Hidradenitis suppurativa - biologic therapy and other available treatment options.

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease which is characterized by painful, recurrent nodules and abscesses. The overall prevalence of HS is estimated to be 11 per 100 000 individuals in the United States and 4% of the world's population. Women are three times more affected than men, especially patients between 18 and 29 years. Similarly to acne vulgaris, HS is primarily associated with follicular occlusion, which results from a number of biological processes, including follicular epithelial hyperplasia and hyperkeratinization. There are numerous available treatment options for cutaneous lesions in the course of HS. A combination of conservative therapy and appropriate surgical treatment conducted by an experienced surgeon ensures the best possible clinical outcomes. Presently, biologic therapy is the most effective pharmacological treatment in patients with a moderate-to-severe course of the disease. Numerous ongoing clinical trials provide hope for greater availability of new biologic therapy methods.

The Role of Epigenetic Factors in Psoriasis.

Psoriasis is a chronic, systemic, immune-mediated disease with an incidence of approximately 2%. The pathogenesis of the disease is complex and not yet fully understood. Genetic factors play a significant role in the pathogenesis of the disease. In predisposed individuals, multiple trigger factors may contribute to disease onset and exacerbations of symptoms. Environmental factors (stress, infections, certain medications, nicotinism, alcohol, obesity) play a significant role in the pathogenesis of psoriasis. In addition, epigenetic mechanisms are considered result in modulation of individual gene expression and an increased likelihood of the disease. Studies highlight the significant role of epigenetic factors in the etiology and pathogenesis of psoriasis. Epigenetic mechanisms in psoriasis include DNA methylation, histone modifications and non-coding RNAs. Epigenetic mechanisms induce gene expression changes under the influence of chemical modifications of DNA and histones, which alter chromatin structure and activate transcription factors of selected genes, thus leading to translation of new mRNA without affecting the DNA sequence. Epigenetic factors can regulate gene expression at the transcriptional (via histone modification, DNA methylation) and posttranscriptional levels (via microRNAs and long non-coding RNAs). This study aims to present and discuss the different epigenetic mechanisms in psoriasis based on a review of the available literature.

Cutaneous manifestations of coronavirus disease 2019 - review of literature and case reports.

Primary clinical manifestations of coronavirus disease are respiratory tract infections, ranging from an asymptomatic carrier state to severe interstitial pneumonia. The most common symptoms are fever, dry cough, fatigue, nausea, diarrhea, and loss of smell or taste. Recent reports indicate the possibility of several nonspecific dermatological symptoms. These include urticaria, maculopapular lesions, vascular lesions involving petechiae, purpura and livedo reticularis. The onset of cutaneous lesions may precede full-blown COVID-19 or remain the only manifestation of the disease (especially in young patients). Focusing on dermatological symptoms may be crucial for preventing the spread of SARS-CoV-2. However, unambiguous assessment of cutaneous manifestations of COVID-19 requires more research and case studies conducted by dermatologists.

The prevalence of SARS-CoV-2 infection and the severity of the course of COVID-19 in patients with psoriasis treated with biologic therapy.

BACKGROUND: Biologics are used for the treatment of patients with moderate to severe psoriasis. According to the recommendations of major global dermatological associations, patients who had not reported clinical symptoms or close contact with a confirmed/probable COVID-19 case in the last 14 days can continue biologic therapy. OBJECTIVE: The aim of our study was to determine the prevalence of SARS-CoV-2 infection, its clinical manifestations and the influence of COVID-19 on the course of the underlying disease in patients with moderate to severe psoriasis and aggressive psoriatic arthritis undergoing biologic therapy. MATERIAL AND METHODS: All 61 patients with moderate to severe psoriasis treated with biologics in the Dermatology Department of Central Clinical Hospital of Ministry of the Interior and Administration in Warsaw were enrolled into the study. Firstly, the medical histories of these patients were assessed for occurrence of severe adverse events, COVID-19 symptoms and deaths. Afterwards, the prevalence of serum anti-SARS-CoV-2 antibodies, and severity of COVID-19 were assessed. RESULTS: Ten patients in the study group have developed anti-SARS-CoV-2 antibodies. One patient presented with mild COVID-19 symptoms. CONCLUSION: While our study had a small sample size, ongoing biologic treatment in psoriasis was not associated with severe form of COVID-19.