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Introduction Immune system activation, microvascular abnormalities and extracellular matrix deposition in tissues play roles in systemic sclerosis (SSc). Th17 cells producing interleukin (IL)-17 are involved in the pathogenesis of many autoimmune-mediated inflammatory diseases; however, the role of IL-17 in SSc remains unclear. Material and methods The concentrations of IL-17A, IL-17B, IL-17E, and IL-17F in the serum of patients with SSc and in the healthy control group were assessed with regard to type of the disease – whether limited (lSSc) or diffuse (dSSc) – and symptoms. Results No difference was found between patients with SSc and the control group as regards the serum concentration of IL-17A. However, IL-17B and IL-17E levels in patients with SSc, and its types diffuse and limited were higher (p < 0.001) compared to the control. The serum level of IL-17F was higher in SSc (p < 0.005) and lSSc (p < 0.05) compared to the control. Serum concentration of IL-17B was elevated in SSc patients with renal abnormalities (p < 0.05) compared to those without. Serum levels of IL-17B correlated with the levels of IL-17E in patients with SSc (r = 0.54, p < 0.05). Conclusions Increased synthesis of IL-17B, IL-17E and IL-17F appears to play a role in the pathogenesis of SSc, in contrast to IL-17A. Higher levels of IL-17B and IL-17E are associated with the development of both lSSc and dSSc, whereas IL-17F is associated with lSSc only. Further studies are needed to elucidate their role in the pathogenesis of the disease.

IntroductionSystemic sclerosis (SSc) is a chronic, autoimmune connective tissue disease characterized by immune system activation, vasculopathy, and collagen accumulation. Despite progressive fibrosis of the vasculature, compensatory angiogenesis is impaired. The cause of the shift towards anti-angiogenesis observed in SSc is unknown. The IL-17 cytokine family participates in the pathogenesis of SSc and angiogenesis.Material and methodsOur study aimed to evaluate levels and find relationships between the levels of proangiogenic cytokines and cytokines from the IL-17 family in 42 SSc subjects and 20 healthy controls. VEGF, PlGF, HGF, TGFβ1, GM-CSF, IL-17A, IL-17B, IL-17E and IL-17F were quantified in the sera of all participants by ELISA sandwich kits.ResultsSignificantly higher mean concentrations of PlGF compared to controls - mean value (19.3 pg/ml in the SSc group vs. 11.4 pg/ml in the control group; pConclusionsIn conclusion, our findings indicate that selected cytokines from the IL17 family participate in the pathogenesis of SSc and are responsible for the vascular abnormalities associated with this disorder.

Systemic sclerosis (SSc) is an autoimmune connective tissue disorder associated with multiple organ involvement. The aim of the study was to present two SSc patients who were diagnosed with ischemic retinopathy in both eyes. As a background to our case study, we decided to investigate the imbalance of angiogenesis factors in 25 SSc patients in relation to 25 healthy controls. Assays of matrix metalloproteinases-2 and -9 (MMP-2, MMP-9), tissue inhibitor of metalloproteinases-1 (TIMP-1) and -2 (TIMP-2), vascular endothelial growth factor (VEGF), and soluble VEGF receptor-2 (sVEGFR-2) in blood serum and tears were performed. A significantly increased levels of MMP-9 in serum and tears, (p = 0.0375 and p &lt, 0.001, respectively) as well as VEGF/sVEGFR-2 ratio in tears (p &lt, 0.001) were found in the whole SSc patients group compared with controls, while reduced levels of these parameters in patients with ischemic sclerodermic retinopathy were noted. We also observed decreased level MMP-2 in tears and increased levels of TIMP-2 in blood serum and tears of SSc patients with retinal ischemic changes. MMP-9, MMP-2, TIMP-2, and VEGF/sVEGFR-2 may play a crucial role in ischemic retinal degeneration or retinal reorganization in SSc.

Introduction : Systemic sclerosis (SSc) is achronic connective tissue disease characterized by microangiopathy with inadequate angiogenesis. Angiostatin (AS) is a potent antiangiogenic factor specifically inhibiting proliferation and inducing apoptosis of vascular endothelial cells. Aim : To evaluate the level of angiostatin in the serum of patients with SSc. Material and methods : Serum levels of AS were measured in 20 SSc patients and 12 healthy controls. Results : A statistically significant difference in the serum levels of AS in SSc patients was observed compared to the control group (636.51 vs. 869.20 ng/ml; p = 0.012). Significant correlations between limited and disseminated SSc (lSSc/dSSc) were not found, however, a difference between lSSc and the control group was demonstrated (620.00 vs. 869.20 ng/ml; p = 0.011). The serum level of AS was not associated positively with organ changes caused by SSc. However, a statistically significant lower serum level of AS was observed in patients with SSc and no esophageal (p = 0.008) or pulmonary changes (p = 0.007) compared to the control group. Conclusions : Our results reveal significant differences in AS level in SSc patients compared to the healthy controls, and suggest that a low level of AS may occur as a result of impaired angiogenesis.

Introduction. Bullous pemphigoid is one of the most common autoimmune bullous dermatoses. It is typically diagnosed in elderly patients and can have various clinical presentations. So far, only individual cases of erythema gyratum repens-like bullous pemphigoid have been described in literature worldwide. Objective. Presentation of the case of a patient with bullae forming a wood grain arrangement. Case report. A 76-year-old female patient hospitalised at the Department of Dermatology with erythematous and edematous figurate lesions and tense bullae on the trunk and extremities. On direct immunofluorescence, complement deposits at the basement membrane zone were found. BIOCHIP indirect immunofluorescence revealed circulating anti-BP180 IgG antibodies. Conclusions . In patients with suspected bullous pemphigoid, direct and indirect immunofluorescence assays are required. As part of the diagnosis of both pemphigoid and erythema gyratum repens, malignancy needs to be excluded as a potential cause of skin lesions. In the presented patient, medical history and additional tests did not demonstrate the presence of a neoplasm. The patient requires further clinical follow-up.

Introduction Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disorder characterized by immunological deviations and generalized microvascular damage. Aim To determine the serum level of the von Willebrand factor cleaving protease (ADAMTS13) in 39 SSc patients and healthy controls. Material and methods ADAMTS13 serum level was determined in 39 SSc patients and 11 healthy controls. Complete history of the patients was recorded and thorough clinical, rheumatological, and dermatological examinations were performed. Results The serum levels of ADAMTS13 were significantly lower in SSc than in normal controls (455.47 ±128 vs. 702.01 ±142 ng/ml, p < 0.00001). However significant correlations among serum ADAMTS 13 levels and organ changes were not found in SSc patients. Conclusions We demonstrate a decreased serum level of ADAMTS13 in SSc patients, which may contribute to the vessel microangiopathy observed in systemic sclerosis.

Introduction. Rowell’s syndrome is a rare subtype of subacute lupus erythematosus associated with erythema multiforme-like skin lesions, positive antinuclear antibodies and anti-Ro/La-antibodies. Objective . To present a case of Rowell’s syndrome. Case report . We describe a case of an 82-year-old man who presented with erythema multiforme-like eruption on the upper extremities and trunk and fulfilled the diagnostic criteria of Rowell,s syndrome. Conclusions . Patients with these characteristic clinical and immunological features of Rowell,s syndrome are rarely seen and reported in the literature. The discussion concerning the character of the disease is still ongoing.

Introduction. Acroosteolysis is a recognized, but under-researched and forgotten manifestation of systemic sclerosis (SSc). Objective . To present a case of exuberant acroosteolysis and subcutaneous tissue calcinosis in the course of SSc. Case report. The patient, aged fifty-three with limited systemic sclerosis (lSSc) for 8 years duration, was under dermatological treatment because of ulcerative inflammation of the 2nd and 4th finger of the right hand. Progressive acroosteolysis of the distal phalanx with calcinosis and severe digital ischaemia was diagnosed. Conclusion . There is growing evidence suggesting that acroosteolysis is an important manifestation of SSc due to the correlation with progressive microangiopathy and severity of digital ischaemia.

Introduction Chronic urticaria (CU) belongs to a group of psychodermatological disorders, thus stress can play a significant role in this dermatosis onset and/or exacerbation. On the other hand, the disease itself accompanied by itch, may be a source of distress and could worsen patients’ quality of life (QoL). Aim The first goal of our study was to compare stress intensity between CU subjects and the control group. The second aim was to investigate the relationships between disease-related parameters (CU severity, itch) and psychological variables (stress and QoL) in CU patients. Material and methods Forty-six female patients with CU participated in our study. Thirty-three healthy females constituted a control group. The following methods were applied: Urticaria Activity Score (UAS), Itch Severity Evaluation Questionnaire, Visual analogue scale (VAS), Social Readjustment Rating Scale (SRRS) and the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL). Results Chronic urticaria patients demonstrated a significantly higher stress level in comparison to the control group (z = 2.699; p < 0.001). Regarding the total pruritus score, all CU-Q2oL dimensions were affected, except for subscale swelling/mental status. The strongest link was revealed between global itch and QoL subscale embarrassment (r = 0.51, p < 0.001). There were also statistically significant correlations between stress (VAS scale and SRRS) and QoL (all at least p < 0.05). Conclusions: Taking into account the significant pruritus contribution to QoL impairment, it would be worth employing itch-coping trainings in the CU group. As a consequence, feeling of self-control and self-efficacy could be enhanced, thus resulting in the well-being improvement.

Introduction: An increasing number of patients with various personality disorders, psychological problems and depression due to real or imaginary cosmetic defects visit a doctor. Aim: Evaluation of the relationship between cosmetic problems and self-reported depression in individuals elect ing to undergo cosmetic procedures, sense of disease in these individuals as well as the relationship between selfreported disease and depression. Material and methods: Investigations using Beck Depression Inventory (BDI) and Self-Esteem Scale (SES) were car ried out on 167 patients, before and 4 weeks after the procedure. Results: There is a statistically significant difference ( p < 0.001) between mean values of measurements before (9.3 points) and after (6.12 points) surgical procedures. The percentage of patients with different severity of depres sion before the procedure decreased from 42% to 18%. Using SES, the problem was assessed in the following cat egories: Obstacle, Challenge, Threat, Injustice, Benefit and Importance. The difference between mean scores before and following the intervention was 6.52 points and was statistically significant ( p < 0.05). Conclusions: The results obtained confirm that depression has an impact on self-reported disease and in the case of the investigated group it may be assumed that the aesthetic defect is a disease.

High effectiveness of isotretinoin treatment for severe types of acne resistant to antibiotics has been widely recognized. However, the recommended doses in conventional therapy, according to consensus of the Polish Dermatological Society, may cause serious adverse effects. Thus, research into less stressful, alternative treatment regimens with the use of low doses of isotretinoin has been carried out. The aim of the paper was to review the selected papers where authors present the results of their studies on different regimens with the use of isotretinoin in low doses in patients with acne, evaluate their efficacy, patient satisfaction, frequency of adverse effects, recurrences and also treatment costs.

Background Psoriasis vulgaris is characterized by disfiguring and stigmatizing skin lesions. The links among lesions distribution, severity, and stigmatization remain unclear. Objective We sought to investigate if the involvement of visible and sensitive areas is linked to stigmatization. Methods In all, 115 patients with psoriasis vulgaris were assessed for disease severity, skin lesions distribution, itch, and stigmatization using the Feelings of Stigmatization Questionnaire. Quality of life was assessed with the Dermatology Life Quality Index and the World Health Organization Quality of Life-BREF. Results The localization of psoriatic lesions on the back of hands was related to higher stigmatization levels ( P = .011, total score of the Feelings of Stigmatization Questionnaire), but not the involvement of nails, the palms, the face, or the genital area nor overall disease severity. All patients reported some level of stigmatization, regardless of the localization of lesions and type of psoriasis. Higher levels of stigmatization characterized patients who claimed not to be able to hide their lesions by clothing ( P = .025), women ( P = .001), and the unemployed ( P = .004). Stigmatization was the strongest predictor of quality of life impairment. Limitations Only hospitalized patients were included. Conclusions Psoriatic lesions on the back of hands are debilitating and warrant effective treatment. Special attention should be paid to female patients, who are more sensitive to stigmatization.