Psoriasis is a chronic, systemic, inflammatory disorder which accelerates the life process of skin cells, based on a genetically induced deviant immune response. High-frequency ultrasonography (HF-USG) is a painless, non-invasive imaging technique that can be performed and repeated whenever the need arises. We evaluated lesional and non-lesional skin of psoriatic patients with the use of HF-USG, focusing on the immune-induced inflammation and skin thickness. Previous studies suggested that HF-USG, being a non-invasive technique, is useful as an aid to clinical evaluation of the severity of psoriatic plaques. Our goal was to determine whether the skin of psoriatic patients is influenced by the background or habits of the patients. The study included a total of 27 patients affected by psoriasis vulgaris. The thickness of the epidermis and dermis and the skin echogenicity were documented for the active plaques, as well as for the non-affected skin of all the patients included in the study, using a high-frequency ultrasonographic system. The patient's local background, sex, family history of psoriasis, smoking habits and sun exposure were analyzed. HF-USG of the psoriatic plaques exposes a three-band structure that is easily distinguished from the surrounding unaffected skin, due to a hypoechoic band in the upper dermis. Although not specific for psoriasis, it is a strong marker of inflammation. The obtained results confirm that, indeed, skin thickness is greater in lesional skin compared to non-lesional skin, by a mean of 1,180 µm (±340 µm). We consider that skin HF-USG should be used as a quantitative method in the clinical evaluation of the patients with psoriasis and may help as an objective means of assessing inflammation in lesional skin.
Psoriasis is one of the most common chronic dermatological conditions, with a strong impact on patients' quality of life. Currently, psoriasis benefits from conventional therapy with a high rate of adverse effects and an increase in non-compliance and self-medication of patients. As such, there is a need to pinpoint low-adverse effects and accessible remedies for this condition. Our single-blind, placebo-controlled study assessed the effect of sea buckthorn extract on psoriasis lesions in previously untreated patients. Our results showed an improvement in Psoriasis Area Severity Index (PASI) scores and in Dermatology Life Quality Index (DLQI) scores when compared to the baseline values, as well as at the 4-and 8-week time marks for the lesions treated with sea buckthorn extract. By contrast, the measurements for the placebo treated lesions showed no alteration at the 4-week mark, and significant worsening at the end of the trial. These findings provide a solid, optimistic base for the in-depth research of sea buckthorn as an adjuvant or a component in psoriasis care protocols.
Psoriasis is a chronic, immune mediated, inflammatory condition, which primarily affects the patient's skin. It is known to associate a variable array of comorbidities such as cardiovascular, metabolic and psychiatric ones, with an important impact on the patients' quality of life. The purpose of this study is to provide a first image of the prevalence, comorbidities, as well as the social impact of psoriasis in Romania. We devised a questionnaire, and with the aid of general practitioners throughout the country, delivered it to patients seeking medical care in their office. The questionnaire assessed demographic criteria as well as patient-related issues. It was completed in the presence of the general practitioner, and clear written instructions for completion were included. After statistical analysis, the resulting data formed the basis of this study. The reported prevalence of psoriasis in Romania is 5.18%. Almost half of the subjects who completed the questionnaire stated they knew somebody affected by the disease, yet almost a third believed it is a contagious condition. Cardiovascular and psychiatric comorbidities, as well as negative impact on social interactions were reported by the subjects in the study. These findings indicate the clear need for better quality of life for patients in a social context and increased awareness of the disease. All these could, in turn, help decrease the rate of psoriasis complications in Romania. Materials and methodsThis is a questionnaire-based study with sample populations coming from all regions of the country, in a representative distribution. The questionnaire (available upon request) was
Atopic dermatitis (AD) is a complex, chronic skin disorder with a broad spectrum of clinical aspects, characterized by abnormal skin barrier function. This has a significant impact on patients' quality of life (QoL), which represents a crucial parameter for their wellbeing. This study assessed the QoL of patients with AD by following parameters such as itching, disturbance of sleep, disturbance of play activity, and community activities. The study included 64 patients clinically diagnosed with AD, aged 0 to 16 years. QoL of patients with AD was measured by evaluating the QoL indices for infants and young children (IDQoL-Infants' Dermatitis Quality of Life Index) and the QoL for children over 4 years (CDQoL-Children's Dermatology Life Quality Index). The severity of the disease was also monitored by evaluating the SCORAD index. The major symptom for atopic dermatitis, pruritus, was found most frequently in our study and influenced patients' QoL. The study showed that the above questionnaires are efficient tools for correlating AD severity with QoL even in younger patients and could be included in current guidelines. This is the first study that analyzed the QoL of pediatric patients with atopic dermatitis in Romania and can constitute the basis for elaborating a more comprehensive disease management guidelines.
Atopic dermatitis (AD) is a chronic, highly pruritic skin disorder, with a broad spectrum of clinical manifestations, characterized by abnormal skin barrier function. High-frequency ultrasonography (HF-USG) is an instrument with potential use in a variety of skin conditions. Previous studies on HF-USG in AD reported that apparently non-lesional skin also presents barrier defects. We aimed to assess lesional and non-lesional skin of AD patients with the use of HF-USG, focusing on skin barrier function and inflammation. We included a group of AD patients and a control group. On both we performed analysis with the use of HF-USG. The thickness of the subepidermal low-echogenic band (SLEB) and the skin echogenity were recorded for active lesions, as well as non-lesional skin in all subjects included. For AD patients the clinical severity was measured using SCORing Atopic Dermatitis and correlated with Dermatology Life Quality Index (DLQI). The mean thickness of the hypoechoic band was wider in the lesional skin of AD. In the non-lesional skin of AD patients SLEB was identified to appear, but it was thinner. The skin echogenity of the control group was higher than that of AD patients. Our results indicate that skin ultrasonography is able to assess specific modifications of the AD skin. A hypoechoic band in the non-lesional skin of some AD patients may indicate subclinical eczematous lesions.
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