Clinical assessment of patients with systemic sclerosis: is there a place for thermography?

Recurrent changes of temperature and persistence of cooling along fingers at the room temperature make hands the most frequent region of interest for thermography in systemic sclerosis (SSc). The aim of this study was to evaluate dependance of temperature in hands on a subtype of the disease, immune profile of antinuclear antibodies (ANA), and lung involvement. There were 29 patients with limited cutaneous involvement (lcSSc) and 10 patients with diffuse cutaneous disease (dcSSc) enrolled for the study. To compare measurements to normal values, there were enrolled 29 healthy volunteers (control group). All participants were submitted to thermography with handheld camera FLIR One Pro for iOS, attached to mobile phone iPhone 11, at the fixed temperature of 21 °C. Measurements included average temperature (Tavg) over nailfolds in thumbs and fingers II-V, as well as the difference in average temperatures (TΔ) between metacarpus of the hand and its thumb and fingers II-V. Both thumbs and fingers II-V remained cooler in subjects with dcSSc compared to those with lcSSc. This implicated a significantly greater TΔ along thumbs and fingers II-V in dcSSc group. Although Tavg at nailfolds in SSc patients was not lower than in healthy controls, TΔ remained significantly more pronounced in both lcSSc and dcSSc subjects. A positivity to ACA in lcSSc group was found to be associated with significantly lower Tavg and more pronounced TΔ in fingers II-V than the presence of anti-Scl70 antibodies. Temperature measurements remained statistically independent on a presence of ILD in lcSSc group, but both thumbs and fingers II-V in dcSSc group were warmer in case of lung involvement. The study showed the dcSSc subtype, the positivity of ACA in lcSSc, but not lung involvement were associated with poorer thermal control in the hands of SSc patients. A comparison to healthy controls highlighted the weakness of temperature measurements at nailfolds (Tavg) but increased the value of TΔ in thermography of hands.

The role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in the pathophysiology of psoriasis and systemic lupus erythematosus.

Inflammation and atherogenic dyslipidaemia are often observed in skin diseases and represent an increased risk of cardiovascular disorders. Proprotein convertase subtilisin/kexin type 9 plays an important role in the regulation of serum low-density lipoprotein cholesterol levels. Its biological role, however, seems to go much beyond the regulation of cholesterol metabolism. The article presents potential pathophysiological links between inflammatory process and lipid disorders based on the example of psoriasis and systemic lupus erythematosus.

Narrow-Band Reflectance Spectrophotometry for the Assessment of Erythematous and Hyperpigmented Skin Lesions in Localized Scleroderma: A Preliminary Study.

BACKGROUND: Localized scleroderma (LoS) is an inflammatory fibrosing disease of the connective tissue, whose esthetic sequelae are atrophic skin lesions with hyperpigmentation. The key element of diagnostic and therapeutic procedures is the assessment of the disease's severity and damage. The study objective was to analyze the usefulness of narrow-band reflectance spectrophotometry (NBRS) to assess erythema and hyperpigmentation in LoS lesions. MATERIALS AND METHODS: Erythema indexes (EI) and melanin indexes (MI) were determined with the use of DermaLab Combo skin colour probe for LoS lesions and symmetrically located areas of normal skin. Then, relative percentage differences were determined for EI and MI, which were compared with the visual assessments of erythema and hyperpigmentation according to the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT). RESULTS: A total of 84 LoS lesions were studied in 41 patients. The study showed a moderate correlations between the spectrophotometric measurements and clinical assessments of erythema as well as hyperpigmentation (Spearman correlation coefficient, r), r = 0.37; p = 0.00047 and r = 0.55; p=0.0000001, respectively. CONCLUSION: NBRS seems to be a useful tool to assess the severity of erythema and hyperpigmentation in LoS lesions. Further studies are required in order to compare the spectrophotometric results with other objective methods.

Psoriasis and Gut Microbiome-Current State of Art.

Psoriasis is a chronic, immune-mediated inflammatory disease that affects around 125 million people worldwide. Several studies concerning the gut microbiota composition and its role in disease pathogenesis recently demonstrated significant alterations among psoriatic patients. Certain parameters such as Firmicutes/Bacteroidetes ratio or Psoriasis Microbiome Index were developed in order to distinguish between psoriatic and healthy individuals. The "leaky gut syndrome" and bacterial translocation is considered by some authors as a triggering factor for the onset of the disease, as it promotes chronic systemic inflammation. The alterations were also found to resemble those in inflammatory bowel diseases, obesity and certain cardiovascular diseases. Microbiota dysbiosis, depletion in SCFAs production, increased amount of produced TMAO, dysregulation of the pathways affecting the balance between lymphocytes populations seem to be the most significant findings concerning gut physiology in psoriatic patients. The gut microbiota may serve as a potential response-to-treatment biomarker in certain cases of biological treatment. Oral probiotics administration as well as fecal microbial transplantation were most reported in bringing health benefits to psoriatic patients. However, the issue of psoriatic bacterial gut composition, its role and healing potential needs further investigation. Here we reviewed the literature on the current state of the relationship between psoriasis and gut microbiome.