Comparative Study of Quality of Life and Psychological Aspects in Patients with Psoriasis and Hidradenitis Suppurativa

Psoriasis and hidradenitis suppurativa are two common dermatological diseases that affect physical, social, and psychological aspects of the patients’ lives. The aim of this study was to compare quality of life, depression, anxiety, self-esteem, and loneliness in patients with psoriasis and hidradenitis suppurativa. One hundred and eight patients with psoriasis, 113 patients with hidradenitis suppurativa and 116 healthy controls were included in the study. The quality of life, depression, anxiety, and loneliness of the patients as well as their self-esteem were assessed using the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), the UCLA loneliness Scale (UCLA-Version 3) and the Rosenberg’s Self-esteem Scale (RSES), respectively. Patients with psoriasis (12.77±4.43) reported a higher mean impairment in DLQI than patients with hidradenitis suppurativa (11.10±6.53, P=0.028), in the univariate comparisons. Patients with psoriasis presented statistically significantly higher levels of anxiety and depression than both patients with hidradenitis suppurativa and healthy controls, while patients with hidradenitis suppurativa also had higher anxiety and depression compared with healthy controls. Patients with psoriasis (46.31±6.36) reported statistically significantly higher loneliness than both patients with hidradenitis suppurativa (43.18±7.40) and controls (40.42±4.41), while the patients with hidradenitis suppurativa also presented higher loneliness in comparison with controls. Lower levels of self-esteem were found in patients with psoriasis (15.08±3.11) compared with both patients with hidradenitis suppurativa (18.89±1.69) and controls (20.25±2.60), while patients with hidradenitis suppurativa also had lower self-esteem than controls. Significant levels of depression, anxiety, and impaired quality of life were strongly associated with disease severity. When patients with mild disease were compared, those with psoriasis presented with both higher levers of loneliness and lower scores for quality of life. Although both psoriasis and hidradenitis suppurativa are associated with impaired quality of life and psychological aspects, significantly worse scores were recorded in patients with psoriasis

Cytokines and Other Mediators in Alopecia Areata

Alopecia areata, a disease of the hair follicles with multifactorial etiology and a strong component of autoimmune origin, has been extensively studied as far as the role of several cytokines is concerned. So far, IFN-γ, interleukins, TNF-α, are cytokines that are well known to play a major role in the pathogenesis of the disease, while several studies have shown that many more pathways exist. Among them, MIG, IP-10, BAFF, HLA antigens, MIG, as well as stress hormones are implicated in disease onset and activity. Within the scope of this paper, the authors attempt to shed light upon the complexity of alopecia areata underlying mechanisms and indicate pathways that may suggest future treatments

Comparative Study of Quality of Life and Psychological Aspects in Patients with Psoriasis and Hidradenitis Suppurativa

Psoriasis and hidradenitis suppurativa are two common dermatological diseases that affect physical, social, and psychological aspects of the patients’ lives. The aim of this study was to compare quality of life, depression, anxiety, self-esteem, and loneliness in patients with psoriasis and hidradenitis suppurativa. One hundred and eight patients with psoriasis, 113 patients with hidradenitis suppurativa and 116 healthy controls were included in the study. The quality of life, depression, anxiety, and loneliness of the patients as well as their self-esteem were assessed using the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), the UCLA loneliness Scale (UCLA-Version 3) and the Rosenberg’s Self-esteem Scale (RSES), respectively. Patients with psoriasis (12.77±4.43) reported a higher mean impairment in DLQI than patients with hidradenitis suppurativa (11.10±6.53, P=0.028), in the univariate comparisons. Patients with psoriasis presented statistically significantly higher levels of anxiety and depression than both patients with hidradenitis suppurativa and healthy controls, while patients with hidradenitis suppurativa also had higher anxiety and depression compared with healthy controls. Patients with psoriasis (46.31±6.36) reported statistically significantly higher loneliness than both patients with hidradenitis suppurativa (43.18±7.40) and controls (40.42±4.41), while the patients with hidradenitis suppurativa also presented higher loneliness in comparison with controls. Lower levels of self-esteem were found in patients with psoriasis (15.08±3.11) compared with both patients with hidradenitis suppurativa (18.89±1.69) and controls (20.25±2.60), while patients with hidradenitis suppurativa also had lower self-esteem than controls. Significant levels of depression, anxiety, and impaired quality of life were strongly associated with disease severity. When patients with mild disease were compared, those with psoriasis presented with both higher levers of loneliness and lower scores for quality of life. Although both psoriasis and hidradenitis suppurativa are associated with impaired quality of life and psychological aspects, significantly worse scores were recorded in patients with psoriasis

Pityriasis rubra pilaris presenting with an abnormal autoimmune profile: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Pityriasis rubra pilaris is an uncommon inflammatory and hyperproliferative dermatosis of juvenile or adult onset. The etiology of the disease is still unknown.</p> <p>Case presentation</p> <p>We present the cases of two Caucasian men aged 53 and 48 who presented with pityriasis rubra pillaris type 1; both patients also exhibited an abnormal immunological profile.</p> <p>Conclusion</p> <p>Pityriasis rubra pillaris is currently classified as a keratinization disorder. The abnormal immunological profile reported in our patients along with the comorbidity of pityriasis rubra pilaris with autoimmune disorders reported in the literature poses the question of a possible pathogenetic role for the immune response in this disorder.</p

IMMUNOHISTOCHEMICAL STUDY IN VARIOUS FORMS OF LEPROSY

THE PRESENT IMMUNOHISTOCHEMICAL WORK WAS UNDERTAKEN TO DETERMINE THE EXPRESSIONOF VARIOUS CELLULAR IMMUNOLOGICAL MARKERS ON DIFFERENT CELL POPULATIONS IN SKIN TISSUE SECTIONS FROM PATIENTS WITH HANSEN'S DISEASE, IN ORDER TO UNDERSTANDTHE IMMUNOLOGICAL MECHANISMS WHICH TAKE PART IN THE PATHOGENESIS OF THE DISEASE. THE MATERIAL CONSISTED OF 25 SPECIMENS. SEVEN SPECIMENS FROM THE TUBERCULOID GROUP WERE STUDIED, 7 FROM THE LEPROMATOUS, 5 FROM THE HISTOID, 4 FROM POSITIVE LEPROMIN REACTIONS AND 2 WERE INDETERMINATE CASES. THE INDIRECT IMMUNOPEROXIDASE AND THE APAAP IMMUNOENZYMIC PROCEDURES FOR STAINING SERIAL FROZEN SECTIONS WERE EMPLOYED. A SIGNIFICANT CELLULAR ACTIVITY WAS OBSERVED IN THE EPIDERMIS AS WELL AS IN THE DERMIS REFLECTING THE EFFORTS OF THE HOST TO ELICIT A DELAYED TYPE HYPERSENSITIVITY REACTION AND TO CONFRONT INFECTION WITH M. LEPRAE. THE IMMUNOPATHOGENESIS OF HANSEN'S DISEASE IS EXTREMELY COMPLEX, WHILE THE APPEARANCE OF THE ONE OR THE OTHER CLINICAL FORM DEPENDS ON THE LEVEL OF THE CELLULAR IMMUNE RESPONSE TO M. LEPRAE.ΣΤΗΝ ΑΝΟΣΟΙΣΤΟΧΗΜΙΚΗ ΑΥΤΗ ΕΡΓΑΣΙΑ ΜΕΛΕΤΗΘΗΚΑΝ 25 ΙΣΤΟΤΕΜΑΧΙΑ ΔΕΡΜΑΤΟΣ ΑΣΘΕΝΩΝ ΜΕ ΝΟΣΟ ΤΟΥ ΧΑΝΣΕΝ. ΜΕ ΤΙΣ ΑΝΟΣΟΕΝΖΥΜΙΚΕΣ ΜΕΘΟΔΟΥΣ ΤΗΣ ΕΜΜΕΣΗΣ ΑΝΟΣΟΥΠΕΡΟΞΕΙΔΑΣΗΣ ΚΑΙ ΤΗΣ APAAP ΔΙΕΡΕΥΝΗΘΗΚΑΝ 7 ΦΥΜΑΤΙΟΕΙΔΕΙΣ ΠΕΡΙΠΤΩΣΕΙΣ, 7 ΛΕΠΡΩΜΑΤΩΔΕΙΣ, 5ΙΣΤΙΟΕΙΔΕΙΣ, 4 ΑΝΤΙΔΡΑΣΕΙΣ ΛΕΠΡΟΜΙΝΗΣ ΚΑΙ 2 ΠΕΡΙΠΤΩΣΕΙΣ ΑΚΑΘΟΡΙΣΤΗΣ ΛΕΠΡΑΣ, ΩΣ ΠΡΟΣ ΤΟΥΣ ΔΙΑΦΟΡΟΥΣ ΚΥΤΤΑΡΙΚΟΥΣ ΠΛΗΘΥΣΜΟΥΣ ΚΑΙ ΥΠΟΠΛΗΘΥΣΜΟΥΣ ΜΕ ΣΚΟΠΟ ΤΗΝ ΚΑΛΥΤΕΡΗ ΚΑΤΑΝΟΗΣΗ ΤΩΝ ΚΥΤΤΑΡΙΚΩΝ ΑΝΟΣΟΛΟΓΙΚΩΝ ΜΗΧΑΝΙΣΜΩΝ ΠΟΥ ΣΥΜΜΕΤΕΧΟΥΝ ΣΤΗΝ ΠΑΘΟΓΕΝΕΣΗ ΤΗΣ ΝΟΣΟΥ. ΣΕ ΟΛΕΣ ΤΙΣ ΟΜΑΔΕΣ ΠΑΡΑΤΗΡΗΘΗΚΕ ΜΙΑ ΣΗΜΑΝΤΙΚΗ ΚΥΤΤΑΡΙΚΗ ΔΡΑΣΤΗΡΙΟΤΗΤΑ ΤΟΣΟ ΣΤΗΝ ΕΠΙΔΕΡΜΙΔΑ ΟΣΟ ΚΑΙ ΣΤΟ ΧΟΡΙΟ ΠΟΥ ΑΝΤΑΝΑΚΛΑ ΤΗΝ ΠΡΟΣΠΑΘΕΙΑ ΓΙΑ ΕΚΛΥΣΗ ΑΝΤΙΔΡΑΣΗΣ ΥΠΕΡΕΥΑΙΣΘΗΣΙΑΣ ΕΠΙΒΡΑΔΥΝΟΜΕΝΟΥ ΤΥΠΟΥ ΜΕ ΣΤΟΧΟ ΤΗΝ ΚΑΤΑΣΤΡΟΦΗ ΤΩΝ ΛΕΠΡΙΚΩΝ ΒΑΚΙΛΛΩΝ. Η ΑΝΟΣΟΠΑΘΟΓΕΝΕΣΗ ΤΗΣ ΝΟΣΟΥ ΤΟΥ ΧΑΝΣΕΝ ΕΙΝΑΙ ΕΞΑΙΡΕΤΙΚΑ ΠΟΛΥΠΛΟΚΗ, ΕΝΩ Η ΕΜΦΑΝΙΣΗ ΤΗΣ ΜΙΑΣ Η ΤΗΣ ΑΛΛΗΣ ΚΛΙΝΙΚΗΣ ΜΟΡΦΗΣ ΕΞΑΡΤΑΤΑΙ ΑΠΟ ΤΟ ΒΑΘΜΟ ΤΗΣ ΚΥΤΤΑΡΙΚΟΥ ΤΥΠΟΥ ΑΝΟΣΟΛΟΓΙΚΗΣ ΑΠΑΝΤΗΣΗΣ ΣΤΟ ΜΥΚΟΒΑΚΤΗΡΙΔΙΟ ΤΗΣ ΛΕΠΡΑΣ

Oxybutynin for the Treatment of Primary Hyperhidrosis: Current State of the Art

Oxybutynin is an anticholinergic drug with an emerging role in the treatment of hyperhidrosis. Several recent studies have documented that it is effective both in focal and generalized hyperhidrosis and shows universally good response among different groups of patients regardless of age, gender, and weight. The most common adverse event is dry mouth reported by almost all patients treated. The way this might affect long-term compliance and tolerability should be better investigated in the future

Immunoglobulin A pemphigus associated with immunoglobulin A gammopathy and lung cancer

Immunoglobulin (Ig)A pemphigus is a rare disease marked by a vesiculopustular eruption characterized by intercellular IgA deposition in the epidermis. It has clinical and histopathological heterogeneity and encompasses two subgroups: subcorneal pustular dermatosis type and intraepidermal neutrophilic IgA dermatosis type. IgA pemphigus has been rarely associated with monoclonal IgA paraprotein, myeloma and B-cell lymphoma in the past. We report the first case, to our knowledge, of a 47-year-old male patient with a subcorneal pustular dermatosis type of IgA pemphigus associated with IgA gammopathy and lung cancer

Treatment of Mycosis Fungoides with Bexarotene Results in Remission of Diffuse Plane Xanthomas

Background: Cutaneous xanthomas develop as a result of intracellular and dermal deposition of lipids in either hyper- or normolipidemic patients. Plane xanthomas may signal the presence of an underlying monoclonal gammopathy, chronic myelomonocytic leukemia, or cutaneous T-cell lymphoma. Investigators have suggested that xanthomatized T cells may result in induction of plane xanthomas. Methods: We report the case of a patient with mycosis fungoides (MF) and plane xanthomas who was treated with bexarotene for his MF. Results: Significant improvement in the clinical signs of MF was observed within 3 months. We also observed a substantial regression of the xanthomas after 5 months of treatment. Complete clinical remission of both the MF and xanthomas was obtained after 6 months. The patient was still free of xanthomas after 3 years of follow-up. Conclusion: Bexarotene led to the clearing of the cutaneous lesions of cutaneous T-cell lymphoma and plane xanthomas. This may be due to an effect of bexarotene on the aberrant T cells that may cause xanthomatization

Treatment of bromhidrosis with a glycine-soja sterocomplex topical product

Aims Bromhidrosis is a common problem with a severe negative impact on the patient’s social and emotional life. The objective of this open-label study was to evaluate the efficacy and safety of a local product with the main active ingredient of glycine-soja sterocomplex in the treatment of local bromhidrosis. Patients/methods Eighteen patients with axillary bromhidrosis and eight patients with bromhidrosis of the genital area were included. Bromhidrosis was evaluated through a sniff test of a worn garment on a four-point scale. Patients applied a glycine-soja sterocomplex topical agent twice daily on the affected areas for 15 days and bromhidrosis was evaluated again. Results Subjective mean level of bromhidrosis at baseline was 3.50 +/- 0.50 and after treatment 1.53 +/- 0.51. Mean impact on quality of life at baseline was 3.30 +/- 0.48 and after treatment 1.30 +/- 0.49. Investigators objective evaluation revealed an improvement in intensity of odor from 3.23 +/- 0.83 to 1.53 +/- 0.53 and in acceptability of odor from 3.1 +/- 1.01 to 1.65 +/- 0.76. Conclusions The glycine-soja sterocomplex topical agent shows encouraging improvement on both the intensity and quality of odor in patients with bromhidrosis and has a profound improvement on the patients’ quality of life without any side effects