Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii最新文献

Introduction: It is essential to understand the underlying changes in the patients' metabolic profiles that may be indicative of the therapy's effectiveness.

Aim: To prospectively analyse the clinical efficacy of ozone autohemotherapy in the treatment of acute herpes zoster and investigate its impact on serum metabolomics.

Material and methods: A total of 76 patients with acute herpes zoster between May 2018 and June 2020 were enrolled and divided into an experimental group and a control group. The pain location, Numeric Rating Scale (NRS) scores before and after treatment (1 week, 1 month, 3 months, and 6 months post-treatment), medication usage, and Quality of Sleep (QS) scores were prospectively analysed. Additionally, serum metabolomic data were obtained and analysed before and 6 months after the treatment.

Results: There were statistically significant differences in the total NRS scores before and after ozone autohemotherapy (p < 0.05). The NRS scores of both groups significantly decreased (p < 0.05). At the 6-month follow-up, no patients were lost, and 83 patients completed the follow-up. The NRS improvement at 1 week, 1 month, 3 months, and 6 months post-treatment in the experimental group was significantly lower than that in the control group (p < 0.05). There was no significant difference in the medication usage (pregabalin or tramadol sustained-release tablets) between the two groups (p > 0.05). One month after treatment, the QS score improvement in the diabetes group was significantly lower than that in the non-diabetes group (p < 0.05). Serum metabolomics analysis revealed three significantly decreased metabolites, namely creatine, adipate, and glucose, after treatment.

Conclusions: Ozone autohemotherapy is an effective treatment for acute herpes zoster patients and can rapidly and effectively alleviate pain symptoms in the short term. The changes in serum metabolomics may provide further insights into the treatment mechanism.

Introduction: Metformin has potential in treating patients with psoriasis, and this meta-analysis aims to explore the impact of metformin supplementation on treatment efficacy for psoriasis.

Material and methods: The PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of metformin on treatment efficacy for patients with psoriasis.

Results: Three RCTs were included in the meta-analysis. Overall, compared with control intervention for psoriasis, metformin intervention resulted in significantly increased psoriasis area severity index (PASI) 75% reduction (odds ratio (OR) = 22.02; 95% confidence interval (CI): 2.12 to 228.49; p = 0.01), and erythema, scaling and induration (ESI) 75% reduction (OR = 9.12; 95% CI: 2.13 to 39.02; p = 0.003), and was associated with substantially decreased fasting plasma glucose (FPG, standard mean difference (SMD) = -0.59; 95% CI: -0.92 to -0.26; p = 0.0005), triglycerides (SMD = -0.92; 95% CI: -1.38 to -0.47; p < 0.0001), total cholesterol (SMD = -0.77; 95% CI: -1.22 to -0.32; p = 0.00008), and low-density lipoprotein (LDL, SMD = -0.67; 95% CI: -1.12 to -0.23; p = 0.003).

Conclusions: Metformin supplementation effectively improves treatment efficacy and metabolic syndrome in psoriasis patients.

Introduction: Specific immunoglobulins E (sIgE) are important parameters for the estimation of severity of allergic diseases.

Aim: To determine the relationship between the concentration of specific IgE antibodies in serum and types of asthma.

Material and methods: The concentration of sIgE antibodies against allergens Dermatophagoides pteronyssinus, cat dander, timothy grass, and Alternaria alternata were determined in the serum of 4077 respondents randomly selected from 8 regions (ECAP study). The positive results of sIgE (≥ 0.35 IU/ml or ≥ 0.7 IU/ml) were correlated to clinical diagnosis (types of asthma, skin-prick tests).

Results: sIgE antibodies against any allergen were detected in 9.9% (classes 1-6)/7.6% (classes 2-6) of healthy respondents. Comparing sIgE antibodies of respondents with intermittent asthma to sIgE antibodies of respondents with persistent asthma, no statistically significant differences were identified. Relating to allergens of D. pteronyssinus, cat dander, and A. alternata, sIgE antibodies were more frequently detected in respondents with atopic asthma and a negative skin-prick test as compared to healthy respondents with a negative skin-prick test (p < 0.005 to p < 0.001). Relating to allergens of D. pteronyssinus, cat dander, and timothy grass, sIgE antibodies were more frequently detected in respondents with atopic asthma and a weakly positive skin-prick test as compared to healthy respondents with weakly positive skin-prick test (p < 0.05 to p < 0.001).

Conclusions: Regarding subjects with a negative or weakly positive skin test, when sIgE antibodies to the same allergen are detected, asthma is much more likely to occur.

Introduction: Allergen immunotherapy (AIT) is an effective therapy for allergic rhinitis and may have long-term benefits. However, these benefits have not been strictly defined for older people.

Aim: The evaluation of the effectiveness of AIT in patients over 60 with allergic rhinitis and house dust mites (HDM) allergy over a period of 7 years was performed.

Material and methods: Patients after three years of HDM-AIT were observed to assess the sustained clinical effect of treatment. The average adjusted symptom score (AAdSS) and sIgG4 were monitored for 7 years after sublingual (SLIT) and injection AIT (SCIT).

Results: After 3 years of HDM-AIT, a significant clinical effect was observed in the group after SLIT and SCIT based on AAdSS compared to the baseline and the placebo group (p < 0.05). After 7 years of follow-up, there was a sustained trend of decrease in clinical symptoms in desensitized patients relative to placebo. Serum sIgG4 was constantly present in all desensitized patients.

Conclusions: AIT may be beneficial for treating seniors with allergic rhinitis and allergies to house dust mites.

Introduction: The interleukin-12/23 (IL-12/23) signalling pathway plays an important role in the pathogenesis of psoriasis. In addition, even molecularly targeted therapy has been reported to lose adequate response to treatment.

Aim: To determine the expression patterns of mRNAs and miRNAs related to IL-12/23 signalling pathways in the human keratinocyte culture exposed to liposaccharide A (LPS) and then adalimumab in comparison with untreated cells.

Material and methods: Human, adult, low-Calcium, high-Temperature keratinocyte (HaCaT) cultures were exposed to 1 µg/ml LPS for 8 h, and then adalimumab was added to the cultures at a concentration of 8 µg/ml and incubated for 2, 8, and 24 h. We used mRNA and miRNA microarray, quantitative reverse transcription polymerase chain reaction, and enzyme-linked immunosorbent assay techniques.

Results: STAT1, STAT3, STAT5, IL-6, IL-6R, SOCS3, and JAK3 genes differentiated HaCaT cultures with the drug from controls regardless of the time the cells were exposed to the drug. The addition of adalimumab to a culture previously exposed to LPS resulted in silencing of SOCS3 and IL-6 expression compared to the control, while for the other transcripts they were found to be overexpressed compared to the control culture. The assessment indicated the strongest connections between JAK3 and hsa-miR-373-5p (target score 96); SOCS3, STAT5, and hsa-miR-1827 (target score 96).

Conclusions: Our study indicates that adalimumab has the strongest modulating effect on mRNA and miRNA expression of JAK/STAT and IL-6-dependent IL-12/23 pathways.

Psoriasis is a chronic autoimmune disease that affects 1-3% of the population. The pathomechanism of psoriasis development is complex, but genetic (non-modifiable) factors play a key role. However, the importance of environmental factors and lifestyle choices, such as the diet, alcohol consumption, and smoking, is increasing. The objective of this review was to analyse the influence of dietary habits, alcohol consumption, and smoking on the clinical course of psoriasis. Stress, a poor diet, alcohol abuse, and smoking can trigger psoriasis or cause its exacerbation. Therefore, in addition to the correct selection of therapy, it is extremely important to educate patients about the impact of these factors on the onset and progression of psoriasis. This literature review confirms that a holistic and multidisciplinary approach is required for patients with psoriasis, further emphasizing Hippocrates' thesis, "Let food be thy medicine, and medicine be thy food".

Introduction: Alexithymia is a psychological condition characterized by difficulty in identifying and expressing one's emotions, and it has been associated with several physical and mental health disorders.

Aim: To determine the prevalence of alexithymia among patients with a range of chronic dermatological diseases in a Saudi public hospital.

Material and methods: 477 patients who were over 14 years old and affected by one of the following chronic skin conditions: psoriasis, atopic dermatitis, acne, alopecia areata, vitiligo, hidradenitis suppurativa, pemphigus vulgaris, chronic urticaria were included in this study. Alexithymia was assessed in these patients by using the Toronto Alexithymia Scale (TAS) which is a widely used, reliable and valid measure of this construct.

Results: Prevalence of alexithymia among chronic dermatological disease patients ranges from 14.8% to 71.4%, with an overall occurrence of 43%. The highest prevalence of alexithymia was found in hidradenitis suppurativa (71.4%) and the lowest in acne (14.8%). Overall, the alexithymia cases were predominantly male (51.7%). The distribution of male and female cases with alexithymia varied among patients with different types of chronic skin diseases, with the highest male prevalence in psoriasis (58.7%) and the highest female prevalence in pemphigus vulgaris (66.7%).

Conclusions: Alexithymia is prevalent among patients with chronic dermatological diseases and dermatologists' awareness of how to identify and address alexithymia among their patients can play a vital role in improving treatment adherence and outcomes.

Introduction: The relationship between rosacea and basal cell carcinoma (BCC) is still not known. Almost all reports questioning the relation between BCC and rosacea are focused on rhinophyma.

Aim: To examine the possible connection of BCC and rosacea.

Material and methods: 110 patients with BCC located on the face treated surgically in the Dermatosurgery Unit in 2020-2021 were included in the study. A trained dermatologist assessed the presence or absence of concomitant rosacea and assessed its severity according to the Investigator's Global Assessment (IGA).

Results: Fifty-one (46.4%) subjects with BCC and concomitant clinically diagnosed rosacea were found. In our group 35.5% of women had BCC located on the cheeks, while in men most cancers were located on the nose (55%, n = 11), however this difference has not reached statistical significance.

Conclusions: The incidence of rosacea in our population was undoubtedly higher, comparing to the normative population. Both rosacea and BCC share the same risk factors - UV exposure, the potential association should not be neglected.

Introduction: Our previous study showed that the severity of atopic dermatitis (AD) in children significantly correlates with the quality of life and perceived stress in their mothers.

Aim: To compare strategies for coping with stress in mothers of children with and without AD, as well as to investigate the relationship between coping strategies of mothers of affected children and AD variables, stress intensity, and quality of life.

Material and methods: The study included 88 mothers of children with AD and 57 mothers of children without AD as controls. The severity of skin lesions in children with AD was assessed by the Scoring Atopic Dermatitis (SCORAD) index, and skin itch was evaluated by the Numerical Rating Scale (NRS). All mothers completed the sociodemographic questionnaire (SD), the Perceived Stress Scale (PSS), and the Coping Orientations to Problems Experienced (COPE) scale. Additionally, mothers of children with AD filled out the Family Dermatology Life Quality Index (FDLQI).

Results: There were no statistically significant differences in coping strategies between the groups. However, there were significant correlations between the selected coping strategies and AD severity, perceived stress of mothers, and quality of life of the entire family of affected children.

Conclusions: Although mothers of children with AD experience higher levels of stress compared with mothers of children without AD, the disease does not change coping strategies. Psychological support for mothers of children with AD should be oriented toward strengthening cognitive coping strategies.