The impact of systemic psoriasis treatments on human papillomavirus activation and propagation.

Psoriasis is one of the most prevalent diseases in the world and it affects up to 2% of the worldwide population. Its pathogenesis is complex and the lesions may be triggered by multiple factors. Human papillomavirus (HPV) is associated with anogenital cancers, cutaneous warts and is considered one of the most prevalent infections in the world. In this review, the available literature on the systemic treatment of patients with psoriasis and concomitant HPV infection was analysed.

Usefulness of high-frequency ultrasonography in the assessment of alopecia areata - comparison of ultrasound images with trichoscopic images.

Introduction: Trichoscopy allows us to distinguish between different types of alopecia and to determine the stage of the disease. High-frequency ultrasonography (HF-USG) enables the evaluation of structures that are not available for clinical and trichoscopic examination, but it has not been widely used to date in the evaluation of patients with alopecia areata (AA) and other scalp disorders. Aim: To characterise the ultrasound images of patients with AA, including different stages of the disease, and to compare them with trichoscopic images and other scalp diseases. Material and methods: Twenty-five patients with AA, on the basis of trichoscopic examination, were qualified to three groups: with active, inactive, and regrowth phase. Next, HF-USG (20 MHz) with qualitative and quantitative evaluation of various elements of the images was performed: entrance echo (EE), dermis (dermal background; DB), follicular structures (FS), dermal/ subdermal border (D/SB). The results were compared with 10 healthy volunteers, 10 patients with androgenic alopecia (AGA), and 12 with seborrhoeic dermatitis (SebD). Results: Active AA was characterised by FS with distinct borders, drop-like shaped, with a widened distal end located in the lower layers of DB. Inactive AA was characterised by a smaller number of FS without distinct borders. In the regrowth phase, FS of different widths, elongated, and with widened distal parts located at different DB depths were observed. Conclusions: HF-USG (20 MHz) may be a valuable diagnostic method in patients with AA. Ultrasound images of AA vary according to the stage of the disease and in comparison with AGA, SebD, and healthy individuals.

Suitability of high-frequency ultrasonography (20 MHz) in evaluation of various forms of primary cicatricial alopecia in relation to trichoscopy - pilot study.

BACKGROUND: Primary cicatricial alopecia is a potentially irreversible process of hair loss, in which for proper diagnosis a skin biopsy is necessary. Searching for new, non-invasive diagnostic methods may shorten the time for final diagnosis, initiating appropriate treatment and reduce the need for biopsy. The aim of this study was to evaluate the usefulness of high-frequency ultrasonography (HF-USG) as a diagnostic method in patients with primary scarring alopecia and to compare it with trichoscopy. MATERIALS AND METHODS: The study covered a total of 44 adults: 8 with classic lichen planopilaris (LPP), 11 with discoid lupus erythematosus (DLE), 14 with frontal fibrosing alopecia (FFA), and 11 healthy volunteers. Each patient underwent physical and trichoscopic examination which was the base for qualification for active/inactive stage of the disease. Then, HF-USG was performed using a probe with a frequency of 20 MHz. In HF-USG images, the following elements were evaluated and measured: entrance echo (EE), follicular structures (FS), dermal background (DB), and dermal/subdermal border (D/SB). RESULTS: Inactive phase was characterized by significantly lower number/lack of FS compared to the active phase of scarring alopecia. HF-USG of active LPP/FFA presented cigar-like shaped FS, while inactive stage pronounced D/SB forming saw-like pattern. Active DLE in HF-USG were associated with focal, doubled EE and widened FS with a tendency to create hypoechogenic wide, structureless bands within the skin. In inactive DLE, there was no specific pattern of D/SB or rarely puzzle-like pattern. CONCLUSION: HF-USG images differ depending on the phase of the disease and the type of scarring alopecia, similarly to trichoscopic examination.

Fungal infections of the feet in patients with erysipelas of the lower limb: is it a significant clinical problem?

BACKGROUND: Erysipelas is a bacterial infection of the superficial layers of the skin usually caused by Group A Streptococci, often seen in clinical practice. Fungal infections of the feet and elderly age are some of the most significant risk factors for the infection. The aim of the study was to evaluate the frequency of fungal infections from different regions of the feet in patients with erysipelas. METHODS: 56 patients with clinically diagnosed erysipelas and 56 healthy individuals were clinically examined and tested for fungal infection in three locations: toenails, interdigital space, and soles. The collected samples were evaluated under a microscope and then mycological cultures on Sabouraud's medium were prepared. After 4 weeks of incubation, the cultures were analysed with the identification of particular pathogens. RESULTS: 42.9% (24/56) of the patients with erysipelas had positive mycological cultures. Toenails and interdigital spaces (both 62.5%) were the most frequently affected areas, followed by soles (37.5%). The most common pathogen was T. rubrum (43.18%), followed by Candida spp. (27.27%), and T. mentagrophytes var.interdigitale (13.63%). Only 14.3% (8/56) of the samples taken from the control group were positive and T.rubrum was the only type of fungus cultured. CONCLUSIONS: Fungal infections of the feet are important risk factors for the first episode as well as recurrent erysipelas. Prevention and early treatment of fungal infections, especially in elderly people, can significantly reduce the incidence of erysipelas.

High-frequency ultrasonography of the scalp - Comparison of ultrasound and trichoscopic images in healthy individuals.

BACKGROUND: Hair loss is a common problem in dermatological patients. Its diagnosis is based on selected non-invasive and invasive tests. Searching for new diagnostic methods, especially non-invasive ones, aims to accelerate the correct diagnosis in the least invasive way possible. The aim of our study was to establish the characteristics of ultrasound images in healthy individuals and to compare them to selected trichoscopic parameters. MATERIALS AND METHODS: Eighteen healthy adults (10 women and 8 men) underwent trichoscopy and high-frequency ultrasound (HF-USG) with 20 MHz DermaScan transducer on the parietal region of the scalp. Selected parameters were compared in relation to sex and the research method used. RESULTS: HF-USG of the parietal area in all examined patients revealed hyperechogenic entrance echo and less echogenic layer corresponding to the dermis with well-defined hypoechoic follicular structures (FS). The number of hair units in trichoscopy and the number of FS in HF-USG did not differ significantly, while the differences in the studied distances between structures were statistically significant. The width of FS in HF-USG was significantly higher than hair shafts thickness in trichoscopy. CONCLUSIONS: HF-USG (20MHz) due to the possibility of visualization of FS can be a valuable complement to the range of non-invasive diagnostic procedures used in evaluation of the scalp.