The influence on skin care of the use of emollients for skin lesions during the course of atopic dermatitis

Background/objective. In this paper, we discuss the principle of skin care with emollients in patients with atopic dermatitis.Patients and methods. The study included 22 patients with features of atopic skin. The indicator of atopic dermatitis (W-AZS), and the Eczema Area and Severity Index (EASI) indicator were used to measure the condition of the skin, and a questionnaire about methods of care for the skin was evaluated.Results. The mean value of the W-AZS indicator in patients using emollients was 34.42 ± 20.64, but in the group of respondents who did not use moisturising-greasing preparations it was 75.95 ± 11.58. The differences were statistically significant (p < 0.005). Furthermore, respondents who used emollients several times a week showed statistically significantly higher values of W-AZS indicator than respondents who used emollients twice a day or more often. These values of W-AZS were as follows: 65.13 ± 10.72 (SD) for people who used emollients several times a week, 17.13 ± 7.34 in patients who used emollients twice a day, and 8.66 ± 1.26 for patients who used emollients several times a day. The W-AZS indicator values due to frequent use of ‘leave-off’ type of emollients were as follows: 10.75 ± 2.49 (SD) for warm water and 12.05 ± 6.43 for cold water. Respondents who used hot water for their bath (over 38°C) received significantly higher values of W-AZS indicator.Conclusions. The study showed the significant effects of emollients, with a particular emphasis on frequency of use. It also stressed the importance of water temperature for bathing with emollients. The EASI indicatoris less precise than the W-AZS indicator

Keratinization Disorders and Genetic Aspects in Palmar and Plantar Keratodermas

Palmoplantar keratoderma (PPK) is a heterogeneous group of hereditary and acquired disorders characterized by abnormal thickening of the palms and soles. There are three clinical patterns: diffuse, focal, and punctuate. Palmoplantar keratodermas can be divided into the following functional subgroups: disturbed gene functions in structural proteins (keratins), cornified envelope (loricrin, transglutaminase), cohesion (plakophilin, desmoplakin, desmoglein 1), cell-to-cell communication (connexins) and transmembrane signal transduction (cathepsin C). Unna-Thost disease is the most common variety of hereditary PPK. Mutations in keratin 1 have been reported in Unna-Thost disease. We report 12 cases in which Unna-Thost disease was diagnosed. Genealogical study demonstrated that the genodermatosis was a familial disease inherited as an autosomal dominant disorder. Dermatological examination revealed yellowish hyperkeratosis on the palms and soles. Oral mucosa, teeth, and nails remained unchanged. Histopathological examination of the biopsy sample taken from the soles of the patients showed orthokeratotic keratosis, hypergranulosis, and acanthosis without epidermolysis.  </p

Masywne przerzuty do skóry jako pierwszy objaw raka piersi — opis przypadku

Introduction: Metastases to the skin are relatively rare, but they are an important diagnostic and therapeutic challenge. In women skin metastases are the most commonly associated with breast cancer. In the men they are often associated with lung cancer. Skin metastasis most often are in form of blue-purple nodules and tumours with tendency of necrosis. Aim: The aim of this paper is to present the case of a patient with diagnosed breast cancer with skin involvement. Case report: The 48-years old female patient was admitted to The Department of Dermatology for diagnosis and treatment of dermal lesions in form of numerous blue-purple nodules and ulcerations localised on the skin of the chest. The ultrasound examination suggested a primary malignant lesion in the left breast spreading to the right side and numerous satellite nodules. A whole nodule was collected for histopathological and immunohistochemical examinations in order to make the final diagnosis. Histopathology tests confirmed the diagnosis of tumour metastases of the skin and positive immunohistochemical reactions for cytokeratin 7 (CK7) and for oestrogen receptors (ER) pointed mammary glands as the primary site. The patient was urgently referred to the Oncology Centre. Conclusions: The occurrence of skin metastasis in all tumour processes significantly worsens the prognosis of the patient. These changes should be quickly recognized by the oncologist or dermatologist. Sometimes the localization of primary tumour is not possible to determine without taking the biopsy for histopathological and immunohistochemistry assays. Rapid treatment of appropriate chemotherapy or radiotherapy can prolong life and reduce pain.Wstęp: Przerzuty nowotworów do skóry stanowią istotny problem diagnostyczy i terapeutyczny, chociaż występują stosunkowo rzadko. Przerzuty do skóry obserwowane są najczęściej w przebiegu raka sutka u kobiet i raka płuca w przypadku mężczyzn. Zazwyczaj mają one postać sinofioletowych guzków i guzów, niekiedy z tendencją do rozpadu. Cel pracy: Celem pracy jest przedstawienie przypadku pacjentki z rozpoznanym nowotworem piersi przebiegającym z zajęciem skóry. Opis przypadku: 48-letnia pacjentka została przyjęta do Kliniki Dermatologii w celu diagnostyki i leczenia zmian skórnych o charakterze licznych sinofioletowych guzków z tendencją do rozpadu oraz owrzodzeń zlokalizowanych na skórze gładkiej klatki piersiowej. W badaniu USG piersi całość obrazu przemawiała za procesem nowotworowym pierwotnie wywodzącym się z piersi lewej, z progresją zmian na stronę prawą, z licznymi guzkami satelitarnymi. Pobrano w całości guzek do badania histopatologicznego oraz immunohistochemicznego w celu ustalenia rozpoznania ostatecznego. Wynik badania histopatologicznego potwierdził rozpoznanie przerzutów nowotworowych do skóry, dodatnie odczyny immunohistochemiczne dla cytokeratyny 7 (CK 7) i receptorów estrogenowych (ER) wskazywały na sutek jako miejsce guza pierwotnego. Pacjentka została w trybie pilnym skierowana do Centrum Onkologii. Wnioski: Wystąpienie przerzutów do skóry w przypadku wszystkich procesów nowotworowych znacznie pogarsza rokowanie pacjenta. Zmiany te powinny być szybko rozpoznane przez prowadzącego onkologa lub dermatologa. Czasem punkt wyjścia nowotworu nie jest możliwy do ustalenia bez pobrania materiału do badania histopatologicznego i immunohistochemicznego. Szybkie wdrożenie odpowiedniej chemioterapii lub radioterapii pozwala przedłużyć życie chorych oraz zmniejszyć dolegliwości bólowe.

Imaging in a rare case of neuroendocrine tumour with skin metastases

Purpose: Disseminated malignancies are a diagnostic and therapeutic challenge that is often encountered in radiology. Finding the primary tumour is crucial for planning proper surgical and oncological treatment. Computed tomography (CT) of the thorax and abdomen is typically the initial examination. However, abdominal magnetic resonance imaging (MRI) or positron emission tomography (PET/CT) or PET/MRI are often subsequently performed. Histopathological examination of metastatic tumours is performed as well, followed by immunohistochemistry. The aim of the report was to present diagnostic workup in a rare case of skin metastases. Case report: A 72-year-old patient was admitted to a dermatology ward because of skin lesions - violaceous nodules localised on the hair-covered skin of the head. On abdominal CT, a generalised neoplastic process with metastases in the liver, pancreas, adrenal glands, lymph nodes, bones, thoracic wall, and a suspected metastasis in the right breast was revealed. Histopathology of the skin nodules confirmed a neuroendocrine tumour. Metastases of a pancreatic neuroendocrine tumour or small-cell lung cancer were suspected on immunohistochemistry. The patient died before we were able to localise the primary source of the tumour and provide treatment. Conclusions: Skin metastases are relatively rare, aggravate the prognosis, and usually indicate spread of the neoplastic process in the internal organs. It is not always possible to localise the primary tumour using radiological imaging. In such cases, co-operation with the pathologist is crucial as are the results of histopathological and immunohistochemical examinations

Prevalence of Impaired Hearing and Vision in Patients with Vitiligo

Vitiligo is a common dermatosis occurring witha frequency of about 0.2-4.0% in world population. Themain skin symptom of disease are white patches appearingas a result of destruction or dysfunction of pigment cells(melanocytes). Melanocytes are localized not only in epidermisand bulge region of hair follicle, but also in inner earand eyeball structures, and therefore vitiligo may coexistswith auditory and visual disorders. The most frequent auditoryand visual disturbances occurring in vitiligo patientsare discussed in this article

The potential role of Helicobacter pylori and other gut dysbiosis factors in the development of rosacea

Rosacea is a chronic inflammatory disease that presents with erythema, telangiectasia, papules, or pustules. Its mechanism of onset stillneeds to be fully understood. There has been an increasing number of studies and reports confirming the beneficial influence of eradicationof Helicobacter pylori on the course of the disease. It has been recognized that the bacterium leads to the activation of the inflammatoryimmune response, resulting in the induction of symptoms similar to rosacea. Another thesis suggests a close connection between thegut–brain–skin axis, which relates to the influence of normal microbiota and gut health, and dermatological diseases. Correlations havebeen noted between the increased incidence of Crohn’s disease, ulcerative colitis, and irritable bowel syndrome in patients with rosacea

Recommendations on the treatment of basal cell carcinoma and squamous cell carcinoma prepared by the Oncology Department of the Polish Dermatology Society and the Melanoma Academy Department of the Polish Society of Oncological Surgery

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most frequent malignant neoplasms among Caucasian patients. Despite the fact that they seldom metastasise and are not directly fatal, they constitute a significant clinical issue. Such cancers infiltrate surrounding tissues and destroy the surrounding structures, e.g. bones and cartilages, as a result of which such structures develop into severe aesthetic defects and significantly deteriorate the life quality of the patients. Among patients from the high-risk group (namely patients under chronic immunosuppression or those genetically predisposed to develop UV-induced skin cancers) skin cancers may be aggressive and fatal. The Oncology Department of the Polish Dermatology Society (Polish: Sekcja Onkologiczna Polskiego Towarzystwa Dermatologicznego — PTD) and the Melanoma Academy Department of the Polish Society of Oncological Surgery (Polish: Sekcja Akademia Czerniaka Polskiego Towarzystwa Chirurgii Onkologicznej — PTChO), based on the current European guidelines, American recommendations of the National Comprehensive Cancer Network (revision 1.2015), and interventional reviews of publications elaborated by the Cochrane Skin Group, attempted to systemise the diagnostic and therapeutic procedures and determine homogenous rules of primary and secondary prevention in patients suspected/diagnosed with a basal cell or squamous cell carcinoma. This paper presents actual recommendations regarding skin cancer diagnosis and treatment, taking all related benefits and challenges into consideration, as well as recommendations for post-treatment patient monitoring