Dry eye syndrome symptoms in patients with psoriasis.

BACKGROUND: Psoriasis is one of the most common dermatoses associated with a variety of comorbidities. There have been some reports on its possible association with ocular disorders however dry eye syndrome (DES) in such patients has been poorly investigated. OBJECTIVES: To investigate the frequency of DES symptoms in psoriatic patients, also regarding psoriasis severity in PASI, manifestation and therapy. METHODS: 40 patients with psoriasis and 40 volunteers without dermatoses were enrolled in the study. They completed Ocular Surface Disease Index (OSDI) questionnaire and were objectively examined by IDRA® device to perform automatic interferometry, automatic meibography of lower eyelid glands, non-invasive break-up time (NIBUT), blink quality and tear meniscus height. RESULTS: Patients with psoriasis had statistically significantly thicker lipid layer (p = 0.0042 left eye, p = 0.0313 right eye) and greater loss of Meibomian glands compared to controls (p = 0.0128 left eye, p = 0.048 right eye). The patients had lower, although insignificantly, eye blink quality and tear meniscus height than the control group, as well as shorter NIBUT and higher score in OSDI. After the division of patients into two groups-with or without nails involvement/psoriatic arthritis/systemic treatment- we did not observe any significant differences between the groups. PASI did not correlate with any DES parameter. CONCLUSIONS: This is the first study of DES symptoms with an objective IDRA® analyzer. We managed to observe that patients with psoriasis have thicker lipid layer and higher Meibomian glands' loss in lower eyelids. Based on all assessed objective and subjective parameters psoriatics do not seem to have an increased risk of DES. The presence of psoriatic arthritis or nail involvement does not seem to be a predisposing factor for DES development. PASI probably cannot be a prognostic factor for any of the DES-associated parameters. Nevertheless, DES in psoriasis requires further research on bigger samples to establish reliable recommendations.

A Breakthrough in the Treatment of Necrobiosis Lipoidica? Update on Treatment, Etiopathogenesis, Diagnosis, and Clinical Presentation.

Necrobiosis lipoidica (NL) is a rare granulomatous disease of a not fully understood etiopathogenesis. Classically, NL is associated with insulin-dependent diabetes mellitus. The disease often fails to respond to conventional treatments and adversely affects patients' quality of life. First-line medications are usually topical corticosteroids, but patients respond to them with varying degrees of success. Other options include tacrolimus, phototherapy, cyclosporine, fumaric acid esters, and biologics (adalimumab, etanercept, and infliximab). Our review aims to present new therapeutic approaches potentially effective in patients with refractory lesions, describe the presumed etiopathogenesis, and provide diagnostic guidance for clinicians. The review concludes that Janus kinase inhibitors and biologics such as ustekinumab and secukinumab can be used effectively in patients with recalcitrant NL. Another promising treatment option is tapinarof (an aryl hydrocarbon receptor agonist). However, studies on larger groups of patients are still needed to evaluate the effectiveness of different therapeutic options and to define consistent treatment regimens for NL. It is advisable to improve the awareness of physicians of various specialties regarding necrobiosis lipoidica as lesions diagnosed earlier usually have a better response to treatment.

Lipid Alterations and Metabolism Disturbances in Selected Inflammatory Skin Diseases.

Lipidomics is a term used to define the field that analyzes the structure, functions, and interactions of lipids. Inflammatory dermatoses and lipid disturbances are interrelated, especially due to chronic inflammatory conditions. This review discusses lipidomics in selected inflammatory skin diseases: psoriasis, lichen planus, and atopic dermatitis, as well as the less commonly mentioned hidradenitis suppurativa, rosacea, and acne vulgaris. Lipid homeostasis disorders are common; they are especially well-documented in psoriasis, lichen planus, and atopic dermatitis. Future studies are required for better insight into this issue, particularly on the skin lipidome. Understanding lipidomics, in particular skin diseases, increases our knowledge about their pathogenesis, and may become useful in adjusting tailored management for each patient as well establishing prognosis. Noteworthily, it seems advisable to alert doctors to the need to analyze lipid parameters and the complications of abnormal lipid metabolism in dermatological patients, which could decrease their comorbidities and improve the life quality and health condition of dermatological patients.

Gasdermin D (GSDMD) Is Upregulated in Psoriatic Skin-A New Potential Link in the Pathogenesis of Psoriasis.

Psoriasis is an important issue in daily dermatological practice. Not only is it an aesthetic defect but it is also a matter of decreased life quality and economic burden. However frequent, the pathogenesis of psoriasis remains uncertain despite numerous investigations. Gasdermins are a family of six proteins. Gasdermin D (GSDMD) is the best-studied from this group and is involved in the processes of inflammation, proliferation, and death of cells, especially pyroptosis. GSDMD has never been studied in psoriatic sera or urine before. Our study involved 60 patients with psoriasis and 30 volunteers without dermatoses as controls. Serum and urinary GSDMD concentrations were examined by ELISA. The tissue expression of GSDMD was assessed by immunohistochemistry. The serum-GSDMD concentration was insignificantly higher in the patients than controls. There were no differences in the urinary-GSDMD concentrations between the patients and controls. Strong tissue expression of GSDMD was significantly more prevalent in psoriatic plaque than in the non-lesional skin and healthy skin of the controls. There was no correlation between the serum-GSDMD concentrations and the psoriasis severity in PASI, age, or disease duration. Taking into consideration the documented role of gasdermins in cell proliferation and death, the increased expression of GSDMD in psoriatic skin may demonstrate the potential involvement of this protein in psoriasis pathogenesis. Neither serum, nor urinary GSDMD can be currently considered a psoriasis biomarker; however, future studies may change this perspective.

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.

Nodulo-ulcerative syphilis - case report and the review of literature.

We describe the case of tertiary syphilis involving the skin. The lesions had a nodular-ulcerative form, localized on both arms. The patient had high titers of treponemal and non-treponemal serological tests for syphilis and histopathological picture was indicative for nodulo-ulcerative syphilis. No cardiological, neurological or ophtalmological abnormalities were found. The patient was treated with 2.4 million units i.m. of benzathine benzylpenicillin three times at weekly intervals, according to European Guideline. Unfortunately, the patient was lost for scheduled follow-up. More than two years later the skin lesions healed completely leaving discrete scars and a four-fold decline in a titre of Venereal Disease Laboratory Test was noticed.

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.

Decreased levels of vaspin and its potential association with cardiometabolic risk in patients with psoriasis: preliminary results.

Introduction: Omentin and vaspin are considered to have beneficial effects preventing the development of metabolic disorders which are common comorbidities in psoriasis. Aim: To evaluate the serum level of these adipokines in psoriatic patients and elucidate possible associations with disease activity, metabolic or inflammatory parameters and systemic treatment. Material and methods: Thirty-three patients with active plaque-type psoriasis and 11 healthy controls participated in the study. Blood samples were collected before and after 3 months of treatment with acitretin or methotrexate. Results: Serum vaspin concentration in psoriatic patients was significantly lower than in the control group (p < 0.05). No correlation between adipokines and severity of disease evaluated with PASI was found. However, median vaspin levels decreased with the severity of skin lesions and the omentin level was higher in patients with severe disease versus those with moderate form (p < 0.05). The vaspin level correlated with BMI of psoriatic patients (p < 0.05), with cholesterol and triglycerides levels (p = 0.054, p = 0.049, respectively). No significant effect of systemic treatment on omentin levels was found. Regarding vaspin, we observed an upward trend in its concentration after treatment. Conclusions: Omentin and vaspin may play a modulating role in the systemic inflammation present in psoriasis and thus may contribute to the development of metabolic complications.

Serum fatty acid binding protein 5 (FABP5) as a potential biomarker of inflammation in psoriasis.

Fatty acid binding protein 5 (FABP5) is elevated in psoriatic keratinocytes and could be involved in systemic metabolic disturbances in psoriasis. The aim of the study was to evaluate serum FABP5 in obese and non-obese psoriatic patients, to assess the relationship between FABP5 and the duration, severity of the disease, inflammatory and metabolic markers and influence of treatment with narrowband-ultraviolet B (NB-UVB). Seventy-four patients (30 treated with NB-UVB) with psoriasis were enrolled in the study. The serum concentrations of FABP5 were measured using Human FABP5 Enzyme-Linked Immunosorbent Assay kit. Serum fatty acids were measured by gas-liquid chromatography. Serum FABP5 levels in psoriatic patients were higher versus control group (P < 0.001). FABP5 in patients with PASI > 20 was higher compared to the mild group (PASI < 10) (P < 0.001) and serum FABP5 correlated positively with PASI score (r = 0.41, P < 0.001). There was also positive correlation between FABP5 and basic inflammation indices. Decrease of PASI after NB-UVB treatment (P < 0.001) was observed and accompanied by decrease of the serum FABP5 (P = 0.007). FABP5 is a potential marker of psoriasis, its severity and clinical outcome after therapy with NB-UVB. FABP5 may reflect metabolic disturbances in psoriatic patients.

Aberrations in Lipid Expression and Metabolism in Psoriasis.

Psoriasis (PSO) is a common skin disease that affects about 1%-3% of the general population. It is a great medical, social and economic burden since PSO is associated with many comorbidities, of which the most common are cardiometabolic disorders. Psoriatic patients suffer more frequently from obesity, dyslipidemia, atherosclerosis, and nonalcoholic fatty liver disease. Research shows that lipid expression and metabolism disorders are present more often in such patients. This review focuses on a variety of aberrations in lipids in the skin, blood, and adipose tissue in psoriatic patients and their multifactorial impact on the pathogenesis of psoriasis.

Females treated for syphilis in Bialystok, Poland 2016-2020.

BACKGROUND: Syphilis is the third most frequent bacterial sexually transmitted disease globally. Untreated syphilis in a pregnant woman may results in a transmission of the infection to the foetus resulting in congenital syphilis. AIM: To characterise females treated for syphilis in Bialystok, north-east Poland, in years 2016-2020. MATERIAL AND METHODS: Retrospective analysis of age, residency, marital status of patients, stage of syphilis, treatment and adherence to follow-up visits was conducted as well as a detailed analysis of clinical characteristics of pregnant women treated for syphilis. RESULTS: Sixteen women were treated for syphilis in 2016-2020, 11 (68.8%) of them were pregnant. The proportion of pregnant women among all syphilis female patients increased substantially as compared to years 2000-2015 (68.8% vs. 36.2%, respectively, P<0.05). Mean age of patients was 37.12±11.25 years, 10 (62.5%) were residents of urban areas and 10 were married. Late latent syphilis or latent of unknown duration was the most frequent stage of syphilis. Chlamydia trachomatis infection was detected in four (25%) patients with syphilis. Benzathine penicillin was mainly used in the treatment. More than half of patients did not complete follow-up. Only one pregnant woman was treated within the first trimester and five of them (45.45%) were lost to follow-up and the outcome of pregnancy was unknown. CONCLUSIONS: Syphilis in females, especially in pregnant ones, is an important problem in the Podlaskie voivodeship. The proportion of pregnant females among all female patients with syphilis is increasing. The detection and the treatment of infection is frequently delayed in pregnant females. The after treatment followup and the knowledge of outcome of pregnancy remains unsatisfactory. The collaboration between dermatovenereologists, gynaecologists and obstetricians should be improved.

The impact of the COVID-19 pandemic on sexually transmitted infections services - experience from Bialystok, Poland.

INTRODUCTION: COVID-19 pandemic had a big impact on the health services organisation, including that of sexually transmitted infections (STIs). AIM: To analyse and evaluate the influence of COVID-19 epidemic on the detection of STIs and healthcare services in a group of these patients on the base of the experience of the Department of Dermatology and Venereology and University Outpatient Clinic in Bialystok, Poland. MATERIAL AND METHODS: Analysis of the number of consultations for suspicion of STIs, number of newly diagnosed cases of syphilis, gonorrhoea, Chlamydia trachomatis infections and genital herpes in two periods: January 2019 - February 2020 (before the epidemic state was introduced) and March 2020 - April 2021 (during pandemic). STIs cases hospitalised in the same periods were also analysed. RESULTS: The number of hospitalisations and outpatient consultations decreased during pandemic as compared to the period before it (by 83.3% and 41.9%, respectively). Patients with syphilis constituted the majority in both periods, remaining STIs were few. During pandemic, the proportion of detected cases of syphilis was higher as compared to the time before it, despite the diminished number of consultations (39.4% and 28%, respectively). Majority of patients with syphilis were men (92.3% and 93.3%), among them men-who-have-sex-with-men constituted at least 50%. Early syphilis was diagnosed more frequently during pandemic than before it (92.3% and 78.6%, respectively), early symptomatic syphilis in particular (46.2% and 35.7%, respectively). HIV coinfection in syphilis patients was more frequent during pandemic (15.8% and 7.1%, respectively). More than half of these patients (53.8%) did not come for follow-up visits after treatment during pandemic. CONCLUSIONS: The pandemic caused the decrease in number of outpatient STIs consultations and hospitalisations. The proportion of newly diagnosed cases of syphilis per number of consultations increased. The percentage of early syphilis cases, especially early symptomatic syphilis increased. Adherence to after treatment follow up was suboptimal.

Secondary syphilis with ocular involvement in a HIV-infected patient - case report.

We describe the case of a HIV-infected patient, in whom a secondary syphilis with skin lesions and ocular involvement developed. On admission papular skin rash and partial visual loss with left eye were observed. Serological tests for syphilis were positive in very high titers. Ophthalmological examination revealed ocular abnormalities indicating ocular syphilis. Cerebrospinal fluid (CSF) tests showed elevated concentration of immunoglobulin G (IgG) with normal white blood count and albumin concentration, serological treponemal tests for syphilis were positive. Intravenous therapy with Penicillinum Crystallisatum (Benzylpenicillinum kalicum) was administered, according to the neurosyphilis treatment schedule, achieving resolution of the skin lesions and partial vision improvement, a month after the end of the treatment a complete recovery of the vision was noted. Serological tests` for syphilis titers decreased fourfold. Described case confirms reasonability of examination for syphilis in patients with sudden vision disturbances, especially those HIV-infected. It also indicates that early appropriate treatment of the ocular syphilis prevents permanent loss of vision.

Lipid profile disturbances may predispose psoriatic patients to liver dysfunction.

INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with metabolic disturbances and liver dysfunction. Both serum fatty acids (FA) and ceramides (Cer) have structural functions but also are signal molecules that could be involved in the pathogenesis of liver dysfunction. AIM: To assess the concentration of the circulating FA and Cer in correlation with the alanine aminotransferase (ALT) blood level in psoriatic patients. In addition, we have examined the relationship between ALT concentration and severity of the disease and inflammation markers. MATERIAL AND METHODS: Eighty-five patients with psoriasis and 32 healthy controls were enrolled in the study. Patients were divided into 2 groups according to ALT blood levels. Serum concentration of 14 FA and 14 Cer were measured by gas-liquid chromatography. The results were correlated with the Psoriasis Area and Severity Index (PASI), serum lipid profile, and inflammatory markers. RESULTS: We observed higher PASI score (p = 0.01) and higher C-reactive protein (p = 0.02) concentration in the group of psoriatic patients with high ALT. Serum ALT positively correlated with saturated fatty acids (SFA) (p = 0.01, r = 0.27) and SFA/unsaturated fatty acids (UFA) ratio (p = 0.01, r = 0.26). ALT negatively correlated with UFA level (p = 0.008, r = -0.28). Lignoceric ceramide positively correlated with ALT level (r = 0.22; p = 0.045) in psoriatic patients. CONCLUSIONS: Patients with severe psoriasis are predisposed to the development of liver dysfunction. We have demonstrated disturbances of serum fatty acid and sphingolipid profile in psoriatic patients, which may trigger liver disease.

Elevated circulating Krüppel-like factor 4 level as a novel independent marker of the proatherogenic risk in patients with psoriasis: a preliminary study.

INTRODUCTION: Krüppel-like factor 4 (KLF4) is a transcription factor of anti-inflammatory and anti-thrombotic properties not studied in psoriasis yet. AIM: To analyze the clinical value of the serum KLF4 level in psoriatics and elucidate the interplay between disease activity, metabolic or inflammatory parameters and systemic therapy. MATERIAL AND METHODS: The study enrolled thirty-four psoriatics and fifteen healthy subjects. Blood samples were collected before and after twelve weeks of treatment with methotrexate or acitretin. Serum KLF4 levels were measured using immune-enzymatic method. RESULTS: Serum KLF4 levels in psoriatic patients did not statistically differ comparing to the controls (p > 0.05). However, in severe psoriasis, KLF4 was significantly higher than in healthy ones before treatment and normalized after treatment to baseline levels of controls (p < 0.05, p > 0.05, respectively). KLF4 positively correlated with body mass index (p = 0.038) but not with psoriasis severity, nor inflammatory or metabolic markers. Interestingly, many pro-atherogenic parameters were shown as variables independently predicting the levels of KLF4. No significant effect of three-month systemic treatment on KLF4 was found. CONCLUSIONS: KLF4 may be a novel independent indicator of the proatherogenic risk in psoriatics, especially with a severe form or obesity.

Cutaneous Rosai - Dorfman disease in a patient with late syphilis and cervical cancer - case report and a review of literature.

BACKGROUND: Cutaneous Rosai - Dorfman disease (CRDD) is extremely rare variant of idiopathic histiocytic proliferative disorder, which may manifest as a non-specific macules, papules, plaques or nodules ranging in size and colour from yellow - red to red -brown. CASE PRESENTATION: A 52-year-old female presented with three gradually enlarging, reddish - brown nodules on the right upper extremity lasting six months. The patients denied fever, weight loss, malaise. Clinical examination and imaging tests showed no sign of lymphadenopathy. A biopsy specimen of a nodule showed a dense dermal polymorphic infiltrate with numerous histiocytes exhibiting emperipolesis phenomenon. Immunohistochemical staining of the histiocytes showed S-100 protein (+), CD68(+), but CD1a (-). Aforementioned findings were consistent with CRDD characteristics. Additionally, a routine serological screening and confirmatory serological tests for syphilis were positive. Syphilis of unknown duration was diagnosed. The IgG antibodies titre against Chlamydia trachomatis was elevated. An isolated sensory impairment over the right trigeminal nerve was found on neurological consultation. Comprehensive gynaecological assessment was carried out because of patient's complaints of bleeding after sexual intercourse and led to diagnosis of cervical cancer. The initial therapy with methotrexate was discontinued after three months due to neutropenia. Further therapy with dapson was ineffective, therefore complete surgical excision was recommended. CONCLUSIONS: CRDD is a rare, benign condition especially difficult to diagnose due to lack of general symptoms and lymphadenopathy. Histopathologic examination with immunohistochemical staining, exhibiting characteristic and reproducible findings play a key role in establishing an accurate diagnosis. In the presented case activated histiocytes demonstrated in a lesional skin might be a response to immune dysregulation related to chronic, untreated sexually transmitted infections and cancer.

Proprotein Convertase Subtilisin/Kexin Type 9, Angiopoietin-Like Protein 8, Sortilin, and Cholesteryl Ester Transfer Protein-Friends of Foes for Psoriatic Patients at the Risk of Developing Cardiometabolic Syndrome?

Psoriasis is a systemic, immune-metabolic disease with strong genetic predispositions and autoimmune pathogenic traits. During psoriasis progression, a wide spectrum of comorbidities comes into play with the leading role of the cardio-metabolic syndrome (CMS) that occurs with the frequency of 30-50% amongst the psoriatic patients. Both conditions-psoriasis and CMS-have numerous common pathways, mainly related to proinflammatory pathways and cytokine profiles. Surprisingly, despite the years of research, the exact pathways linking the occurrence of CMS in the psoriasis population are still not fully understood. Recently published papers, both clinical and based on the basic science, shed new light into this relationship providing an insight into novel key-players proteins with plausible effects on above-mentioned interplay. Taking into account recent advances in this important medical matter, this review aims to discuss comprehensively the role of four proteins: proprotein convertase subtilisin/kexin type-9 (PSCK9), angiopoietin-like protein 8 (ANGPLT8), sortilin (SORT1), and cholesteryl ester transfer proteins (CEPT) as plausible links between psoriasis and CMS.

Higher Serum Selenoprotein P Level as a Novel Inductor of Metabolic Complications in Psoriasis.

Selenoprotein P (SeP), a member of hepatokines, is involved in the development of various metabolic diseases closely related to psoriasis, but it has not been explored in that dermatosis so far. The study aimed to evaluate the clinical value of serum SeP concentrations in patients with psoriasis and its interplay between disease activity, metabolic or inflammatory parameters and systemic therapy. The study included thirty-three patients with flared plaque-type psoriasis and fifteen healthy volunteers. Blood samples were collected before and after three months of treatment with methotrexate or acitretin. Serum SeP levels were evaluated using the immune-enzymatic method. SeP concentration was significantly higher in patients with psoriasis than in the controls (p < 0.05). Further, in patients with severe psoriasis, SeP was significantly increased, compared with the healthy volunteers before treatment, and significantly decreased after (p < 0.05, p = 0.041, respectively). SeP positively correlated with C-reactive protein and platelets and negatively with red blood counts (p = 0.008, p = 0.013, p = 0.022, respectively). Therapy resulted in a significant decrease in SeP level. Selenoprotein P may be a novel indicator of inflammation and the metabolic complications development in psoriatics, especially with severe form or with concomitant obesity. Classic systemic therapy has a beneficial effect on reducing the risk of comorbidities by inhibiting SeP.

Epidemiological and clinical characteristics of patients with pemphigus treated in Bialystok in 2001-2018.

BACKGROUND: Pemphigus is a group of potentially fatal dermatological autoimmune disorders. AIM: Analysis of cases of pemphigus vulgaris (PV) and pemphigus foliaceus (PF) newly diagnosed and treated at the Department of Dermatology and Venereology, Medical University of Bialystok, North-east Poland in years 2001-2018. MATERIAL AND METHODS: A retrospective analysis and comparison of sociodemographic, epidemiological and clinical characteristics of PV and PF patients, including: age, gender, residency, initial severity of skin lesions, involvement of mucous membranes, co-morbidities and their treatment, efficacy of therapy. RESULTS: Sixty-two new cases - 41 (66.13%) of PV and 21 (33.87%) of PF were diagnosed. The average age of PV patients was 54.85±12.35 years and those of PF - 63.81±31.52 years, P<0.05. Females constituted 75.61% and 61.90% in PV and PF group, respectively. Majority of patients with PV were residents of urban and these with PF - of rural areas (70.73% and 66.67%, respectively). On admission, 14 patients with PV (34.15%) and 11 with PF (52.38%) had more than 30% of body surface area involved. In 22 (53.66%) PV mucous membrane (oropharyngeal cavity) was involved. Ten (24.39%) patients with PV and 12 (57.14%) - with PF had more than one concomitant disorder (P<0.05). In treatment prednisone in monotherapy or with additional immunosuppressive agent was mainly used. The disease relapsed within three years after achieving clinical and immunological remission in 29.27% of PV and in 38.10% of PF patients. CONCLUSIONS: PF patients are older than PV ones, more frequently live in rural areas, have more comorbidities. Females constitute majority of pemphigus patients. The disease may relapse in about one third of patients. Because of frequent comorbidities, also these related to pemphigus treatment, patients with pemphigus require complex and multispecialistic medical care.