IntroductionMany recent epidemiological studies have shown the influence of treatment with anti-TNF-α on body mass of patients with psoriasis but there are no reports in the literature on the influence of ustekinumab on that parameter.AimTo review the effect of ustekinumab therapy on body weight in patients with psoriasis.Material and methodsThe examined group consisted of 11 patients with psoriasis treated at the Department and Clinic of Dermatology in Olsztyn. Patients’ body mass and body mass index (BMI) were evaluated prior to the first administration of the ustekinumab dose and at week 28 of treatment (the day of the fourth dose).ResultsBody mass increase was determined in 7 patients (64%), on average by 2.27 kg (p < 0.05), and the BMI increased by 3.35% (p < 0.1).ConclusionsObserving a correlation between ustekinumab application and body mass increase, similar to the treatment with anti-TNF-α preparations, an attempt was undertaken at explaining that correlation by analysing the role of IL-12 and IL-23 in psoriasis pathogenesis. IL-12 and IL-23, by influencing the naïve lymphocytes T and stimulating their diversification towards Th1 and Th17, also, indirectly, cause an increase in TNF-α and other cytokines production (IL-2, IFN-γ, IL-17, IL-10, IL-22). Ustekinumab will then have a significant influence on decreasing the production of cytokines, which are important for metabolism and body mass.

Dermatitis herpetiformis is a rare chronic, autoimmune bullous disease linked to gluten sensitivity with intense pruritus and characteristic skin eruptions. Etiopathogenesis is complex and not fully understood. It is currently considered to be a specific cutaneous manifestation of celiac disease. Genetic, environmental and immunological factors influence both conditions. Exposure to gluten is the starting point of an inflammatory cascade leading to the formation of circulating IgA antibodies against tissue transglutaminase and skin immune IgA deposition followed by skin lesions. Binding of the immune complex deposits of IgA transglutaminases and epidermal antibodies with enzymes in the papillary dermis stimulates complement activation, neutrophil influx, proinflammatory cytokine release and overproduction of matrix metalloproteinases. We have collected current knowledge of the pathogenesis of dermatitis herpetiformis.

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Purpose The aim of this study was to assess the incidence and characteristics of COVID-19 cutaneous manifestations among geriatric patients infected with the SARS-CoV-2 virus. Patients and Methods Sixty-four nursing home residents in Dobre Miasto, Poland (mean age: 79 years) infected with SARS-CoV-2 were monitored for skin lesions during the epidemic outbreak in 2020. Only five of them presented COVID-19 dermatological manifestation: vesicular (4 cases) and erythematous (1 case) skin lesions, which appeared after the remaining symptoms of the disease had resolved. Results The average time between COVID-19 onset and cutaneous manifestation was 22 days. Skin lesions persisted in five cases 112, 17, 21,19 and 27 days, respectively, and were often accompanied by pruritus and neuropathic pain. Conclusion Skin manifestations of SARS-CoV-2 infection might be misdiagnosed or overlooked, particularly among elderly patients with chronic diseases. The recognition of skin lesions due to COVID-19 might improve patients’ quality of life by reducing the intensity of symptoms such as pruritus or neuropathic pain.

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