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Introduction: Introduction of novel biologic treatments for plaque psoriasis has revolutionized treatment approach and improved outcomes in patients with moderate-to-severe disease. New groups of biologics are even more effective and better tolerated compared to their predecessors. However, none of the currently available biologic drugs is associated with complete skin clearance in all treated patients. Moreover, the requirement to stop therapy in accordance with previous therapeutic program guidelines in Poland may have contributed to a gradual loss of efficacy of biologic drugs. Betamethasone dipropionate (BD) and calcipotriol (CAL) foam is the most widely studied topical drug in the therapy of mild forms of psoriasis. Numerous clinical trials have demonstrated its excellent efficacy not only in reactive therapy but also in preventing recurrences through the implementation of proactive therapeutic regimens. Case reports: We present two cases of patients with severe psoriasis and psoriatic arthritis who were treated with biologic drugs with incomplete remission of skin lesions. Topical therapy with BD/CAL foam was introduced to treat refractory psoriatic lesions, leading to excellent outcomes. Conclusions: The reported cases show that therapy with BD/CAL foam may be an effective adjuvant treatment of psoriasis in cases of incomplete and unsatisfactory response to systemic therapies, including biologics. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin disease that affects approximately 1-3% of the general population in Poland. It is estimated that in 70-80% of patients skin lesions are mild and require only topical medications. In severe plaque psoriasis, classic treatments often lead to a loss of efficacy, adverse effects or insufficient treatment effect, therefore it is necessary to search for new therapeutic methods. Multiple studies show that secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A (IL-17A), has significant efficacy in the treatment of moderate to severe psoriasis, demonstrating a rapid onset of action and sustained response with a good safety profile. The role of secukinumab in the treatment of plaque psoriasis is discussed in this article. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin disease which concerns approx. 1-3% population worldwide. In children psoriasis is less common, with the peak of morbidity in teenagers. Because of its more common prevelance in children in last decade, especially the disease with moderate and severe course, it is necessary to remind its clinical features and comorbidities. The aim of the recommendation of Polish Dermatological Society was to give the newest data on the psoriasis treatment in pediatric population which may be extremely important for everyday dermatological treatment. We described both topical and systemic treatments in details, including biological therapies. [ABSTRACT FROM AUTHOR]

Introduction. Acrodermatitis continua Hallopeau (ACH) is a rare form of psoriasis. Sterile pustules are usually located in the area of the fingertips and nails at the site of injury or infection. Nail lesions are always present. Case report. A 65-year-old man was admitted to the Department of Dermatology for diagnostics and treatment of lesions of the skin and fingernails that developed as a consequence of an injury. Initially, he was treated on an outpatient basis with topical glucocorticoids, without improvement. On admission, numerous pustules, maceration of the epidermis, severe hyperkeratosis of the skin in distal parts of fingers and soles, and swollen, red nail folds with dystrophy of many finger and toe nail plates were observed. Acitretin was introduced. An improvement in the condition of the skin was observed during the hospitalisation. An outpatient follow-up was recommended, during which further improvement was noted. Conclusions. Acrodermatitis continua Hallopeau is a chronic and progressive dermatosis that can lead to irreversible complications. The nail apparatus becomes affected early. Untreated acrodermatitis continua Hallopeau may lead to onychodystrophy or anonychia, and even to osteolysis of distal phalanges. So far, no specific guidelines for the treatment of acrodermatitis continua Hallopeau have been developed. [ABSTRACT FROM AUTHOR]

Introduction. Psoriasis vulgaris is one of the most common dermatoses. Increased prevalence of metabolic abnormalities coexisting with psoriasis vulgaris is caused by systemic inflammation. One feature of inflammation is endothelial dysfunction, which appears to be responsible for these comorbidities. In recent years several markers of endothelial dysfunction have been implicated in the pathogenesis of psoriasis vulgaris, from which endocan, fetuin-A, and endothelin-1 seem most reliable. Objective. To determine whether endocan, fetuin-A, and endothelin-1 could serve as biomarkers of psoriasis vulgaris, and their relationship with the disease severity and metabolic abnormalities observed in psoriasis vulgaris. Material and methods. The study group consisted of 60 patients with psoriasis and 28 patients with non-psoriatic skin diseases, who served as controls. Psoriasis Area and Severity Index and Body Surface Area were assessed. Waist circumference, body mass index, blood pressure, fasting glucose, lipid profile and serum endothelin-1, fetuin-A, and endocan levels were determined in both groups. Results. There were no significant differences in blood pressure, waist circumference, concentration of total cholesterol, low-density lipoprotein, high-density-lipoprotein, and endothelin-1 between the groups. The body mass index, endocan, triglycerides, and fasting glucose were significantly higher in patients with psoriasis compared to the control group, while the concentration of fetuin-A was significantly higher in the control group. Conclusions. The results obtained in the study indicate a possible role of fetuin-A and endocan in the pathogenesis of psoriasis and its metabolic comorbidities. [ABSTRACT FROM AUTHOR]

Introduction. Lack or loss of efficacy of biologic treatment in patients with severe plaque psoriasis is more and more often observed in clinical practice. A new group of drugs, which antagonize the p19 subunit of interleukin 23, is an interesting therapeutic option in this group of patients. Objective. To show difficulties in choosing an effective biologic treatment in a patient with severe plaque psoriasis. Case report. A 36-year-old man with severe psoriasis had been administered adalimumab and infliximab; however, in both cases loss of treatment efficacy was observed. Then, ixekizumab was administered to the patient. During a 16-week therapy, further exacerbation of psoriasis was observed - at the moment when the drug was discontinued PASI equalled 51, and BSA - 89%. The patient was started on risankizumab, and a complete remission of psoriasis was achieved in subsequent weeks of the treatment. Conclusions. The case is being presented due to difficulties in choosing the right treatment, extreme exacerbation of psoriatic lesions, and a rarely observed complete inefficacy of anti-IL-17A biologic drug. Risankizumab proved to be an effective drug when other biologic drugs turned out to be ineffective. [ABSTRACT FROM AUTHOR]