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Introduction: Psoriasis is a chronic inflammatory disease that negatively impacts patients' quality of life (QoL) and mental health. Itch and pain are prevalent symptoms of psoriasis and contribute to the psychosocial burden of this disease. This study aimed to evaluate the impact of skin pain on the prevalence and severity of symptoms of anxiety and depression and on the QoL in psoriasis patients. Methods: The studied population comprised 106 adults with psoriasis (34% female; mean age 42.1 ± 13.0 years). Disease severity was measured with the Psoriasis Area and Severity Index (PASI). The intensity of skin pain was assessed with the NRS and the Short Form McGill Pain Questionnaire (SF-MPQ). The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) questionnaires were used to estimate the severity of depression and anxiety, respectively, as was the Hospital Anxiety and Depression Scale (HADS). Quality of life (QoL) was studied using the Dermatology Life Quality Index (DLQI). Results: Regarding anxiety assessment, females reported significantly higher scores with the HADS-A (8.42 ± 4.85 points vs. 5.14 ± 3.9 points; p < 0.001) and the GAD-7 compared to men (7.50 ± 5.58 points vs. 5.24 ± 4.79 points; p = 0.036). Similarly, the severity of depression was significantly higher in women, as measured with the PHQ-9 (7.50 ± 5.58 points vs. 5.24 ± 4.79 points, p = 0.021). Psoriasis patients with skin pain scored significantly higher in HADS Total score (p = 0.043), HADS-A (p = 0.022), PHQ-9 (p = 0.035), and DLQI (p < 0.001) than the rest of the studied group. The intensity of skin pain measured with the SF-MPQ correlated significantly with HADS Total score (p = 0.021), HADS-A (p < 0.001), HADS-D (p = 0.038), and PHQ-9 (p < 0.001). Additionally, there was a significant correlation between the intensity of cutaneous pain assessed using the VAS and the PHQ-9 (p = 0.022). Conclusions: Skin pain significantly influences the well-being of patients with psoriasis as well as the symptoms of anxiety and depression. In particular, women with psoriasis are at increased risk of developing anxiety and depression. Our findings underline the necessity for a multidisciplinary approach to the management of this dermatosis. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a common inflammatory disease that is often associated with itch and pain. This study aimed to evaluate the clinical characteristics of skin pain among patients with psoriasis. Materials: A total of 106 patients diagnosed with psoriasis were included in the study (34% female; mean age 42.1 ± 13.0 years). Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Itch severity was evaluated using the numeric rating scale (NRS) and 4-Item Itch Score (4IIS). The intensity of skin pain was measured through the NRS, short-form McGill pain questionnaire (SF-MPQ), visual analog scale (VAS), and Douleur Neuropathique-4 questionnaire (DN4). Results: In the past week, 84.9% of psoriasis patients reported itch, while 50% of them reported skin pain. The average NRS for itch was 4.52 ± 2.88 points, and the 4IIS yielded a mean score of 6.79 ± 4.37 points. In terms of the intensity of cutaneous pain, the mean NRS was 2.42 ± 2.96 points; the SF-MPQ score averaged 4.84 ± 7.51 points; and the VAS score was 1.92 ± 2.65 points. Furthermore, 17% of adult psoriasis patients reported neuropathic pain. In 84.9% of the participants, skin pain was concurrent with areas affected by itch, while 18.9% of patients exhibited cutaneous pain encompassing all itchy areas. The pain NRS demonstrated significant correlations with the SF-MPQ (r = 0.531, p < 0.001), VAS (r = 0.779, p < 0.001), itch NRS (r = 0.551, p < 0.001), and 4IIS (r = 0.569, p < 0.001). No association was found between the pain NRS and PASI or disease duration. Conclusions: Skin pain of mild intensity and itch of moderate intensity are prevalent symptoms in psoriasis patients. Strong correlations between skin pain and itch can be explained by the process of neurogenic inflammation. [ABSTRACT FROM AUTHOR]

Copyright of Paediatrics & Family Medicine / Pediatria i Medycyna Rodzinna is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Epidemiological Review / Przegląd Epidemiologiczny is the property of National Institute of Public Health - National Institute of Hygiene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Cutaneous lupus erythematosus (CLE) presents clinically heterogeneous manifestations, partially explained by the different expression of Toll-like receptors (TLRs) type 8 and 9, located to endosomal compartments where they are poised to recognize microbial nucleic acids. This disease is empirically treated with hydroxychloroquine (HCQ), which is hallmarked with a safe and effective profile, but induces a slow and sometimes clinically insufficient therapeutic response. Currently, no biomarkers predictive of response are validated or even proposed in the scientific literature. We aimed to evaluate endosomal TLR type 7, 8 and 9 as predictive biomarkers of HCQ efficacy. Materials and Methods: We conducted a case–control study comparing CLE patients retrospectively assigned to three subgroups based on 3–6-month Cutaneous LE Disease Area and Severity Index (CLASI) reduction upon treatment with HCQ (I = <40% vs. II = 40–80% vs. III = >80%). Before HCQ, lesional skin specimens were collected in untreated CLE and through immunohistochemistry; TLR-7, -8 and -9 expression was evaluated in the epidermis and the lymphocytic infiltrate was evaluated in the dermis. Results: Sixty-six lesional skin biopsies were compared with healthy controls. CLE patients displayed lower epidermal expression of total TLR 8 and 9 as well as infiltrating TLR-8, TLR9 + lymphocytes compared to controls. High HCQ responders differed from low responders for TLR-9 positivity (high vs. low) and for the lymphocytic dermal infiltrate (high vs. low). Conclusions: TLR9 could be envisaged as a possible biomarker to predict HCQ response level and dosage in CLE patients. [ABSTRACT FROM AUTHOR]

Introduction: Granuloma faciale is a rare dermatosis classified within the group of eosinophilic dermatoses, which presents a persistent challenge in both diagnosis and treatment. Objective: Presentation a case of granuloma faciale along with a comprehensive discussion of the pathophysiology, clinical presentation, and treatment of the disease. Case report: A 68-year-old man presented to a dermatologist with nodular and plaque-like lesions on his face that had been present for 6 months. Initially, based on histopathological findings, fixed drug eruption was diagnosed, and the patient was instructed to discontinue the medications he had been taking, including acetylsalicylic acid and non-steroidal anti-inflammatory drugs. Nevertheless, the skin lesions persisted. Following extended differential diagnosis (including dermoscopy and repeated histopathological examination), the diagnosis of granuloma faciale was established and, consequently, cryotherapy with liquid nitrogen was administered, resulting in a significant improvement in the patient's skin condition. Conclusions: Despite being typically located in the specific areas, granuloma faciale poses diagnostic challenges. Cryotherapy seems to be an effective and safe therapeutic approach in patients who fail to respond to topical medications. [ABSTRACT FROM AUTHOR]

Introduction: Pityriasis rubra pilaris is a rare, chronic dermatosis presenting with erythema and papular eruptions as well as characteristic perifollicular hyperkeratosis and ‘islands of sparing’ (normal appearing skin). In the literature, there are reports of cases where symptoms of infection preceded the onset of pityriasis rubra pilaris. Objective: Presentation of the case of a 67-year-old patient with type I pityriasis rubra pilaris to highlight the possible association between pityriasis rubra pilaris with infectious agents. Case report: A 67-year-old patient was referred to hospital because of rapidly progressive erythematous papular skin rash preceded by symptoms of an upper respiratory tract infection. On physical examination, attention was drawn to perifollicular papules covered with cap-like scales as well as confluent erythema and features of hyperkeratosis on the hands and feet. Based on the clinical presentation and histopathological findings, type I pityriasis rubra pilaris was diagnosed and treatment with acitretin was initiated. Conclusions: Infectious agents have the potential to be a trigger for pityriasis rubra pilaris. Acitretin continues to demonstrate efficacy in the treatment of pityriasis rubra pilaris. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic, recurrent inflammatory dermatosis. The most characteristic symptoms of the disease include itch, eczematous eruptions and excessive dryness of the skin. Elderly patients with AD represent a poorly characterized population because the physiological ageing, possible comorbidity and polypharmacy modify the clinical presentation typically observed in the younger age groups. The aim of the study is to comprehensively assess the clinical characteristics of elderly patients (>60 years old) with AD. Data were collected from 26 AD patients treated in the Department of Dermatology of the University Hospital in Krakow. Late-onset AD with generalized/prurigo lesions was the most predominant phenotype. Skin biopsy was required in 15 (58%) patients in the differential diagnosis process. Allergic rhinitis, a positive family history of atopy and xerosis were associated with a higher number of hospitalizations during the year prior to the last admission (p = 0.034, p = 0.046 and p = 0.036, respectively). Xerosis was more prevalent among subjects with polypharmacy (p = 0.046) and higher serum total IgE concentration (p = 0.048). AD in elderly patients is a new phenotype of the disease that requires careful differential diagnosis. Aged patients with an individual or family history of atopy, due to the increased incidence of severe exacerbations of AD, may benefit from the introduction of proactive therapy. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is the most common inflammatory skin disease. However, recent reports concerning the simple clinical aspects of treatment with topical glucocorticosteroids (TCS) and calcineurin inhibitors (TCI) are lacking. The objective of this study is providing an update on these characteristics of AD management. A group of 150 adults suffering from AD treated with TCS during last year was asked to fill an anonymous questionnaire. The course of topical treatment was analyzed in the context of the severity of symptoms and the knowledge of the patients about therapy. During the last year, the majority of patients (66%) were treated with class IV TCS; however, in the last two weeks, class I TCS was used the most frequently (35%). Only 11% were familiar with the concept of intermittent therapy and 4% used the fingertip unit (FTU). In total, 77% of them used TCI. Most of the patients used the same class of TCS permanently. Unfortunately, patients are unaware of simple approaches (like intermittent therapy or FTU) that increase both the effectiveness and safety of the treatment. Practicians should be aware of these problems to identify and eliminate them, primarily through the education of patients. [ABSTRACT FROM AUTHOR]

Copyright of Dermatology Review / Przeglad Dermatologiczny is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Currently pellagra is usually the subject of dermatological or non-dermatological case reports. Since the first description of the disease, its cause has remained unknown for many years. There were no known methods of prevention and treatment. For two centuries, pellagra was an incurable disease and caused several hundred thousand deaths in Europe and North America. Research by clinicians and scientists has made it possible to refute the common theory of the infectious etiology of the disease and link the disease epidemic to maize, which was then the primary source of food for the poor. Consumption limited to this grain resulted in an extreme deficiency of niacin (vitamin B3) and symptoms of pellagra. Niacin supplementation caused the lesions to regress, and became crucial to combat the epidemic. The article presents the first descriptions, the greatest outbreaks of the epidemic and the stormy process of discovering data on the etiology of pellagra, as well as typical clinical features of the diseases. [ABSTRACT FROM AUTHOR]

Introduction: Glomus tumor is a painful, subcutaneous tumor. The lesion may occur in various locations. In the case of the nail apparatus, it affects both the matrix area and the nail bed. Case report: We present a 71-year-old patient who presented to our clinic with a painful nodule lasting for about 15 years, located on the fifth finger of his left hand. After surgical removal, a histological examination was performed, which confirmed the clinical suspicion of glomus tumor. Intraoperative contact onychoscopy revealed a gray-blue nodule with linear vessels at the periphery. Conclusions: In the differential diagnosis of glomeroma, the following should be considered: pyogenic granuloma, subugual viral wart, melanoma, hemangioma, leiomyoma, sweat gland tumor, gout, neuroblastoma and hemangioma. Dermoscopy can be useful in the differential diagnosis, but the final diagnosis is based on a histopathological examination. Surgical removal of the lesion is considered the treatment of choice. [ABSTRACT FROM AUTHOR]

Introduction: Many atopic dermatitis (AD) patients suffer from insomnia. Out of numerous factors associated with sleep disorders, melatonin seems to play a significant role. Aim: To assess the relation between melatonin concentration and sleep disorders in adult patients with severe and very severe AD. Material and methods: The study included 36 adult patients with severe and very severe AD and 20 healthy Caucasian volunteers. The severity of skin lesions was assessed by the EASI scale. Skin itch was evaluated by a visual-analogue scale (VAS), and sleep disorders were assessed by the Polish version of the Athens Insomnia Scale (AIS). Serum melatonin concentration of patients and controls was determined by ELISA. Results: Melatonin concentration in patients with very severe AD was significantly (p < 0.001) lower than in patients with severe AD, however, melatonin concentration in the group of AD patients did not differ significantly (p = 0.33) from that observed in the control group. There was a significant negative correlation between the concentration of melatonin in the study group and the severity of itching (R = -0.54, p < 0.001). The intensity of sleep disorders was significantly higher (p < 0.001) in patients with a very severe form of AD compared to patients with severe AD. Moreover, there was a significant negative correlation between melatonin concentration and sleep disorders (R = -0.67, p < 0.001). Conclusions: Our results clearly showed that sleep disturbances are more expressed in very severe AD patients compared to subjects suffering from severe disease. We also suggest that melatonin serum concentration could play a role in the pathogenesis of sleep disturbances in AD patients. [ABSTRACT FROM AUTHOR]

Introduction: Female pattern hair loss (FPHL) is one of the most common causes of hair loss in women. Genetics plays an important role in the development of the disease, but the etiopathogenesis and the inheritance pattern in women remain unexplained. Aim: To determine the extent to which FPHL is of genetic origin in women from the Polish population and whether a positive family history is a risk factor for its earlier onset. Material and methods: Family histories of 111 unrelated female patients with FPHL and 129 female patients without hair thinning were analysed. FPHL was diagnosed based on a detailed medical history, the clinical picture and trichoscopic features. Results: A positive family history was noted in 69 (62.2%) patients with FPHL. In 32 (28.8%) patients from that group, more than one person in the family suffered from hair loss, whereas in the healthy group, the same was true of only 4 patients (3.1%) (p < 0.0001). A positive family history on the mother's side proved statistically significant for FPHL patients. In the case of 20 (18%), hair loss had been identified in their grandparents, while the healthy group had a negative history in that respect. A positive family history of hair loss in grandparents was three times more frequent in the group of patients with the disease onset before 40. Conclusions: A positive history on the mother's side may be of great significance for FPHL development. Hair loss in more than one family member and in one's grandparents may also indicate a higher risk of disease development. [ABSTRACT FROM AUTHOR]

Pellagra is a rare disease caused by niacin deficiency or a disruption of its metabolism. Its manifestations are dermatitis with pronounced photosensitivity, gastrointestinal symptoms, and neuropsychiatric ailments. Currently pellagra is developed in people who chronically abuse alcohol or are treated with medications from specific pharmacological groups (immunosuppressive and anti-tuberculosis drugs). Although the root cause of the disease was established in the mid-twentieth century, a detailed explanation of the processes leading to the development of symptoms has not yet been proposed. They include complex abnormalities at the molecular, metabolic, and immunological levels. Diagnostics is based primarily on the clinical presentation of the disease, while auxiliary tests play secondary role. The low prevalence of the disease, meaning that physicians are unfamiliar with its recognition, often leads to delays in diagnosis and appropriate treatment. The therapy is causal and based on administering niacinamide. Failure to implement treatment in the early stages of the disease leads to the patient's death. The aim of this literature review is to summarize the current state of knowledge on the pathomechanisms of pellagra, highlighting the clinical implications, and key elements of diagnostic and therapeutic management that are important in the treatment of pellagra patients. [ABSTRACT FROM AUTHOR]

Introduction: The diagnosis of cutaneous lymphomas is extremely difficult because of their morphological diversity and clinical similarity to many dermatoses. Objective: Presentation of the case of a 70-year-old woman diagnosed with lichen sclerosus in whom the evolution of skin lesions raised suspicions of lymphocytic hyperplasia. Case report: The patient diagnosed with lichen sclerosus was hospitalized three times due to exacerbation of skin lesions with accompanying mycosis fungoides-mimicking infiltration. Cutaneous lymphoma was excluded in biopsy specimens collected from skin lesions. In the following months, a new nodular lesion appeared on the patient's face that turned out to be marginal zone lymphoma. After increasing the dose of methotrexate to 20 mg/week, a rapid remission of skin lesions was achieved. Conclusions: The presented case shows that the diagnosis of primary cutaneous lymphoma is a significant challenge in everyday dermatological practice and requires repeated biopsy. [ABSTRACT FROM AUTHOR]

Introduction. The nail apparatus is a skin appendage which, among other functions, stabilises the fingertips and protects the distal parts of fingers or toes from injuries. It may become dystrophic following chemotherapy. Diverse nail symptoms require a complex differential diagnosis. Objective. Presentation of a case of Lindsay's nails in a patient treated with paclitaxel for breast cancer. Case report. A 65-year-old woman reported to a dermatology outpatient clinic with changes to her fingernails and toenails. Six months earlier, she had undergone left-sided mastectomy for breast cancer and then commenced chemotherapy with paclitaxel in combination with trastuzumab. A few weeks after starting this chemotherapy regimen, the patient noticed pronounced haemorrhages in the region of the toes, followed by matt whitening of the proximal part of the fingernail apparatus, sharply demarcated from the brown-coloured distal part. In addition, the patient experienced neuropathic symptoms in the fingers. The clinical picture of the lesions and the patient's disease history suggested a variant of leukonychia, i.e. Lindsay's nails, induced by chemotherapy. Conclusions. The presented case of Lindsay's nails ("half-and-half" nails) is unique, as it was never before reported in the literature in association with paclitaxel therapy. [ABSTRACT FROM AUTHOR]

Introduction. Subcorneal pustular dermatosis is a rare and chronic dermatosis which often has a recurrent course. The differential diagnosis of the condition should include above all pustular psoriasis and IgA pemphigus. Objective. Presentation of a case of subcorneal pustular dermatosis successfully treated with acitretin. Case report. A 28-year-old male patient was admitted to the Department with extensive erythematous eruptions arranged in a polycyclic pattern with small pustules on the periphery. The findings of histopath-ological examination confirmed the diagnosis of subcorneal pustular dermatosis. After introducing treatment with acitretin a remission of skin lesions was achieved. Conclusions. The reported case and the literature data show that the differential diagnosis of subcorneal pustular dermatosis continues to be a clinical and histopathological challenge. Because of therapeutic differences associated with the disease entities in question, the establishment of correct diagnosis of subcorneal pustular dermatosis is especially important, while the improvement seen in the patient's condition confirms the efficacy of acitretin in the treatment of the disease. [ABSTRACT FROM AUTHOR]

Byline: Maciej. Pastuszczak, Jacek. Zeman, Andrzej. Jaworek, Anna. Wojas-Pelc Background : Syphilis is caused by a spirochete Treponema pallidum. Invasion of the central nervous system (CNS) by T. pallidum may [...]

The article discusses a topic dermatitis (AD) has the common itchy inflammatory skin disease with a chronic and recurrent course worldwide. Topics include the aims of study have to evaluate and compare itch response in patients with AD treated with NB-UVB and cyclosporine; and the baseline characteristics of both studied groups showed no significant difference in itch intensity.

Papulo- and vesiculo-necrotic lesions are rare manifestations of secondary syphilis. Until now it has been described only in HIV-infected patients with advanced stages of immunosuppression. This case report describes an unusual case of PLEVA-like syphilis in a 33-year-old man with newly diagnosed HIV infection. Despite that the CD4 cells level and viral load did not indicate the advance stage of immunosuppression, the unusual manifestation of syphilis and neurosyphilis occurred. The presented case indicates the need for HIV screening in every patient with syphilis especially when the clinical manifestation is unusual. Importance of syphilis testing in every case with atypical rashes should be also highlighted. [ABSTRACT FROM AUTHOR]

The most specific criterion for diagnosing neurosyphilis is a reactive CSF VDRL. Unfortunately, there are in Europe, including Poland small number of specialized laboratories for serological diagnosis of syphilis. Thus, CSF serology results are obtained with delay. Therefore, the decision on recommended therapy for neurosyphilis is taken on the basis of CSF basic tests. In this paper we attempt to determine the utility of CSF glucose concentration and its cut-off values in prediction of asymptomatic neurosyphilis. CSF and blood were collected from 55 HIV-uninfected patients with syphilis of unknown duration. Patients with neurosyphilis (14.5%) were characterized by higher CSF pleocytosis (p<0.0001), elevated CSF protein concentration (p<0.05) and lower CSF glucose concentration (p<0.0001). Multivariate regression analysis identified CSF pleocytosis and CSF glucose concentration as the two independent predictors of reactive CSF VDRL (p<0.0001). In the selected group of patients with CSF pleocytosis ≥5/µL (n=25) CSF glucose concentration ≤2.72 mmol/L was associated with 100% sensitivity (95%CI: 63-100%) and 100% specificity (95%CI: 75.3-100%) for reactive CSF VDRL. CSF glucose concentration may be particularly useful as a predictive marker of neurosyphilis in HIV uninfected patients with syphilis of unknown duration with CSF plecytosis ≥5/µL. [ABSTRACT FROM AUTHOR]

Primary cutaneous follicle center lymphoma is an Indolent Cutaneous B-cell Lymphoma responsible for almost 11% of primary cutaneous hematopoietic skin neoplasm. Although PCFCL has excellent prognosis of more than 95% 5 year survival rate it might be a challenge for a clinician because of diagnostic difficulties and a need to proceed complete differential diagnosis with systemic follicle center lymphoma. We present a case of a 55-year-old male patient with small, bug bite alike, erythematous, gradually extending lesion on the parietal area of the head. There were no other sign of disease on the skin and no other sides spreading of disease which was confirmed in CT imaging and no other systemic symptoms. After the diagnosis was made course of radical skin lesions 30 Gy radiotherapy were administered. In the follow-up examination skin lesion resolved completely and patient achieved complete remission of the disease. [ABSTRACT FROM AUTHOR]