Postepy Dermatologii I Alergologii最新文献

Actinic keratosis (AK) is a prevalent benign intraepidermal dysplasia, classified as squamous cell carcinoma in situ (SCC in situ). Chronic ultraviolet (UV) light exposure is the primary etiological factor for AK, which predominantly manifests in sun-exposed areas. Management of AK emphasizes primary prevention through education, sun protection, and vigilant patient monitoring. Therapeutic strategies for AK are categorized into lesion-directed and field-directed approaches, encompassing topical treatments (imiquimod, 5-fluorouracil, diclofenac) and physical modalities (cryotherapy, photodynamic therapy, chemical peels, laser therapy, electrocoagulation, curettage). This comprehensive review discusses the current treatments and explores novel therapeutic options for AK.

Introduction: Serofast state is defined as an insufficient decrease in the non-treponemal reaction titre after 6-12 months for early syphilis or after 12-24 months for late syphilis counting from the recommended treatment, with the simultaneous resolution of the infection symptoms.

Aim: The aim of this article was to review the current understanding of the serofast state. Additionally, data on recommended diagnostic and therapeutic approaches for patients with serofast state were presented.

Methods: In order to review the current understanding in the field of serofast syphilis, the PubMed database was searched.

Results: The available literature relating to serofast syphilis is mainly concerned with predictive factors of the serofast state.

Conclusions: Understanding the predictive factors of the serofast state and its pathomechanism is crucial. This knowledge enables early identification of patients who, following treatment, may require increased clinical supervision and a slightly altered therapeutic management plan.

Introduction: Pemphigus vulgaris (PV) is a rare autoimmune bullous dermatitis caused by autoantibodies against desmoglein-1 and desmoglein-3. Sulfhydryl group/total thiols play a key role in numerous cellular activities, such as antioxidant protection, detoxification, cell growth, and apoptosis. Acantholysis may develop due to chemical reasons.

Aim: The aim of this study was to investigate the relationship between PV and serum total sulfhydryl levels.

Material and methods: The study was conducted with a total of 177 individuals, comprising 86 PV patients and 91 controls. Age, gender, smoking status, alcohol consumption, and pemphigus-triggering food intake were recorded. Diagnosis of PV was established based on the clinical and histopathologic examinations followed by a direct immunofluorescence and indirect immunofluorescence test. Serum total sulfhydryl level (TSH) was measured by spectrophotometric method.

Results: Mean age was 41.94 ±11.41 years in the patient group and 39.86 ±11.72 years in the control group. In the PV group, smoking was noted in 62.8% (n = 54) and alcohol consumption was noted in 32.6% (n = 28) of the patients. There was a significant difference in total sulfhydryl levels between the groups.

Conclusions: Our findings suggest that foods and drugs containing sulfhydryl groups may induce pemphigus vulgaris or aggravate the disease.

Kidney transplantation has become the preferred treatment for end-stage renal disease, significantly enhancing quality of life and life expectancy compared to dialysis. However, immunosuppressive therapy post-transplantation causes various side-effects, including skin and hair disorders. While the literature extensively documents cutaneous malignancies post-transplantation, hair disorders remain less explored. This review synthesizes the existing literature on trichological problems in transplant recipients, focusing on the correlation between immunosuppressive medications and hair disorders. A more concise version might be: The review highlights a discrepancy between patient-reported alopecia rates and physician perceptions, suggesting an underestimation of the issue. It underscores the importance of recognizing and managing trichological complications, which can significantly impact patients' quality of life, especially in some groups such as women experiencing alopecia and in teenagers of both sexes. Further research is needed to better understand the prevalence, patterns, and mechanisms of trichological complications post-transplantation as well as to explore potential therapeutic interventions. Future studies on the etiopathogenesis of these complications can improve patient care and management strategies.

Introduction: Asthma and allergic rhinitis are common respiratory diseases in children, with complex aetiologies involving genetic and environmental factors.

Aim: This work was to identify the genetic and environmental risk factors' prevalence in asthma and allergic rhinitis in paediatric patients.

Material and methods: A cross-sectional study was conducted among 120 paediatric patients with asthma and allergic rhinitis. Univariate analysis was used to examine the associations between various factors, including age, weight status, personal history of allergies, CD14 polymorphisms, and environmental exposures.

Results: The study included 120 paediatric patients (65 males, 55 females; mean age: 6.4 ±3.5 years) with asthma and allergic rhinitis. The results showed significant associations between asthma and allergic rhinitis and several factors, including age (c² = 34.48, p < 0.001), weight status (c² = 63.1, p < 0.001), personal history of allergies (c² = 54.1, p < 0.001), and CD14 polymorphisms (-159C/T, -550C/T, and 2758A/G) (c² = 23.5, p < 0.001; c² = 20.63, p < 0.001; c² = 24.5, p < 0.001, respectively). Environmental factors, including paternal and maternal education levels, parental history of asthma and allergies, caesarean section delivery, home renovation history, exposure to pets, household dust, pollen, plush toys, cold air exposure, long-term family smoking, number of cars near the residence, outdoor activities, winter gas heating, and natural gas use, were also significantly more prevalent in our patients.

Conclusions: This study highlights the importance of both genetic and environmental factors in the development of childhood asthma and AR. The identification of specific genetic polymorphisms and environmental risk factors can provide information about the development of personalized prevention and treatment strategies for these diseases.

Introduction: Cutaneous T-cell lymphoma (CTCL), including mycosis fungoides (MF) and Sézary syndrome (SS), significantly affects patients' quality of life (QoL) due to its chronic and progressive nature. Both conditions often lead to diagnostic delays and have a profound impact on daily activities and emotional well-being.

Aim: This study aimed to evaluate the QoL impairment in patients with MF and SS compared to individuals with psoriasis vulgaris and other dermatological diseases. Additionally, the study explored the potential role of high-frequency ultrasound (HFUS) in monitoring CTCL.

Material and methods: A total of 104 patients, including 16 with MF, 1 with SS, 34 with psoriasis, and 53 with other dermatological diseases, were recruited from the University Centre of General Dermatology and Oncodermatology of the Wroclaw Medical University. QoL was assessed using the Polish version of the Dermatology Life Quality Index (DLQI) questionnaire. Statistical analyses included descriptive statistics, the Shapiro-Wilk test, and the Kruskal-Wallis H test.

Results: Patients with CTCL had reduced QoL, with DLQI scores ranging from 2 to 22 (median: 10). However, intergroup comparisons showed no statistically significant differences between CTCL, psoriasis, and other dermatological disorders. HFUS emerged as a promising tool for assessing disease progression by measuring epidermal thickness, subepidermal low-echogenic band (SLEB) changes.

Conclusions: CTCL significantly impairs QoL, necessitating individualized management strategies. While treatments like low-dose total skin electron beam therapy (TSEBT) and extracorporeal photopheresis (ECP) offer QoL improvements, disease progression remains a concern. HFUS shows potential as a non-invasive diagnostic and monitoring tool, but further research is needed to validate its routine clinical application.

Introduction: Adult asthma as inflammatory-based disease can be an independent risk factor for stroke.

Aim: To evaluate the relationship between adult asthma and cerebrovascular accident.

Material and methods: 120 patients (asthma stroke, asthma non-stroke, and non-asthma stroke groups) who were matched for age and gender were included in this prospective cohort study to observe pulmonary function changes and recurrence rate of stroke among asthmatic patients during 6-month follow-up after first even after first even stroke.

Results: In the asthma stroke group, post stroke forced vital capacity (FVC) (3.04 ±0.13 vs. 2.58 ±0.15, p = 0.006), forced expiratory volume in 1 s (FEV1) (2.68 ±0.15 vs. 2.01 ±0.12, p = 0.02), FEV1/FVC (0.88 ±0.03 vs. 0.77 ±0.02, p = 0.001), maximal inspiratory pressure (MIP) (74.05 ±5.36 vs. 56.57 ±3.83, p = 0.001), maximal expiratory pressure (MEP) (88.30 ±3.65 vs. 71.42 ±3.98, p = 0.001) and 6-minute walk test (6MWT) (446.32 ±47.56 vs. 338.62 ±28.85, p = 0.001) were significantly decreased in comparison to before stroke. Also, stroke recurrence was 32.5% in the asthma stroke group and 12.5% in the non-asthma stroke group, which was significantly higher in the asthma stroke group (p = 0.001). Comparison of pulmonary function showed that all FVC (2.58 ±0.15 vs. 3.36 ±0.14, p = 0.001), FEV1 (2.01 ±0.12 vs. 2.73 ±0.16, p = 0.001), FEV1/FVC (0.77 ±0.02 vs. 0.81 ±0.03, p = 0.001), MIP (56.57 ±3.83 vs. 70.62 ±2.77, p = 0.001), MEP (71.42 ±3.98 vs. 85.97 ±2.31, p = 0.001) and 6MWT (338.62 ±28.85 vs. 385.67 ±29.82, p = 0.001) in the asthma stroke group were significantly decreased in comparison to the non-asthma stroke group.

Conclusions: FVC, FEV1, FEV1/FVC, MIP, MEP and 6MWT were significantly decreased in allergic asthma patients after stroke, also adult asthma can increase the risk of recurrence of risk of stroke in asthmatic stroke patients.

Introduction: Chronic spontaneous urticaria (CSU) is defined as the appearance of itchy wheals and/or angioedema for at least 6 weeks. Cigarette smoking is one of the world's most common addictions. It is a cause of serious diseases such as renal cancer or thromboembolic incidents. Nevertheless, some studies show that nicotine might have a protective effect on various autoimmune diseases. The neutrophil-lymphocyte ratio (NLR) is a good marker of inflammation.

Aim: To check the prevalence of smokers in our CSU patients and to assess their profile of NLR as a marker of inflammation.

Material and methods: 68 adult patients were included (52 females, and 16 males). The average age of respondents was 52. All of the patients were diagnosed with CSU. The group was divided by gender and smoking. The Mann-Whitney U test (Statistica ver.13) was used.

Results: 73.5% of the respondents were non-smokers, and the remaining 26.5% were smokers. In the female group, irrespective of smoking, statistically significant different levels of neutrophils (NEU), lymphocytes (LYM), and neutrophil-lymphocyte ratio (NLR) were found compared to males. No statistical difference was found between smokers and non-smokers regarding the level of inflammatory factors. Compared to males, females had significantly different levels of LYM in the group of non-smokers and NEU in the group of smokers.

Conclusions: Our study does not support claims that smoking has a protective effect on CSU. Significant differences in NEU, LYM, and NLR need to be further investigated.

Introduction: Tattoos are a form of body modifications. Alexithymia is a complex personality structure that includes emotional and cognitive deficits such as difficulty in recognizing and describing feelings.

Aim: To assess the prevalence of alexithymia among tattooed individuals. Moreover, we aimed to check if the type of tattoo is related to alexithymia.

Material and methods: This was a cross-sectional survey, conducted on 403 individuals from Poland. 200 of them had tattoos and were assigned to the study group, and 203 of them had no tattoos and were assigned to the control group.

Results: Most respondents (24%) had one tattoo. Most tattoos (29.8%) were situated on forearms and palms, had a plant motif (21.8%) and were done to express personality of the respondents (20.7%). In the research group 80 (19.9%) respondents were classified as alexithymic ones. Out of them, 47 (11.7%) individuals had tattoos and 33 (8.9%) belonged to the non-tattooed group. 35 (17.5%) respondents with non-verbal tattoos were screened as alexithymic while 12 (6%) individuals with verbal, personal tattoos were classified as alexithymic ones (p < 0.05). Twenty-two (11%) respondents who did their tattoos for psychological reasons and 25 (12.5%) individuals who did their tattoos for aesthetic reasons were classified as alexithymic (NS).

Conclusions: Subjects with tattoos should be regarded as a group with increased prevalence of alexithymia. Individuals with non-verbal tattoos had a higher tendency to be screened as alexithymic as alexithymic ones. Motivation for getting the tattoo does not seem to have a significant impact on the prevalence of alexithymia.

Introduction: The idea that chronic inflammatory processes may play a role in the etiopathogenesis of both treatment - refractory chronic spontaneous urticaria and cardiovascular diseases is an important research topic.

Aim: Within the scope of this research, we aimed to elucidate a new perspective on the follow-up of chronic urticaria patients by evaluating the 10-year cardiovascular risk and metabolic syndrome in resistant chronic spontaneous urticaria patients who were unresponsive to maximum antihistamine treatment.

Material and methods: A total of 170 individuals who applied to our institution's Health Science University, Tepecik Education and Research Hospital, allergy and immunology outpatient clinic have been analysed in this retrospective case-control study. Metabolic syndrome was calculated according to the National Cholesterol Education Program -- Adult Treatment Panel III, and the cardiovascular risk was calculated according to the Framingham Heart Study of the National Heart, Lung and Blood Institute.

Results: The study included 85 patients diagnosed with chronic spontaneous urticaria (CSU) alongside 85 control subjects. Comparative analysis between the CSU patient group and the control group revealed substantial differences in terms of gender distribution, smoking habits, metabolic syndrome prevalence, waist circumference measurements, body mass index (BMI), hypertension incidence, and levels of C-reactive protein (CRP) (p < 0.05). However, factors such as patient age, fasting blood glucose, diabetes status, triglyceride (TAG), high density lipoprotein (HDL), low density lipoprotein (LDL), and the percentage risk of cardiovascular events over 10 years were not found to influence CSU (p > 0.05).

Conclusions: Regarding the outcomes of this study, the presence of hypertension, obesity, waist circumference and C-reactive protein values associated with metabolic syndrome should be followed for antihistamine-refractory CSU. Early diagnosis and treatment of metabolic syndrome and its components in these patients may play a role in preventing potential complications. No significant increase in the 10-year cardiovascular risk was observed.