Zespół Sweeta — etiopatogeneza, obraz kliniczny, diagnostyka, leczenie

Zespół Sweeta jest rzadko występującym schorzeniem o charakterze zapalnym, należącym do grupy dermatoz neutrofilowych. Charakteryzuje się nagłym występowaniem zmian skórnych o charakterze grudek, guzków, blaszek z towarzyszącą gorączką i leukocytozą. Zazwyczaj wyróżnia się następujące podtypy zespołu: klasyczny, związany z nowotworami i indukowany przez leki. Etiopatogeneza zespołu Sweeta pozostaje niejasna. Zespół bywa poprzedzony infekcją układu oddechowego, układu pokarmowego, szczepieniem bądź współwystępuje z chorobą nowotworową, chorobą zapalną lub ciążą. Dla zespołu Sweeta charakterystyczna jest dobra odpowiedź na leczenie ogólne preparatami glikokortykosteroidowymi i szybkie ustępowanie wykwitów. Średnio u jednej trzeciej pacjentów zmiany nawracają. Słowa kluczowe: ostra gorączkowa dermatoza neutrofilowa, dermatozy neutrofilowe, zespół Sweet

Nail involvement in psoriatic arthritis

Nail psoriasis is considered a significant psychological and social problem causing functional impairment in affected patients. Nail changes hamper their daily and occupational activities and contribute to a worse quality of life. Almost 50% of patients with psoriasis vulgaris and up to 80% of patients with psoriatic arthritis are afflicted with nail lesions. The important correlation between psoriatic arthritis and nail changes is well established – the presence of the latter is a strong predictor of the development of arthritis. There is a broad spectrum of nail dystrophies associated with psoriasis, ranging from the common pitting, subungual hyperkeratosis and loosening of the nail plate to less frequent discolouration and splinter haemorrhages. Some of these symptoms are also observed in other nail diseases, and further diagnostics should be performed. The assessment tools NAPSI (Nail Psoriasis Severity Index), mNAPSI (Modified Nail Psoriasis Severity Index), and PNSS (Psoriasis Nail Severity Score) are most commonly used to grade the severity of nail involvement in psoriasis and enable the evaluation of therapy effectiveness. The treatment of nail psoriasis is a major clinical challenge. It should be adjusted to the extent of dermal, articular and ungual lesions. Systemic therapies of psoriasis, especially biological agents, are most likely to be effective in treating nail psoriasis. However, as their use is limited in scope and safety, topical therapy remains a mainstay, and the combination of corticosteroids and vitamin D3 analogues is considered to be most helpful

Sweet’s syndrome — etiopathogenesis, clinical presentation, diagnosis, treatment

Zespół Sweeta jest rzadko występującym schorzeniem o charakterze zapalnym, należącym do grupy dermatoz neutrofilowych. Charakteryzuje się nagłym występowaniem zmian skórnych o charakterze grudek, guzków, blaszek z towarzyszącą gorączką i leukocytozą. Zazwyczaj wyróżnia się następujące podtypy zespołu: klasyczny, związany z nowotworami i indukowany przez leki. Etiopatogeneza zespołu Sweeta pozostaje niejasna. Zespół bywa poprzedzony infekcją układu oddechowego, układu pokarmowego, szczepieniem bądź współwystępuje z chorobą nowotworową, chorobą zapalną lub ciążą. Dla zespołu Sweeta charakterystyczna jest dobra odpowiedź na leczenie ogólne preparatami glikokortykosteroidowymi i szybkie ustępowanie wykwitów. Średnio u jednej trzeciej pacjentów zmiany nawracają.Sweet’s syndrome is a rare inflammatory disorder belonging to the group of neutrophilic dermatoses. It is characterized by a sudden onset of skin lesions such as papules, nodules, plaques, accompanied by fever and leukocytosis. The syndrome is typically classified into the following subtypes: classical, malignancy-associated and drug-induced. The etiopathogenesis of Sweet’s syndrome remains unclear. The syndrome is sometimes preceded by infection of the respiratory system, digestive system, vaccination or coexists with neoplastic disease, inflammatory disease or pregnancy. A characteristic feature of Sweet’s syndrome is a good response to systemic treatment with glucocorticosteroids and a rapid resolution of the lesions. On average, one third of patients have recurrent lesions

The Role of Epigenetic Factors in Psoriasis

Psoriasis is a chronic, systemic, immune-mediated disease with an incidence of approximately 2%. The pathogenesis of the disease is complex and not yet fully understood. Genetic factors play a significant role in the pathogenesis of the disease. In predisposed individuals, multiple trigger factors may contribute to disease onset and exacerbations of symptoms. Environmental factors (stress, infections, certain medications, nicotinism, alcohol, obesity) play a significant role in the pathogenesis of psoriasis. In addition, epigenetic mechanisms are considered result in modulation of individual gene expression and an increased likelihood of the disease. Studies highlight the significant role of epigenetic factors in the etiology and pathogenesis of psoriasis. Epigenetic mechanisms in psoriasis include DNA methylation, histone modifications and non-coding RNAs. Epigenetic mechanisms induce gene expression changes under the influence of chemical modifications of DNA and histones, which alter chromatin structure and activate transcription factors of selected genes, thus leading to translation of new mRNA without affecting the DNA sequence. Epigenetic factors can regulate gene expression at the transcriptional (via histone modification, DNA methylation) and posttranscriptional levels (via microRNAs and long non-coding RNAs). This study aims to present and discuss the different epigenetic mechanisms in psoriasis based on a review of the available literature

In the Pursuit of Metabolic Markers of Systemic Sclerosis—Plasma Adiponectin and Omentin-1 in Monitoring the Course of the Disease

Systemic sclerosis (SSc) is a connective tissue disease leading to cutaneous and visceral fibrosis. Pathological features of SSc include immune dysregulation, vasculopathy, and impaired angiogenesis. Adipokines act as cytokines and hormones and are involved in various pathological processes, including metabolic disorders, inflammation, vasculopathy, and fibrosis. This study aimed to determine the level of omentin-1 and adiponectin to evaluate their potential role in the pathogenesis of SSc. We assessed serum omentin-1 and adiponectin as well as metabolic parameters in 58 patients with SSc and 30 healthy controls. The follow-up was performed in SSc individuals. Omentin-1 levels were significantly higher in SSc individuals as compared to the controls. In post-hoc analysis, omentin-1 was higher in the group with disease duration ≥7 years than in the control group. A positive correlation was noted between disease duration and both adipokines and increased with longer disease duration. However, there were no correlations between selected adipokines and metabolic parameters. Enhanced omentin-1 levels and higher levels of omentin-1 in patients with longer disease duration may suggest that omentin-1 is involved in the pathomechanisms of SSc as its concentrations are not directly related to BMI, age, and insulin resistance

Skin manifestations of neuroendocrine neoplasms: review of the literature

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

The prevalence of SARS-CoV-2 infection and the severity of the course of COVID-19 in patients with psoriasis treated with biologic therapy

Background Biologics are used for the treatment of patients with moderate to severe psoriasis. According to the recommendations of major global dermatological associations, patients who had not reported clinical symptoms or close contact with a confirmed/probable COVID-19 case in the last 14 days can continue biologic therapy. Objective The aim of our study was to determine the prevalence of SARS-CoV-2 infection, its clinical manifestations and the influence of COVID-19 on the course of the underlying disease in patients with moderate to severe psoriasis and aggressive psoriatic arthritis undergoing biologic therapy. Material and methods All 61 patients with moderate to severe psoriasis treated with biologics in the Dermatology Department of Central Clinical Hospital of Ministry of the Interior and Administration in Warsaw were enrolled into the study. Firstly, the medical histories of these patients were assessed for occurrence of severe adverse events, COVID-19 symptoms and deaths. Afterwards, the prevalence of serum anti-SARS-CoV-2 antibodies, and severity of COVID-19 were assessed. Results Ten patients in the study group have developed anti-SARS-CoV-2 antibodies. One patient presented with mild COVID-19 symptoms. Conclusion While our study had a small sample size, ongoing biologic treatment in psoriasis was not associated with severe form of COVID-19