitudes of the public towards individuals with skin diseases and discussing the implications for healthcare practices and patient outcomes.

Methods: A thorough literature review was conducted of the main databases available for health research - PubMed, Scopus, and Google Scholar - using keywords related to public perception, knowledge, attitudes, stigma, and skin diseases. To ensure the reliability of the extracted data, two reviewers conducted the review independently and combined their findings. For analysis of the collated data, thematic analysis was then employed so that the key themes from the selected studies could be rigorously identified and explored.

Results: Key findings include different levels of awareness among the public, the influence of information sources such as healthcare providers, the media, and personal experiences. Factors such as education, socioeconomic status, personal experiences, and the influence of the healthcare providers also play important roles in shaping the perception, knowledge, and attitudes.

Conclusions: Overall, this review underscores the need for collaborative efforts across different sectors aimed at promoting accurate knowledge, empathy, and inclusivity towards individuals with skin diseases.

Aim: The aim of the study was to evaluate the efficacy and safety of baricitinib in treating atopic dermatitis (AD) and to provide evidence-based guidance for clinical use.

Methods: Randomized controlled trials (RCTs) of baricitinib (experimental group) versus placebo (control group) were searched in PubMed and Cochrane Library databases by computer, and the search period was from the establishment of the database to December 2024. After screening the literature and extracting data, the quality of the included studies was assessed using the bias assessment tools recommended in the Cochrane Handbook for Systematic Reviews 5.1.0. Meta-analysis was conducted using RevMan 5.4 software, and sensitivity analysis and publication bias analysis were performed using Stata software.

Results: A total of 6 studies were included, comprising 7 RCTs with a total of 2966 patients. The results of the meta-analysis showed that the EASI 50 or EASI 75 in the experimental group (OR = 2.68, 95% CI (2.15, 3.34), p < 0.00001), vIGA-AD (OR = 2.67, 95% CI (1.97, 3.63), p < 0.00001), EASI 90 (OR = 2.58, 95% CI (1.83, 3.62), p < 0.00001), SCORAD 75 (OR = 3.99, 95% CI (2.47, 6.45), p < 0.00001), and NRS ≥ 4 (OR = 2.45, 95% CI (1.90, 3.17), p < 0.00001) were all significantly higher than those in the control group. There was no statistically significant difference in the incidence of adverse drug events, serious adverse events, nasopharyngitis, upper respiratory tract infections, diarrhoea, etc. between the two groups of patients (p > 0.05). Subgroup analysis results showed that there were significant differences in treatment effects between the 1 mg experimental group and the 2 mg experimental group, as well as between the 2 mg experimental group and the 4 mg experimental group. The results of the sensitivity analysis and publication bias analysis indicated that the findings of this study are robust and there is a low possibility of publication bias.

Conclusions: Baricitinib demonstrates good efficacy and safety in the treatment of AD.

Introduction: Acne scars are a common and often distressing consequence of acne vulgaris, leading many patients to pursue aesthetic treatments. While microneedling and chemical peels are effective on their own, combining them may yield better results.

Aim: To systematically evaluate the efficacy and safety of combining microneedling with chemical peeling versus either treatment alone in the management of atrophic acne scars.

Material and methods: This systematic review and meta-analysis followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251082268). A comprehensive search of PubMed, Embase, and Cochrane databases identified randomised and non-randomised trials comparing combined microneedling and chemical peeling to monotherapies. Outcomes included clinical improvement, patient satisfaction, adverse events, and quality-of-life measures.

Results: Nine studies (n = 566) met inclusion criteria; six were eligible for meta-analysis. The combination therapy significantly outperformed microneedling (OR = 5.72, 95% CI: 2.82-11.61) and chemical peeling (OR = 8.94, 95% CI: 4.72-16.95) alone. Responder rates ≥ 75% reached 40-50% with combination therapy versus ≤ 13% with monotherapy. ECCA scores improved more with dual therapy. Patient-reported satisfaction and DLQI (Dermatology Life Quality Index) scores also favoured combination protocols. Adverse events were mild and transient, with no serious complications.

Conclusions: Combined microneedling and chemical peeling is superior to either treatment alone for atrophic acne scars, with favourable safety and patient-reported outcomes.

Introduction: Preterm children suffer from atopic dermatitis (AD) less frequently than term children do. The reason for this phenomenon has not yet been identified. Hypotheses include changes in the T-helper 1 (Th1)/T-helper 2 (Th2) balance or altered development of the thymus.

Aim: This study was designed to compare the Th1/Th2 cytokine balance and thymus size in preterm and term children and investigate the associations between these results and a possible diagnosis of AD in the second year of life.

Material and methods: The population comprised 28 preterm and 19 term children. During the first week of life, Th1/Th2/Th17 cytokine levels in the blood were assessed, and the thymus was measured via ultrasound. In the second year of life, 30 children were examined to determine whether AD was present, and the abovementioned procedures were repeated.

Results: AD was diagnosed in 3 out of 18 (16.7%) preterm children and 1 out of 12 (8.3%) term children (OR = 2.2; 95% CI: 0.201-24.086). For all patients, the thymus/weight index was lower, and there was a significant decrease in the level of IL-2 and increases in the levels of IL-4 and IL-17 in the second year of life compared with those after birth. There were no differences in cytokine levels or thymus size in the second year of life between the preterm/term and AD/non-AD subgroups.

Conclusions: The observed associations may indicate that the immunological status of preterm children in the second year of life may not vastly differ from that of term children.

Introduction: The gastrointestinal microbiota is thought to play a role in the pathogenesis of food allergies. One potential contributing factor is small intestinal bacterial overgrowth (SIBO).

Aim: This study aims to investigate the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with diagnosed allergic diseases and to assess potential associations between SIBO and allergy burden.

Material and methods: This study included 44 patients aged 21-73 years, who were evaluated for suspected food hypersensitivity of various origin. A medical history was collected, followed by a physical examination, point-of-care skin tests and a breath test for SIBO. Patients with celiac disease, known autoimmune or malignant disorders, or those receiving medications that could influence study outcomes were excluded. Additionally, patients who had recently undergone endoscopy or abdominal surgery, were experiencing an exacerbation of a chronic illness, or had an acute infection were not included in the study.

Results: A positive breath test for SIBO was found in 85.7% of patients with a history of food allergy and 78.3% of patients without confirmed allergy; however, the difference was not statistically significant.

Conclusions: This pilot study did not confirm a higher prevalence of SIBO in patients with food allergies compared to those without. Further studies with larger sample sizes and more comprehensive allergological diagnostics are needed to definitively assess the potential link between SIBO and food allergies.