A study conducted at "Naftalan" Special Hospital in Croatia evaluated the impact of naphtalanotherapy (NT) combined with individually tailored physiotherapy (ITP) on 119 patients with psoriatic arthritis and psoriasis. Patients underwent treatments for either two or three weeks. Results indicated that both treatment durations significantly improved pain, stiffness, swelling, disease activity, skin condition, and quality of life, with the three-week program proving more effective. The findings support the inclusion of NT and ITP in the management psoriatic disease and suggest that extended rehabilitation could have long-term benefits, potentially influencing health insurance policies.
Psoriasis is a chronic, incurable disease. Chronic skin diseases, including psoriasis, are a significant issue. The general population often does not have enough information and knowledge about psoriasis. The goal of the present study was to examine the awareness, knowledge, attitudes, and prejudices about psoriasis among fourth-grade high school students and to determine whether there are gender differences in awareness, knowledge, attitudes, and prejudices about psoriasis. A prospective study was conducted in the period between March and December 2023, which included 333 male and female respondents, fourth graders in secondary schools, over eighteen years of age, of both sexes, in the area of the Tuzla Canton. Almost half of the participants (48.14%) did not know what psoriasis is, and three quarters of the respondents (79.62%) did not know anyone suffering from psoriasis. More than two thirds of respondents (68.82%) did not know the date of World Psoriasis Day. Almost half of the respondents (48.76%) would not shake hands with a person with psoriasis, and 11.41% believed that it is transmitted by touch; 14.50% of respondents believed that psoriasis is contagious, while 32.09% of respondents would not associate with a person with psoriasis. We also examined whether there were gender differences among respondents in awareness and knowledge on psoriasis (Hi-test significance = 0.99952), attitudes and prejudices about psoriasis (Hi-test significance = 0.753619), but the results were not statistically significant. Continuous education on psoriasis is needed, which will primarily inform the general public about psoriasis.
Background: Oral lichen planus (OLP) is a chronic inflammatory and autoimmune condition of the oral mucosa with significant variation in pathophysiology. Accordingly, the present study aims to evaluate the socio-demographic profile of OLP patients in an eastern Indian population, examining the interplay between socio-economic status (SES), lifestyle factors, and disease characteristics.
Methods: This prospective study was conducted at a teaching hospital in eastern India from January 2019 to February 2022. Out of 1589 diagnosed OLP patients, 546 voluntarily agreed to participate in the study. We collected socio-demographic data, such as age, gender, education level, occupation, income, lifestyle habits, and comorbidity, through structured interviews and medical records. We performed statistical analyses using SPSS 20.0 software to identify significant associations between these variables and the clinical features of OLP.
Results: Among the 546 participants, 54.02% were women and 45.97% were men, with the highest prevalence (40.10%) in the middle aged adult group (31-40 years). Furthermore, the majority of participants came from lower castes (64.64%), belonged to a lower socio-economic class (45.60%), and over 53% were involved in agricultural farming and daily labor. From a lifestyle perspective, 53.39% of participants were highly addicted to paan, gutka, cigarettes, and alcohol. Common comorbidities included hypertension (18.68%), diabetes (16.84%), thyroid disorders (10.62%), and past hepatitis C infection history (16.84%). Approximately 70.69% experienced stress, anxiety, and depression, while 21.79% frequently encountered chronic trauma post-OLP development.
Conclusion: This study highlights OLP prevalence and severity in a teaching hospital, where lower socio-economic status and lifestyle factors, such as tobacco use, comorbidities, and hepatitis C infection, are significantly associated with OLP manifestations.
Introduction: Lupus erythematosus is an autoimmune disorder with various clinical manifestations. Depending on the clinical-immunological correlation different variants with a variable prognosis, multiple strategies for therapy and follow-up are described. Moreover, a regular immunological monitoring could help for a timely established aggravation of the disease from localized to systemic form. The aim of preset study was to analyze the antibody profile of patients with cutaneous manifestations in different subtypes of lupus erythematosus.
Methods: Sixty-seven Bulgarian patients with different clinical variants of lupus erythematosus, admitted in the Department of Dermatology in Alexandrovska University Hospital in Sofia between October 2017 and May 2021 were investigated and their data were compared to those of 63 persons control group. Several immune-serological markers as ANA, anti-dsDNA, anti-Sm, anti-SM/RNP, anti-histone, anti-C1q, anti-SSA/Ro, anti-SSA/Ro52, anti-SSA/Ro60 and anti-SSB/La were used. Statistical analysis was performed using the parametric analysis with SPSS for Windows 21.0 (IBM, SPSS statistics) software and receiver operating characteristic (ROC) curve and the area under the curve (AUC) analysis by MedCalc for Windows, version 20.0.23 statistical software.
Results: A statistical significance (p<0.05) was found in all serological markers in LE comparing to the control group. Anti-C1q (p=0.06) had a tendency for a significance in the context of subacute cutaneous LE.Anti-SSA/Ro 52 and anti-SSA/Ro 60 were found to prevail significantly in patients with chronic cutaneous LE. Anti-dsDNA, anti-Sm, anti-Sm/RNP (p<0.05) were related straightly with systemic LE. All patients in our research with higher than 1:320 titers of ANA are found to have bad disease control.
Discussion: Our data confirmed the strong association between anti-dsDNA, anti-Sm, anti-Sm/RNP and SLE, as well as anti-SSA/Ro 52 and anti-SSA/Ro 60 and subacute cutaneous LE. ANA is a relevant marker of lupus disease activity. All lupus patients with ANA higher than 320 titter had a bad disease control. Based on our results, ANA and anti-SSB/La could be used as follow-up markers for a disease conversion form CLE to SLE. Anti-SSB/La antibodies are found in higher prevalence in patients with discoid cutaneous LE.
Erythrodermic psoriasis (EP) is a rare but severe variant of this inflammatory cutaneous disease, occurring in less than 3% of patients with psoriasis. It is characterized by involvement of more than 90% of body surface area (BSA), with diffuse scaling and erythema. Usually, EP develops in subjects with poor control of psoriatic disease (1). EP is considered an emergency condition in dermatology due to extensive skin involvement and systemic symptoms; moreover, it is often resistant to conventional therapies (1,2). While the pathogenesis of plaque psoriasis is well-understood, with a complex interplay between Th1, Th2, and Th17 responses, the inflammatory mechanisms of EP are less known, but the IL-17 pathway seems to play a pivotal role (2). Brodalumab is a fully human monoclonal antibody blocking the interleukin-17 receptor A, thus interfering with different isoforms of IL-17 (A, A/F, F, C, and E) (3). This results in a complete block of the IL-17 response, including IL-17 C and E, which are released by keratinocytes and not directly by the Th17 line. Therefore, brodalumab presents a broader action in comparison with anti-IL-23 and other anti-IL-17 drugs, which act upstream on the Th17 line (4). As shown by Yamasaki et al. in a 52-week open-label study, brodalumab is associated with a rapid response, even in patients with EP, showing a drastic improvement in symptoms after just two weeks (3). Herein we report a case of a 57 -year-old woman with a recent diagnosis of plaque psoriasis, naïve to systemic therapies, who rapidly developed EP. Psoriasis diagnosis was confirmed by skin biopsy. With regard to comorbidities, she presented a history of excessive alcohol use and tested positive for latent tuberculosis. At the first evaluation, the patient presented with BSA involvement of 90%, a PASI score of 42, and a DLQI of 26, without psoriatic arthritis (Figure 1, a). At the examination, a concomitant ocular involvement was particularly evident, with conjunctival redness and a reported burning sensation (Figure 1, b). After receiving prophylactic treatment for latent tuberculosis, brodalumab was initiated at the labeled dosage. A dramatic improvement was observed after just two weeks, with a reduction of erythema and scaliness as well as the itching and burning sensation (Figure 2, a). Furthermore, the conjunctive redness completely disappeared. After 4 weeks, the PASI score was reduced to 2 and BSA decreased to 5%, with a positive impact on quality of life (Figure 2, b). The patient did not report any adverse events. Due to the rarity of this form of psoriasis, international guidelines or recommendations on EP treatment and management are lacking. Several biologic drugs are currently being used off label based on case reports or small case series, with an optimal response and tolerance profile (1). To our knowledge, , there have been only six cases of EP treated with brodalumab in real-life settings (2,4,5). Our experience, in accordance with
Background: Neurofibromatosis type 1 is one of the more common rare disorders, and its atypical/segmental or mosaic forms are underdiagnosed. Thus far, only a few dozen cases of localized mosaic neurofibromatosis have undergone combined germline and somatic genetic testing for the NF1 gene.
Methods: A 65-year-old female patient was referred to our center for multiple neurofibromas on her right shoulder, with a clinical diagnosis of localized mosaic neurofibromatosis. One of the neurofibromas was surgically removed. Massively parallel sequencing and multiplex ligation-dependent probe amplification were utilized to identify the germline and somatic variants in the NF1 gene.
Results: The heterozygous pathogenic NF1 gene variant c.7549C>T and multiple heterozygous intragenic NF1 gene deletions were detected in the DNA taken from the shoulder neurofibroma, but not in the DNA from blood leukocytes or buccal smear.
Study limitations: The healthy skin around neurofibromas was not analyzed due to limited available material.
Conclusion: Germline and somatic genetic testing in localized forms of neurofibromatosis are advisable since this facilitates proper genetic counseling regarding risks to offspring, who could inherit a germline pathogenic variant. Another important point to consider is cancer surveillance, which is often underutilized in mosaic forms of neurofibromatosis.
Background: Aquagenic pruritus (AP), characterized by intense itching upon water contact, poses a significant challenge for effective treatment, especially in its idiopathic form. This study investigated beta-alanine as a potential therapeutic option for AP.
Methods: A comprehensive online survey was conducted among 75 self-reported patients with AP, predominantly Italian, recruited through a dedicated social media group to assess the efficacy and side-effects of beta-alanine supplementation.
Results: Beta-alanine emerged as a prevalent choice among participants, demonstrating promising efficacy with an average relief rating of 8.84 out of 10 (95% CI: 8.52-9.16). The average daily dosage during pruritus exacerbation was 1.59 grams (SD ± 0.73). Transient paresthesia represented the primary side-effect, reported by 39.6% of users.
Conclusion: While further controlled trials are necessary, this anecdotal evidence underscores beta-alanine's potential as a valuable adjunct to AP management, addressing a condition that profoundly impacts quality of life.
By examining several hundred pathographies of composers, we identified numerous skin changes . We emphasize Rachmaninov's melanoma. Notable pathographies were studied in more details and shown chronologically by the composers date of birth. Skin changes in composers were usually mild and rarely fatal.
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