Evaluation of the use of betamethasone dipropionate with calcipotriol foam in patients with psoriasis

Łuszczyca jest przewlekłą dermatozą zapalną, która u większości pacjentów wymaga leczenia miejscowego oraz właściwej pielęgnacji skóry. Z uwagi na tempo obecnego życia, brak czasu oraz chęci wśród pacjentów do aplikowania nieakceptowalnych kosmetycznie preparatów recepturowych, osoba chorująca na łuszczycę oczekuje pomocy oraz wskazania leku miejscowego łatwego i skutecznego w codziennym stosowaniu. Pomimo że indywidualizacja leczenia pozostaje ważna, istnieje zapotrzebowanie, aby uzyskać jak najlepsze wyniki leczenia u jak największej liczby pacjentów. Jedną z dostępnych opcji terapii miejscowej dla pacjentów z łagodną i umiarkowaną postacią łuszczycy jest lek złożony zawierający kalcypotriol/dipropionian betametazonu (Cal/BD) w pianie. W niniejszej pracy przedstawiono i omówiono przypadki dotyczące leczenia skóry gładkiej oraz owłosionej skóry głowy z wykorzystaniem preparatu dipropionianu betametazonu z kalcypotriolem w pianie. Celem pracy była ocena krótkookresowej i długotrwałej skuteczności preparatu dipropionianu betametazonu z kalcypotriolem w pianie u pacjentów z łuszczycą. Obserwacje zostały przeprowadzone u pacjentów z łuszczycą podczas 3-miesięcznego oraz 6-miesięcznego okresu leczenia preparatem miejscowym zawierającym dipropionian betametazonu z kalcypotriolem w formie piany. Zwrócono uwagę na zasady leczenia miejscowego łuszczycy w codziennie praktyce dermatologicznej. W pracy omówiono efektywność kliniczną oraz zalecenia dotyczące leczenia miejscowego preparatem dipropionianu betametazonu z kalcypotriolem w pianie u pacjentów z łuszczycą w okresie długofalowym, ze szczególnym uwzględnieniem terapii proaktywnej.Psoriasis is a chronic inflammatory dermatosis that requires topical treatment and care in most patients. Due to the current pace of life,lack of time and unwillingness of patients to apply cosmetically unacceptable topical preparations, a person suffering from psoriasisexpects help and an indication of an easy-to-use and effective topical preparation. Currently, several topical treatments are available forpsoriasis patients. Although individualization of treatment remains important, there is a demand to achieve the best possible treatmentoutcomes in the greatest number of patients. This paper presents and discusses cases involving the treatment of skin and scalp witha foam formulation of betamethasone dipropionate with calcipotriol.The aim of the study was to assess the use of combination of betamethasone dipropionate and calcipotriol in patients with psoriasis.The observation was performed during a 3-month and 6-month treatment period with a topical combination of betamethasone dipropionateand calcipotriol in foam, in patients with psoriasis. The principles of local treatment of psoriasis in daily dermatological practicehave been emphasized.The paper discusses the use of the topical treatment with the combination of betamethasone dipropionate and calcipotriol in patientswith psoriasis in the long term outcome, with particular emphasis on proactive therapy

Cognitive impairment in patients with severe psoriasis

Introduction : Psoriasis is a chronic inflammatory skin disease, in which an important role is played by psychological factors. Aim : To evaluate the frontal cognitive functions in patients with psoriasis. Material and methods : The study included 188 subjects (97 patients with psoriasis and 91 healthy controls). To assess the dorsolateral prefrontal cortex functions, the Trail Making Test and the Stroop test were applied. Severity of psoriasis was assessed by means of the PASI index. Results : Compared to healthy subjects, psoriatics scored lower in neuropsychological tests assessing memory and executive functions. Conclusions : Cognitive dysfunction disclosed by neuropsychological assessment of frontal functions was evident in patients with psoriasis

Toxic epidermal necrolysis: a study of 3 cases and review

Toxic epidermal necrolysis syndrome is a life-threatening adverse skin reaction requiring admission to dermatology wards or intensivecare units. Preceded by fever and general malaise, the condition leads to the separation of the epidermis from the dermis resulting inlarge erosions. Epidermal loss results in loss of fluid and electrolytes as well as an increased risk of infections. The above paper presentsa description of 3 patients treated for toxic epidermal necrolysis. The first patient, in addition to typical skin involvement, had lesions onthe eyes and in the throat, thus the treatments required cooperation with a laryngologist and ophthalmologist. The second patient, dueto his mental disorder, caused numerous difficulties in the ward, which disrupted its work, as the ward does not have doctors on duty24 hours a day. A third patient with cirrhosis had a rapidly progressing disease that did not respond to any form of treatment. For the firsttwo patients, intravenous immunoglobulin therapy proved crucial for recovery, while the third patient died due to a lack of underlyingdisease treatment options. The most common cause of Lyell’s syndrome is medications, mainly antiepileptics, and antibiotics, althoughthe list of substances that can cause the syndrome has been growing in recent years. There are no new global guidelines and current onesemphasize drug withdrawal, topical treatment and early assessment via the SCORTEN scale. The role of systemic steroid therapy, remainsunclear, although recent evidence suggests that it could potentially reduce mortality. Cyclosporine and intravenous immunoglobulinshave been gaining prominence in recent years for the treatment of this condition

The incidence and management of cutaneous adverse events of the epidermal growth factor receptor inhibitors

Overexpression of the epidermal growth factor receptor (EGFR) is found in many cancers, including those of the head and neck area, non-small-cell lung cancer, and colorectal, cervical, prostate, breast, ovary, stomach, and pancreatic cancer. The EGFR inhibitors are used at present in the treatment of such cancers. Skin lesions that develop during and after cancer treatment may be due to specific cytostatics, molecular-targeted drugs, radiation therapy, complementary therapy, or the cancer itself, and hence knowledge is essential to distinguish between them. The mechanism through which skin toxicity arises during treatment with EGFR inhibitors is not well known, but seems to be due to the modification of the RAS/RAF/MEK/ERK signal path associated with its activation, which results in the similarity between the adverse effects of EGFR inhibitors and the treatment of melanoma with BRAF and MEK inhibitors. The most common side effects are pruritus, xerosis, papulopustular rash, hand-foot skin reaction, alopecia and dystrophy of the hair, and paronychia. This work presents options for prevention and suggestions for managing these adverse events, which are of importance in the care of patients undergoing oncological treatment

The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis

Background: Quality of life (QoL) and sleep, which are essential for well-being in the mental, physical, and socioeconomic domains, are impaired in psoriatic patients. However, the exact role of the clinical subtype of psoriasis in this aspect remains poorly studied. Objectives: The aim of this study was to investigate differences in QoL impairment and sleeping problems in patients suffering from various clinical subtypes of psoriasis and to evaluate the effects of pruritus on QoL. Methods: This cross-sectional, multicenter study included 295 eligible subjects with diagnosed psoriasis. Each patient was examined with the use of the same questionnaire. Measures included predominant subtype of psoriasis, disease severity, pruritus scores, patients’ health-related QoL and the incidence of sleep disturbance. Results: The QoL of most patients was decreased irrespectively of clinical psoriasis subtype, however, the most impaired QoL was in patients with erythrodermic psoriasis. The majority of patients reported sleep disturbances caused by pruritus, albeit there was no relevant differences between analyzed subgroups in this aspect of patients’ well-being. Pruritus was an important factor determining QoL and sleeping problems in the studied population. Conclusions: Identifying the most disturbing area of life and recognizing the most bothersome subjective symptoms of psoriasis are pivotal to focusing on the most relevant treatment goal and achieving therapeutic success