Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis with unclear aetiopathology, considered as an autoinflammatory disease, associated with other immune-mediated disorders. Chitinase-3-like protein 1 (YKL-40) is an inflammatory biomarker secreted by a wide variety of cells, including neutrophils. To evaluate YKL-40 serum level in relation to clinicopathological data, 48 patients with PG and 40 healthy controls were enrolled in the study. Skin lesions were measured to calculate the affected area. Inflammatory parameters (C-reactive protein, white blood cell count with neutrophils) were determined from blood samples. YKL-40 and IL-6 levels were measured in serum by enzyme-linked immunosorbent assay. YKL-40 serum level was significantly higher in patients with PG than in controls (58.4 vs 36.4 ng/ml, respectively; p < 0.00001). The positive correlation between YKL-40 level and IL-6 level was observed (r=0.48, p = 0.0006) along with a trend towards significance of relationship between YKL-40 level and C-reactive protein (r=0.28, p = 0.052). YKL-40 can be considered a valuable biomarker of inflammation in PG.
In everyday practice, cosmetologists often observe abnormalities on the facial skin of his or her clients. Facial lesions have a diverse clinical picture, although most are benign. However, some lesions may be malignant and demand fast diagnosis and treatment. Among benign lesions are xanthomas, epidermal cysts, milia and seborrheic keratoses. Xanthomas are usually localized on the eyelids and often coexist with dyslipidemia. They appear clinically as yellowish papules that vary in size. Epidermal cysts are the most common type of skin cyst. They typically occur on the head and neck, and usually affect young adults in their 20s. Milia are common skin lesions that are typically numerous in presence and appear as small-sized sebaceous papules. Seborrheic keratoses are another important type of lesion that are localized on the face and may be disturbing for clients. These are benign tumors that usually appear in individuals over 50 years of age and have an incidence that rises with age. Typically, they are brown in color but they can also be other colors including black, yellow, grey or bluish. Other skin changes include basal cell carcinoma, actinic keratosis, squamous cell carcinoma and lentiginous malignant melanoma. Basal cell carcinoma is a slow-growing, locally malignant epithelial cancer of the skin. This cancer presents mainly in areas exposed to ultraviolet (UV) radiation. Actinic keratosis is a pre-cancerous lesion that is associated with UV radiation. It predisposes to squamous cell carcinoma and other skin cancers rarely. In contrast to basal cell carcinoma, squamous cell carcinoma may cause metastases with high mortality. Melanoma on the head and face usually takes the form of a lentiginous malignant melanoma. This manifests clinically as a brown spot that slowly grows centrifugally. Melanomas vary in size and color. Dermoscopy is an important tool that may help during diagnosis of facial lesions. Given the severe consequences of some skin lesions, it is very important for cosmetologists to have knowledge of the conditions described above. This is because he or she is often the first person who can persuade the client to undergo further diagnosis.
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