Keratosis follicularis (Darier disease) - clinical characteristics and treatment - a review and update.

Darier disease is one of the most common genodermatoses. Although Darier disease was described in 1886, targeted therapies remain unknown. Current literature lacks specific guidelines for treatment of Darier disease. Treatment remains symptomatic and may be challenging for dermatologists. The aim of this article is to present clinical characteristics and treatment options. In a mild form of the disease with a small number of skin lesions, the symptoms can be reduced by the use of topical medications. Oral retinoids, alternatively doxycycline, seem to be beneficial in extensive and persistent lesions unresponsive to local treatment. In limited, hypertrophic forms, surgical methods, laser therapy and photodynamic therapy could be used.

Analysis of serum chemerin concentrations in psoriatic patients in relation to metabolic abnormalities.

INTRODUCTION: Recent data depict psoriasis as a systemic disease with many comorbidities, especially metabolic syndrome and cardiovascular diseases. Chemerin, an adipokine secreted by adipose tissue cells, may prove to be an important link between psoriasis and its comorbidities. AIM: Assessment of serum concentrations of chemerin in patients with psoriasis and the healthy control group as well as evaluation of a possible correlation between adipokine concentrations and selected psoriasis severity indices and metabolic syndrome components. MATERIAL AND METHODS: One hundred and two patients with diagnosed psoriasis and 40 healthy volunteers were enrolled in the study. In all subjects, serum chemerin concentrations and selected metabolic syndrome components including lipid and glucose levels were determined. Psoriasis severity was assessed using the PASI and BSA indices. RESULTS: A higher concentration of chemerin was demonstrated in the group of psoriasis patients compared to the control group (p < 0.05). A positive correlation between chemerin concentration and C-reactive protein concentration (p = 0.001), body mass index (p = 0.031) and triglyceride concentration (p = 0.043) was found. An inverse correlation with high-density lipoprotein cholesterol concentrations (p = 0.015) was also noted. Significantly higher concentrations of chemerin were observed in psoriatic patients with elevated low-density lipoptotein (LDL) cholesterol levels in comparison with patients with normal LDL values (p = 0.032). Chemerin concentrations were also significantly higher in patients with both psoriasis and elevated glucose levels compared to patients with normal blood glucose values (p = 0.043). CONCLUSIONS: The results obtained suggest a possible role of chemerin as an adipokine linking psoriasis with metabolic syndrome.

The Role of Vitamin D in Non-Scarring Alopecia.

Non-scarring hair loss is a common problem that affects both male and female patients. Since any disturbances in the hair follicle cycle may lead to hair shedding, or alopecia, it is not surprising that the possible role of vitamin D in alopecia was investigated in many studies. Vitamin D has been shown to have many important functions. A growing body of evidence shows that vitamin D and its receptor are responsible for maintaining not only calcium homeostasis but also skin homeostasis. Moreover, vitamin D could also regulate cutaneous innate and adaptive immunity. This paper presents a review of current literature considering the role of vitamin D in alopecia areata, telogen effluvium, and female pattern hair loss. The majority of studies revealed decreased serum 25-hydroxyvitamin D levels in patients with different types of non-scarring alopecia, which could suggest its potential role in the pathogenesis of hair loss. According to the authors, vitamin D supplementation could be a therapeutic option for patients with alopecia areata, female pattern hair loss, or telogen effluvium. However, further studies on a larger group of patients are required.

Spectacular Effect of Massive Facial Angiofibromas Removal With a Carbon Dioxide Laser as a Manifestation of a Tuberous Sclerosis Complex.

Introduction: Tuberous sclerosis complex (TSC) is a rare, genetic disease which leads to neurological, cardiological, nephrological, ophthalmic, pulmonary and skin disorders. Case Presentation: Here, we describe a case of a 64-year-old man with the presence of giant angiofibromas located on his chin and nasolabial folds which caused inconvenience and unaesthetic appearance. All angiofibromas were removed with the use of a CO2 laser. The patient was extremely satisfied with the obtained result. No side effects were observed after a 6-month follow-up. Conclusion: Despite the fact that giant facial angiofibromas may be troublesome not only for patients but also for medical doctors, adequate CO2 laser usage with local anesthesia and control of massive bleeding is a promising treatment option for patients with TSC.

Osteopontin Serum Concentration and Metabolic Syndrome in Male Psoriatic Patients.

Psoriasis (Ps) is an immune-mediated inflammatory skin disease that is widely associated with the clinical features of metabolic syndrome (MetS), including hypertension, abdominal obesity, insulin resistance, type 2 diabetes and dyslipidemia. Osteopontin (OPN), a multifunctional protein involved in the modulation of inflammatory processes, may contribute to the development of atherosclerosis and MetS. Therefore, the aim of the study was the assessment of the correlation between OPN concentration in the peripheral blood and the presence of MetS as well as its particular components in the Ps patients. The study comprised 107 male Ps patients (50 patients with MetS and 57 without MetS) and 38 healthy volunteers (HVs). The concentration of OPN in serum was determined using enzyme-linked immunosorbent assay (ELISA) method. Fasting blood glucose and lipid profile components: total cholesterol (total CHOL), high-density lipoprotein cholesterol (HDL-CHOL), low-density lipoprotein cholesterol (LDL-CHOL), triglycerides (TG) were examined. Ps patients with MetS had significantly higher obesity, systolic blood pressure, TG, CHOL/HDL, LDL/HDL and TG/HDL ratios than Ps patients without MetS. OPN serum concentration was significantly higher in the Ps patients than in the HVs (p = 0.022) but not significantly different between the Ps patients with and without MetS (p = 0.275). OPN serum concentration in Ps patients correlated negatively with total CHOL (p = 0.004) and TG (p = 0.009). OPN is increased in Ps patients and may serve as a biomarker of some lipid abnormalities in them.

Assessment of visfatin concentrations in the serum of male psoriatic patients in relation to metabolic abnormalities.

BACKGROUND: Visfatin is one of the pro-inflammatory adipokines secreted by adipose tissue cells. Recent scientific research has drawn attention to the role of adipokines in the pathophysiology of metabolic disorders and their association with inflammatory diseases, including psoriasis. Visfatin may be one of the important links explaining the connection between psoriasis and diseases which are components of metabolic syndrome. OBJECTIVES: The aim of this study was to assess the serum visfatin concentration in patients with psoriasis and to evaluate its possible correlations with parameters of metabolic syndrome and the clinical severity of psoriasis. MATERIAL AND METHODS: A group of 102 patients with psoriasis and a control group of 40 healthy subjects were examined. The clinical severity of psoriasis was assessed according to Psoriasis Area and Severity Index), BSA (Body Surface Area) and DLQI (Dermatology Life Quality Index) indicators, the presence and type of obesity, and hypertension. In both the study and control groups, laboratory tests (C-reactive protein (CRP), glucose concentration, total cholesterol, low-density-lipoprotein (LDL) cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglycerides (TG)) were performed and serum visfatin concentrations were determined. The clinical data, results of laboratory tests and visfatin concentrations were then subjected to statistical analysis. RESULTS: There was a significantly higher concentration of visfatin in the psoriatic patients (p < 0.001) than in the control group. Significant positive correlations between visfatin concentration and PASI (p = 0.008) and BSA (p = 0.007) were observed. In the psoriatic group, there were positive correlations between the concentrations of visfatin and the concentrations of CRP (p = 0.008) and total cholesterol (p = 0.002). Visfatin concentration was elevated in the psoriatic patients who had elevated total cholesterol (p = 0.001), LDL cholesterol (p = 0.012) and TG levels (p = 0.001) compared to the psoriatic patients with normal levels of these lipid profile components. CONCLUSIONS: The results indicate the possible participation of visfatin in pathophysiological and inflammatory processes in the course of psoriasis. Adipokines may be an important link connecting psoriasis with coexisting metabolic disorders.

The role of immune checkpoint inhibitors in prostate cancer.

INTRODUCTION: Prostate cancer (PC) is the most commonly diagnosed malignant tumour and the third cause of cancer deaths among men in Europe. The treatment of early-stage PC is very effective and in many cases allows achievement of a complete cure, whereas the treatment of metastatic prostate cancer (mPC) is still a huge challenge for clinicians. New therapeutic strategies for mPC are urgently needded. One of the most promising methods of treatment is anticancer immunotherapy including the monoclonal antibodies against immune checkpoint inhibitors. OBJECTIVES: To present the potential possibilities of using checkpoint inhibitors blockage in the treatment of mPC, and to overview the results of recent research on immune checkpoint inhibitors in patients with PC. STATE OF KNOWLEDGE: Recent studies suggest that monoclonal antibodies directed against immune checkpoint inhibitors in combination with traditional therapy may become a breakthrough in the treatment of mPC in the near future. CONCLUSIONS: The immunotherapy using monoclonal antibodies against immune checkpoint inhibitors seems to be a new opportunity for patients with advanced PC. The key to achieve the maximum anti-tumour response is to choose the best candidates for this therapy and determine the optimal sequence and combination of drugs. The introduction of immunotherapy as the standard treatment of patients with advanced PC requires further studies.