Cardiovascular Magnetic Resonance Imaging in Physically Fit Young Patients Sans Comorbidities Who Recently Recovered from Coronavirus Disease 2019 (COVID-19).

INTRODUCTION AND OBJECTIVE: Multiple studies showed that patients with a severe course of COVID-19 may develop cardiovascular complications. Assessment of the incidence of myocardial injury in young, physically fit male patients with no comorbidities, and asymptomatic/mild course of the disease who recovered from COVID-19. MATERIAL AND METHODS: A prospective, single-center, observational cohort study of 75 young (median[IQR] age 22 years) physically fit male patients, without comorbidities and smoking who recently recovered from COVID-19. Results were compared with a control group of age-matched, physically fit men with no comorbidities who tested negative for SARS-CoV-2. RESULTS: 19(25%) patients had possible COVID-19 related myocardial injury[PCRMI] on cardiovascular magnetic resonance [CMR] including definitive myocarditis (n=1;1.3%) and possible myocarditis (n=3;4%). Other abnormalities: mildly decreased (<50%) left ventricular(LV) ejection fraction (n=4;5%), increased LV end-diastolic volume index (n=8;11%) and LV mass index (n=9;12%). Patients with PCRMI had higher NT-pro-BNP level (29 vs 20pg/mL respectively, P=0.02) and lower LV ejection fraction (55% vs 59% respectively, P=0.03). PCRMI was demonstrated in 3(27%) volunteers from the control group based on the presence of LGE (2/18%) and decreased LV ejection fraction (1/9%). No volunteer from the control group was diagnosed with definitive or possible myocarditis. CONCLUSIONS: PCRMI was a frequent finding in young, asymptomatic, physically-fit patients sans comorbidities relatively late after recovery from COVID-19. Whereas no definitive or possible myocarditis was found in the control group, LGE was relatively frequent suggesting that our findings might not be COVID-19 specific. This warrants a need for further investigation into the long-term cardiovascular consequences of COVID-19.

Should the Dermatological Assessment of Patients with Inflammatory Bowel Disease Become Standard during Qualifications for Biological Treatment? A Retrospective, Single-Center Experience from a Tertiary Center.

Background: Oncological anxiety associated with biological therapy is a particular challenge in inflammatory bowel disease (IBD), and it has raised questions about the need for the dermatological assessment of the skin before starting biological therapy. Methods: The aim of this study was to assess the frequency of dermal lesions, including cutaneous malignancies, in IBD patients. This retrospective, single-center study evaluated 805 IBD patients who qualified for biological treatment and were subjected to a dermatological assessment. Results: Dermal lesions (DLs) were found in 15.5% (125) of IBD patients. A risk factor for DLs was higher with body mass index (OR = 1.08, 95% CI [1.02; 1.14], p = 0.007). Surprisingly, there was no effect of thiopurines between the groups with and without DLs (90.4% vs. 84.6%, MD = 0.06, 95% CI [0.01; 0.12], p = 0.118). Moreover, cutaneous malignancies were diagnosed in 9 cases (1.1%), including 4 basal cell carcinomas, 4 squamous cell carcinomas, and 1 melanoma skin cancer. Only 13.4% of patients complied with our strict policy of skin surveillance every 6-8 months. Conclusions: DLs, including cutaneous malignancies, are common in patients with IBD, making skin monitoring at the initiation of biological treatment an extremely useful tool. The lack of effect of the drugs used suggests that skin surveillance is necessary in all IBD patients. The low compliance of skin monitoring among immunosuppressed patients indicates the need for better education on the prevention of cutaneous malignancies.

Dermal lesions associated with anti-tumor necrosis factor α therapy in patients with inflammatory bowel disease (IBD): findings from a tertiary IBD center in Poland.

INTRODUCTION: There are scarce data on the occurrence of dermal lesions in patients with inflammatory bowel disease (IBD) treated with anti-tumor necrosis factor α (anti-TNF­α) antibodies. Characteristics of the skin lesions, their clinical course, and impact on treatment are of high importance. OBJECTIVES: The aim of this study was to assess the prevalence, risk factors, and clinical sequelae of dermal lesions in IBD patients treated with anti-TNF­α antibodies. PATIENTS AND METHODS: This retrospective, single­center study evaluated 541 IBD patients treated with anti-TNF­α drugs and 688 IBD individuals with no history of anti-TNF­α treatment. RESULTS: Higher prevalence of dermal lesions was noted in the patients on anti-TNF­α therapy than in the individuals not receiving such treatment (30.9% vs 16.4%; P <0.001). Risk factors for dermal lesions included higher body mass index (BMI), Crohn disease located in the small intestine, and longer duration of therapy. Some types of dermal lesions were associated with anti-TNF­α therapy; these included infusion reactions and injection site reactions, cutaneous infection, psorasiform reactions, and lupus­like symptoms. Overall, 5.9% of the patients on anti-TNF­α therapy required treatment change or discontinuation due to dermal lesions (alopecia, lupus­like symptoms, melanoma, and psoriasis). CONCLUSIONS: We observed a higher prevalence of dermal lesions in patients with IBD undergoing anti-TNF­α therapy than in the treatment-naive group, although development of such lesions rarely necessitated a change in or discontinuation of treatment. Patients with IBD should regularly undergo follow-up dermatologic evaluation, which may improve detection of dermal lesions. Moreover, biologic therapy in IBD patients requires close collaboration with an experienced dermatologist.

Hidradenitis suppurativa - biologic therapy and other available treatment options.

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease which is characterized by painful, recurrent nodules and abscesses. The overall prevalence of HS is estimated to be 11 per 100 000 individuals in the United States and 4% of the world's population. Women are three times more affected than men, especially patients between 18 and 29 years. Similarly to acne vulgaris, HS is primarily associated with follicular occlusion, which results from a number of biological processes, including follicular epithelial hyperplasia and hyperkeratinization. There are numerous available treatment options for cutaneous lesions in the course of HS. A combination of conservative therapy and appropriate surgical treatment conducted by an experienced surgeon ensures the best possible clinical outcomes. Presently, biologic therapy is the most effective pharmacological treatment in patients with a moderate-to-severe course of the disease. Numerous ongoing clinical trials provide hope for greater availability of new biologic therapy methods.

Risankizumab Therapy for Moderate-to-Severe Psoriasis-A Multi-Center, Long-Term, Real-Life Study from Poland.

The present multi-center, long-term, real-life study made an attempt to assess the efficacy of risankizumab in the treatment of moderate-to-severe plaque psoriasis. The study comprised 185 patients from 10 Polish dermatologic departments undergoing risankizumab treatment. The disease severity was measured using the Psoriasis Area and Severity Index (PASI) before the start of the risankizumab treatment and next at the defined timepoints, i.e., 4, 16, 28, 40, 52 and 96 weeks of treatment. The percentage of patients achieving PASI90 and PASI100 responses as well as the PASI percentage decrease at the defined timepoints were calculated, and correlations with clinical characteristics and therapeutic effect were analyzed. The number of patients evaluated at the defined timepoints was: 136, 145, 100, 93, 62, and 22 at 4, 16, 28, 40, 52 and 96 weeks of treatment, respectively. At 4, 16, 28, 40, 52 and 96 weeks, the PASI90 response was achieved in 13.2%, 81.4%, 87.0%, 86.0%, 88.7% and 81.8% of patients, whereas the PASI100 response was achieved in 2.9%, 53.1%, 67.0%, 68.8%, 71.0% and 68.2% of patients, respectively. Our study revealed a significant negative correlation between a decrease in the PASI and the presence of psoriatic arthritis as well as the patient's age and duration of psoriasis at several timepoints throughout the observation period.

Psychological consequences of hospital isolation during the COVID-19 pandemic - research on the sample of polish firefighting academy students.

Currently, a very important thread of research on COVID-19 is to determine the dimension of the psychopathological emotional reactions induced by the COVID-19 pandemic. A non-experimental online research project was designed to determine the predictors of the severity of psychopathological symptoms, such as depression and PTSD symptoms, and the nature of the feedback mechanism between them in groups of men, remaining in hospital isolation due to infection and at-home isolation during the COVID-19 epidemic. The presence of symptoms of depression, post-traumatic stress disorder (PTSD) and a sense of threat due to the pandemic were assessed using the following screening tests: IES-R by Weiss and Marmar, PHQ-9 by Spitzer et al., and a self-constructed sliding scale for assessing COVID-19 anxiety. The study was carried out on a group of 57 firefighting cadets, hospitalized in a COVID-19 isolation room (Mage = 23.01), staying in isolation due to SARS-CoV-2 virus infection and a control group of 57 healthy men (Mage = 41.38) staying at home during quarantine and national lockdown. COVID-19 pandemic causes many psychopathological reactions. The predictive models revealed that the predictors of symptoms of PTSD in isolated patients included depression and the experienced sense of COVID-19 threat resulting from the disease, while in the control group the symptoms of depression were the only predictor of PTSD. PTSD experiences are usually associated with depression. It may also be a form of the re-experiencing process or the effect of high affectivity, indirectly confirmed by the participation of hyperarousal in the feedback loop. Our findings highlight the importance of mental health aspects in patients treated during the COVID-19 pandemic. The COVID-19 pandemic requires social distancing, quarantine and isolation, which may cause psychopathological symptoms not only in affected people, but also in the general population. Moreover, the need for greater psychological support can be emphasized for both: the sick and the general population.

Skin manifestations of neuroendocrine neoplasms: review of the literature.

Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare tumours derived from peptidergic neurons and specialized neuroendocrine cells capable of secreting various peptides or amines. These cells may be present in endocrine tissue or diffused in the tissues of the digestive or respiratory system. The article reviews the characteristic features of NENs, with particular emphasis on skin manifestations, such as necrolytic migratory erythema (NME), tongue inflammation, angular cheilitis, venous thrombosis and alopecia in glucagonoma; "flushing", "lion face", pellagra skin symptoms, "scleroderma-like features without Raynaud's phenomenon" in carcinoid tumours. The paper also presents the clinical picture of the neuroendocrine tumour of the skin - Merkel cell carcinoma. The aim of this study was to draw attention to the need for precise and comprehensive diagnosis of the patients, with particular emphasis on skin lesions as a revelator of neuroendocrine tumours. This management allows for the early implementation of appropriate treatment.

Effectiveness of infliximab biosimilars in the treatment of moderate to severe chronic plaque psoriasis: experience of real-world data from the register of the program "Treatment of moderate and severe forms of plaque psoriasis (B.47)" of the National Health Fund in Poland.

Introduction: Infliximab (IFX) is a monoclonal antibody that binds to and neutralizes TNF-α. IFX (Remicade) was approved by the U.S. Food and Drug Administration in 2006 for the treatment of severe plaque psoriasis. In 2013 two infliximab biosimilars: Remsima and Inflectra were also registered. The introduction of biosimilar drugs is associated with a significant reduction in treatment costs. Aim: To evaluate the efficacy of treatment with biosimilar IFX with non-medical switch option in patients with plaque psoriasis under the drug program "Treatment of moderate and severe plaque psoriasis" of the Ministry of Health in Poland. Material and methods: The group of 91 adult patients with moderate to severe plaque psoriasis, unresponsive or with contraindications to the standard treatment were qualified to the drug program (in 2016-2018). Efficacy of treatment with biosimilar IFX was evaluated using the Psoriasis Area and Severity Index, body surface area and Dermatology Life Quality Index scoring performed at week 0, 14, 46 and 94. Results: The mean change in PASI, DLQI, and BSA scores at week 14 was 89.92%, 93.75% and 90.91%, respectively. By week 14, 83.52% of patients achieved PASI75, 49.45% PASI ≥ 90 and 26.37% PASI100. At week 46, 84.62% of patients achieved PASI75, 54.95% PASI ≥ 90, and 21.98% PASI100. At week 94 of therapy, 80.22% of patients achieved PASI75, 48.35% PASI ≥ 90, and 18.68% PASI100. At week 94 of therapy, PASI100 was maintained by 37.5% of patients who achieved PASI100 at week 14. Conclusions: 94-week therapy with biosimilar infliximab results in high and sustained clinical efficacy in patients with moderate to severe psoriasis.

Dermatological manifestations of the Coronavirus disease 2019 in children: a systemic review.

Introduction: An increasing number of publications describing dermatoses associated with Coronavirus disease 2019 (COVID-19) have shown differences in the morphology and incidence of dermatoses in children compared to the general population. Material and methods: Among 22 selected full-text articles, dermatoses associated with COVID-19 have been described in 196 children (average age: 12.57 years). Dermatoses were the only symptom in most patients (n = 134; 68.4%). RT-PCR tests of nasopharyngeal swabs confirmed SARS-CoV-2 infection in only 18 cases (n = 18/69; 26.1%). Results: Dermatoses described include chilblain-like lesions (n = 173; 88.3%), maculopapular rash (n = 16; 8.2%), erythema multiforme-like lesions (n = 12; 6.1%), varicella-like exanthema (n = 1; 0.5%), and urticaria (n = 1; 0.5%). Conclusions: This publication aims to summarise existing data on dermatoses and to draw attention to how identification of dermatological symptoms in paediatric patients can provide a quick and reliable indicator of COVID-19.

Comparative effectiveness of adalimumab versus ustekinumab in the treatment of severe chronic plaque psoriasis: The results based on data from the program "treatment of moderate and severe forms of plaque psoriasis (B.47)" of the National Health Fund in Poland.

Biological agents: TNF-α inhibitors, IL-12, and IL-23 blockers, IL-17 inhibitors are used in the treatment of plaque psoriasis. Adalimumab (ADA) is an antibody that binds to TNF-α. Ustekinumab (UST) blocks IL-12 and IL-23. The data obtained from medical records is of exceptional value. The aim of the study was to evaluate the efficacy of ADA and UST during a single 40-week period of biological treatment of patients under the drug program "Treatment of moderate and severe form of plaque psoriasis." The group of 620 adult patients with moderate to severe form of plaque psoriasis, who were unresponsive or had contraindications to the standard treatment were qualified to the drug program. In the evaluated group, 50.64% patients were treated with UST, 49.36% with ADA. The efficacy of treatment was assessed during weeks 0, 4, 16, 28, and 40. At week 16th, PASI75 reached 80.72% patients in ADA treated group, PASI ≥90 54.88%, PASI100 19.6% of patients. In the UST group (week 16th) PASI75 reached 70.38%, PASI90 44.26%, PASI100 15.6% of patients. At week 28th PASI90 and PASI100 were more pronounced in the ADA group than in UST. In addition, the total percentage of PASI improvement was significantly higher in the ADA group (p = 0.0006). The percentage of PASI improvement in week 40 was statistically higher in ADA group compared to UST (p = 0.015). Compared to UST, ADA was clinically more effective during a 40-week observation. Patients receiving ADA achieved PASI75, PASI90, and PASI100 more frequently and faster than those treated with UST. Additionally, ADA improved the quality of life of psoriatic patients more substantially compared to UST.

The prevalence of SARS-CoV-2 infection and the severity of the course of COVID-19 in patients with psoriasis treated with biologic therapy.

BACKGROUND: Biologics are used for the treatment of patients with moderate to severe psoriasis. According to the recommendations of major global dermatological associations, patients who had not reported clinical symptoms or close contact with a confirmed/probable COVID-19 case in the last 14 days can continue biologic therapy. OBJECTIVE: The aim of our study was to determine the prevalence of SARS-CoV-2 infection, its clinical manifestations and the influence of COVID-19 on the course of the underlying disease in patients with moderate to severe psoriasis and aggressive psoriatic arthritis undergoing biologic therapy. MATERIAL AND METHODS: All 61 patients with moderate to severe psoriasis treated with biologics in the Dermatology Department of Central Clinical Hospital of Ministry of the Interior and Administration in Warsaw were enrolled into the study. Firstly, the medical histories of these patients were assessed for occurrence of severe adverse events, COVID-19 symptoms and deaths. Afterwards, the prevalence of serum anti-SARS-CoV-2 antibodies, and severity of COVID-19 were assessed. RESULTS: Ten patients in the study group have developed anti-SARS-CoV-2 antibodies. One patient presented with mild COVID-19 symptoms. CONCLUSION: While our study had a small sample size, ongoing biologic treatment in psoriasis was not associated with severe form of COVID-19.

Organization of biologic therapy during the COVID-19 pandemic based on example of Dermatology Clinic Centre of Postgraduate Medical Education in Warsaw.

The COVID-19 pandemic spread to almost all countries in the world within a few months, necessitating changes in medical care for patients with SARS-CoV-2 infections as well as patients with various chronic diseases. Ensuring the safety of medical staff and patients in hospitals specializing in infectious diseases is a major logistical challenge. Psoriasis patients treated with immunosuppressive medications, including those under biologic therapy, are a special group. Many scientific societies do not recommend discontinuing therapy in patients without symptoms or confirmation of SARS-CoV-2 infection despite the potentially higher risk of respiratory tract infections in this patient population. Based on our own experience, we present the organization of the biologic therapy within the unit of a Single Specialty Infectious Hospital.

The Role of Epigenetic Factors in Psoriasis.

Psoriasis is a chronic, systemic, immune-mediated disease with an incidence of approximately 2%. The pathogenesis of the disease is complex and not yet fully understood. Genetic factors play a significant role in the pathogenesis of the disease. In predisposed individuals, multiple trigger factors may contribute to disease onset and exacerbations of symptoms. Environmental factors (stress, infections, certain medications, nicotinism, alcohol, obesity) play a significant role in the pathogenesis of psoriasis. In addition, epigenetic mechanisms are considered result in modulation of individual gene expression and an increased likelihood of the disease. Studies highlight the significant role of epigenetic factors in the etiology and pathogenesis of psoriasis. Epigenetic mechanisms in psoriasis include DNA methylation, histone modifications and non-coding RNAs. Epigenetic mechanisms induce gene expression changes under the influence of chemical modifications of DNA and histones, which alter chromatin structure and activate transcription factors of selected genes, thus leading to translation of new mRNA without affecting the DNA sequence. Epigenetic factors can regulate gene expression at the transcriptional (via histone modification, DNA methylation) and posttranscriptional levels (via microRNAs and long non-coding RNAs). This study aims to present and discuss the different epigenetic mechanisms in psoriasis based on a review of the available literature.

Does smoking affect your skin?

Smoking has a negative influence on human beings. Carcinogens detected in smoke can increase the risk of developing chronic disorders, cancer and premature death. Nicotine can also affect dermatological diseases such as psoriasis, hidradenitis suppurativa, chronic dermatoses, alopecia, lupus erythematosus, polymorphous light eruption, skin cancer and tobacco-associated oral lesions. Advanced education at a doctor's surgery in various medical occupations can change the bad habits and protect people from the consequences.

Cutaneous manifestations of coronavirus disease 2019 - review of literature and case reports.

Primary clinical manifestations of coronavirus disease are respiratory tract infections, ranging from an asymptomatic carrier state to severe interstitial pneumonia. The most common symptoms are fever, dry cough, fatigue, nausea, diarrhea, and loss of smell or taste. Recent reports indicate the possibility of several nonspecific dermatological symptoms. These include urticaria, maculopapular lesions, vascular lesions involving petechiae, purpura and livedo reticularis. The onset of cutaneous lesions may precede full-blown COVID-19 or remain the only manifestation of the disease (especially in young patients). Focusing on dermatological symptoms may be crucial for preventing the spread of SARS-CoV-2. However, unambiguous assessment of cutaneous manifestations of COVID-19 requires more research and case studies conducted by dermatologists.

Trichoscopy of Tinea Capitis: A Systematic Review.

INTRODUCTION: An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct diagnosis in patients with hair loss and inflammatory hair disorders. The objective was to review and analyze current data on the trichoscopy of tinea capitis. METHODS: A systematic review of the literature was conducted using the PubMed, EBSCO and Scopus databases. The search terms included 'tinea capitis' combined with 'trichoscopy', 'dermatoscopy', 'dermoscopy', 'videodermatoscopy' or 'videodermoscopy'. RESULTS: Of 326 articles, 37 were considered eligible for the quantitative analysis. The most characteristic (with a high predictive value) trichoscopic findings of tinea capitis included comma hairs (51%), corkscrew hairs (32%), Morse code-like hairs (22%), zigzag hairs (21%), bent hairs (27%), block hairs (10%) and i-hairs (10%). Other common, but not characteristic, trichoscopic features were broken hairs (57%), black dots (34%), perifollicular scaling (59%) and diffuse scaling (89%). Morse code-like hairs, zigzag hairs, bent hairs and diffuse scaling were only observed in Microsporum tinea capitis (8/29, 28%; 6/29, 21%; 4/29, 14% and 4/29, 14%, respectively). In Trichophyton tinea capitis, corkscrew hairs were more commonly detected compared to Microsporum tinea capitis (21/38, 55% vs 3/29, 10%). CONCLUSION: The presence of characteristic trichoscopic features of tinea capitis is sufficient to establish the initial diagnosis and introduce treatment before culture results are available. Trichoscopy may be useful in distinguishing between Microsporum and Trichophyton tinea capitis.

Skin and gastrointestinal symptoms in COVID-19.

INTRODUCTION: The first cases of coronavirus disease 2019 (COVID-19) were noted in December 2019 in Wuhan province, China. The World Health Organisation (WHO) announced the pandemic status on March 11, 2020. The manifestations of the disease are as follows: fever, cough, fatigue, anosmia and ageusia, dyspnoea, chest pain, muscle soreness, chills, sore throat, rhinitis, headache, gastrointestinal (GI) symptoms, and dermal lesions. AIM: To evaluate the relationship between dermal lesions and GI symptoms in a group of COVID-19 patients. MATERIAL AND METHODS: A group of 441 COVID-19 patients admitted to the Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw between March 15th and June 15th, 2020. RESULTS: Of 441 patients with confirmed SARS-CoV-2 infection, 255 (58.5%) experienced gastrointestinal (GI) symptoms: lack of appetite was reported in 124 (48.6%) cases, diarrhoea was noted in 109 (42.7%), abdominal pain in 95 (37.3%), vomiting in 37 (14.5%), and nausea in 32 (12.5%) cases. Eight (1.81%) patients had dermal lesions: erythematous macular lesions (2 patients - 25%), erythematous infiltrated lesions (2; 25%), erythematous infiltrated and exfoliative lesions (3; 37.5%), erythematous papular lesions (3; 37.5%), and erythematous oedematous lesions (2; 25%). All of those patients reported gastrointestinal symptoms during the hospitalisation. CONCLUSIONS: The following study analyses possible causes of dermal lesions and their coexistence with GI symptoms. Several possible theories were taken into account, including the microbiota alterations and issue of drug-related complications.

JAK-inhibitors in dermatology: current evidence and future applications.

The Janus kinase (JAK) and signal transducer and activator of transcription (STAT) pathway is a ubiquitous intracellular signaling network. Selective JAK-inhibitors have anti-inflammatory properties and have been approved in many countries for the treatment of rheumatoid arthritis (tofacitinib, baricitinib) and myelofibrosis or polycythemia vera (ruxolitinib). The aim of the publication was to summarize and critically analyze the efficacy and safety of JAK-inhibitors in skin diseases, such as psoriasis, alopecia areata, atopic dermatitis and vitiligo. Databases PubMed, Scopus and EBSCO were searched. After exclusions, 17 articles were analyzed (11 randomized clinical trials, 4 case reports, 1 retrospective study of a case series and 1 nonrandomized pilot study). The strongest evidence of JAK-inhibitor efficacy was established for treatment of psoriasis. Additionally, data are available on the potential efficacy of JAK-inhibitors in alopecia areata, atopic dermatitis and vitiligo. Mostly, JAK-inhibitors are used orally. However, there are studies showing efficacy of topical administration of this group of drugs in psoriasis and vitiligo. Further research is needed, especially the head-to-head comparison studies with JAK-inhibitors and current therapeutic methods to verify the superiority of this new group of drugs in dermatological diseases.

Skin changes during pregnancy. Is that an important issue for pregnant women?

OBJECTIVES: The aim of the study was to investigate the prevalence of self-reported skin complaints during pregnancy, applied treatment and the impact on well-being of pregnant women. MATERIAL AND METHODS: We asked 1935 women that were maximum 4 years after labor to fill in our questionnaire. The questionnaire included questions concerning the course of pregnancy, observed skin lesions, applied treatment and influence on the quality of life. RESULTS: Skin changes during pregnancy were reported by 1447 patients (74.78%). The prevalence of self-reported skin complaints were as follows: stretch marks (77.4%), acne (21.6%) and recurrent herpes labialis (11.6%). In 43.67% (n = 632) of women who reported dermatological problems during pregnancy the disease caused significant deterioration in their well-being. Only 168 patients (11.61%) received dermatological treatment from their obstetricians. Dermatological con-sultation required 217 patients (14.99%). For 133 of treated women (25.68%) the recommended treatment was expensive. However, in the majority of patients (379; 73.15%) who received treatment the skin changes resolved after therapy. Skin symptoms resolved significantly faster in the treated group (3.5 ± 4.3 week vs 5.8 ± 6.2 week; p < 0.001). CONCLUSIONS: Self-reported skin complaints seem to be a relevant problem during pregnancy. Proper skin care as well as appropriate treatment applied by obstetricians and/or dermatologists may help women to recover.