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Aleksandra Bolewska,1 Monika Słowińska,1 Agata Błońska,1 Justyna Ceryn,2 Bartłomiej Grala,3 Joanna Narbutt,2 Magdalena Ciążyńska,4 Wojciech Małecki,5 Małgorzata Skibińska,2 Aleksandra Lesiak,2 Elwira Paluchowska,1 Witold Owczarek1 1Department of Dermatology, Military Institute of Medicine, Warsaw, Poland; 2Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland; 3Department of Pathology, Military Institute of Medicine, Warsaw, Poland; 4Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, Łódź, Poland; 5Department of Clinical Oncology and Chemotherapy, Poddębice Health Centre, Poddębice, PolandCorrespondence: Aleksandra Bolewska Tel +48 261 816 241; +48 604 783 340Email aleksandra.bolewska@wp.plAbstract: Lung cancer most often metastasizes to the central nervous system, bone and liver. Although metastases to the skin are quite rare, it is estimated that they may be the first clinical manifestation of this disease in 0.7%– 12% of cases. Metastases to the skin are caused by adenocarcinoma (about 30%), squamous cell carcinoma (30%) and undifferentiated carcinoma (40%). Nasal tip metastases are extremely rare. They can be confused with more common skin problems, including non-melanoma skin cancers, rhinophyma, inflammatory tumors or infectious diseases. We report two patients with a tumor on the nose, which proved to be the first sign of the metastatic lung cancer.Keywords: lung cancer, skin metastasis, ulceration, tumor

Joanna Narbutt,1 Janusz Krzyścin,2 Piotr Sobolewski,2 Małgorzata Skibińska,1 Marcin Noweta,1 Witold Owczarek,3 Bonawentura Rajewska-Więch,2 Aleksandra Lesiak1 1Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Łódź, Łódź, Poland; 2Institute of Geophysics, Polish Academy of Sciences, Warsaw, Poland; 3Department of Dermatology, Military Institute of Medicine, Warsaw, PolandCorrespondence: Janusz KrzyścinInstitute of Geophysics, Polish Academy of Sciences, Warsaw, 01-452, PolandTel +48-2269-15950Email jkrzys@igf.edu.plBackground: Nowadays, patients with moderate-to-severe psoriasis are treated with conventional immunosuppressants or with new biological agents. Phototherapy is the first-line treatment for patients in whom topical therapy is insufficient. Although numerous studies have been carried out, it is still difficult to predict the outcome of phototherapy in individual patients.Methods: Prior to standard narrow band (NB) ultraviolet B (UVB) phototherapy, the patients filled out a questionnaire about personal life and health status. Several standard blood tests, including selected cytokine levels, were performed before and after a course of 20 NB-UVB treatments. The questionnaire answers, results of the blood tests, and treatment outcomes were analyzed using an artificial intelligence approach—the random forest (RF) classification tool.Results: A total of 82 participants with moderate-to-severe psoriasis were enrolled. Prior to starting phototherapy, the patients with expected good outcome from the phototherapy, shorter remission, and quitting a possible second course of the NB-UVB treatment could be identified by the RF classifier with sensitivity over 84%, and accuracy of 75%, 85%, and 79%, respectively. The inclusion of cytokine data did not improve the performance of the RF classifier.Conclusion: This approach offers help in making clinical decisions by identifying psoriatic patients in whom phototherapy will significantly improve their skin, or those in whom other therapies should be recommended beforehand.Keywords: psoriasis, phototherapy, outcome prediction, artificial intelligence

(1): Atopic dermatitis and psoriasis vulgaris are chronic, inflammatory diseases. Clinical presentation usually leads to a proper diagnosis, but sometimes neither clinical examination nor histopathological evaluation can be conclusive. Therefore, we aimed to build up a novel diagnostic tool and check it for accuracy. The main objective of our work was to differentiate between healthy skin (C), atopic dermatitis (AD) and psoriasis vulgaris (PV) biopsies on the base of involucrin (IVL) and human β-defensin-2 (hBD-2) concentrations and their mRNA, as well as mRNA for TPP2 and PSMB8. (2): ELISA for IVL and hBD-2 proteins and Real-time PCR for the relative expression of mRNA for: IVL (IVL mRNA), hBD-2 (hBD-2 mRNA), PSMB8 (PSMB8 mRNA) and TPP2 (TPP2 mRNA), isolated from skin biopsies taken from AD and PV patients and healthy volunteers were performed. (3): hBD-2 mRNA and PSMB8 mRNA correlated with some parameters of clinical assessment of inflammatory disease severity. hBD-2 mRNA expression, exclusively, was sufficient to distinguish inflammatory skin biopsies from the healthy ones. (4): hBD-2 mRNA and PSMB8 mRNA analysis were the most valuable parameters in differentiating AD and PV biopsies.

Background : Non-melanocytic benign skin tumours encompass a diverse group of lesions, classified based on their cellular origin, such as epidermal, vascular, fibrous, neural, muscle, and adnexal tumours. Though they often reveal solitary lesions, multiple skin tumours focus on genodermatoses. Each syndrome exhibits distinct clinical characteristics and potential complications, including cutaneous and extra-cutaneous malignancies, some of which are potentially life-threatening. Diagnosing genetic syndromes is complex and requires numerous histopathological and immunohistochemistry tests due to similarities between the adnexal tumours and basal cell carcinoma upon pathology. Methods : To illustrate the clinical practice, we conducted a retrospective case study that included eleven patients with genodermatoses referred to a tertiary dermatology clinic from September 2018 to April 2024. We have also conducted a research study on available treatment modalities in this setting. Results : Five patients with excellent aesthetic results were treated using a recently approved FDA plasma device. After searching SCOPUS and PubMed database records, we assessed 96 original articles to present current knowledge regarding the dermato-surgical approach. Conclusions : Multiple skin tumours, especially on the face, may significantly affect patients' quality of life and have psychological consequences. An appropriate treatment selection tailored to the patient's needs should be provided. There is no standardised treatment for multiple benign tumours in genodermatoses, and selected methods with varying efficacy are employed. We presented the utility of a new plasma device in these settings.

Background: There is limited insight into the current disease burden and everyday clinical management of moderate-to- severe AD in Poland, Czechia, Russia, and Turkiye. Therefore, this study aimed to get information-driven insights regarding the current disease burden and clinical management of patients with moderate-to-severe AD with common and differentiating aspects of the patient journey and establish a consensus., Methods: In this modified 2-round Delphi panel, 133 questions were asked in total to 27 dermatologists. A consensus was achieved when 70% of the panel members strongly agreed or agreed (or strongly disagreed or disagreed) with an item. Statements with <40% agreement dropped from the Delphi rounds and were not repeated., Results: The results state that AD has a significant impact on the quality of life for both patients and their families with social and economic consequences in these countries. While there were significant dissimilarities regarding the current treatment approach by preference order and treatment duration among participants, there was also a high percentage of consensus on literature and guideline-based statements. Current topical therapies and the immune response modifiers were not found to be sufficient by panelists to cover the therapeutic needs of patients with moderate-to-severe AD. Moreover, panelists highlighted the significant burden of adverse events with the off-label use of currently available immunosuppressants., Conclusions: These results underlined that there is a significant disease burden with an unmet treatment need for patients with moderate-to-severe AD in Poland, Czechia, Russia, and Turkiye., Competing Interests: All panel members/authors received honoraria from Pfizer for their consultancy on answering the questionnaires. DF has acted in advisory board of Novartis, Takeda, GlaxoSmithKline and has received speaker honorarium from Abbvie, Novartis, GlaxoSmithKline, Sanofi, Takeda, CSl Behring, AstraZeneca. MS has acted in advisory board of Novartis, Pfizer, Bristol Byers Squibb and has received speaker honorarium from Abbvie and Pfizer. AL'v has acted in advisory board of Bayer AG, Pfizer, Novartis, Abbvie, and Sanofi and has received speaker honorarium from Pfizer, LEO Pharma, Sanofi, Janssen, Bayer AG, and Sun Pharma. MT has acted in advisory board of Sanofi, Abbvie, and Leopharma, has received speaker honorarium from Abbvie, Bioderma, LEO Pharma, Pierre Fabre, La Roche Possey, Bausch Health, Mead Johnson, Eli Lilly and subinvestigator in clinical trials sponsored by Amge, Novartyis, and Pfizer. MB has acted in advisory board of UCB, Sanofi, Novartis, Pfizer, Lilly, Janssen, Abbvie, and has received speaker honorarium from UCB, Sanofi, Novartis, Pfizer, Lilly, Janssen, and Abbvie. AM has acted in advisory board of Bayer AG and has received honorarium from L'Oreal, Roche, and Novartis. ZP has acted in advisory board of Novartis, Pfizer, and Bristol Byers Squibb and has received speaker honorarium from Pfizer and Abbvie. EA has acted in advisory board of Novartis, Johnson and Johnson, and Abbvie and has received speaker honorarium from Novartis, Johnson and Johnson, and Abbvie. AR has been a consultant or speaker for AbbVie, Bioderma, Bristol-Myers Squibb, Celgene, Chema Elektromet, Eli Lilly, Galderma, Janssen, Leo Pharma, Medac, Menlo Therapeutics, Novartis, Pierre-Fabre, Sandoz, and Trevi; and principal investigator or sub investigator in clinical trials sponsored by Abbvie, Argenx, Corbus, Drug Delivery Solutions Ltd., Eli Lilly, Galderma, Genentech, Janssen, Kymab Limited, LEO Pharma, Menlo Therapeutics, MetrioPharm, MSD, Novartis, Pfizer, Trevi, and VielaBio. OE has acted in advisory boards of Abbvie, Eli-Lilly, Pfizer, and Sanofi and has received speaker honorarium from Abbvie, Sanofi, Berlin-Chemie/Menarini, and Eli-Lilly. EÖ has acted in advisory boards of Pfizer and Sanofi, and has received speaker honorarium from Pfizer and Sanofi. MK has served as consultant, speaker, or investigator for Abbvie, Amgen, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, and UCB. BE has acted in advisory board of Novartis, Lilly, and Abbvie and has received speaker honorarium from Novartis and Abbvie. EF has acted in advisory board of Novartis, Pfizer, Abbvie, Sanofi, and Eli Lilly and has received speaker honorarium from Novartis, Pfizer, Abbvie, Sanofi, Eli Lilly, and Berlin-Chemie/Menarini. WO has worked as a Consultant or Speaker and participated as Principal Investigator or Subinvestigator in clinical trials sponsored by AbbVie, Alfasigma, Almirall, Bioderma, Bristol-Myers Squibb, Egis, Eli Lilly, Galenica, Galderma, Janssen-Cilag, Leo Pharma, Medac GmbH, Mylan, Novartis, Pfizer, Pierre-Fabre, Roche, Sandoz, Teva Pharmaceuticals, and UCB Pharma. MC-O has acted in the Advisory Board of Novartis and Pfizer. OF has acted in advisory board of Lilly, Novartis, Abbvie, Sanofi, and Janssen and was Principal Investigator in clinical studies of Bristol Myers Squibb, Pfizer, Abbvie, Sanofi, Lilly, Novartis, and Janssen. NM has received research grants from Jansen, Eli Lilly, and Novartis; has acted in advisory board of Galderma, Pierre Fabre, Bayer, LEO Pharma, Pfizer, AbbVie, Amryt Pharma, Zeldis Pharma LLC companies and has received speaker honorarium from LEO Pharma, Abbvie, Novartis, and Viatris. AG has received speaker honorarium from Pfizer, L'Oreal, and Piere Fabre. SB has received speaker honoraria/travel fees from LEO Pharma. ALe has acted in advisory board of Novartis, Abbvie, Leo pharma, Sandoz, Sanofi, and Jansssen Squibb and has received speaker honorarium from Pfizer, Abbvie, Sandoz, Novartis, Leo pharma, Galderma, and Janssen. LR member of advisory boards –Janssen Pharmaceutical Companies, L'Oreal, Leo Pharma, Lilly, Pfizer, Sanofi, Novartis, UCB; invited speaker – Eli Lilly, Leo Pharma, Abbvie, L'Oreal, Lilly, and Pierre Fabre. SA has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer and Abbvie. BG is an employee of Pfizer., (Copyright © 2024 Trzeciak, Rudnicka, Arenberger, Engin, L'vov, Alper, Alpsoy, Benáková, Bobko, Borlu, Czarnecka-Operacz, Elisyutina, Ergun, Ertam, Fedenko, Filipovská, Fomina, Gadzhigoroeva, Kojanová, Lesiak, Michenko, Murashkin, Owczarek, Özkaya, Plzáková, Reich, Selerova and Gurbuz.)

Objectives: This study aims to update the understanding of Alopecia Areata (AA) in Poland, Czechia, Russia, and Türkiye, focusing on the disease burden, clinical management, and patient journey. It seeks to establish a consensus on optimal management strategies for AA in these regions., Methods: A modified 2-round Delphi panel was conveyed with 23 Dermatologists (Russia; 4, Türkiye; 7, Poland; 6, and Czechia; 6). The Delphi questionnaire consisted of 61 statements and 43 questions designed to obtain an overall understanding of the perception and acceptance of available information regarding the care of patients with alopecia areata., Results: The study revealed that moderate-to-severe AA significantly impacts patients' and their families' QoL, consistent with previous studies. AA was found to cause more substantial impairment when additional lesions appeared in visible areas besides the scalp. Work and productivity impairment were notably higher in adults with moderate-to-severe AA. Diagnostic consensus highlighted the importance of skin biopsies and trichoscopy, while the need for more practical severity scoring systems was emphasized. Current treatments, including topical therapies, corticosteroids, and systemic immune modifiers, were deemed insufficient, highlighting the unmet medical need., Conclusion: The Delphi study underscores a significant disease burden and unmet medical needs in patients with moderate-to-severe AA. It highlights the necessity of access to novel treatments and further research to develop more effective therapies with a tolerable safety profile. The findings align with global research, emphasizing the psychosocial impact of AA and the need for standardized, effective treatment protocols., Competing Interests: PA has acted in advisory board of AbbVie, Bristol Myers Squibb, Merck Sharp Dohme, Novartis, Pfizer Pharmaceuticals, and has received speaker honorarium from Pfizer, Abbvie. MK has served as consultant, speaker, or investigator for Abbvie, Almirall, Amgen, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, Sanofi and UCB. MC has acted on the advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received a speaker honorarium from Pfizer, Abbvie, OF has acted in advisory board of Novartis, Lilly, LeoPharma, Almirall and in clinical studies Pfizer, Janssen, Lilly, Amgen, Abbvie, Novartis, Regeneron. AM has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from L’Oreal, La Roche Posay. MT has been a speaker and/or consultant an/or investigator and/or participant of Advisory Board of Abbvie, BauschHealth, Bioderma, Eli Lilly, La Roche, Leo pharma, Novartis, Pfizer, Pierre-Fabre, Sanofi Genzyme. ZP has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer, Abbvie. IS has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer, Abbvie. WO received honorarium for lectures and clinical research from AbbVie, Aflofarm Farmacja, Alfasigma, Almirall, Amgen, Apotex Polska Astellas Pharma, AstraZeneca, Bausch Health Poland, Berlin Chemie Menarini, Boehringer Ingelheim, Bristol Myers Squibb, EGIS, Eli Lilly, Galderma, Janssen-Cilag, LEO Pharma, Medac GmbH, Merck, Mylan Healthcare, Novartis, Pfizer, Pierre Fabre Medicamente, TZF Polfa S.A., Roche Diagnostics, Sandoz, Sanofi-Aventis, SUN-FARM, Teva Pharmaceuticals, UCB Pharma. AL has acted in advisory board of Novartis, Pfizer Pharmaceuticals, Abbvie, Sanofie, Sandoz, Lilly, Janssen, Almiral and has received speaker honorarium from Pfizer, Abbvie, Novartis, Pfizer Pharmaceuticals, Abbvie, Sanofie, Sandoz, Lilly, Almiral, UCB. AG has received speaker honorarium from Pfizer. NM reports grants and personal fees from Jansen, grants from Eli Lilly, grants and personal fees from Novartis, personal fees from Galderma, personal fees from Pierre Fabre, personal fees from Bayer, personal fees from Leofarma, grants and personal fees from Pfizer, grants and personal fees from AbbVie, grants from Amryt Pharma, personal fees and non-financial support from Viatris, outside the submitted work. NB declare to have acted as member of Advisory Board of Pfizer Pharmaceuticals and has received speaker honorarium from Pfizer. SB has received speaker honorarium from Pfizer, LEO PHARMAEB has acted in advisory board of Novartis and Pfizer Pharmaceuticals has received speaker honorarium from Pfizer, Abbvie. SA has acted in advisory board of Novartis, Pfizer and Bristol Myers Squibb, and has received honorarium from Pfizer and Abbvie. AR has worked as a consultant or speaker for AbbVie, Bioderma, Celgene, Chema Elektromet, Eli Lilly, Galderma, Janssen, Leo Pharma, Medac, Menlo Therapeutics, Novartis, Pierre-Fabre, Sandoz and Trevi and has participated as principal investigator in clinical trials sponsored by AbbVie, Almirall, Amgen, Anaptys, Argenx, Biogen, Biothera, BMS, Celltrion, Dermira, Dice, Evelo, Galderma, Genentech, Horizon Therapeutics, Incyte, Janssen, Kymab Ltd., Leo Pharma, Eli Lilly, Menlo Therapeutics, MetrioPharm, MSD, Novartis, Pfizer, Regeneron, Sanofi, Takeda, Trevi, and UCB. BG is an employee of Pfizer. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Rudnicka, Trzeciak, Alpsoy, Arenberger, Alper, Benáková, Bobko, Borlu, Czarnecka Operacz, Engin, Ergun, Sağduyu, Filipovská, Gadzhigoroeva, Kojanová, Lesiak, Michenko, Murashkin, Onsun, Owczarek, Plzakova, Reich, Selerová and Gürbüz.)

Introduction: It is well known that biological medications acting on selected elements of the immune response are highly effective in psoriasis treatment. It is a common perception that psoriasis is a seasonal disorder with improvement in warmer months, however it has not been unequivocally confirmed. It is not known whether the time of year of starting systematic therapy for psoriasis influences treatment outcomes., Material and Methods: Changes in psoriasis severity scores during treatment with biologics were investigated. The scores were recorded for 62 patients with moderate to severe psoriasis at the beginning, after 1, 4 and 7 months of the therapy. Patients were divided into two groups: those beginning the treatment in the cold period of the year (November-March) and in the warm period (May-September). The seasonal groups were also divided into subgroups according to the type of biologics used: interleukin inhibitors and tumor necrosis factor α (TNF-α) inhibitors. Results of the treatment were analysed using standard statistical tests of differences between samples., Results: After 1 and 4 months of the therapy, better efficacy of interleukin inhibitors was found in patients starting treatment in summer. The course of psoriasis improvement in patients taking TNF-α inhibitors resulted in consistent improvement regardless of the season. The outcome of the treatment after 7 months was similar for both seasonal groups and types of biologics used., Conclusions: Our understanding of the effectiveness of the treatments depending on the time of the year combined with the type of biologics used, may further improve results of the therapy., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 Termedia Sp. z o. o.)

Background: Although the role of melanoma risk factors is well documented, their correlation with patients' age is less frequently analyzed., Method: The analysis was performed among 189 melanoma patients in different age groups, including <30 years, 31-60 years, and >60 years, to investigate the risk factors, topography, and coexistence of morphological features of 209 melanomas (dermoscopic and histopathological)., Results: Among the youngest age group, no correlation with the presence of estimated risk factors was found. The most common dermoscopic pattern was spitzoid and multicomponent asymmetric. The group of middle-aged patients was the most diverse in terms of the occurrence of risk factors, solar lentiginosis, dermoscopic patterns, topography, histological subtypes, and invasiveness of melanomas. The oldest group characterized a strong correlation between solar lentiginosis, NMSC comorbidity, the prevalence of facial melanomas, the dermoscopic pattern of melanoma arising on chronic sun-damaged skin, and regression., Conclusion: The findings regarding the presence of age-specific features in melanoma patients, especially in the youngest and middle-aged groups, might be helpful for clinicians and to target secondary prevention efforts.

The present multi-center, long-term, real-life study made an attempt to assess the efficacy of risankizumab in the treatment of moderate-to-severe plaque psoriasis. The study comprised 185 patients from 10 Polish dermatologic departments undergoing risankizumab treatment. The disease severity was measured using the Psoriasis Area and Severity Index (PASI) before the start of the risankizumab treatment and next at the defined timepoints, i.e., 4, 16, 28, 40, 52 and 96 weeks of treatment. The percentage of patients achieving PASI90 and PASI100 responses as well as the PASI percentage decrease at the defined timepoints were calculated, and correlations with clinical characteristics and therapeutic effect were analyzed. The number of patients evaluated at the defined timepoints was: 136, 145, 100, 93, 62, and 22 at 4, 16, 28, 40, 52 and 96 weeks of treatment, respectively. At 4, 16, 28, 40, 52 and 96 weeks, the PASI90 response was achieved in 13.2%, 81.4%, 87.0%, 86.0%, 88.7% and 81.8% of patients, whereas the PASI100 response was achieved in 2.9%, 53.1%, 67.0%, 68.8%, 71.0% and 68.2% of patients, respectively. Our study revealed a significant negative correlation between a decrease in the PASI and the presence of psoriatic arthritis as well as the patient's age and duration of psoriasis at several timepoints throughout the observation period.

Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare tumours derived from peptidergic neurons and specialized neuroendocrine cells capable of secreting various peptides or amines. These cells may be present in endocrine tissue or diffused in the tissues of the digestive or respiratory system. The article reviews the characteristic features of NENs, with particular emphasis on skin manifestations, such as necrolytic migratory erythema (NME), tongue inflammation, angular cheilitis, venous thrombosis and alopecia in glucagonoma; "flushing", "lion face", pellagra skin symptoms, "scleroderma-like features without Raynaud's phenomenon" in carcinoid tumours. The paper also presents the clinical picture of the neuroendocrine tumour of the skin - Merkel cell carcinoma. The aim of this study was to draw attention to the need for precise and comprehensive diagnosis of the patients, with particular emphasis on skin lesions as a revelator of neuroendocrine tumours. This management allows for the early implementation of appropriate treatment., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2022 Termedia Sp. z o. o.)

Introduction: Infliximab (IFX) is a monoclonal antibody that binds to and neutralizes TNF-α. IFX (Remicade) was approved by the U.S. Food and Drug Administration in 2006 for the treatment of severe plaque psoriasis. In 2013 two infliximab biosimilars: Remsima and Inflectra were also registered. The introduction of biosimilar drugs is associated with a significant reduction in treatment costs., Aim: To evaluate the efficacy of treatment with biosimilar IFX with non-medical switch option in patients with plaque psoriasis under the drug program "Treatment of moderate and severe plaque psoriasis" of the Ministry of Health in Poland., Material and Methods: The group of 91 adult patients with moderate to severe plaque psoriasis, unresponsive or with contraindications to the standard treatment were qualified to the drug program (in 2016-2018). Efficacy of treatment with biosimilar IFX was evaluated using the Psoriasis Area and Severity Index, body surface area and Dermatology Life Quality Index scoring performed at week 0, 14, 46 and 94., Results: The mean change in PASI, DLQI, and BSA scores at week 14 was 89.92%, 93.75% and 90.91%, respectively. By week 14, 83.52% of patients achieved PASI75, 49.45% PASI ≥ 90 and 26.37% PASI100. At week 46, 84.62% of patients achieved PASI75, 54.95% PASI ≥ 90, and 21.98% PASI100. At week 94 of therapy, 80.22% of patients achieved PASI75, 48.35% PASI ≥ 90, and 18.68% PASI100. At week 94 of therapy, PASI100 was maintained by 37.5% of patients who achieved PASI100 at week 14., Conclusions: 94-week therapy with biosimilar infliximab results in high and sustained clinical efficacy in patients with moderate to severe psoriasis., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2022 Termedia Sp. z o. o.)

Background: Patients with diagnosed keratinocyte carcinomas (KCs) have an increased risk of subsequent skin cancers development. Current studies indicate that patients with subsequent tumors should be followed up regularly. However, none of the studies indicate the connection between the specific subtypes and an increased risk for further KCs development. The study assesses the differences in the risk of developing a subsequent skin cancer after a previous diagnosis of KC, especially considering individual types of skin malignances, and identifies potential factors associated with an increased risk of new cutaneous tumor describing non-invasive diagnosis and monitoring., Methods: Pathology and medical records were examined to identify the characteristics of patients with multiple KCs diagnosed between 1999 and 2019., Results: The study group comprised 13,913 KCs occurring in 10,083 patients. Multiple KCs were observed in 2300 patients (22.8%). The analysis showed aggressive subtypes, multiple tumors, and male sex as significant prognostic factors., Conclusions: The most crucial risk factors for developing subsequent KC are being of a male gender, an aggressive tumor subtype, and previous history of multiple skin cancers. Basal cell carcinoma subtypes, such as infiltrative basosquamous, with aggressive growth patterns predispose not only to increased risk for the recurrence but are also expected to be at higher risk of subsequent KCs.

Biological agents: TNF-α inhibitors, IL-12, and IL-23 blockers, IL-17 inhibitors are used in the treatment of plaque psoriasis. Adalimumab (ADA) is an antibody that binds to TNF-α. Ustekinumab (UST) blocks IL-12 and IL-23. The data obtained from medical records is of exceptional value. The aim of the study was to evaluate the efficacy of ADA and UST during a single 40-week period of biological treatment of patients under the drug program "Treatment of moderate and severe form of plaque psoriasis." The group of 620 adult patients with moderate to severe form of plaque psoriasis, who were unresponsive or had contraindications to the standard treatment were qualified to the drug program. In the evaluated group, 50.64% patients were treated with UST, 49.36% with ADA. The efficacy of treatment was assessed during weeks 0, 4, 16, 28, and 40. At week 16th, PASI75 reached 80.72% patients in ADA treated group, PASI ≥90 54.88%, PASI100 19.6% of patients. In the UST group (week 16th) PASI75 reached 70.38%, PASI90 44.26%, PASI100 15.6% of patients. At week 28th PASI90 and PASI100 were more pronounced in the ADA group than in UST. In addition, the total percentage of PASI improvement was significantly higher in the ADA group (p = 0.0006). The percentage of PASI improvement in week 40 was statistically higher in ADA group compared to UST (p = 0.015). Compared to UST, ADA was clinically more effective during a 40-week observation. Patients receiving ADA achieved PASI75, PASI90, and PASI100 more frequently and faster than those treated with UST. Additionally, ADA improved the quality of life of psoriatic patients more substantially compared to UST., (© 2022 Wiley Periodicals LLC.)

Introduction: Palatine tonsil disease often coexists with dermatological diseases. Correct diagnosis of inflammation of the palatine tonsil tissue and removal of the diseased palatine tonsils results in remission of the disease., Aim: To determine similarities and differences in the immunohistochemistry profile of the palatine tonsil tissue between tonsillitis and hypertrophy, including location of the immunohistochemistry reactions in specific histological sites., Material and Methods: A prospective analysis of 50 palatine tonsils that had undergone tonsillectomy due to tonsillitis (30 cases) and hypertrophy (20 cases) was performed. The collected material underwent immunohistochemistry staining for: IL-1, IL-10, CD25, CD40, and CD69, and subsequently phenotypic expression of the obtained results was performed including their histological location., Results: Statistically significant differences ( p < 0.05) between the tonsillitis and hypertrophy groups were found for almost all IHC reactions in the epithelium covering the tonsils for CD-25, CD-69, IL-1, IL-10. Furthermore, significant differences between these groups were found for IL-10 reaction in the subepithelial inflammatory infiltrate and follicular centres of lymphatic follicles as well as for CD-69 reaction between the follicles. When all the locations were summarized, significant ( p < 0.05) differences were found for all IHC reactions except for CD-40., Conclusions: The investigated markers and cytokines: CD25 and CD69, and IL-1 and IL-10 are more abundant in tonsillitis than in hypertrophy of the palatine tonsils., Competing Interests: The authors declare no conflict of interests., (Copyright © 2022 Termedia.)

Competing Interests: The author declares no conflict of interest.

Objective: The aim of the study was to verify two hypotheses. The first concerned the possibility of diagnostic dermoscopic differentiation between cutaneous melanomas of the histopathological category in situ (pTis) and thin melanomas (pT1a) in terms of their diameter. The second assessed the diagnostic feasibility of two dermoscopic algorithms aiming to detect ≤ 5.0 mm-sized melanomas histopathologically confirmed as pTis and pT1a., Methods: Dermoscopic images of consecutive cases of histopathologically confirmed melanomas were evaluated by three independent investigators for the presence of the predefined criteria. The melanomas were subdivided according to their diameter into small melanomas, so-called micromelanomas (microM)-sized ≤ 5.0 mm and >5.0 mm, according to published definitions of small melanocytic lesions. The Triage Amalgamated Dermoscopic Algorithm (TADA) and the revisited 7-point checklist of dermoscopy (7-point) algorithm were chosen for the diagnostic feasibility. Odds ratios and corresponding 95% confidence limits (CL) were calculated using the logistic regression adjusted for age for the melanoma-specific dermoscopic structures, the dermoscopic patterns and the diagnostic feasibility of the 7-point checklist and TADA algorithms. The p -values of the results were corrected using the Bonferroni method., Results: In total, 106 patients with 109 melanomas, 50 sized ≤ 5.0 mm and 59 exceeding the diameter of 5.0 mm, were retrospectively analyzed. The prevalent general pattern of microM was the spitzoid one (48% vs. 11.86%, p = 0.0013). Furthermore, 40% of microM vs. 6.78% melanomas sized > 5.0 mm ( p = 0.0023) did not present melanoma-specific patterns. The asymmetric multicomponent pattern was present in 64.41% melanomas sized > 5.0 mm and in 26.00% microM ( p = 0.0034). The asymmetry of structures or colors was detected in 56% microM vs. 89.83% ( p = 0.0020) and 56% microM and 94.92% ( p = 0.000034) melanoma sized > 5.0 mm, respectively. The differences in frequency of the detected dermoscopic structures specific to melanomas revealed that microM are almost deprived of negative networks ( p = 0.04), shiny white structures ( p = 0.0027) and regression features ( p = 0.00003). Neither prominent skin markings nor angulated lines were found in the entire study group. Out of the vascular structures, microM presented only dotted (32%) or polymorphous (28%) vessels, although more rarely than melanomas sized > 5.0 mm (66.1% p = 0.017 and 49% p > 0.05, respectively). The diagnostic feasibility revealed a score ≥ 3 of the 7-point algorithm (indicative for malignancy) in 60% microM and 98.31% melanomas sized > 5.0 mm ( p = 0.000006). The TADA algorithm revealed melanoma-specific patterns in 64% microM and 96.61% > 5.0 mm-sized melanomas ( p = 0.00006) and melanoma-specific structures in 72% and 91.53% ( p > 0.05), respectively., Conclusion: In the dermoscopy, 40% of micromelanomas histopathologically staged as pTis and pT1a did not reveal melanoma-specific patterns. Among the general melanocytic patterns, the spitzoid one was the most frequently found in melanomas sized ≤ 5.0 mm. The 7-point checklist and TADA dermoscopic algorithms were helpful in the identification of the majority of melanomas sized ≤ 5.0 mm.

Psoriasis vulgaris is a chronic, immune-mediated disorder, which has a substantial impact on all aspects of patients' quality of life. In most patients, the disease is mild to moderate and is successfully treated with topical agents. The most common therapy involves a vitamin D 3 analogue (calcipotriene) in combination with a synthetic corticosteroid (betamethasone dipropionate). The aerosol vehicle (foam) with softening properties is another formulation of this combination drug, apart from ointment and gel, expanding the therapeutic options available to patients with psoriasis. The article describes the pharmacokinetic and pharmacodynamic properties of calcipotriene/betamethasone dipropionate foam. The results of the key randomised clinical studies investigating the efficacy, including patients' quality of life and safety of the foam versus ointment, gel and either active ingredient in foam vehicle are presented. In addition, the results of a study on maintenance treatment with calcipotriene/betamethasone dipropionate foam as well as reports on real-world use of this medicine in patients with psoriasis, are discussed., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Termedia Sp. z o. o.)

JAKs are intracellular protein tyrosine kinases that, through activation of STATs, are responsible for signal transduction pathways that regulate cellular responses to numerous cytokines, growth factors and hormones in many different cells. JAK-STAT signaling plays a key role in regulating immune function, and cytokines - such as IL-23, IL-12 and type I interferons - are central to the pathogenesis of autoimmune diseases, including psoriasis, inflammatory bowel disease and systemic lupus erythematosus. Here the authors review the evidence for targeting TYK2 as a more specific approach to treating these conditions. TYK2 inhibitors are clinically effective in autoimmune and inflammatory diseases and may avoid some of the complications reported with nonselective JAK inhibitors.

The aim of this study is analysis of time to relapse after discontinuation of biologic treatment and identification of factors associated with risk of relapse. The analysis used real-world data of 705 patients treated with biologic drugs (adalimumab [ADA], ustekinumab, infliximab, and etanercept) in Poland in 2013-2019. Time to relapse was analyzed by Kaplan-Meier estimator. Data was stratified by the number of prior relapses. Determinants of risk to relapse were analyzed with Prentice-Williams-Peterson model. Kaplan-Meier estimate of time to the first relapse was 276 days, to the second relapse was 246 days, to the third relapse was 218 days, and to the fourth relapse was 178 days. In multidimensional analysis statistically significant variables affecting risk of relapse were the following: biologic naivety (hazard ratio [HR] 0.707), ADA (HR 0.787), psoriasis area and severity index at the last follow-up visit (HR 1.049), abnormal hemoglobin level (HR 0.794), and abnormal lymphocyte counts (HR 1.278). The findings of this study suggest that periods to relapse after discontinuation of biologic drugs become shorter with the number of prior relapses experienced by the patient. Ninety-five percentage of observed relapses occurred within 613 days of the end of the first treatment cycle, within 478 of the second cycle and within 351 days of the third cycle., (© 2021 Wiley Periodicals LLC.)

Smoking has a negative influence on human beings. Carcinogens detected in smoke can increase the risk of developing chronic disorders, cancer and premature death. Nicotine can also affect dermatological diseases such as psoriasis, hidradenitis suppurativa, chronic dermatoses, alopecia, lupus erythematosus, polymorphous light eruption, skin cancer and tobacco-associated oral lesions. Advanced education at a doctor's surgery in various medical occupations can change the bad habits and protect people from the consequences., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Termedia Sp. z o. o.)

Studies have shown that the levels of pro-inflammatory adipokines in patients with psoriasis are higher than in general population. The aim of the study was to investigate the influence of 36-month therapy with TNF-α inhibitors (adalimumab, etanercept, infliximab) on the levels of adipokines (resistin, adiponectin, leptin) and lipids (TG, cholesterol, LDL, HDL) in 37 psoriasis patients and 30 healthy controls. The mean serum concentrations of adiponectin in patients from adalimumab, etanercept and infliximab group were similar to control group (p > 0.05, 142.71, 164.32, 129.35 and 174.44 μg/ml respectively). Resistin levels were higher in patients (p < 0.05, 4.48, 4.53 and 3.39 ng/ml respectively) than in controls (3.05 ng/ml). Mean leptin concentrations were significantly higher (p < 0.05) in the study group than in subjects without psoriasis (428.61, 523.24, 755.27 and 154.10 pg/ml respectively). A significant decrease in the mean resistin concentration was observed under the influence of biological therapy (p < 0.05). Decrease in serum leptin level was noted in etanercept and infliximab groups (p = 0.001 and p = 0.002 respectively). Improvement in all lipidogram parameters was noted in all examined groups (p < 0.05). Results may prove that biologic therapy affects the systemic inflammation associated with psoriasis and this effect persists with long-term therapy.

Localized scleroderma is an inflammatory disease causing sclerosis of the skin. The aetiology and pathogenesis of localized scleroderma remain unclear. Localized scleroderma is considered a genetically driven disease. It is not well understood if genetic factors or environmental exposure individually can cause its development or if their interaction is needed to trigger the disease. Some authors postulate that familial clustering is evidence of a hereditary disease. Familial localized scleroderma has been rarely reported and is a case worth studying. We present the review of literature on this subject with 3 additional cases of familial localized scleroderma with paediatric onset., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Termedia.)

Non-melanoma skin cancers (NMSCs) are the most common malignancies diagnosed in Caucasian populations. Basal cell carcinoma (BCC) is the most frequent skin cancer, followed by squamous cell carcinoma (SCC). Unfortunately, most European cancer registries do not record individual types of NMSC. To evaluate the incidence of primary BCCs and SCCs regarding age, sex, tumour site and tumour subtype to determine trends in epidemiology of both cancers. Retrospective analysis of BCCs and SCCs diagnosed and treated across seven sites in Poland from 1999 to 2019. We recorded 13,913 NMSCs occurring in 10,083 patients. BCC represented 85.2% of all cases. SCC patients were older than BCC patients (77.1 ± 11.3 years vs. 70.1 ± 12.3 years, p < 0.01). The nodular subtype was the most common subtype of BCC, followed by the superficial and infiltrative subtypes. The superficial BCC subtype was more common on photoprotected areas (p < 0.01), whereas the nodular BCC subtype occurred on the face (p < 0.01). The high-risk SCC subtypes were more common on face compared to low-risk SCC subtypes (p < 0.01). BCC and SCC are common malignancies developing at various ages and anatomical sites. These data underline the need for better registration policies regarding NMSC in order to improve prevention and treatment strategies for these tumours.

Background: Genital warts are the manifestation of the human papillomavirus (HPV) infection, which may last for weeks or months before the clinical presentation. The primary aim of the study was the correlation of the DNA HPV genotypes eradication with the treatment response in male patients with persistent genital warts., Methods: Twenty-one male patients (age range: 22-58) after failure of cryotherapy and podophyllotoxin treatment were enrolled in the study. Genetic tests (Real Time - PCR method) analyzed the presence of DNA-HPV before and 6 months after four sessions (4 weeks apart) of photodynamic therapy with 5-aminolaevulinic acid (ALA-PDT). The treatment efficacy was evaluated before each PDT session and at the end of the study., Results: The single HPV DNA type was present in 15/21 of the patients (13/15 HPV6). The high-risk HPV types were found in 8/21 subjects, of which 6/8 had several types. Six months after four sessions of PDT, complete response was found in 16/21 (76.19%; p = 0.0007) of patients, and DNA HPV clearance was found in 66.67% ( p = 0.03). The eradication rate differed among patients with primary low-risk and high-risk HPV types-76.92% (10/13; p = 0.0003) and 50% (4/8; p = 0.05) respectively., Conclusion: ALA-PDT is an effective treatment even after the failure of previous modalities. The persistence of clinical lesions and high oncological risk HPV types should be an indication for treatment prolongation.

Introduction: Information on the possibility of using biological drugs in psoriasis patients planning to conceive, patients who are pregnant or during lactation is limited., Aim: Presenting recommendations published in clinical guidelines regarding the use of biological drugs - adalimumab, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab, and ustekinumab, by psoriasis patients in the period of planning pregnancy, during pregnancy or during lactation., Material and Methods: The paper was based on a comprehensive review of over 40 websites of HTA agencies, dermatological associations worldwide and medical databases (PubMed, Embase), the objective of which was to identify clinical guidelines relating to biological treatment of women of childbearing potential, published after 2018, which used GRADE - a system for rating the quality of a body of evidence., Findings: Certolizumab pegol is recommended in women who are planning to conceive. Furthermore, guidelines indicate other TNF-α inhibitors as possible treatment. Certolizumab pegol is also recommended as first-line treatment in pregnant patients. Furthermore, for trimesters 2 and 3, guidelines allow using other TNF-α inhibitors. Treatment with secukinumab and ustekinumab should be discontinued when planning pregnancy or when pregnancy was diagnosed. Biological treatment during pregnancy and lactation (continuation or initiation of treatment) can be used only after an analysis of risks and benefits has been conducted., Conclusions: TNF-α inhibitors seem to be the safest and most researched biological drugs used in psoriasis treatment of patients planning to conceive, during pregnancy or lactation. Given its non-existent or minimal placental permeability, most likely the safest alternative is certolizumab pegol., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Termedia Sp. z o. o.)

Dysfunctional regulatory T lymphocytes are important for the pathogenesis of psoriasis and atherosclerosis. We analyzed the severity of atherosclerosis and the concentration of regulatory cytokines in patients with psoriasis who were administered methotrexate or adalimumab for 12 weeks. We included 34 patients with psoriasis (17 each, administered methotrexate or adalimumab) and eight healthy volunteers. BMI, psoriasis area and severity index (PASI), body surface area (BSA), and at least 75% and 90% improvements in PASI were observed. The 10-year risk of fatal cardiovascular disease was estimated using Systematic Coronary Risk Evaluation charts. The plasma interleukin (IL)-10, IL-35, and transforming growth factor β1 (TGF-β1) levels were determined using enzyme-linked immunosorbent assay before and after the 12-week treatment regimen. PASI (P = .0006) and BSA (P = .0001) were positively correlated with the BMI, IL-35 (-0.38), and IL-10 (0.48) levels. Baseline IL-35 concentrations were the highest in healthy volunteers; the IL-10 and TGF-β1 level were the highest in the methotrexate group. IL-10 concentration decreased in both treatment groups (P = .02 for the methotrexate and P = .09 for adalimumab group), and IL-35 decreased in the adalimumab group (P = .019), consistent with skin lesion recovery. Thus, this study demonstrates the dysregulated secretion of regulatory cytokines in psoriatic patients under systemic treatment., (© 2020 Wiley Periodicals LLC.)