Chronic graft-versus-host disease – the role of dermatological treatment

Introduction . The number of allogeneic haematopoietic stem cell transplantations is increasing year by year. The most common long-term complication is chronic graft-versus-host disease, with skin involvement noted in over 90% of cases. Objective . To present and discuss skin lesions occurring in chronic graft-versus-host disease with a particular focus on available dermatological treatment modalities. Case report . A 45-year-old male patient, who received allogeneic haematopoietic stem cell transplantations in December 2012, presented for the treatment of skin lesions secondary to chronic graft-versus-host disease. Clinical examination revealed hyperpigmented lichenoid eruption on the trunk; irregular patches of non-scarring alopecia; poikiloderma on the face and upper limbs; and sclerodermatous lesions on the hands with diffuse epidermal exfoliation on the palms and soles. Histopathological examination confirmed the diagnosis of chronic graft-versus-host disease. Treatment consisting of phototherapy and intensive topical treatment was introduced. Conclusions . Skin lesions secondary to chronic graft-versus-host disease may impair the daily functioning of post-transplant patients. Comprehensive therapeutic management should be based on the cooperation between haematologists and dermatologists

The Influence of FTO Polymorphism rs9939609 on Obesity, Some Clinical Features, and Disturbance of Carbohydrate Metabolism in Patients with Psoriasis

Background. Psoriasis is often accompanied by obesity, hyperlipidemia, diabetes, and metabolic syndrome as risk factors of cardiovascular conditions and premature mortality. Objective. The study was aimed at investigating whether psoriatic patients, who carry risk allele of obesity-related FTO gene, are more predisposed to obesity and metabolic disturbances and whether it influences the severity of psoriasis. Methods. 197 patients with psoriasis, representing Lower Silesia region of Poland, underwent physical examination and anthropometric measurements. Blood samples for biochemical and genetic analysis were collected. All patients were genotyped for FTO gene rs9939609 variant. Identification of SNP was conducted with the use of minisequencing method. Results. Around 63% of patients were carriers of at least one risk allele A and 20% were AA homozygotes. The A allele was associated with increased BMI and hip and waist circumferences. The carriers of risk allele had increased PASI and CRP values and tended to have an increased insulin concentration. Conclusion. Psoriatic patients, carriers of risk allele of FTO gene rs9939609, have an increased risk for more severe psoriasis and obesity and may develop obesity-induced insulin resistance