No abstract

A growing body of research has indicated that pruritus is an important feature of hidradenitis suppurativa (HS). This study evaluated pruritus and pain among 103 patients with HS. Pruritus and pain intensity were assessed with a visual analogue scale, numerical rating scale and 4-item Itch Questionnaire. Dermatology Life Quality Index (DLQI) was implemented to assess quality of life (QoL) issues. Various clinical features and factors influencing pruritus were also examined. Pruritus and pain during the last week were reported among 41.7% and 77.5% of patients, respectively. The presence of pruritus did not have an impact on DLQI, nor did it show interaction with the pain in this regard. The presence of pain was a crucial contributor, even more relevant than disease severity. None-theless, intensity of pruritus correlated positively with DLQI. The most troublesome symptom of HS was pain, followed by exudation, pruritus, appearance and smell, consecutively. Pruritus of mild-to-moderate intensity is a common HS-associated symptom that adversely affects patients' QoL.

Psoriasis is a multifactorial disease in which genetic, environmental and epigenetic factors regulating gene expression play a key role. In the “genomic era”, genome-wide association studies together with target genotyping platforms performed in different ethnic populations have found more than 50 genetic susceptible markers associated with the risk of psoriasis which have been identified so far. Up till now, the strongest association with the risk of the disease has been proved for HLA-C*06 gene. The majority of other psoriasis risk SNPs are situated near the genes encoding molecules involved in adaptive and innate immunity, and skin barrier function. Many contemporary studies indicate that the epigenetic changes: histone modification, promoter methylations, long non-coding and micro-RNA hyperexpression are considered as factors contributing to psoriasis pathogenesis as they regulate abnormal keratinocyte differentiation and proliferation, aberrant keratinocytes – inflammatory cells communication, neoangiogenesis and chronic inflammation. The circulating miRNAs detected in the blood may become specific markers in the diagnosis, prognosis and response to the treatment of the disease. The inhibition of expression in selected miRNAs may be a new promising therapy option for patients with psoriasis.

Psoriasis is a systemic disease that is strictly connected with metabolic disorders (insulin resistance, atherogenic dyslipidemia, arterial hypertension, and cardiovascular diseases). It occurs more often in patients with a more severe course of the disease. Obesity is specially an independent risk factor and it is associated with a worse treatment outcome because of the high inflammatory activity of visceral fatty tissue and the production of inflammatory mediators involved in the development of both psoriasis and metabolic disorders. However, in psoriasis the activation of the Th17/IL-17 and the abnormalities in the Th17/Treg balance axis are observed, but this pathomechanism does not fully explain the frequent occurrence of metabolic disorders. Therefore, there is a need to look for better biomarkers in the diagnosis, prognosis and monitoring of concomitant disorders and therapeutic effects in psoriasis. In addition, the education on the use of a proper diet as a prophylaxis for the development of the above disorders is an important element of holistic care for a patient with psoriasis. Diet may affect gene expression due to epigenetic modification which encompasses interactions of environment, nutrition and diseases. Patients with psoriasis should be advised to adopt proper diet and dietician support.

StreSzczenieZapalenie skórno-mięśniowe (dermatomyositis -DM) zalicza się do grupy tzw. idiopatycznych miopatii zapalnych (ang. idiopathic inflammatory myopathies -IIM). Schorzenie to ma podłoże autoimmunologiczne, cechuje się obecnością zmian skórnych i/lub objawami zapalenia mięśni. Wyróżnia się tzw. klasyczną postać DM, postać dziecięcą DM oraz paraneoplastyczną DM, DM indukowane lekami i DM bez zaję-cia mięśni. Ostatnio obserwuje się dynamiczny postęp w identyfikacji nowych autoprzeciwciał towarzyszących poszczególnym odmianom DM, w tym anty-TIF1, anty-NXP2, anty-SAE czy anty-MDA5. Prawdopodobnie w niedalekiej przyszłości przyczyni się on do zwiększenia częstości rozpoznawania DM i jego poszczególnych odmian, lepszej stratyfikacji pacjentów pod względem ryzyka zajęcia poszczególnych narządów wewnętrznych oraz wpłynie na całościową poprawę wyników leczenia. Obecnie glikokortykosteroidy są podstawą terapii DM, jednak wprowadzenie do lecznictwa szeregu nowych leków immunomodulujących i immunosupresyjnych, w tym leków biologicznych, wiąże się ze znaczącym zwiększeniem przeżywalności pacjentów z tą chorobą. W niniejszej pracy dokonano przeglądu piśmiennictwa na temat najnowszych trendów w diagnostyce i leczeniu DM. AbStrActDermatomyositis (DM) is one of the so-called idiopathic inflammatory myopathies (IIM). Dermatomyositis is an autoimmune disorder characterized by the presence of cutaneous lesions and/or symptoms of muscle involvement with the following variants: the "classic" variant of DM, juvenile DM, paraneoplastic DM, drug-induced DM and amyopathic DM. Dynamic discoveries of novel autoantibodies, including anti-TIF1, anti-NXP2, anti-SAE or anti-MDA5, related to certain DM variants, have been described in recent years. It seems that these antibodies will contribute to better recognition of DM and its particular variants, a better risk stratification for predicting internal organ involvement, and to a global improvement of treatment outcome. Corticosteroids remain the mainstay of DM therapy, but new immunomodulatory and immunosuppressive agents, including biologicals, resulted in a significant increase of the survival rate of DM patients. Here, we review the current literature data on DM with special emphasis on new trends in its diagnostics and treatment.