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

Stevens Johnson syndrome after carbamazepine and SJS/TEN overlap syndrome after amoxicillin: case reports and a review

We present a case of Stevens Johnson syndrome in a child after carbamazepine application and Stevens Johnson/TEN overlap syndrome in an adult after amoxicillin application. On the basis of two reported cases we review the most commonly associated drugs, the postulated pathogenesis, clinical manifestation and management in these severe life-threatening diseases. We especially discuss the controversial systemic corticosteroid therapy. Topical care is also discussed

Effectiveness of EFFACLAR H ISO-BIOME preparations as an adjunct to conventional treatment of acne vulgaris — results of an observational study

Background: Although topical dermocosmetics are widely used care products, only a few studies investigated their effectiveness in enhancing the tolerance and efficacy of medical anti-acne therapies. The primary objective of this study was to assess the safety and efficacy of EFFACLAR H ISO-BIOME cream and washing cream as an adjunct to pharmacological treatment (local and/or systemic) administered for at least 12 weeks in patients with mild to very severe acne vulgaris. Material and methods: This observational study was conducted in patients (n = 306) aged 14 years and over with mild to very severe [Global Acne Severity Scale (GEA) 1–5] acne vulgaris. Participants were instructed to apply the EFFACLAR H ISO-BIOME cream and washing cream twice daily for at least 12 weeks along with prescribed anti-acne therapy (topical agents, oral isotretinoin, or systemic antibiotics/ /spironolactone combined with topical agents). Results: The treatment regimen led to an improvement in GEA scores in 88.9% of all patients (p &lt; 0.05). Statistically significant changes were observed in the reduction of sebum secretion, number of papules and pustules, postinflammatory hyperpigmentation, and erythema (p &lt; 0.05). The vast majority of dermatologists and patients rated the tolerance of the products as very good (97% and 94%, respectively). The quality of life of most patients improved by the end of the study. Conclusions: EFFACLAR H ISO-BIOME cream and washing cream are safe and effective products used as adjunctive treatment to topical or systemic therapy of mild to very severe acne vulgaris

Nanoparticle as a novel tool in hyperthermic intraperitoneal and pressurized intraperitoneal aerosol chemotheprapy to treat patients with peritoneal carcinomatosis

The treatment of peritoneal surface malignances has changed considerably over the last thirty years. Unfortunately, the palliative is the only current treatment for peritoneal carcinomatosis (PC). Two primary intraperitoneal chemotherapeutic methods are used. The first is combination of cytoreductive surgery (CRS) and Hyperthermic IntraPEritoneal Chemotherapy (HIPEC), which has become the gold standard for many cases of PC. The second is Pressurized IntraPeritoneal Aerosol Chemotheprapy (PIPAC), which is promising direction to minimally invasive as safedrug delivery. These methods were improved through multicenter studies and clinical trials that yield important insights and solutions. Major method development has been made through nanomedicine, specifically nanoparticles. Here, we are presenting the latest advances of nanoparticles and their application to precision diagnostics and improved treatment strategies for PC. These advances will likely develop both HIPEC and PIPAC methods that used for in vitro and in vivo studies. Several benefits of using nanoparticles will be discussed including: 1) Nanoparticles as drug delivery systems; 2) Nanoparticles and Near Infrred (NIR) Irradiation; 3) use of nanoparticles in perioperative diagnostic and individualized treatment planning; 4) use of nanoparticles as anticancer dressing's, hydrogels and as active beeds for optimal reccurence prevention; and 5) finally the curent in vitro and in vivo studies and clinical trials of nanoparticles. The current review highlighted use of nanoparticles as novel tools in improving drug delivery to be effective for treatment patients with peritoneal carcinomatosis

Reasons of endogenous aging of the skin

Starzenie się jest procesem złożonym, dotyczącym całego organizmu, także skóry, charakteryzującym się zanikiem komórek, zmniejszeniem rezerw komórkowych tkanki oraz pogorszeniem zdolności komórek do pełnienia swych fizjologicznych funkcji. Starzenie się populacji danego gatunku przebiega w sposób podobny, co wskazuje, że jest to z góry zaprogramowany proces, wynikający z kodu genetycznego. Jest on uwarunkowany brakiem zdolności do replikacji ostatniej pary zasad chromosomu przy każdym podziale, co prowadzi do skrócenia końcowej części chromosomu, w wyniku czego bardzo krótkie telomery uniemożliwiają transkrypcję i sygnalizują zestarzenie się komórki oraz jej apoptozę. Starzenie się organizmu wiąże się również z destrukcyjnym działaniem wolnych rodników, nieustannie produkowanych w wyniku tlenowego metabolizmu komórkowego. Pomimo komórkowych systemów ochrony antyoksydacyjnej, wolne rodniki w sposób ciągły uszkadzają składniki komórkowe, a przede wszystkimi DNA. Do uszkodzenia DNA oraz produkcji wolnych rodników w skórze dochodzi również w wyniku działania zewnętrznych czynników środowiskowych, zwłaszcza promieniowania UV i dymu tytoniowego. U kobiet w okresie menopauzy dodatkowo znajdujące się w skórze receptory estrogenowe nie są pobudzane, co stanowi jedną z głównych przyczyn wewnątrzpochodnego starzenia się skóry w wieku menopauzalnym i współwystępuje zarówno ze starzeniem związanym z wiekiem, jak i fotostarzeniem. Ponieważ objawy starzenia się skóry powstają pod wpływem różnych procesów, obecnie wyróżnia się: starzenie mimiczne, zewnątrzpochodne, wewnątrzpochodne związane z wiekiem oraz menopauzalne. Objawy starzenia się skóry często jednak nie wiążą się z wiekiem i są cechą indywidualną każdego człowieka. Starzenie skóry jest procesem nieuchronnym, stale postępującym i dotyczy wszystkich warstw skóry, przy czym na starzenie wewnątrzpochodne mamy mniejszy wpływ niż na zewnątrzpochodne.Aging is a complex process which pertains to the whole organism including the skin, which is characterised by atrophy of cells, decrease of tissue cell reserve and deterioration of capabilities to fulfil physiological cell functions. Aging runs in a similar way in different species which suggests that the process of aging is a deliberately programmed process, i.e., it is a result of the genetic code. It is conditioned by the deficiency to replicate of the last pair of chromosome at each division, which leads to shortening the end part of the chromosome and as a result the short telomers make transcription impossible and indicate aging of a cell and its apoptosis. The process of aging is also associated with damaging process of free radicals, which are constantly produced as a result of an aerobiccell metabolism. Despite cell antioxidant protection systems, free radicals continuously damage cell components and cause DNA as well as other biological particles damage. DNA damage and production of free radicals are also caused by exogenous environment factors, particularly by UV radiation and nicotine smoke. In women at the age of menopause estrogen receptors in the skin are not stimulated which is one of the major reasons of endogenous factors of skin aging, which overlaps aging pertaining to age and photo-aging. With reference to different processes leading to aging symptoms of the skin, we can distinguish: mimic aging, endogenous aging in connection with the age, menopause aging and exogenous aging. Symptoms of aging may not accompany the age and constitute an individual feature of each human being. Skin aging is an inevitable, progressive process and pertains to all layers of the skin, although we have a less significant influence on the endogenous rather than on the exogenous aging

Management of complications associated with the use of hyaluronic acid fillers. Recommendations of the Aesthetic Dermatology Section of the Polish Dermatological Society

The most common treatments in the field of aesthetic dermatology and broadly understood aesthetic medicine are those with the use of fillers. For many, hyaluronic acid injections are considered very safe and the effects predictable. Therefore, the widely recognised reversibility of the effects of hyaluronic acid fillers and the growing variety of approved applications and formulations of these products increase their popularity. There are also numerous undesirable effects and complications, especially due to the fact that these treatments are performed both by unauthorised persons and under inappropriate conditions. Complications may be related to: incorrect injection technique, lack of treatment asepsis, reaction of the body to the presence of a foreign body and anatomical changes. Depending on the time when complications occur after hyaluronic acid administration, following complications may be distinguished: immediately complications that occur immediately or up to 3–5 days after administration are and late complications that occur even after several weeks, months or even years. Non-vascular complications of hyaluronic acid administration are: nodules, granulomas, persistent swelling, Tyndall effect, infections and biofilm. The most dangerous are vascular complications after hyaluronic acid administration, such as: ischaemia/partial or complete necrosis, vision abnormalities and blindness. Early recognition of a complication largely prevents permanent defects. The use of hyaluronidase injections is considered management of choice in the treatment of complications of hyaluronic acid fillers and should be performed immediately after the procedure with the use of the filler. Therefore, it was necessary to develop a consensus on the principles of hyaluronidase administration for complications of hyaluronic acid filler procedures

The possible role of diet in the pathogenesis of adult female acne

Acne in adults is a chronic, increasingly common disease, especially among women. It differs in pathogenesis and clinical presentation from adolescent acne. Acne in adults is associated with Western diet, defined as high consumption of milk, high glycemic load and high calorie intake. Metabolic signals of this diet result in a significant increase in insulin/insulin growth factor 1 serum level and consequently in the molecular interplay of mammalian target of rapamycin complex 1 kinase (mTORC1)/forkhead box protein 1 (FoxO1) mediated nutrient signaling, leading to increased proliferation of keratinocytes, increased lipogenesis and sebum production and finally to aggravation of acne