Agnieszka Gerkowicz

Serum Levels of Selected Th17 and Th22 Cytokines in Psoriatic Patients

Introduction. Psoriasis is a T cell-mediated inflammatory disease in which pathogenesis T helper (Th) lymphocytes (Th1, Th17, and Th22) play an important role. The aim of the study was to assess the serum levels of some cytokines involved in the Th17 and Th22 responses in psoriatic patients. Material and Methods. The study comprised 60 psoriatic patients and 30 healthy controls. In the serum collected from psoriatic patients and healthy controls, the concentrations of IL-6, IL-12, IL-17, IL-20, IL-22, and IL-23 were examined with ELISA kits. Severity of psoriatic skin lesions was assessed by means of PASI, BSA, and PGA scores. Results. IL-6, IL-20, and IL-22 concentrations were significantly higher in psoriatic patients in comparison with the control group. The positive correlations between the concentrations of IL-22 and IL-20 and severity of psoriasis assessed with PASI and BSA scores as well as IL-17 and PASI score were found. There was also a positive correlation between IL-23 and IL-17 concentrations. Conclusions. Results of the conducted studies suggest that Th22 response may contribute to the skin and systemic inflammatory disease in psoriasis. It seems that early identification of soluble biomarkers and initiation of well-matched treatment may prevent exacerbation and progression of psoriasis.

Biochemical markers of psoriasis as a metabolic disease

Psoriasis is a chronic immune mediated inflammatory skin disease with a population prevalence of 2-3%. In recent years, psoriasis has been recognized as a systemic disease associated with metabolic syndrome or its components such as: obesity, insulin resistance, hypertension and atherogenic dyslipidemia. Many bioactive substances have appeared to be related to metabolic syndrome. Based on current literature, we here discuss the possible role of adiponectin, leptin, ghrelin, resistin, inflammatory cytokines, plasminogen activator inhibitor 1, uric acid, C-reactive protein and lipid abnormalities in psoriasis and in 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.

Videocapillaroscopic Alterations in Alopecia Areata

Alopecia areata (AA) is a common hair disorder observed in dermatological practice; however, the exact mechanisms that lead to the hair loss are still unknown. Disturbances in the blood supply of hair follicles may be one of the elements in the complex pathogenesis of AA. Nailfold videocapillaroscopy is a noninvasive technique that allows analysis of skin microcirculation in vivo. The aim of the study was the videocapillaroscopic assessment of skin microcirculation in AA patients. The study included 44 patients with patchy alopecia areata, 27 with alopecia universalis or totalis, and 40 healthy volunteers. Nailfold videocapillaroscopy was performed in all participants according to a standard protocol. Obtained images were assessed qualitatively and quantitatively. Two types of videocapillaroscopic images were distinguished in the study. Abnormal videocapillaroscopic images were found in 42% of patients. Tortuous and branching capillaries (P = 0.013, P = 0.001), decreased density of capillaries (P = 0.009), enlargement of the efferent limb (P < 0.017), or top part of the loop (P = 0.009) were observed significantly more often than in the control group. Only some patients with AA presented with microvascular abnormalities characterised by altered videocapillaroscopic images. More studies, including larger group of patients with AA, are required to determine the role of observed videocapillaroscopic alterations in AA.

Diffuse partial woolly hair in a patient with epidermolysis bullosa simplex with mottled pigmentation.

Diffuse partial woolly hair (DPWH) is an uncommon pilar dysplasia defined by the presence of two hair shaft populations with wooly hairs distributed diffusely among normal hairs throughout the scalp. So far the condition has been reported as an isolated disorder with familial occurrence. We report a case of DPWH in 35-year-old female patient with epidermolysis bullosa with mottled pigmentation.

Psoriatic arthritis – new perspectives

Psoriatic arthritis (PsA) is a seronegative arthropathy with many clinical manifestations, and it may affect nearly a half of patients with psoriasis. PsA should be diagnosed as early as possible to slow down joint damage and progression of disability. To improve the diagnosis of PsA, physicians should look for peripheral inflammatory pain, axial inflammatory pain, dactylitis, and buttock and sciatic pain. In most patients with PsA, pharmacologic treatment with non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and biologic agents is effective. However, when pharmacological treatment fails, patients with PsA may benefit from orthopedic surgery, which can improve both joint function and quality of life. Total hip arthroplasty, total knee arthroplasty, and arthroscopic synovectomy of the knee are the most common surgical procedures offered to patients with PsA. The management of PsA requires the care of a multidisciplinary team, which should include dermatologists, rheumatologists, physiotherapists, and orthopedic surgeons.

Selected methods of rehabilitation in systemic sclerosis

Systemic sclerosis is a chronic connective tissue disease characterized by microvascular abnormalities, immune disturbances and progressive fibrosis of the skin and internal organs. Skin involvement may result in contractures, leading to marked loss of hand mobility, adversely affecting the performance of daily activities and decreasing the quality of life. Face involvement not only causes functional loss, but also lowers the self-esteem of patients. Increasing attention has recently been focused on the need to rehabilitate patients with systemic sclerosis in order to prevent the development of joint contractures and loss of mobility. The study presents a review of the current literature on rehabilitation possibilities in patients with systemic sclerosis, with a special focus on physiotherapy methods.

The role of vitamin D in alopecia areata

Alopecia areata is an inflammatory disease with noncicatricial hair loss. Despite its high prevalence in the dermatological patient population, the pathogenesis is not sufficiently understood. In recent years, the contribution of autoimmune processes has been emphasized, as indicated by the presence of autoantibodies against hair follicle antigens and inflammatory cell infiltrates with increased expression of cytokines around the hair follicle. Vitamin D performs many important functions in the human body – is responsible for maintaining calcium homeostasis but is also an important regulator of the immune response. It acts mainly via the nuclear vitamin D receptor located on the surface of dendritic cells, macrophages, B and T cells, keratinocytes and cells of the hair follicle papillae. Vitamin D suppresses the immune system cells, and its deficiency may be important in pathophysiological phenomena in alopecia areata. According to current data, vitamin D supplementation may be a therapeutic option worth considering in patients with alopecia areata. rola witaminy D w łysieniu plackowatym the role of vitamin D in alopecia areata Katarzyna M. chyl-Surdacka, Agnieszka Gerkowicz, Grażyna chodorowska Katedra i Klinika Dermatologii, Wenerologii i Dermatologii Dziecięcej Uniwersytetu Medycznego w Lublinie Przegl Dermatol 2016, 103, 185–188 DOI: 10.5114/dr.2016.59142 SłowA Kluczowe: witamina D, niedobór witaminy D, łysienie plackowate, VDR. Key worDS: vitamin D, deficiency of vitamin D, alopecia areata, VDR. ADreS Do KoreSponDencji: Katarzyna M. Chyl-Surdacka Katedra i Klinika Dermatologii, Wenerologii i Dermatologii Dziecięcej Uniwersytet Medyczny w Lublinie ul. Radziwiłłowska 13 20-080 Lublin tel.: +48 508 320 087 e-mail: kasiachyl@gmail.com

Immune system disturbances in Clouston syndrome

Clouston syndrome belongs to the family of ectodermal dysplasias. So far, a defective immune response has not been reported in Clouston syndrome. We report, for the first time, immunological particularities of a large multigenerational Polish family with Clouston syndrome.

Application of antimalarial medications in the treatment of skin diseases

Antimalarial drugs used in medicine for over 300 years, nowadays, due to their anti-inflammatory, immunomodulatory and antiproliferative photoprotective properties, are used in the therapy of many dermatologic and rheumatologic disorders. The efficacy of these medications is proven in systemic lupus erythematosus, rheumatoid arthritis, porphyria cutanea tarda, lichen planus, ulcerative stomatitis, sarcoidosis, and even alopecia areata. Chloroquine and hydroxychloroquine belong to a group of well-tolerated drugs that occasionally cause adverse effects, which include gastrointestinal disorders, retinopathy, cardiomyopathy, neuromuscular disorders, skin hyperpigmentations, and hematological disorders. Nevertheless, these drugs continue to be frequently applied, including for systemic diseases of connective tissue during pregnancy. However, the treatment must be monitored – periodic ophthalmologic examinations during therapy with chloroquine must be performed, especially during prolonged treatment with high doses of these drugs. The article discusses the mechanism of action, pharmacokinetics, indications and adverse effects of these medications. zastosowanie leków przeciwmalarycznych w terapii chorób skóry Application of antimalarial medications in the treatment of skin diseases Katarzyna M. chyl-Surdacka, Joanna Przepiórka-Kosińska, Agnieszka Gerkowicz, Dorota Krasowska,