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Rosacea is a chronic inflammatory skin disease characterised by periods of remission and subsequent relapses typically provoked by environmental factors. Eruptions located on the face are easily visible and may be difficult to conceal, which leads to a decrease in patients’ self-esteem, quality of life, and general well-being. Since the aetiology of rosacea is multifactorial and not entirely understood, and the clinical characteristics and course of the disease are heterogeneous, therapy may be challenging. While a complete cure is not possible, in the majority of cases clinical improvement and long-term remission are satisfying both to the patient and physician. In recent years, the therapeutic approach has been significantly modified. Currently, the focus is placed on the need to personalise the treatment process and adapt it to the patients’ phenotypic characteristics. Combination therapies and new variants of existing topical and systemic drugs are increasingly being recommended. The mainstays of therapy are antiinflammatory agents. Proper skin care – along with the identification and avoidance of factors known to trigger consecutive episodes of rosacea – are also essential.

Rosacea is a chronic, relapsing, inflammatory, but not infectious, skin disease. The prevalence of rosacea is relatively high in the adult population of Northern Europe. Its characteristic symptoms include recurrent flushing, erythema, telangiectasia, papules and pustules, localized on cheeks, nose, chin and forehead. At present, four, not mutually exclusive subtypes of acne are classified: erythematotelangiectatic, maculopapular, hypertrophic and ocular. The clinical presentation of this dermatosis is heterogeneous. Clinical symptoms and their severity may vary individually. For this reason, treatment should be individualized and take into consideration the type of cutaneous lesions, presence of comorbidities, patient’s occupation, impact of the disease on the quality of life, and patient’s preferences. In addition to topical and systemic medications, adequate skin care is important.

Atopic dermatitis and allergic contact dermatitis are two dermatoses associated with eczema and pruritus, accompanied by hypersensitivity reactions. However, the etiopathogenesis of these diseases is different, therefore also their diagnostic and therapeutic procedures vary. Atopic dermatitis, a skin-epidermal barrier defective disorder, is a more characteristic for children, although it also occurs in a small percentage of adults. Contact allergy, in which epidermal patch tests are the diagnostic tool, is diagnosed in children and in as many as 20% of adults. Atopic dermatitis and allergic contact dermatitis may coexist in the same patient. Etiologically different types of hand eczema often coexist. In addition, contact allergy may relate to substances used in the treatment of atopic dermatitis, such as emollients or, less frequently, antiseptics and glucocorticosteroids. For this reason, epidermal patch tests may be useful in this group of patients.

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.

Hirsutism is a common clinical diagnosis defined by the presence of excess growth of terminal hair in androgen-sensitive areas. It affects 5–15% of women, often having a significant impact on their daily functioning. Hirsutism is mainly caused by ovarian or adrenal hyperandrogenism, although it can be idiopathic, drug induced or caused by other endocrinopathies. Severity of the disease can be assessed using a modified Ferriman-Gallwey visual scoring scale. Therapeutic options include hair removal using lasers or electrolysis, combined oral contracetion, antiandrogens and topical eflornithine. This article presents a clinical scheme for diagnosis and management of hirsutism from a dermatological perspective.

Aim. The aim of this paper is to analyse and review the currently available evidence and research with regard to allergy to the iodinated contrast media, which still remains an important, albeit rare, clinical complication. Material and Methods. We performed our research using the PubMed search engine provided by the National Centre for Biotechnology Information, having inserted ‘iodinated contrast media’, ‘allergy’, ‘adverse reactions’ as the keywords. Results. Even though the modern iodinated contrast media are much safer than those used in the past, adverse reactions still occur in up to 1–3% of patients undergoing radiological procedures. Their range varies from skin changes, such as a macular rash, prurigo or urticarial, to the more severe multisystemic reactions including anaphylactic shock. The underlying mechanisms are still investigated and are not fully comprehended, although the most frequently accepted explanations include a systemic inflammatory reaction associated with increased histamine and tryptase levels, activation of memory T cells and both direct and indirect damage to the vascular epithelium. The significance of classic allergy tests has not yet been fully established. The associated known risk factors are of various character and researchers have come with different, occasionally contradicting results regarding patients’ age and gender, however, other factors have been more clearly described, and include concomitant conditions and medications. Conclusions. The aforementioned data emphasizes the importance of clinical aspects of allergy to the iodinated contrast media for every practicing physician, as more and more medical specialties benefit from the advantages of modern vascular imaging.

Psoriasis is one of the most common chronic inflammatory dermatoses. We present the second part of the diagnostic and therapeutic guidelines on psoriasis. The second part discusses the principles of treatment of plaque psoriasis, with a particular emphasis on systemic drugs. The second part of the guidelines constitutes an integral whole with the first part which addresses the general principles of diagnostic management, prevention of cardiovascular complications, therapeutic goals, and selected specific forms of psoriasis. The guidelines have been updated to take account of access to new therapies which have recently been approved in Poland, ongoing improvements in the efficacy of available therapeutic methods, and changing needs of patients. We hope that the current guidelines will assist physicians in making diagnostic and therapeutic decisions, and contribute to the improvement of medical care provided to patients with psoriasis.

Psoriasis is a chronic inflammatory disease affecting approximately 1–3% of the general population. Although skin lesions are the primary clinical manifestation of the condition, psoriasis – especially moderate to severe – is currently regarded as a systemic disease, not only associated with the development of psoriatic arthritis but also linked to a range of other health consequences including cardiovascular complications. In view of new data on the pathogenesis of psoriasis, very rapid progress in the development of new therapeutic approaches, and in particular the registration of new drugs, a need arose to update the guidelines for the diagnosis and treatment of this nosological entity. The aim of the recommendations of the Polish Dermatological Society is to summarise the most recent literature and formulate guidelines for the treatment of psoriasis that may be useful in daily dermatological practice. However, the final decision regarding the diagnostic and therapeutic procedure should always be made individually for each patient based on the patient’s current clinical status and the most up-to-date scientific reports.

Scabies is a widespread, contagious parasitic disease that affects all socioeconomic groups and was added to the list of WHO Neglected Tropical Diseases. Recent studies indicate misdiagnosis in 45% of patients with scabies. Crusted scabies is a rare, acute and highly contagious form of scabies infestation, mainly observed in patients with immunosuppression or mental illness. Standard therapy for crusted scabies is a combination of a topical scabicide and oral ivermectin. The aim of the study was to present the case of a 19-year-old male patient with Down syndrome and systemic disorders, who was diagnosed with crusted scabies and successfully treated with ivermectin. We suggest that ivermectin is an effective and safe therapy for crusted scabies treatment. The presented case shows the desirability of ivermectin registration for crusted scabies in Poland.

The treatment goal in atopic dermatitis is eliminating clinical symptoms of the disease, preventing exacerbations and complications, as well as improving patients’ quality of life. In cases of severe atopic dermatitis and lack of response it is recommended to introduce systemic therapy. Patients ofter require multi-specialist consultations, and occasionally hospitalization. It is not recommended to use acupuncture, acupressure, bioresonance, homeopathy, or Chinese herbs in the treatment of atopic dermatitis.

Background: The nail unit (NU) is a complex structure that performs a number of functions, including protection, defense, manipulation, and palpation. Non-invasive research methods can facilitate the recognition of NU structure and function. Evaporimetry and HF-USG due to their availability of equipment and low research costs seem to be particularly noteworthy, but so far have been assessed to a limited extent. The aim of the presented study was to check the usefulness of TOWL and HF-USG in examination of NU.Materials and Methods: A total of 58 volunteers aged 25–65 years (mean age: 41 ± 10.16 years) were qualified for the study. The subjects did not present symptoms of clinically evident onychopathy and did not suffer from any dermatoses associated with lesions occurring within the NU. Additionally, the patients did not suffer from systemic diseases that could affect NU (including heart, lung, and endocrine diseases). In all volunteers, the measurement of TOWL and 20 MHz ultrasonography [high-frequency ultrasonography (HF-USG)] with the special emphasis on determination of nail plate thickness were performed.Results: Analysis of 464 HF-USG images revealed that the nail plate presented as two hyperechoic, parallel streaks (railway sign) with a linear hypoechoic middle layer between them. Matrix was visualized as a hypoechoic structure with blurred boundaries, mostly within the fourth and fifth fingers and more often in women. We found statistically significant correlations between the type of a finger and the thickness of the nail plate both in the entire study group and taking into account gender. In the dominant hand, the results were r = −0.341; p < 0.001; r = −0.417, p < 0.001; and r = 0.337; p = 0.001 (for the whole group, for women, and for men, respectively). In the non-dominant hand, the results were r = −0.465; p < 0.001; r = −0.493, p < 0.01; and r = −0.503; p < 0.01 (for the whole group, for women, and for men, respectively). There were statistically significant differences in the thickness of the nail plates of the corresponding types of fingers between female and male NUs. Statistically significant correlations were found between the type of a finger and the TOWL value in the whole group and taking into account gender (p < 0.05), except for the non-dominant hand in men. There were no statistically significant differences in the TOWL values of the corresponding types of fingers between male and female NUs (p > 0.05). There was no statistically significant correlation between the TOWL value and the nail plate thickness in any of the tested NUs, apart from the one statistically significant correlation in nd5 (r = 0.390, p = 0.021).Conclusions: To sum up, non-invasive methods, such as HF-USG and TOWL, enable assessment of the NU and are useful in examination of its structure and function. HF-USG shows characteristic elements of NUs that can be distinguished because of differences in their echogenicity. The thickness of the nail plate and TOWL depend on the type of finger, and show a relationship with gender.

Rosacea is a chronic dermatosis, manifesting with erythema, papular or pustular eruptions located in the facial area. The authors present a case of an 84-year-old woman with a long-term history of rosacea who had a mycotic infection of the facial skin imitating aggravation of the underlying disease. The case presented by us can be regarded as a variant of “tinea incognito”, i.e., undiagnosed mycosis, misdiagnosed as another dermatosis, which is often aggravated by the patient by using local glucocorticosteroids or other local immunomodulators, which hinders proper diagnosis. It may be diagnostically relevant to consider other comorbidities in elderly patients with rosacea.

Occupational diseases are characterised by a diverse aetiology. The causative agents may be chemical, physical or biological. In the past 14 years there has been a decrease in the number of reported occupational dermatoses in Poland. In 2017 occupational dermatoses ranked 7th among all occupational diseases, whereas in 2003 they were in the 5th position. There were 1694 recorded cases of cutaneous occupational diseases. The most common entity was allergic contact dermatitis (80.5% of total occupational skin disease cases), while hands were the most frequent location of occupational dermatoses. The number of registered cases of occupational diseases is low compared to other European countries. This indicates that this number may not reflect the true scale of disease incidence and may lead to underestimation of the problem of occupational dermatoses in Poland.

Atopic dermatitis is a chronic and recurrent inflammatory dermatosis with concomitant intensive pruritus, and is diagnosed both in children and adults. Atopic dermatitis -patients are predisposed to have bacterial, viral and fungal skin infections; they also suffer from an increased risk of developing food allergies (especially, at an infantile age), allergic rhinitis, or bronchial asthma (a so-called atopic march). Currently, an increasing atopic dermatitis incidence constitutes a serious medical problem that regards not only dermatology and allergology, but also paediatrics, and family medicine. The basis for atopic dermatitis treatment and prophylaxis is restoration of epidermal barrier functions by means of tailored emollients. Atopic dermatitis therapies should effectively eliminate clinical symptoms of the disease, prevent exacerbations as well as complications, and improve patients’ quality of life.

We report the case of a 36-year-old male patient with alcohol dependence syndrome who was admitted to the Dermatology Unit with erythroderma of unknown aetiology persisting for approximately 2 years. A considerable degree of deformity and ulceration were noted on the patient’s right hand. The patient reported that the abnormalities were due to a fall suffered the year before. The culture of material collected from the ulcer was positive for Staphylococcus aureus, Corynebacterium diphtheriae and Streptococcus dysgalactiae. Following a 10-day course of intravenous clindamycin the ulcer healed successfully. Corynebacterium diphtheriae infection should be considered in the differential diagnosis of skin ulcers, particularly in patients with alcohol dependence syndrome and general immunosuppression.

Background: Retinoids, which include isotretinoin, reduce sebum levels, the degree of epidermal wetness (CORN) and cause an increase in transepidermal water loss (TEWL). Weight gain has also been observed in isotretinoin-treated patients. An agent that can reduce the severity of isotretinoin side effects is evening primrose oil (Oenothera paradoxa). The purpose of this study was to evaluate the effect of evening primrose oil supplementation in patients with acne vulgaris treated with isotretinoin on skin hydration status (CORN), transepidermal water loss (TEWL), skin oiliness (sebum) and changes in body weight and BMI. Methods: Patients diagnosed with acne were assigned to the isotretinoin-treated group (n = 25) or the isotretinoin and evening primrose oil-treated group (n = 25). The intervention lasted 9 months. CORN (with a corneometer), TEWL (with a tewameter) and sebum (with a sebumeter) were assessed twice, as well as body weight and BMI (Tanita MC-780). Results: The isotretinoin-treated group showed statistically significant reductions in CORN (p = 0.015), TEWL (p = 0.004) and sebum (p < 0.001) after the intervention. In the group treated with isotretinoin and evening primrose oil, TEWL and sebum levels also decreased significantly (p < 0.05), while CORN levels increased from 42.0 ± 9.70 to 50.9 ± 10.4 (p = 0.017). A significant decrease in body weight (p < 0.001) and BMI (p < 0.001) was observed in both groups after 9 months of intervention. Conclusions: During isotretinoin treatment, supplementation with evening primrose oil increased skin hydration. However, there were no differences between groups in transepidermal water loss, skin oiliness, weight loss and BMI.

High-frequency ultrasonography (HF-USG) is a non-invasive and in vivo method of visualization of the skin and upper part of subcutaneous tissue based on ultrasounds above 20 MHz. Although initially HF-USG was introduced to measure skin thickness, it currently gained widespread acceptance in dermato-oncology, primarily when used to determine skin tumor margins. Moreover, its application in different dermatology fields is known, particularly as a rapidly evolving method in the objective evaluation of the severity of various chronic skin diseases. Among different specialties, teledermatology belongs to leading and continually developing areas of successful telemedicine applications. Various skin conditions are visible to the human eye, which makes them particularly suitable for telemedicine. However, HF-USG enables specialists to look into deeper skin layers, thus extending diagnostic options. On the other hand, teledermatology creates the possibility of sending images for consultation and facilitates the therapeutic decision as HF-USG can be used in an asynchronous store and forward manner. It seems that HF-USG and teledermatology may be regarded as a truly matched pair. The aim of this work is to present current applications of 20-MHz ultrasonography in dermatology, including skin neoplasms and chronic skin diseases. Moreover, the authors aimed to analyze the possibilities of HF-USG use as a valuable tool in teledermatology, especially in diagnosing and monitoring patients suffering from long-lasting skin conditions.

Background: Acne vulgaris is one of the most common skin diseases. One of the therapeutic options recommended for severe acne or acne that has not responded to previous therapies is isotretinoin. However, its use may lead to adverse changes in the serum lipid profile and increased levels of transaminases. In this study, we evaluated the effect of supplementation with evening primrose oil in acne vulgaris patients treated with isotretinoin on blood lipid parameters and transaminase activity. Methods: Study participants were randomly assigned to two treatments: conventional with isotretinoin (25 patients) and novel with isotretinoin combined with evening primrose oil (4 × 510 mg/day; 25 patients) for 9 months. Results: Compared to isotretinoin treatment, isotretinoin treatment combined with evening primrose oil had a positive effect on TCH concentrations (mean: 198 vs. 161, p < 0.001), LDL (95.9 vs. 60.2, p < 0.001), HDL (51.0 vs. 48.0, p < 0.001), TG (114 vs. 95.0, p < 0.001), ALT (24.0 vs. 22.0, p < 0.001), and AST (28.0 vs. 22.0, p < 0.001), but had no effect on the energy and ingredient content of the diets (p > 0.05) after treatment. Conclusion: Evening primrose oil was found to have beneficial effects on lipid profiles and transaminase activity during isotretinoin treatment. However, longer studies are needed to make more reliable decisions regarding the use of evening primrose oil and its safety in clinical practice. The evening primrose oil treatment group also showed a reduction in dietary energy due to a reduction in dietary protein and carbohydrates.

Due to increasing resistance of pathogenic fungi to antifungal treatments, new types of drugs are needed. For this purpose, active substances with antifungal properties occurring in natural compounds should be considered. The herb Psephellus bellus shows strong antifungal activity and is characterized by unique guaianolides, which have an ester on C-2. Thus, a specialized method of isolation and testing was applied to assess the pharmacological effects of these guaianolides. After phytochemical analysis (chromatography and spectral methods), selected lipophilic compounds and the herb extract of this species containing 26 sesquiterpene lactones were tested. The antifungal effect of the herbal compounds was determined on clinical strains of fungi Candida, Rhodotorula, Trichophyton, Microsporum, and Scopulariopsis using a diffusion test. The MTT assay was employed to study the cytotoxic effects of the extract against human fibroblasts. Statistical analysis was performed. All analyzed compounds exhibited antifungal activity in cultivations suitable for assessment. Most lipophilic cebellins from Psephellus bellus prevent the growth of most fungal strains.

Introduction. The superficial mycoses remain a group of diseases of public health significance. The increased incidence of mycoses is related, among other factors, to deficiency of the immune system, coexisting systemic and dermatological diseases, long-term, non-target antibiotic therapy and the increase in the number of people at risk of immunosuppression. Objective. To analyze the etiology and epidemiology of mycosis in patients under 18 years of age in the years 2013–2016 diagnosed in the Unit of Medical Mycology at the Department of Dermatology, Poznan University of Medical Sciences. Material and methods . A retrospective, etiological and epidemiological analysis was performed on the incidence of superficial mycosis in 295 patients under 18 years of age diagnosed in the years 2013–2016 in the Unit of Medical Mycology at the Department of Dermatology, Poznan University of Medical Sciences. Results . The study group included mostly cases of dermatophytic superficial mycosis of the scalp with prevalent zoophilic species, including Microsporum canis as the most common. Conclusions. Superficial mycoses are common during childhood. Increased incidence of certain forms of superficial mycoses in children has been observed, for example infections transmitted from exotic animals or onychomycosis.

Background Acceptance of disease is an important determinant of quality of life in psoriasis patients. Social support and positive body image are considered important contributors to coping with the disease, but no studies have yet examined the role of body image and body experience in relation to psychological adjustment to psoriasis. We aimed to identify the role of biopsychosocial aspects – medical characteristics, body image, body experience, and social support – in acceptance of psoriasis. Participants and procedure The Berlin Social Support Scale, the Acceptance of Illness Scale, and the Body-Self Questionnaire (BSQ) were administered to 109 patients. Disease severity was measured with the Psoriasis Area and Severity Index (PASI). Results None of the investigated medical aspects were related to disease acceptance. Disease acceptance was associated with perceived social support (instrumental, informational, and emotional) and the following aspects of body experience and body image: lack of disturbances in perceiving, interpretation and regulation of emotions and physiological needs, appearance satisfaction, acceptance of biological sex, and fitness satisfaction. The acceptance of appearance and biological sex and social support were the best predictors, explaining 33% of the variance in disease acceptance (R2 = .33, F = 18.93). Conclusions Disease acceptance is independent of medical disease parameters, which demonstrates the limitations of the biomedical model in explaining the process of coping with psoriasis. Our findings demonstrate the buffering effect of social support, positive body image, and body experience against the negative consequences of psoriasis. Psychological intervention focused on body image and body experience enhancement can support psychological adjustment to disease.

Introduction. Frequent occurrence of elevated nickel levels in everyday items explains why allergic contact dermatitis to nickel is the most common in the general population. In Northern America and Europe, 20% of the general population suffers from contact dermatitis while 8.6% of patients suffering from contact dermatitis are allergic to nickel. Material and Methods. A group of 25 patients (24 females and 1 male) sensitized to nickel and cobalt on the basis of patch testing was analyzed during a 2-year-long period in Department of Dermatology Poznań University of Medical Sciences. Contact allergy to nickel and cobalt was confirmed with the positive result of patch test, conducted with the Polish Standard Series of chemotechnique. Results. An excessive nickel release was detected in over a quarter of the tested items, respectively in 7.5% of jewellery, 57.89% of clothing accessories, 56.89% of other utility goods, such as keys, telephones or stationery. Cobalt excessive release was found in 7.3% of tested items, respectively in none of jewellery and kitchen accessories, 25% of clothing accessories, 12.5% of other utility goods (keys, pens, pendants). Conclusions. In general, everyday-use items are not nickel-free and more legislation steps are necessary to provide it and prevent initial sensitization in future generations. Several articles of every-day use release nickel and cobalt above migration limits.

Fungal infections are very commonly occurring diseases in everyday dermatological practice, and knowledge of the wide spectrum of antifungal preparations available nowadays is helpful in almost all medical disciplines. The treatment of fungal infections should be preceded with a proper diagnosis based on the patient’s history, precise clinical examination and diagnostic mycological procedures. A correct diagnosis of fungal infection is possible by its confirmation with proper investigations carried out in a mycological laboratory. The main criteria of diagnosis of fungal infection justifying its therapy is isolation and identification of the fungal pathogen from the patient. In the review of the treatment of the fungal infections most commonly occurring in dermatological practice, the best known antifungals currently used in our country, whose usefulness in clinical practice has been confirmed by long-term observations, are presented. We hope that the presented treatment proposals of the most commonly occurring superficial fungal infections will be helpful in everyday medical practice.

Psoriasis is a chronic inflammatory skin disease affecting about 1–3% of the general population. Recent years have seen great development in the treatment of this dermatosis, especially regarding moderate to severe psoriasis. More numerous and more widely available systemic therapies raise new challenges for all physicians treating patients with psoriasis. New questions arise about patients’ follow-up and long-term safety of such therapies. To meet the expectations of Polish dermatologists, we have prepared a second part of guidelines on the treatment of psoriasis, particularly concentrated on the therapy of severe forms of this disease. We hope that our suggestions will be valuable for physicians in their daily clinical practice. However, we would like to underline that every guideline is characterized by some vagueness, and the final decision about diagnosis and therapy should always be made individually for every patient based on the patient’s current clinical status and the most up-to-date scientific literature data.

In recent years we can observe a dynamic increase in skin cancers in whose pathogenesis exposure to ultraviolet radiation (UVR) plays an important role. Actinic keratosis (AK) is a common skin disease, characterized by hyperkeratotic lesions located on skin damaged by UVR (photodamaged skin) or senile skin, most frequently present in people of Caucasian origin. The most frequent risk factors for AK development are: elderly age, male sex, cumulative UVR dose, low skin phototype, living in equatorial regions and long-lasting administration of immunosuppressive agents. In various papers on pathogenesis of AK it was revealed that it is an initial form of lesions leading in consequence to development of skin cancers, especially squamous cell carcinoma (SCC). To date there clinical features of AK predisposing to development of SCC are not known, however, inflammation, diameter over 1 cm, rapid enlargement, bleeding and ulceration are considered as risk factors. AK may spontaneously regress, remain stay stable for many years or progress to SCC. This new concept on pathogenesis of AK caused a new approach to its treatment, with a special emphasis on field of cancerisation, with the use of 5-fluorouracil, imiquimod, photodynamic therapy and ingenol mebutate. In the article we present current knowledge on the pathogenesis of actinic keratosis, a review of therapeutic options and principle rules of prophylaxis.

Łuszczyca jest przewlekłą zapalną chorobą skóry dotyczącą około1–3% populacji rasy kaukaskiej. Wprowadzenie do leczenia tego schorzenialeków biologicznych, które cechują się dobrą skutecznościąi wysokim profilem bezpieczeństwa, spowodowało, że obecnie wieluchorych na łuszczycę może prowadzić normalny tryb życia. Z tegopowodu niezbędne jest, aby leki biologiczne były dostępne również dlapolskiej populacji pacjentów, zwłaszcza tych, u których inne metodyterapii okazały się nieskuteczne lub też nie mogą być stosowane. Obecnewytyczne opracowano w celu ułatwienia polskim dermatologomkwalifikowania pacjentów z łuszczycą do leczenia biologicznego i ichdalsze prowadzenie. Mamy nadzieję, że przedstawione wskazówkibędą cenną pomocą dla lekarzy, którzy dopiero rozpoczynają doświadczeniaz tą grupą leków.W polskich realiach ekonomicznych do leczenia biologicznego powinnibyć kwalifikowani pacjenci z łuszczycą zwyczajną o średnim lubdużym nasileniu, u których nie uzyskano poprawy po leczeniu z zastosowaniemprzynajmniej dwóch różnych metod tradycyjnej terapiiogólnej lub którzy mają przeciwwskazania do stosowania innychmetod terapii ogólnej. W przypadku łuszczycowego zapalenia stawówterapię lekami biologicznymi można rozważyć u pacjentów z jegoaktywną postacią, u których nie uzyskano wystarczającej poprawy pozastosowaniu przynajmniej dwóch przeciwreumatycznych leków modyfikujących przebieg choroby, podawanych w monoterapii lubpoliterapii. Autorzy nie rekomendują żadnego leku biologicznego jakopierwszego leku z wyboru. Decyzję tę lekarz podejmuje sam, w zależnościod indywidualnego przypadku i na podstawie bieżących danychpiśmiennictwa na temat ich skuteczności i bezpieczeństwa.

Wprowadzenie: Leczenie łuszczycy głowy owłosionej jest dużym problemem.Preparaty dotychczas stosowane nie zawsze są skuteczne,a także nie satysfakcjonują pacjentów. Cel pracy: Określenie skuteczności i bezpieczeństwa szamponu zawierającegopropionian klobetazolu u pacjentów z łuszczycą głowy owłosionej. Materiał i metodyka: U 29 pacjentów hospitalizowanych na OddzialeChorób Skóry Szpitala Wojewódzkiego w Poznaniu oceniano nasileniełuszczycy w obrębie głowy owłosionej za pomocą określenia stopnianacieku, złuszczania i rumienia, a także zajęcia powierzchni głowyowłosionej poprzez zmiany chorobowe. Lek stosowano przez 4 tygodnie,oceniając powyższe parametry co tydzień. W analizie wynikówuwzględniano zarówno ocenę stanu skóry dokonaną przez lekarza, jaki pacjenta. Wyniki: U wszystkich pacjentów uzyskano poprawę. Po 4 tygodniachstosowania preparatu zaobserwowano zmniejszenie powierzchni zajętejchorobowo z 45 do 5%. Średnia ocena leczenia przez lekarza wynosiła2,9 pkt, a przez pacjenta 2,8 pkt w 3-stopniowej skali. Stwierdzonorównież zmniejszenie objawów subiektywnych w postaci pieczeniaskóry w obrębie głowy owłosionej z 2,5 do 0 w skali 0–3. Nie odnotowanodziałań niepożądanych. Wnioski: Szampon z klobetazolem jest preparatem nie tylko skutecznym,ale również bezpiecznym i dobrze tolerowanym.

Treatment of acne inversa (also known as hidradenitis suppurativa) is complicated and chronic. This debilitating, inflammatory disease of the follicular sacks affects mostly young adults and has a strong negative impact on their quality of life. We present a case of a 28 year old woman with a history of acne inversa of Hurley grade 2 for 6 years. Patient underwent surgical excision of the skin of the left inguinum followed by negative pressure therapy dressings for 2 and a half weeks (5 dressing changes). This allowed a full closure of the wound after 12 weeks and formation of a well accepted scar. Patient’s pain decreased from 4.5 to 1.5 according to visual assessment scale. We also noted a 28 point decrease in disease severity score according to Sartorius scale and a 19 point decrease in Dermatology Life Quality Index. Two years prior admission patient had undergone surgical treatment of her right inguinum with split thickness skin grafting, which healed for 26 weeks and yielded less satisfactory results. Comparison photographs of both treatment results are presented.