Being one of the most common dermatological inflammatory disorders, psoriasis is a frequent subject of research. It is considered to be a T cell-dependent immune disease whose pathogenesis is influenced by cytokines, such as IL-10, IL-17A, IL-17RA, IL-23A and IL-23R. The present study examines whether the expression of selected genes is correlated with the clinical course of psoriasis, assessed by the PASI, BSA and DLQI scales. Skin biopsies and blood from 60 patients with psoriasis and 24 healthy controls were obtained for RNA isolation. These were subjected to RT-PCR for IL-10, IL-17A, IL-17RA, IL-23A and IL-23R genes. The results were presented as an RQ value. IL-17A and IL-23R expression levels were higher in psoriatic skin compared to controls, while IL-10 expression was lower. A positive correlation was also found between RQ for IL-23A and PASI index. Psoriatic skin is characterised by elevated expression of IL-17A and IL-23R and decreased expression of IL-10. This indicates that the selected cytokines may be one of the factors involved in the pathogenesis and pathomechanism of psoriasis, but more studies need to be made before we can elucidate the exact reason for the unbalance in cytokine expression levels.

As a chronic, recurrent, immunologically mediated systemic disease and a common cause of dermatological problems, psoriasis is often a subject of scientific research. Skin changes located on the hands can cause difficulties and limitations in the performance of professional activities, especially manual ones. The main role in pathogenesis is played by immunological factors-improper functioning of the components of the immune system, among others, T lymphocytes and cytokines like interleukin-12 (IL-12), interleukin-22 (IL-22) and interferon gamma (IFN-γ). Material and Methods: The obtained tissue and blood were destined for RNA isolation. The RNA was then subjected to a reverse transcription reaction. The relative gene expression level was evaluated by the real-time polymerase chain reaction for IL-12B, IL-22 and IFN-γ genes, and presented as the relative quantification (RQ) value, relative to the reference gene GAPDH. In addition, a correlation analysis of the expression level of selected genes with the clinical course of the disease, as assessed by the Psoriasis Area and Severity Index (PASI), the Body Surface Area (BSA) and the Dermatology Life Quality Index (DLQI) scores was performed. Results: Statistical analysis confirmed a significant increase in RQ values for IL-12B, IL-22 and IFN-γ in the group of psoriatic patients vs. the control group. A positive correlation was also found between BSA and PASI and RQ for the IL-12B gene. Conclusions: Increased expression levels of IL-12B, IL-22 and IFN-γ genes in psoriatic skin confirm that selected cytokines play an important role in the initiation and sustenance of psoriasis.

Przegląd Dermatologiczny 2016/5 400 StreSzczenie Bielactwo nabyte (vitiligo) jest stosunkowo często występującą chorobą skóry. Chociaż nie powoduje żadnych dolegliwości podmiotowych, stanowi istotny problem natury kosmetycznej mający znaczny wpływ na obniżenie jakości życia. W patogenezie choroby rozpatruje się szereg czynników, między innymi podłoże genetyczne, czynniki środo-wiskowe i stres. Wyniki badań ostatnich lat wskazują na udział zjawisk immunologicznych w rozwoju choroby, o czym może świadczyć współwystępowanie vitiligo z chorobami tarczycy, reumatoidalnym zapaleniem stawów, łuszczycą i cukrzycą oraz autoimmunologicznymi zespołami wielogruczołowymi. W pracy przedstawiono także obraz kliniczny, przebieg i czynniki rokownicze choroby. Poznanie przyczyn depigmentacji skóry może się przyczynić do opracowania skutecznych metod leczniczych, a wiedza dotycząca współistnienia z innymi chorobami pozwoli na ich wcześniejszą diagnozę. AbStrActVitiligo is a quite frequently occurring skin disease. Although it does not cause any pain or internal organ damage, it constitutes a significant cosmetic problem having a significant impact on quality of life. A number of factors can influence the disease pathogenesis, including the genetic background, environmental factors and stress. Studies performed in recent years indicate the role of immunological phenomena in the development of vitiligo, as is confirmed by co-occurrence with other autoimmune diseases such as thyroid disease, rheumatoid arthritis, psoriasis, diabetes and many autoimmune polyendocrine syndromes. In the manuscript the clinical presentation, course of the disease and prognostic symptoms are also presented. Understanding the causes of skin depigmentation may allow for the development of effective therapeutic methods, and the knowledge of coexistence with other autoimmune diseases will help with the early diagnostic process. Bielactwo nabyte (vitiligo) jest powszechnie wystę-pującą chorobą skóry oraz błon śluzowych spowodowaną niszczeniem melanocytów w obrębie błony podstawnej zajętych obszarów. Objawia się dobrze odgraniczonymi, zazwyczaj licznymi, odbarwionymi plamami różnych kształtów i wielkości. Zmiany najczęściej lokalizują się na kończynach górnych (zwłaszcza grzbietach rąk) oraz twarzy, ale często

Psoriasis is a common immune-mediated inflammatory dermatosis affecting 2-3% of the northern European population. Although its aetiology is not completely elucidated, it is widely accepted that activated immune cells and keratinocytes stimulate keratinocyte hyperproliferation by production of cytokines; indeed, elevated amounts of proinflammatory cytokines have been observed in skin lesions and patient serum. By identifying those playing a central role in the disease pathogenesis, it will be possible to indicate a potential therapeutic target. Drugs targeting tumour necrosis factor α (TNF-α), interleukin (IL)-12/23, IL-17, IL-22 and IL-23 and Janus kinase inhibitors have been found to successfully alleviate resistant skin lesions. However, psoriasis is a complex disease with varied cellular interactions and cytokines, and a complex receptor network. Therefore, this review paper examines the less widely known cytokines IL-20 and IL-8, their therapeutic potential and their role in skin lesion development. Although promising results have been obtained for IL-20 and IL-8 treatment, and their role in the psoriasis skin lesion development is well documented, the role of these two cytokines remains overshadowed by that of the wider systemic cytokine storm.

Introduction. Autoimmune polyendocrine syndromes constitute a group of diseases with a diverse clinical picture, and a common aetiology associated with autoreactive mechanisms. Four basic types of the disease have been specified. Type 3 autoimmune polyendocrine syndrome includes coexistence of autoimmune thyroid disease with at least one of the following: type 1 diabetes, leucoderma, alopecia areata, chronic atrophic gastritis, or myasthenia. Objective. To describe type 3 autoimmune polyendocrine syndrome diagnosed in a patient admitted to the hospital due to chronic urticaria. Case report. An 87-year-old female patient was admitted to Dermatology and Venereology Clinic to determine the cause and modify the treatment for chronic urticaria. Physical examination revealed disseminated urticarial nodules, depigmentation lesions covering about 98% of the body surface, and alopecia areata of the scalp. Furthermore, hypothyroidism and malignant anaemia were confirmed. The patient was diagnosed with type 3 autoimmune polyendocrine syndrome. Conclusions. Not only does the ability to diagnose the described disease unit have a cognitive value, but it also enables diagnosing and treating concomitant autoimmune diseases. streszczenie Wprowadzenie. Autoimmunologiczne zespoły niedoczynności wielogruczołowej to grupa schorzeń o zróżnicowanym obrazie klinicznym, ale o wspólnej etiologii związanej z mechanizmami autoreaktywnymi. Wyodrębniono cztery podstawowe typy choroby. Autoimmunologiczny zespół niedoczynności wielogruczołowej typu 3 obejmuje współwystępowanie autoimmunologicznej choroby tarczycy z co najmniej jednym z następujących schorzeń: cukrzyca typu 1, bielactwo, łysienie plackowate, przewlekłe zanikowe zapalenie błony śluzowej żołądka, miastenia. Cel pracy. Omówienie przypadku autoimmunologicznego zespołu niedoczynności wielogruczołowej typu 3 rozpoznanego u pacjentki przyjętej do szpitala z powodu pokrzywki przewlekłej.