Lipid Disturbances in Psoriasis: An Update

Psoriasis is a common disease with the population prevalence ranging from 2% to 3%. Its prevalence in the population is affected by genetic, environmental, viral, infectious, immunological, biochemical, endocrinological, and psychological factors, as well as alcohol and drug abuse. In the recent years, psoriasis has been recognised as a systemic disease associated with numerous multiorgan abnormalities and complications. Dyslipidemia is one of comorbidities in psoriatic patients. Lipid metabolism studies in psoriasis have been started at the beginning of the 20th century and are concentrated on skin surface lipids, stratum corneum lipids and epidermal phospholipids, serum lipids, dermal low-density lipoproteins in the psoriatic skin, lipid metabolism, oxidative stress and correlations between inflammatory parameters, lipid parameters and clinical symptoms of the disease. On the basis of the literature data, psoriasis can be described as an immunometabolic disease

Somatyczne i pozasomatyczne problemy związane z łuszczycą w ciąży

Zmiany hormonalne, metaboliczne oraz immunologiczne występujące w okresie ciąży w istotny sposób wpływają na funkcjonowanie skóry. Łuszczyca należy do najczęstszych schorzeń dermatologicznych i zaliczana jest do nieswoistych dermatoz okresu ciąży. Celem artykułu jest przedstawienie znaczenia wsparcia w przebiegu łuszczycy u kobiet ciężarnych. Ciąża w różny sposób wpływa na przebieg łuszczycy. Łuszczyca może powodować wystąpienie nawracających poronień, przewlekłego nadciśnienia tętniczego, cukrzycy, otyłości prowadząc do wystąpienia powikłań okołoporodowych i porodu przedwczesnego. W sytuacji stwierdzenia współistnienia łuszczycy w ciąży konieczne jest wdrożenie profilaktyki w sferze emocjonalnej i objęcie ciężarnych wsparciem i opieką psychoterapeutyczną. Wspieranie ciężarnej z łuszczycą wymaga od personelu medycznego umiejętności oceny stanu psychicznego kobiety oraz wiedzy w zakresie chorób skóry.Hormonal, metabolic and immunological changes occurring during pregnancy have significant effects on the function of the skin. Psoriasis is one of the most common dermatological diseases and it is known as a nonspecific dermatosis in pregnancy. The aim of this article is to present the importance of support in the course of psoriasis in pregnant women. Psoriasis may cause recurrent miscarriages, chronic hypertension, diabetes or obesity, leading to perinatal complications and premature birth. The coexistence of psoriasis and pregnancy requires emotional prophylaxis, as well as support and psychotherapeutic care. Medical staff requires knowledge of skin diseases and skills to assess a patient’s mental state

Somatyczne i pozasomatyczne problemy związane z łuszczycą w ciąży

Hormonal, metabolic and immunological changes occurring during pregnancy have significant effects on the function of the skin. Psoriasis is one of the most common dermatological diseases and it is known as a nonspecific dermatosis in pregnancy. The aim of this article is to present the importance of support in the course of psoriasis in pregnant women. Psoriasis may cause recurrent miscarriages, chronic hypertension, diabetes or obesity, leading to perinatal complications and premature birth. The coexistence of psoriasis and pregnancy requires emotional prophylaxis, as well as support and psychotherapeutic care. Medical staff requires knowledge of skin diseases and skills to assess a patient’s mental state.Zmiany hormonalne, metaboliczne oraz immunologiczne występujące w okresie ciąży w istotny sposób wpływają na funkcjonowanie skóry. Łuszczyca należy do najczęstszych schorzeń dermatologicznych i zaliczana jest do nieswoistych dermatoz okresu ciąży. Celem artykułu jest przedstawienie znaczenia wsparcia w przebiegu łuszczycy u kobiet ciężarnych. Ciąża w różny sposób wpływa na przebieg łuszczycy. Łuszczyca może powodować wystąpienie nawracających poronień, przewlekłego nadciśnienia tętniczego, cukrzycy, otyłości prowadząc do wystąpienia powikłań okołoporodowych i porodu przedwczesnego. W sytuacji stwierdzenia współistnienia łuszczycy w ciąży konieczne jest wdrożenie profilaktyki w sferze emocjonalnej i objęcie ciężarnych wsparciem i opieką psychoterapeutyczną. Wspieranie ciężarnej z łuszczycą wymaga od personelu medycznego umiejętności oceny stanu psychicznego kobiety oraz wiedzy w zakresie chorób skóry

Plasma Interleukin-18 and Dendritic Cells in Males with Psoriasis Vulgaris

Peripheral blood dendritic cells seem to play a crucial role in psoriatic inflammatory processes. The aim of our study is to investigate the relationship between plasma interleukin-18 (IL-18) levels and blood dendritic cells in psoriatic patients. IL-18 plasma levels were measured by ELISA. Phenotypes of dendritic cell subsets were analyzed by double-colour flow cytometry. Plasma IL-18 level in psoriatic males was significantly higher, whereas counts of BDCA-2+ cells were lower than in the control group. The myeloid/plasmacytoid ratio was significantly higher in the patient group compared to the control one. In the patient group, significant negative correlations between plasma IL-18 level and both the BDCA-1+ and BDCA-2+ counts were found. BDCA-1+ counts correlated negatively with percentage of skin involvement. IL-18 seems to play a role in psoriasis pathogenesis. The decreased counts of blood plasmacytoid DCs in psoriatic patients might result from IL-18 down-regulation of plasmacytoid DC precursor proliferation

Hepato-Splenic and Lipid Profile Abnormalities – Do They Exist in Children Affected with Vitiligo?

Autoimmune disturbances and metabolic abnormalities observedin vitiligo, a disease of still unclear etiology, may provide evidence onthe systemic nature of the disease. The aim of the study was to assess functionaland morphological parameters of the liver and spleen, as well as thelipid profile in vitiligo-affected children, in order to ascertain whether anymetabolic abnormalities or structural changes in these organs accompaniedthe course of vitiligo. The study included 34 patients with vitiligo hospitalizedat the Department of Dermatology at the Medical University of Lublin and acontrol group of 35 healthy individuals, aged 7-15 years. Children with the activephase of vitiligo and at least 6 month history of vitiligo lesions were studied.Ultrasound examination of the liver and spleen enabled assessment of thesize and parenchyma of the organs. Liver and spleen functions were assessedby means of the following additional examinations: blood test, transaminases,protein electrophoresis, lipid profile, autoantibodies, and HCV antibodies. Thesize of the liver was not significantly different in the vitiligo and control groups.The ultrasonographic pictures of the spleen revealed no abnormalities in organsize and structure. The concentration of HDL-cholesterol was significantlylower, whereas the concentration of LDL-cholesterol was significantly higherin patients with vitiligo than in healthy controls. The value of the LDL/HDL ratiowas significantly higher in vitiligo patients. The results of our study indicatelipid disturbances in vitiligo-affected children. Since no structural and functionalabnormalities in the liver and spleen were found, it seems likely thatlipid disturbances in vitiligo may result from disturbed metabolic processes inthe adipose tissue as well as from oxidative stress

Psoriasis and menopause : part I : impact of psoriasis on quality of life in women in peri- and postmenopausal age

Niniejszy artykuł stanowi przegląd piśmiennictwa medycznego na temat wpływu przewlekłej choroby skóry, jaką jest łuszczyca, na jakość życia u kobiet w wieku około- i pomenopauzalnym. W badaniach poświęconych tej kwestii pojawia się coraz więcej doniesień dotyczących istnienia zależności pomiędzy zaawansowaniem zmian skórnych a stanem psychicznym pacjentek w okresie klimakterium. Autorzy publikacji podkreślają zasadność holistycznego spojrzenia na pacjenta z uwzględnieniem jego potrzeb zarówno na poziomie biologicznym, jak i psychologicznym. Wszystkie te kwestie wydają się bowiem istotne dla poprawy jakości życia kobiet w wieku okołomenopauzalnym ze współwystępującą łuszczycą.This article is a review of medical literature on the effects of chronic skin disease that is psoriasis on the quality of life in women in peri- and postmenopausal age. In studies on this issue there is a growing literature about the existence of the relationship between the severity of skin lesions and mental state of women during menopause. Authors emphasize the legitimacy of a holistic approach to the patient, taking into account their needs at both the biological and psychological levels. All these issues seem to be vital for improving the quality of life in perimenopausal women with co-occurring psoriasis

Systemic sclerosis : diagnostic and therapeutic recommendations of the Polish Dermatological Society : part 2 : treatment

Systemic sclerosis is an immune-mediated disease characterized by a chronic progressive course. The complex and diverse clinical features seen in patients require case-by-case approach and cooperation of multiple specialists both at the stage of diagnosis and treatment. Critical factors in systemic sclerosis include early diagnosis, assessment of internal organ involvement, identification of patients at potential risk of organ complications, assessment of disease dynamics and activity, and implementation of optimal therapy. Treatment decisions should be made individually for each patient after careful consideration of such aspects as the severity of skin lesions, duration and activity of the disease, manifestations and possible internal organ involvement. On account of potential organ dysfunctions, patients require a multidisciplinary therapeutic approach and coordinated treatment by experienced specialists or in specialist medical centres. Part 2 presents current guidelines for the treatment of systemic sclerosis

Suppressed Programmed Death 1 Expression on CD4 +

Psoriasis is a chronic inflammatory disease mediated by T cell immunity. Programmed death 1 (PD-1), a coinhibitory receptor, plays an important role in immune regulation and maintaining peripheral tolerance. The aim of the study was to compare the expression of PD-1 on the peripheral T cells between psoriatic patients and healthy controls. The study included 75 psoriatic patients and 52 healthy volunteers. The percentages and absolute numbers of CD3+, CD4+, CD8+, CD4+PD-1+, and CD8+PD-1+ T cells were analyzed using flow cytometry. The absolute numbers and percentages of CD4+PD-1+ and CD8+PD-1+ T cells were significantly decreased in the psoriatic patients in comparison with the control group. No significant correlations were found between the absolute numbers and percentages of CD4+PD-1+ or CD8+PD-1+ T cells and clinical characteristics of psoriasis. Decreased PD-1 expression on the T cells may be responsible for impaired negative regulation of immune response in psoriasis pathogenesis