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Introduction . Patients with psoriasis develop nonalcoholic fatty liver disease more often than healthy subjects. Objective . To estimate the level of basic parameters of liver function, compare these values between groups of patients with psoriasis and healthy individuals, and refer these values to selected risk factors of developing atherosclerosis. Material and methods . A case-control study in the dermatology department included 66 patients with psoriasis and 30 healthy volunteers. The two groups were comparable as regards age, sex and body mass index as well as abdominal circumference. In all subjects we estimated the parameters of liver function and selected the risk factors of atherosclerosis. Results . γ-Glutamyltransferase activity in patients with psoriasis was significantly higher than in the reference group individuals (p = 0.002) and it applies to men only (p = 0.0003). In women γ-glutamyltransferase activity was higher in patients with positive family history of psoriasis (p = 0.03). γ-Glutamyltransferase activity was also higher in smoking patients (p = 0.02). Activity and concentration of other liver function markers (alanine aminotransferase, aspartate aminotransferase, and bilirubin) did not differ significantly between healthy individuals and patients with psoriasis. There were no differences between patients with severe, moderate and mild psoriasis. A negative correlation between bilirubin concentration and age of patients (p = 0.02) and bilirubin and C-reactive protein concentration (p = 0.03) was observed. Activity of alanine aminotransferase correlated positively with abdominal circumference (p = 0.001), uric acid concentration (p = 0.004) and body mass index (p = 0.001). Activity of aspartate aminotransferase correlated positively with abdominal circumference (p = 0.001), uric acid concentration (p = 0.03) and body mass index (p = 0.001). Additionally, the increase in alanine aminotransferase activity was proportional to the increase in cholesterol (p = 0.01) and apolipoprotein B concentrations (p = 0.03). γ-Glutamyltransferase activity correlated positively with the concentration of uric acid (p = 0.008), cholesterol (p = 0.04), triglycerides (p = 0.04), and apolipoprotein B (p = 0.03). Conclusions . In patients with psoriasis increased activity of alanine aminotransferase and aspartate aminotransferase parameters probably result from liver diseases since they accompany dyslipidemia and obesity whereas the increase of γ-glutamyltransferase activity is probably associated mainly with psoriasis.

Isotretinoin is considered a gold standard in treating severe cases of acne. It brings lots of benefits but on the other hand can cause series of undesirable side-effects. We present 2 cases of patients suffering from acne fulminans in the course of treatment with oral isotretinoin. Acne fulminans is a very severe systemic disease and its course is difficult to foresee. The most important is rapid diagnosis and implementation of treatment. Systemic corticosteroids combined

Isotretinoin is considered a gold standard in treating severe cases of acne. It brings lots of benefits but on the other hand can cause series of undesirable side-effects. I present 2 cases of patients suffering from acne fulminans in the course of treatment with oral isotretinoin. Acne fulminans is a very severe systemic disease and its course is difficult to foresee. The most important is rapid diagnosis and implementation of treatment. Systemic corticosteroids combined with isotretinoin or high does of antibiotics are the most effective. The alternative methods are: dapsone, infliximab.