Wharton's jelly-derived mesenchymal stem cells in the treatment of four patients with alopecia areata.

BACKGROUND: Alopecia areata (AA) is the second most common cause of non-scarring alopecia. Little is known on the etiopathogenesis of AA. It is considered an autoimmune disease, with T lymphocytes and antibodies directed against hair follicle structures. Topical and systemic therapies are used for the treatment of AA, but none of the therapies used to date have a permanent therapeutic effect. OBJECTIVES: To evaluate the efficacy and safety of AA treatment through a single intradermal injection of a suspension of allogeneic MSCs extracted from Wharton's jelly (WJ-MSCs) into the alopecia foci. MATERIAL AND METHODS: The study involved 4 AA patients who underwent experimental therapy with a suspension of WJ-MSCs. The AA intensity was measured using the SALT score. This measure was performed 3 times during treatment: 1st measure (SALT0) prior to treatment; 2nd measure (SALT12) 12 weeks after the treatment; and 3rd measure (SALT24) 24 weeks after the treatment. Furthermore, during each follow-up visit (6, 12, 18, and 24 weeks after the administration of WJ-MSCs) the patient's general condition (physical examination) and local condition were assessed, their mood was evaluated, and a photo of the scalp was taken. RESULTS: Hair regrowth was observed in all patients by an average of 67% at the sites where the cell suspension was administered. In all cases, we observed greater dynamics of hair regrowth in the first 3 months after the treatment, with an average increase of 52.2%, compared to the following 3 months, with an average of 32%. CONCLUSIONS: The results of the applied intradermal injections of an allogeneic WJ-MSC suspension were positive with hair growth observed in all participants and the therapy was found to be safe, with no side effects.

Pack-year cigarette smoking affects the course of palmoplantar pustulosis.

BACKGROUND: Palmoplantar pustulosis (PPP) is a chronic inflammatory disease with poorly understood pathogenesis. The disease has a chronic course with improvements and exacerbations. Due to palmoplantar location, PPP has a severely negative impact on patients' quality of life. OBJECTIVES: To identify demographic and environmental factors, concomitant diseases, medications, and bacterial factors which may affect the course of PPP. MATERIAL AND METHODS: A total of 51 patients suffering from PPP took part in the study. They were classified according to the Palmoplantar Pustulosis Psoriasis Area and Severity Index (ppPASI) into 3 groups due to the severity of the disease. Pack-year of smoking score was established as a quotient of packets smoked every 24 h and the years of being addicted. Diagnosis of metabolic syndrome was based on the IDF criteria from 2009. Chlamydia trachomatis was detected using enzyme-linked immunosorbent assay (ELISA) technique, Staphylococcus aureus by the culture swabs. Contact hypersensitivity was examined with the T.R.U.E. test. RESULTS: Significantly high severity of PPP was observed in patients addicted to smoking with a high pack-year score (p = 0.03). Significantly lower intensity of PPP lesions was observed in patients treated with ibuprofen (p < 0.01). There was no correlation between severity of PPP skin lesions and comorbidities. CONCLUSIONS: Addiction to cigarette smoking and a high pack-year score aggravates the course of PPP. Treatment with ibuprofen can improve the course of the disease.

Infectious diseases of the skin in contact sports.

Although the benefits of practicing sports are unquestionable, it can contribute to the spread of skin diseases. Mechanical trauma, exposure to environmental and infectious agents, and contact with the skin of other athletes increase the chances of getting an infection. In contact sports, skin infections are responsible for up to 20% of lost training and competition time. In the USA, skin infections, with an incidence of 8.5-20.9%, are the 2nd cause (following upper respiratory infections) of all medical consultations among young wrestlers. The high morbidity of skin diseases poses a great challenge for the diagnosis and treatment of skin infections in athletes practicing contact sports, for whom recommendations may differ from those in the general population. In this review paper, we summarize and discuss the management of infectious diseases of the skin in contact sports. The review shows that the most frequent among athletes are bacterial infections, including folliculitis, erysipelas, furuncles and inflammation of the subcutaneous tissue; viral infections caused by herpes simplex virus, human papilloma virus and molluscum contagiosum virus; fungal infections such as tinea; and infestations, including pediculosis and scabies. Preventing the spread of the infection is the 2nd most important aspect of treatment, following pharmacotherapy. This includes avoiding contact with other athletes, protection or removal of lesions, disinfection of common sports equipment, not sharing towels or other personal equipment. We conclude that protecting against infection and transmission of pathogens in sports teams is crucial in avoiding unnecessary morbidity and minimizing disruption to the training and competition schedule.