Crosstalk between Serum and Skin Sphingolipids in Psoriasis.

Psoriasis is a chronic, complex, immunological disorder, which may lead to many different systemic complications. Sphingolipids, including ceramide, are bioactive lipids, which take part in the regulation of immune reactions, cell growth, and apoptosis. Twenty psoriatic patients and twenty-eight control subjects were included in the study. Skin (both lesional and non-lesional) and serum samples were collected from both the control group and the psoriatic patients. The levels of sphingosine (SFO), sphingosine-1-phosphate (S1P), sphingomyelin, sphinganine (SFA), sphinganine-1-phosphate (SFA1P), and ceramide (CER) were assessed in both tissue (t) and serum (s) samples using high-performance liquid chromatography (HPLC). We identified elevated serum levels of SFO, S1P, SFA, and SFA1P in psoriatic patients when compared to healthy individuals. As far as the lesional skin and serum of psoriatic patients are concerned, we demonstrated positive associations between CER_t and CER_s, SFA_t and CER_s, and SFO_t and CER_s. Additionally, we found negative correlations in the non-lesional skin and serum of psoriatic patients, including SFO_t vs. SFO_s, CER_t vs. SFA_s, CER_t vs. SFO_s, and SFO_t vs. SFA_s. Finally, we observed a positive correlation between S1P and SFA1P in both the serum samples of psoriatic patients and the serum samples of the control group. In this study, we did not observe any correlations between psoriasis area and severity index (PASI) scores and sphingolipid levels. In conclusion, our findings indicate an interplay between skin and serum lipids in psoriatic patients, which is not observed in healthy individuals.

The Interplay between Bioactive Sphingolipids in the Psoriatic Skin and the Severity of the Disease.

Psoriasis is a complex chronic immunologically mediated disease that may involve skin, nails, and joints. It is characterized by hyperproliferation, deregulated differentiation, and impaired apoptosis of keratinocytes. Sphingolipids, namely ceramide, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate, are signal molecules that may regulate cell growth, immune reactions, and apoptosis. Fifteen patients with psoriasis and seventeen healthy persons were enrolled in the study. Skin samples were taken from psoriatic lesions and non-lesional areas. Tissue concentration of ceramides, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate was measured by liquid chromatography. We assessed that all levels of ceramides, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate were higher in lesioned psoriatic skin than in non-affected skin. The profile of bioactive lipids in the lesional skin of patients with psoriasis differed significantly from non-involved psoriatic skin and skin in healthy subjects.

Great hopes or disappointment - a survey-based study on patients' and doctors' perception of telemedicine during the COVID-19 pandemic in Poland.

Introduction: During the COVID-19 pandemic health care systems worldwide rapidly implemented telemedicine solutions in order to avoid spreading the coronavirus among doctors and patients. Aim: To analyse the knowledge, usage, and attitude towards telemedicine among patients, dermatologists, and other doctors during the COVID-19 pandemic. Material and methods: An original anonymous online survey was carried between 22 September 2020 and 29 December 2020 in Poland among 121 patients, 63 dermatologists, and 50 doctors of other specialties. Statistical analysis was performed using the χ2 test, and a statistically significant difference was considered at p < 0.05. Results: In the analysed period in the patient group 58.7% suffered from a skin disease and 79.3% used telemedicine during the COVID-19 pandemic, 54.5% of all respondents viewed teleconsultations unfavourably, and 96.6% of dermatologists and 88% of other doctors had to schedule in office visit or ask for additional pictures because of an unclear clinical picture during teleconsultation. There was a statistical significance between dermatologists and other specialty doctors regarding telemedicine's ability to replace office visits, its usefulness in the elderly, and the duration of the teleconsultation compared to a traditional in-person visit (all p < 0.05). Conclusions: The results showed that in many cases issues raised during teleconsultations could not have been solved using telemedicine. The results obtained highlight the unfavourable perception of telehealth. Overall, telemedicine is a safe and useful tool for communicating with patients, increasing access to medical care, but it needs to be evaluated in the context of potential limitations and optimizing the patients' experience.

Assessment of Life Quality, Stress and Physical Activity Among Patients with Psoriasis.

INTRODUCTION: Psoriasis is a chronic, autoimmune, inflammatory skin disease affecting 2-4% of the general population, which nowadays is even perceived as a systemic illness. The nature of this dermatosis may negatively influence patients' general condition, life expectancy, and quality of life, which highlights the severity of the problem and the need to perform further investigation. We aimed to assess quality of life, stress severity, and physical activity of patients with psoriasis in relation to demographic and clinical data and comparison to the control group without dermatoses. METHODS: A set of surveys was conducted in 56 patients with psoriasis hospitalized at the Department of Dermatology, Medical University of Bialystok. Questionnaires used involved the Dermatology Life Quality Index, WHO Quality of Life questionnaire, International Questionnaire of Physical Activity, and a self-invented stress survey. Obtained data were compared to a sex- and age-matched control group without dermatoses. Statistical analysis was performed using GraphPad Prism. RESULTS: Patients with psoriasis were found to be significantly less satisfied with their health and had lower scores in WHO social, environmental, and psychological domains, comparing to controls. Patients reported higher stress severity and lower satisfaction with sex life and physical appearance than controls. Patients with psoriasis also tended to perform less intensive physical activity than controls. CONCLUSIONS: This study highlights the perception of psoriasis as not only affecting skin but also having a multifactorial impact on psychological and internal condition. Described lifestyle abnormalities can be easily evaluated with validated questionnaires, which could be introduced to patients in order to raise their awareness of comorbidities and mobilize them to modify incorrect lifestyle habits. Screening for other disorders and introduction of a holistic approach to every patient could be beneficial because the improvement of patients' life quality is one of the most important issues.

The Assessment of Risk and Predictors of Sleep Disorders in Patients with Psoriasis-A Questionnaire-Based Cross-Sectional Analysis.

Psoriasis is a chronic, inflammatory skin disease affecting 2-4% of the general population. Accompanying subjective symptoms (pruritus or pain) may cause decreased life quality including sleep disorders (SD). Sixty psoriatic patients fulfilled the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), STOP BANG for the obstructive sleep apnea syndrome (OSAS) assessment, and Restless Legs Syndrome (RLS) Severity Scale. Patients' laboratory and clinical data were also investigated. All data obtained were compared to 40 participants without dermatoses. Mean PSQI, risk of OSAS, and RLS severity of psoriatics were significantly higher than in controls (p < 0.0001, p < 0.05, p < 0.05 respectively). There was a positive correlation between the time of suffering from psoriasis and the risk of OSAS (R = 0.286, p < 0.05). We did not observe any significant relationship between PSQI, risk of OSAS, or RLS and psoriasis severity assessed with PASI (Psoriasis Area and Severity Index). We identified four possible predictors of RLS: glucose, CRP and total cholesterol concentrations, and PSQI. SD are significantly more frequent in psoriatics than in people without chronic dermatological diseases but surprisingly they are not correlated with psoriasis severity. SD decrease patients' life quality and may result in serious consequences. Therefore, establishing recommendations concerning screening for SD and their predictors should be considered.

What do you know about sexually transmitted infections? Survey concerning knowledge and risky behaviors among students of Bialystok universities.

INTRODUCTION: Sexually-transmitted infections (STIs) are serious public health problem, being acquired by more than 1 million people every day worldwide. OBJECTIVE: Assess the knowledge, attitudes, risky behaviors and preventive practices related to STIs among medical and non-medical faculties students from Bialystok. MATERIALS AND METHODS: In 2018 an original anonymous survey was carried among 168 subjects from medical and 142 from non-medical universities. They filled 37 questions: general and specific regarding STI. Statistical analysis was performed using Chi-Square test, statistically significant difference was at p=0.05. RESULTS: In the group 80,6% were females and 19,4% males, with a mean age of 21,9 years. Over 73% were sexually active and almost half of them admitted risky sexual behavior in the past. Almost 16% have ever done an examination for STIs. HIV remains the best known STIs, while hepatitis B was known mainly among medical students. Three fourth students knew that STIs could be asymptomatic. Over half of the students knew that vaccinations against STIs were available and 88,6% of them heard about the HPV vaccine. There was statistically significant difference between the groups regarding the knowledge of diseases transferred sexually, causative agents, history of STI examination, vaccines against STIs. CONCLUSIONS: Almost all participants identified HIV as STIs. Unfortunately, knowledge about other STIs is still at lower level. Both groups have indicated the Internet as a source of knowledge about STIs and the need to acquire additional education about these diseases. To conclude, non-medical students have less awareness about STIs.