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Patrycja Rogowska,1 Paula Walczak,2 Karolina Wrzosek-Dobrzyniecka,2 Roman J Nowicki,1 Aneta Szczerkowska-Dobosz1 1Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland; 2Faculty of Medicine, Medical University of Gdańsk, Gdańsk, PolandCorrespondence: Patrycja Rogowska, Department of Dermatology, Venereology and Allergology, Faculty of Medicine Medical University of Gdańsk, Smoluchowskiego 17 Street, Gdańsk, 80-214, Poland, Tel +48585844014, Fax +48585844020, Email patrycja.rogowska@gumed.edu.plPurpose: Among populations of Western countries, tattoos have become an accepted form of skin ornamenting. With tattoos growing in popularity, also patients suffering from chronic dermatoses may more often be willing to get tattooed. Psoriasis is not considered as a strict contraindication for tattooing; however, it is not advised to get a tattoo while undergoing immunosuppressive treatment and during an active stage of the disease. We attempted to assess the knowledge level of tattooed psoriatic patients about the potential risks connected with tattooing, as well as to explore their attitudes and tendencies towards this procedure. Moreover, we analyzed the frequency and type of tattoo complications in this study group.Patients and Methods: An anonymous, online questionnaire was performed among online communities dedicated to psoriasis. Data from 150 tattooed psoriatic patients have been scrutinized.Results: Eight percent of the surveyed psoriatic patients sought medical advice before getting a tattoo. While undergoing the tattooing procedure, 23 (15.3%) of the respondents received systemic psoriasis treatment: 8 (5.3%) being treated with methotrexate, 5 (3.3%) with cyclosporine A, one (0.7%) acitretin, and 9 (6%) patients were under biological treatment. Thirteen (8.7%) of the participants experienced complications associated with their tattoos, among which, the insurgence of the Koebner phenomenon on the tattoo, was the most frequent one (8 cases- 5.3%). Getting tattooed improved patients’ self-esteem in 76 (50.7%) of the cases.Conclusion: An increased level of education among patients, medical practitioners, and tattooists concerning general precautions of tattooing in psoriasis is advisable.Keywords: tattoo, psoriasis, psoriasis therapy, immunosuppression, Koebner phenomenon

Acne vulgaris is a chronic inflammatory skin condition with a high global prevalence. Light-based therapies can be used in acne treatment on account of their good safety profile, lack of potential for developing resistance, and mechanism of action. Despite variations in research methodologies and diverse findings among researchers, numerous clinical studies have shown a statistically significant improvement in the skin condition of acne patients treated with light. In the majority of studies, the follow-up period is comparatively short, preventing the evaluation of long-term effects of therapy. This paper examines the literature on the effects of various light therapies (based on LED devices, photodynamic therapy, intense pulsed light, and laser therapy), on the clinical signs of acne.

This study aimed to comprehensively analyze the problem of overweight and obesity among psoriatic patients by investigating the influence of body mass composition, anhedonia and depression, environmental factors and FTO gene polymorphisms. Methods: The study enrolled 30 overweight or obese adult patients with chronic plaque psoriasis and 30 overweight or obese volunteers (northern Poland region, Caucasian population). Mood disorders, body mass composition by using bioelectrical impedance analysis (BIA) and FTO gene polymorphisms (rs9939609, rs1558902) by tetra-primer amplification refractory mutation system PCR (T-ARMS-PCR) were assessed. Results: Results revealed significantly higher visceral adipose tissue levels in psoriatic patients (5.23 ± 2.29 [L] vs. 3.41 ± 1.86 [L]), p = 0.001), especially among men, along with elevated rates of moderate and severe depression (26.67% vs. 6.67% and 13.33% vs. 3.33%, p = 0.048 respectively). Additionally, FTO gene polymorphisms correlated with waist–hip ratio differences in both groups. Conclusions: The study highlights the importance of evaluating body composition beyond body mass index, recognizing its influence on psoriasis and associated conditions like depression. The FTO gene may serve as a potential genetic link between psoriasis and obesity, warranting further research for validation. Adiposity emerges as a key and modifiable risk factor, underscoring the clinical implications of body composition complexities in psoriasis management.

Antigen presentation plays a critical role in the pathogenesis of immune-mediated disorders. This study aimed to investigate the effects of IFN-γ and a cytokine mix (5MIX: IL-1α, IL-17A, IL-22, OsM, and TNF-α) on the antigen-presenting capabilities of keratinocytes, with a specific focus on immune-mediated dermatological conditions such as psoriasis (Ps). To achieve this, keratinocytes were treated with IFN-γ and 5MIX, and their impact on the expression of key antigen-presentation molecules, HLA-DRα and CD74, was assessed. Transcriptomic analysis revealed that IFN-γ alone altered the expression of 254 genes, highlighting its central role in modulating immune responses, including the recruitment of immune cells and regulation of inflammation. Temporal experiments further demonstrated that IFN-γ and 5MIX enhanced early endocytic activity and lysosomal degradation pathways, both essential for effective antigen presentation and T-cell activation. To extend these findings to a clinical context, a co-culture model using keratinocytes derived from psoriatic patients was established. This model revealed increased cytokine production following antigen stimulation, indicating robust and consistent CD4+ and naïve T-cell responses. These results elucidate the complex dynamics of cytokine signaling and antigen presentation in keratinocytes, providing insights into potential therapeutic strategies for immune-mediated skin disorders like Ps. [ABSTRACT FROM AUTHOR]

Background and Objectives: Psoriasis is a common, chronic, and immune-mediated inflammatory skin disease recognized to lead to a wide range of comorbid disorders, mainly obesity. The study aimed to evaluate the problem of overweightness and obesity among psoriasis patients in the context of their prevalence and influence on the disease course. Materials and Methods: The study group encompassed 147 adult patients with plaque psoriasis. Results: The prevalences of overweightness (39.46%) and obesity (37.41%) demonstrated in the study showed the strong predisposition of psoriatic patients for abnormal body mass. The vast majority (77%) of subjects with psoriatic arthritis were overweight or obese. The results of the correlation analysis revealed the significant impacts of overweightness and obesity, as defined by the BMI index, on modifying the severity of psoriasis (as assessed by the PASI with a correlation coefficient of R = 0.23, p = 0.016; and BSA values with a correlation coefficient of R = 0.21, p = 0.023), particularly in contrast to patients with a normal body mass. Conclusions: Overweightness and obesity constitute a major health burden among psoriatic patients, influencing the disease course and severity. Enhanced understanding of the phenomenon may directly translate into improving disease management and overall patient care.

Introduction: Acne vulgaris is a highly prevalent skin disorder, driving the ongoing search for innovative treatment modalities. While numerous studies have demonstrated the effectiveness of photodynamic therapy (PDT) in managing acne vulgaris, there remains a lack of clear guidlines regarding optimal treatment parameters. Aim: To assess the efficacy and safety of 10% concentration 5-aminolevulinic acid-(ALA) in comparison to 15% ALA PDT for treating facial acne vulgaris. Material and methods: A randomized, double-blind, split-face clinical trial was conducted on 25 patients with moderate to severe acne (Leeds grades 2–4). Patients were randomly assigned to two groups with different ALA concentrations applied on one cheek, while a placebo was applied on the other side. After a 1.5-hour incubation, illumination with 633 nm red light from a Light Emitting Diode (LED) lamp (96 J/cm2) was performed in three sessions with 7–10 days' intervals. Treatment effectiveness was assessed by the lesion reduction rate based on lesion counts before the study, after each session, and at 4 and 8 weeks after the last session. Results: Both 15% and 10% ALA-PDT treatments demonstrated significant reductions in inflammatory acne lesion counts compared to the placebo: 10% ALA-PDT showed a reduction of 27.36% versus 12.64% for the placebo (p = 0.04), while 15% ALA-PDT showed a reduction of 40.45% compared to 13.41% (p < 0.01). However, there was no significant difference between ALA-PDT and placebo in treating non-inflammatory lesions. Additionally, there was no difference between the effectiveness of 10% and 15% ALA in reducing any type of acne lesions. Conclusions: ALA-PDT is effective in treating acne vulgaris. However, ALA-PDT provides an advantage over red light only for inflammatory acne lesions. The study indicates that higher concentrations of ALA do not result in more significant reductions in acne lesions. [ABSTRACT FROM AUTHOR]

Angioedema is a non-inflammatory edema of the subcutaneous tissue and/or mucosal membranes. It commonly coexists with urticaria and is considered a deep form of urticaria. Less commonly, it occurs as an isolated disease in one of two basic forms: acquired angioedema and hereditary angioedema. Four types of acquired angioedema and seven types of hereditary angioedema were difinied. The treatment of angioedema depends on its form and etiological factors, with hereditary angioedema posing a most significant challenge.

This study aimed to comprehensively analyze the problem of overweight and obesity among psoriatic patients by investigating the influence of body mass composition, anhedonia and depression, environmental factors and FTO gene polymorphisms. Methods: The study enrolled 30 overweight or obese adult patients with chronic plaque psoriasis and 30 overweight or obese volunteers (northern Poland region, Caucasian population). Mood disorders, body mass composition by using bioelectrical impedance analysis (BIA) and FTO gene polymorphisms (rs9939609, rs1558902) by tetra-primer amplification refractory mutation system PCR (T-ARMS-PCR) were assessed. Results: Results revealed significantly higher visceral adipose tissue levels in psoriatic patients (5.23 ± 2.29 [L] vs. 3.41 ± 1.86 [L]), p = 0.001), especially among men, along with elevated rates of moderate and severe depression (26.67% vs. 6.67% and 13.33% vs. 3.33%, p = 0.048 respectively). Additionally, FTO gene polymorphisms correlated with waist–hip ratio differences in both groups. Conclusions: The study highlights the importance of evaluating body composition beyond body mass index, recognizing its influence on psoriasis and associated conditions like depression. The FTO gene may serve as a potential genetic link between psoriasis and obesity, warranting further research for validation. Adiposity emerges as a key and modifiable risk factor, underscoring the clinical implications of body composition complexities in psoriasis management. [ABSTRACT FROM AUTHOR]

Raynaud’s phenomenon is one of the most common disorders of the blood vessels, which usually affects fingers and toes. Raynaud’s disease, also called primary Raynaud’s phenomenon, is diagnosed when the cause is unknown, whereas Raynaud’s syndrome or secondary Raynaud’s phenomenon occurs as a skin manifestation of concomitant disease. The most common trigger is exposure to cold. Specific clinical features allow a quick diagnosis. Raynaud’s phenomenon usually does not require pharmacologic treatment, but in some cases symptoms are severe and pharmacotherapy is necessary. Calcium channel blockers are usually used as a first-line treatment. Alternative forms of therapy include angiotensin-converting-enzyme inhibitors, 1-adrenergic blockers, phosphodiesterase-5 inhibitors, endothelin antagonists, nitrates, antioxidants, statins, botulinum toxin, and even autologous fat grafting.

Acne vulgaris is a chronic inflammatory skin condition with a high global prevalence. Light-based therapies can be used in acne treatment on account of their good safety profile, lack of potential for developing resistance, and mechanism of action. Despite variations in research methodologies and diverse findings among researchers, numerous clinical studies have shown a statistically significant improvement in the skin condition of acne patients treated with light. In the majority of studies, the follow-up period is comparatively short, preventing the evaluation of long-term effects of therapy. This paper examines the literature on the effects of various light therapies (based on LED devices, photodynamic therapy, intense pulsed light, and laser therapy), on the clinical signs of acne. [ABSTRACT FROM AUTHOR]

The article in the Journal of Cosmetic Dermatology discusses traumatic tattoos, which are accidental implantations of dark pigments into the skin, often caused by incidents like road accidents or explosions. The study presents four cases of posttraumatic tattoos that were initially mistaken for pigmented skin tumors. Through videodermoscopic examination, it was revealed that these lesions were actually traumatic tattoos resulting from incidents like graphite pencil tips or metal fillings. The article emphasizes the importance of considering a patient's history of accidents to differentiate between traumatic tattoos and actual skin tumors, highlighting the need for accurate diagnosis through biopsy when in doubt. [Extracted from the article]

Introduction. Keratoderma of the hands and feet is a chronic disorder of epidermal keratinization, which consists of many various forms. Objective. To present a case of a 54-year-old woman with severe hereditary punctate palmoplantar keratoderma. Case report. The patient was admitted to the Department of Dermatology in Copernicus Hospital because of hyperkeratotic lesions on the hands and feet, with restriction of individual mobility. No coexisting malignancies or nail and hair disorders were diagnosed. Similar changes were found in many members of her family. Intensive topical treatment and oral therapy with retinoids were applied, resulting in a partial improvement. Conclusions. Hereditary punctate palmoplantar keratoderma is a rare disorder. Its long-term course and therapeutic difficulties significantly affect the quality of life.

Introduction. Actinic keratosis is a common diagnosis in dermatological practice. Lesions usually appear on senile skin or skin exposed to sunlight. As they can progress to squamous cell carcinoma, all lesions should be properly treated. Ingenol mebutate is one of the newest topical agents. Objective. To present a severe site reaction during treatment of actinic keratosis with ingenol mebutate gel. Case report. An 85-year-old patient was treated with ingenol mebutate for an actinic keratosis lesion on the head. After the third day of treatment a massive local reaction was observed, with numerous pustular lesions. It was treated with a topical antibacterial agent. Complete remission of actinic keratosis was observed one month later. Conclusions. Treatment of actinic keratosis with ingenol mebutate carries the risk of local adverse effects, including severe pustular reaction. Patients should always be informed about possible side effects of the treatment and their transient nature.

Introduction. Qualification of patients for the therapeutic program of severe plaque psoriasis should be preceded by many tests. Abnormal test results require further evaluation and possibly implementation of treatment. False positive results lead to prolongation of the qualification process and may cause disqualification of the patient. Objective. To draw attention to qualification to a drug program. Case reports . A screening test for Lyme disease performed in a 45-year-old man, during qualification for biological treatment, was positive, but verification by Western blot showed a negative result. It caused significant prolongation of the qualification process. In a 26-year-old patient the QuantiFERON test gave a positive result. It was repeated in another laboratory and a negative result was established. Conclusions . False-positive results may result in disqualification from biological treatment. Exchange of experience between doctors is essential for improving inclusion criteria of patients for biological therapy.

Introduction . Pitted keratolysis (PK) is a mild infectious skin disorder caused by Corynebacterium spp., Kytococcus sedentarius or Dermatophilus congolensis . These bacteria produce enzymes that digest keratin, causing superficial lesions in the plantar surface. The disease is predominantly observed in young men. Objective . Pitted keratolysis despite the characteristic presentation of skin lesions is often misdiagnosed. In this article we aimed to remind readers of its clinical aspects and treatment by presenting a typical PK case. Case report. A 35-year-old man was admitted to the dermatological clinic due to skin lesions on both soles. In the physical examination we found multiple crateriform pits, associated with hyperhidrosis and malodour diagnosed as PK. Remission of lesions was observed after treatment with oral erythromycin. Conclusions . The differential diagnosis of plantar skin lesions should include PK. Due to typical clinical manifestation the diagnosis is based on physical examination.

Psoriasis is a chronic inflammatory skin disease associated with increased proliferation of the epidermis. Combination of genetic, immunological and environmental factors underlies the skin lesion. Until recently, psoriasis has been conceived as a skin limited disorder. Studies during the last decade revealed that psoriasis is a systemic disease which is associated with increased incidence of a many conditions, including cardiovascular diseases. It is considered that chronic inflammation, which is part of the pathogenesis of both psoriasis and vascular diseases, is responsible for it. It has been shown that psoriatic patients more often than in the general population have hypertension, atherosclerosis, dyslipidemia, diabetes and obesity. Abnormal life style of patients with psoriasis, resulting, inter alia, in social stigmas, is important for the cardiovascular risk. Because of increased cardiovascular risk factors, patients with psoriasis require interdisciplinary medical care and prevention – imaging studies of the heart and blood vessels.

Interleukin-16 (IL-16) is a proinflammatory cytokine with a pleiotropic impact on cells of the immune system. Based on its biological properties including activation of CD4+ T cell migration and proliferation and also stimulation of proinflammatory cytokine synthesis, it could be postulated that IL-16 may play an important role in the pathogenesis of many diseases associated with immunological disturbances. Interleukin-16 acts as a chemoattractant not only for T CD4+ lymphocytes, but also for other cells, which have specific receptors on their surface. Moreover, IL-16 acts as a cell cycle regulator. This cytokine is produced by cells of the immune system, i.e. T CD4+ and T CD8+ lymphocytes, eosinophils, mast cells, dendritic cells and also fibroblasts and epithelial cells. The mechanism of action of IL-16 may suggest its significant role in the pathogenesis of skin disorders associated with an inflammatory reaction and infiltration composed of T CD4+ lymphocytes. Both this interleukin and anti-IL-16 antibodies may be useful in diagnosis and therapy of many skin diseases. Further detailed studies on the release of IL-16 and its biological functions are needed to reveal the role of this cytokine in the complex immunological process. The aim of this article is a current literature review of the relationship between IL-16 and the development of selected skin diseases: atopic dermatitis, systemic lupus erythematosus, bullous pemphigoid, cutaneous T-cell lymphomas and psoriasis.

Psoriasis is a complex disease with multifactorial mode of inheritance,whichmeans that its clinicalmanifestations depend uponmultiple genesinteracting with environmental agents. The major genetic factor responsiblefor 35-50% susceptibility for early psoriasis in the Caucasian population,HLA-Cw*06, is located within the major histocompatibility complex(MHC) on the sixth chromosome. Whole genome associationstudies, the newest research trend, revealed three genetic, non-MHCrelated pathways connected with psoriasis susceptibility: Th17, Th2 andNF-κB-dependent. These genes are responsible for inflammation, epidermalproliferation and epidermal barrier function in psoriasis.