Igor A. Bednarski

Are interleukin-15 and -22 a new pathogenic factor in pustular palmoplantar psoriasis?

Introduction Pustular palmoplantar psoriasis (PPP) is a rare type of psoriasis affecting mainly distal parts of the limbs. Despite numerous theories about etiology of PPP, the pathogenesis still remains unclear. Recent data indicate that interleukin (IL)-15, IL-17 and IL-22 enhance a proinflammatory response in certain skin inflammatory diseases such as psoriasis and atopic dermatitis. There is also evidence that anti-endomysial (anti-EMA) and anti-gliadin (AGA) antibodies are engaged in PPP development. Aim To assess IL-15, IL-17, IL-22 serum levels and evaluate the presence of anti-endomysial and anti-gliadin antibodies in patients with PPP. Material and methods The study group consisted of 20 females of the mean age of 51.8 suffering from PPP. Additionally 29 healthy individuals, age and sex matched, served as controls. ELISA was performed to evaluate serum IL-15, IL-17, IL-22 concentrations while an indirect immunofluorescence test (IIF) was used to determine anti-EMA and AGA presence. Results The mean value of IL-15 and IL-22 serum concentrations was significantly higher in the study group than in the control group (IL-15: 6.48 vs. 4.88 pg/ml; IL-22: 81.47 vs. 4.90 pg/ml, respectively; p < 0.05 for all comparisons). The IL-17 serum level in the study group was higher when compared to the control group (2.0 vs. 0.75 pg/ml), however the results were not statistically significant (p = 0.26). There were no anti-EMA and AGA antibodies detected, both in the control and study group. Conclusions The results obtained may suggest involvement of IL-15 and IL-22 in the pathogenesis of PPP.

Impact of Ultraviolet Radiation on Expression of Transforming Growth Factor β, Smad2, Metalloproteinases-1, -3, -8, -9, Cathepsin K and Progerin

Ultraviolet radiation (UVR) is one of the most important environmental factors involved in photoaging. Exposure to UVR leads to dysregulation of expression of cell cycle‐related proteins which play key role in skin photodegradation that pretends to develop carcinogenesis. This study examines the role of various UVB doses on the expression of transforming growth factor beta (TGF‐β), Smad2, cathepsin K, progerin and matrix metalloproteinases (MMPs)‐1,‐3,‐8,‐9. A group consisting of 63 healthy individuals underwent one of the following treatments: (1) whole body exposed to UVB irradiation on each of 10 consecutive days with 0.7 MED, or (2) whole‐body irradiation as described followed by a single erythemal UVB dose on a small body area, or (3) irradiated only with a single erythemal UVB dose on small body area, or (4) were not irradiated at all (control group). When we compared all irradiated groups to the control group, there was significantly higher expression of TGF‐β, MMP‐1,‐3,‐9 and cathepsin K proteins evaluated by Western blot method. The results suggest the role of UVB in impairment of proteins expression that is involved in cell cycles regulation. Changes in the protein expression involved by acute and chronic UVR confirm its essential role in skin photodestruction. Moreover, obtained result indicates the tendency to occurrence of photoadaptation phenomenon.

Proteins involved in cutaneous basal cell carcinoma development

Basal cell carcinoma (BCC) is the most common skin malignancy type in the Caucasian population, with a continuously increasing incidence rate. The etiology of BCC remains unknown, but it appears to have a multifactorial origin resulting from intrinsic and extrinsic factors, including short-wavelength ultraviolet B radiation. The role of specific proteins in BCC that are known to be responsible for the regulation of cell division and are involved in skin aging, including transforming growth factor (TGF)-β, Smad2, matrix metalloproteinases (MMPs)-1, -3, -8 and -9, cathepsin-K and progerin, remains unknown. The aim of the present study was to assess the mRNA and protein expression profile of samples with diagnosed nodular BCC (nBCC) compared with that of healthy skin samples collected from matched areas. The study group included 22 patients (10 men and 12 women; mean age, 59 years; range, 44-82 years) with pathologically confirmed nBCC, and 22 healthy volunteers (10 men and 12 women; mean age, 59 years; range, 43-78 years) as a control group. The expression of the studied proteins was assessed in all samples by western blotting and reverse transcription-quantitative polymerase chain reaction analysis. Statistically significant increases in the expression of TGF-β, Smad2, cathepsin-K, progerin and MMP-1, -3, -8 and -9 were detected in skin biopsies with diagnosed nBCC compared with the control group, confirming the important role of these proteins in skin carcinogenesis.

Omalizumab for urticaria treatment in clinical practice: a case series

Introduction Omalizumab (Xolair) originally intended to reduce symptoms of moderate to severe asthma uncontrollable with steroids is the first monoclonal antibody approved for treatment of chronic spontaneous urticaria in 2014. Aim To evaluate response and potential side effects to omalizumab treatment in clinical practice. Material and methods Eleven patients (6 males and 5 females) were recruited into the study. All participants signed written informed consent before enrollment to the study. At the beginning they were receiving 300 mg of omalizumab in a subcutaneous injection every 4 weeks in an outpatient clinic. Five the clinical response was sufficient, the dose of omalizumab was decreased to 150 mg. We evaluated response to the treatment using the Urticaria Activity Score in the last 7 days and the Urticaria Control Test at certain time points. Results Nine out of 11 patients achieved complete syndrome resolution. Five patients achieved clinical remission after the first dose of omalizumab. Mean time to remission was 9.3 weeks. During the study, no side effects were observed. Conclusions Omalizumab appears to be a safe drug, which in a quick and effective way inducts remission in patients who have not responded to previous treatment.

One week of exposure to sunlight induces progerin expression in human skin

1Department of Dermatology, Medical University of Lodz, Lodz, Poland 2Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Lodz, Poland 3Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland 4Department of Pathology, Medical University of Lodz, Lodz, Poland 5St John’s Institute of Dermatology, King’s College London, London, UK Adv Dermatol Allergol 2017; XXXIV (6): 629–631 DOI: https://doi.org/10.5114/pdia.2016.62416

Necrobiosis lipoidica – an old but challenging dermatosis

Introduction. Necrobiosis lipoidica (NL) is a rare skin condition associated with diabetes that occurs in 0.3–1% of diabetic patients. Nevertheless, there are patients who develop this entity in the absence of diabetes mellitus. Objective. To highlight some problems in differential diagnosis and treatment of NL. Case report. We report a case of a 44-year-old woman with a 3-year history of undiagnosed skin lesions. Clinical examination revealed atrophic plaques on an erythemal background located on both shins. The first histopathological examination revealed infiltrated granulomatous lesions, later confirmed as deep tuberculoides chronic granulomatous dermatitis. However, after 6-month anti-tubercular treatment skin lesions were still present. Based on another skin biopsy we restricted the diagnosis to polyarteritis nodosa, necrobiosis lipoidica and granuloma annulare. Further examination led us to establish a diagnosis of necrobiosis lipoidica. The patient was treated with many therapeutic regimens without a satisfactory response. Conclusions. Lack of treatment guidelines and therapy based on dermatologists’ clinical experience suggest that NL needs to be evaluated in the near future. A large retrospective study and systematic review are required to establish diagnostic and treatment regimens.

Molecular factors involved in skin dryness in diabetic patients

Diabetes is a chronic systemic disease affecting 8.3% of the general population, thus constituting an important clinical and financial problem for healthcare systems throughout the world. Complications of diabetes damage both many internal organs and skin. Skin complications of diabetes can anticipate its clinical symptoms. Diabetic skin, irritated and dry in many cases, is susceptible to skin infections. However, there is little known about molecular changes in skin in diabetes. Many studies are concentrated on epidermal barrier damage, dysfunction of epidermis integrity and dysfunction of sebaceous glands. Another complex problem is skin care in diabetic patients. A profound understanding of cellular-level processes in diabetes could lead to the discovery of new therapy efficacy markers and new skin care products. SŁOWA KLUCZOWE: cukrzyca, sucha skóra, emolienty.

The effect of an emollient with benfothiamine and Biolin prebiotic on the improvement of epidermal skin function

Introduction Complications of diabetes can damage internal organs and the skin. Diabetic skin, irritated and dry, is susceptible to skin infections. However little is known about influence of emollients on biophysical changes in skin during diabetes. Aim To evaluate clinical skin changes after application of emollients with benfothiamine and Biolin prebiotic and to assess changes in biophysical parameters of the skin before and 4 weeks after daily application of an emollient. Material and methods We recruited 50 patients with diabetes mellitus type 1 (DM1) or type 2 (DM2). All participants applied emollients on their left forearms and left shins for 4 weeks. The biophysical properties: pH, transepidermal water loss (TEWL), hydration of the stratum corneum and sebum content were measured and compared to those before enrollment to the study, after 1 h, 1 week and 4 weeks after application of an emollient. Results After 4 weeks of treatment, there was an increase in skin hydration (40.61 ±19.03 vs. 48.83 ±15.51), pH (5.11 ±0.56 to 5.27 ±0.48) and sebum content (22.16 ±8.67 to 63.99 ±25.41) and a decrease in TEWL (12.54 ±5.6 vs. 9.85 ±5.69 g/m2/h) on forearms (p < 0.05 for all comparisons). On lower legs, significant changes in skin hydration (37.21 ±14.01 vs. 43.95 ±12.67), pH (5.04 ±0.57 to 5.31 ±0.49), sebum content (25.82 ±10.46 to 72.63 ±31.23) and TEWL (8.87 ±4.05 vs. 7.39 ±3.22 g/m2/h) were observed (p < 0.05 for all comparisons). Conclusions Our study provides an insight into changes in diabetic skin after application of an emollient. To our knowledge, this is the first report on the emollient containing benfothiamine and Biolin prebiotic and its influence on biophysical parameters of epidermis.