Frequent Skin Diseases Research Articles

Comparative Analysis of the Cutaneous Microbiome in Psoriasis Patients and Healthy Individuals—Insights into Microbial Dysbiosis: Final Results

Psoriasis is one of the most frequent chronic inflammatory skin diseases and exerts a significant psychological impact, causing stigmatization, low self-esteem and depression. The pathogenesis of psoriasis is remarkably complex, involving genetic, immune and environmental factors, some of which are still incompletely explored. The cutaneous microbiome has become more and more important in the pathogenesis of inflammatory skin diseases such as acne, rosacea, atopic dermatitis and psoriasis. Dysbiosis of the skin microbiome could be linked to acute flare ups in psoriatic disease, as recent studies suggest. Given this hypothesis, we conducted a study in which we evaluated the cutaneous microbiome of psoriasis patients and healthy individuals. In our study, we collected multiple samples using swab sampling, adhesive tape and punch biopsies. Our results are similar to other studies in which the qualitative and quantitative changes found in the cutaneous microbiome of psoriasis patients are different than healthy individuals. Larger, standardized studies are needed in order to elucidate the microbiome changes in psoriasis patients, clarify their role in the pathogenesis of psoriasis, decipher the interactions between the commensal microorganisms of the same and different niches and between microbiomes and the host and identify new therapeutic strategies.

Gasdermin A (GSDMA) Tissue Expression, Serum and Urinary Concentrations with Clinicopathologic Outcome in Psoriasis.

Psoriasis is a frequent and incurable skin disease that is an important issue in contemporary dermatology, although its pathogenesis is still uncertain. Gasdermin A (GSDMA) is a member of the gasdermin protein family which are able to cause pore formation in cellular membranes leading to cell death called pyroptosis. Our aim was to investigate the role of GSDMA in psoriatic patients. The study enrolled 60 patients with active plaque-type psoriasis and 30 sex- and age-matched volunteers without dermatoses. GSDMA concentration was assessed in serum and urine samples of all participants using ELISA. GSDMA tissue expression was assessed by immunohistochemistry. GSDMA serum concentration was significantly higher in patients compared to controls, whereas urinary GSDMA/creatinine ratio was insignificantly lower. GSDMA tissue expression was more prominent in psoriatic plaque compared to non-lesional patients' skin and healthy skin of subjects without dermatoses. There was a strong negative correlation between GSDMA serum concentration and ALT activity. GSDMA did not correlate with PASI or psoriasis duration. Obtained results point to the probable involvement of GSDMA in psoriasis. GSDMA overexpression may probably lead to keratinocytes hyperproliferation and be responsible for triggering inflammation in psoriatic skin. Serum GSDMA could become psoriasis biomarker, whereas urinary GSDMA, not at this point.

Clinicopathological concordance of mucocutaneous manifestations in people living with HIV: A cross-sectional study.

To describe the frequency and clinicopathological concordance of mucocutaneous manifestations in people living with HIV (PLWH) and its correlation with CD4+ T lymphocyte count and HIV viral load. Cross-sectional study of patients diagnosed with HIV infection who underwent skin biopsy for histopathological study from 1992 to 2022. Skin diseases were categorized as opportunistic and sexually transmitted infections, inflammatory dermatoses, benign cutaneous neoplasms, and premalignant and malignant cutaneous neoplasms. Clinicopathological concordance was classified as complete, partial or discordant. Frequency of skin diseases are presented by category and according to lymphocyte CD4+ count and HIV viral load. A total of 659 patients were included of whom 88.5% (n = 583) were male. The most frequent diagnostic category was opportunistic or sexually transmitted infections in 34% (n = 224) and the most frequently found condition was Kaposi sarcoma in 17% (n = 112). Clinicopathological concordance was complete in 53.7% (n = 354) of cases, partial in 26.7% (n = 176) and discordant in 19.6% (n = 129). Among the 282 patients with available serological data, 58.9% (n = 166), 23.8% (n = 67) and 17.4% (n = 49) had CD4+ counts below 200, between 200 and 499, and above 500 cells/μl, respectively. Although there is a high variability in skin conditions which people with HIV may present, there was a high rate of clinicopathological concordance (80.4%). We emphasize the importance of diagnostic skin biopsies due to their diverse morphological presentation. The frequency of skin diseases in PLWH depending on different clinical settings should aid the clinician in reaching an adequate diagnosis in this population.

Research progress of vitiligo repigmentation: from oxidative stress to autoimmunity.

Vitiligo belongs to a frequent chronic autoimmune skin disease with the features of pigmented plaques on the diseased skin along with potential damage of melanocytes. There are many factors underlying the pathogenesis of vitiligo, among which oxidative stress is extensively regarded to be the critical factor leading to the loss of melanocytes. The changed redox state resulting from oxidative stress, containing ROS overproduction along with the reduced activity of the skin's antioxidant system, makes melanocytes less resistant to exogenous or endogenous stimuli, and ultimately pushes normal defense mechanisms, resulting in the loss of melanocytes. Given the crucial potential of innate together with adaptive immunity in vitiligo, there is growing evidence of a relation between oxidative stress and autoimmunity. Our review offers estimable insights into the possible properties of oxidative stress and autoimmunity in pathogenesis of vitiligo, as well as the potential role of antioxidant-based supportive therapy in vitiligo repigmentation, providing a hopeful value for further research and development of effective treatments.

Pattern of Skin Diseases in Children Attending the Dermatology Clinic in Al-Gamhoria Teaching Hospital, Aden, Southern Yemen

Background: Skin diseases constitute a major health problem affecting a large proportion of the population including children causing distress and disability. This study aimed to determine the pattern and frequency of skin diseases. Methods: A retrospective hospital-based, cross-sectional study of all children up to 14 years old who attending dermatology clinic of Al-Gamhoria teaching hospital, Aden Yemen from January to December 2022. Results: Out of 3,184 patients, pediatric patients constituted 191 (6%),56.5% were boys and 43.5 were girls. Maximum number of patients were in the age group of >1-5 years. Majority of dermatoses belonged to infections (45.1%), followed by eczema (20.9%) Bacterial infections (19.9 %) were the most common infections followed by fungal (17.3%), viral (7.9 %) and infestation constituted (13.1%). The majority of patients had one disease, (95.3%) while the rest had two diseases (4.7%). Conclusions: in the present study, infections and eczema were the most common dermatological conditions. This study provides insight about the pattern of various dermatoses among children in urban setting. Keywords: Pattern, skin disorders, children, hospital –based

Teledermatology to Improve Access to and Quality of Skin Care in Eastern Indonesia.

Skin diseases are a major public health concern in Indonesia, although access to specialized care in remote areas is limited. We initiated a low-cost teledermatology service in Sumba, a remote island in eastern Indonesia. Eighteen healthcare workers (HCWs) at five primary healthcare centers received training to manage common skin diseases and submit clinical cases beyond their expertise to an online platform. Submitted cases were reviewed by at least one dermatologist. Diagnostic agreement between HCWs and dermatologists was calculated. The HCWs participated in a satisfaction survey 2 years after project initiation. Since October 2020, of 10,384 patients presenting with skin complaints in a 24-month period, 307 (3%) were submitted for a teledermatology consultation. The most frequent skin diseases were infections and infestations (n = 162, 52.8%) and eczematous (85, 27.7%) and inflammatory (17, 5.5%) conditions. Fifty-three patients (17.3%) were diagnosed with a neglected tropical skin disease, including leprosy and scabies. Dermatologist advice was provided within a median of 50 minutes (interquartile range, 18-255 minutes), with 91.9% of consultations occurring within 24 hours. The diagnostic agreement level between HCWs and dermatologists significantly improved over time, from 46.9% in the first 6-month period (κ = 0.45; 95% CI, 0.37-0.54) to 77.2% in the last 6-month period (κ = 0.76; 95% CI, 0.67-0.86; global P < 0.001). The HCWs reported that the teledermatology service was extremely/very useful in supporting daily practice (100%) and improved their knowledge of skin diseases tremendously/a lot (92%). Teledermatology can improve accessibility and quality of skin services in medically underserved areas, providing opportunities for scalability and knowledge transfer to frontline HCWs.

In vitro Evaluation of Nerium oleander Leaf Extract against Sarcoptes scabiei var. cuniculi Mite Isolated from Naturally Infested Rabbits

Background: Infestation of the mite Sarcoptes scabiei var. cuniculi is one of the most frequent skin diseases in rabbits all over the world. Disease is characterized by intense pruritus, alopecia, erythema, scales and crusts around the head, neck, trunk, feet, ears, nose and genitals, resulting in hypertensive reactions, considerable losses in body weight and productivity causing significant economic losses in rabbit production. Methods: This study is aimed to evaluate the efficacy of Nerium oleander extract against S. scabiei var. cuniculi mite in vitro. Acaricidal bioassay,a dipping method was conducted on mites isolated from naturally infested rabbits. PBS and ivermectin were used as the negative and positive controls, respectively. In addition, three different concentrations of extract (100, 200 and 400 ìg/ml) weretested at different periods and changes over time in the viability of mites were registered for (0.5, 1, 2, 4 and 8 hours). A chemical assay was performed via GC-MS to investigate the presence of several anticipated active chemical compounds in Nerium oleander leaf extract. Result: The results showed that the extract had high efficacy in killing mites at 100%, 78% and 49% and ivermectin 91%, respectively, for 8 hours. The results indicate that Nerium oleander possesses effective compounds as a valuable therapeutic method for treating scabies. Further studies are needed to determine the precise active chemicals present in Nerium oleander leaf extract and their modes of action and application in vivo.

Patch testing in occupational dermatology: Practical aspects in relation to the conditions in Germany.

Allergic contact dermatitis is one of the most frequent occupational skin diseases. Targeted allergen avoidance can only be achieved by identification of the causative allergen. Therefore, patch testing is of utmost importance in occupational dermatology, not only in terms of assessing causal relationships but also regarding the implementation of prevention measures and evaluation of the legal criteria for an occupational skin disease in Germany (statutory occupational disease BK 5101). The lack of commercial patch test preparations poses a great diagnostic challenge. Patch testing of patient's own materials from their workplace is therefore very important to reduce diagnostic gaps. The performance and documentation of the patch test should be in line with current guidelines and recommendations to ensure the necessary test quality and comprehensibility of the test results.

Skin Diseases in Geriatric Patients: One-year Single Center Experience

Purpose: The aim of this study was to investigate the distribution and frequency of skin diseases in geriatric age group, as well as the variation of this frequency according to age, sex, and season.&#x0D; Methods: Data from 1039 geriatric patients admitted to dermatology clinic between January 1, 2022 and January 1,2023 were retrospectively analysed according to sex, age and seasons.&#x0D; Results: The five most frequently observed disease groups in elderly patients were eczematous dermatitis (22.4%), fungal infections (14.4%), infestations (10.1%), pruritus (6.9%), and premalignant skin lesions (6.4%). The most common five dermatologic diseases in all patients were contact dermatitis (11.16%), scabies (8%), tinea ungium (6.8%), actinic keratosis (6.1%), and generalized pruritus (6.1%), respectively. Generalized pruritus was significantly less frequent in the 65-74 age group compared with the other two groups (p

Histone deacetylase 3 inhibition alleviates 2,4-dinitrochlorobenzene-induced atopic dermatitis via epigenetically upregulating Nrf2/HO-1 signaling pathway

Atopic dermatitis (AD) is a frequent skin disorder that is associated with immune dysfunction and skin inflammation. Histone deacetylase 3 (HDAC3) possesses strong immune and inflammatory modulatory properties in multiple diseases. However, the role and mechanism of HDAC3 in AD remain unknown. Here, we reported that HDAC3 expression was aberrantly upregulated in 2,4-dinitrochlorobenzene (DNCB)-induced lesional AD skin in mice. Inhibition of HDAC3 by RGFP966 protected against DNCB-induced AD, indicated by improved histological damages, relieved inflammatory and immune dysfunction. Nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1) signaling pathway activity in lesional AD skin was significantly decreased and RGFP966 attenuated the decrease. Inhibition of Nrf2/HO-1 signaling pathway via Nrf2 inhibitor ML385 blunted anti-AD effect of RGFP966 in DNCB-treated mice. Mechanistically, RGFP966 promoted Nrf2 expression and upregulated H3K27ac deposition on the promoter region of Nrf2. Collectively, HDAC3 inhibition protects against AD via epigenetically activating Nrf2 transcription to upregulate Nrf2/HO-1 signaling pathway activity. HDAC3 may act as a promising therapeutic target for the treatment of AD.

The journey of patients with skin diseases from the first consultation to the diagnosis in a representative sample of the European general population from the EADV burden of skin diseases study.

The journey of patients with skin diseases through healthcare has been scarcely investigated. To analyse the journey of people with skin diseases in the different healthcare environment in Europe. This multinational, cross-sectional, European study was conducted on a representative sample of the adult general population of 27 European countries. The prevalence of the most frequent skin diseases was determined. Information was collected on the patient journey from the first medical consultation to the diagnosis, and the reasons for not consulting a healthcare professional. On a total of 44,689 individuals, 30.3% reported to have consulted a dermatologist during the previous 2 years. Participants consulted mainly for mole control or skin cancer screening (22.3%), followed by chronic skin diseases (16.2%). The diagnoses of acne, atopic dermatitis, psoriasis and rosacea were made most frequently by a dermatologist, while fungal skin infections were diagnosed more often by a general practitioner (GP), and sexually transmitted diseases (STD) by other specialists. The diagnosis was not always definitive at the first consultation, in particular for STD. The percentage of people who did not consult a healthcare professional for their skin disease was particularly high for acne (36.4%), alopecia (44.7%) and fungal infection (30.0%). Moreover, 17.7% of respondents with psoriasis did not consult. A high percentage of participants with alopecia thought that the disease was not worrying, while patients with psoriasis often answered that they were able to manage the disease since they had already consulted a doctor. Many patients with acne (41.1%) and fungal infection (48.2%) thought that they were able to handle the disease by themselves. The analysis of the self-reported medical journey of patients with common skin diseases may allow to understand the unmet needs of patients, thus improving outcomes and reducing expenses.

The Psoriasis Disability Index in Romanian Psoriasis Patients during COVID-19 Pandemic: Contribution of Clinical and Psychological Variables.

Psoriasis is one of the most frequent chronic inflammatory skin diseases and has a negative impact on the interpersonal relationship and psychosocial well-being. The aims of this study were to examine the effects of intensity of pruritus on quality of life and depression, to investigate the relationship between anger, self-esteem, and depression, and to compare patients with early and late onset of psoriasis. As our study was carried out during the COVID-19 pandemic, we aimed also to investigate the safety concerns and anxiety related to COVID-19 in psoriasis patients. This cross-sectional study included 137 patients diagnosed with plaque psoriasis. The patients were classified as early-onset (age < 30 years) and late-onset psoriasis (age ≥ 30 years). Duration of disease, pruritus scores, and socio-demographic characteristics were recorded. Measures included the State-Trait Anger Expression Inventory (STAXI), Rosenberg Self-Esteem Scale, Beck Depression Inventory (BDI-II), Psoriasis Disability Index (PDI), and Fear and anxiety in relationship with COVID-19 Scale were used for determining anger, anger expression style, self-esteem, depression, anxiety, and quality of life. The psoriasis patients had a lower score for self-esteem than the normative data from the Romanian general population. The average scores for state anger and trait anger are similar to the normative data from the Romanian general population, but the scores for anger-in and anger-out are higher. Patients with early onset had higher depression scores and lower quality of life. Self-esteem correlates negatively with depression, anger, severity of disability due to psoriasis, number of affected areas, and duration of disease. Lower level of self-esteem led to increased anger. Reduced self-esteem, increased anger levels, and depression are present in psoriasis patients. The effective treatment of psoriasis must, therefore, consist of a multidisciplinary approach, in which the personalized treatment of the skin condition is as important as the adjuvant therapies that reduce the patients' stress level.

Gasdermin E (GSDME)-A New Potential Marker of Psoriasis and Its Metabolic Complications: The First Combined Study on Human Serum, Urine and Tissue.

Psoriasis is a frequent and incurable skin disease whose pathogenesis is still not fully understood. It is characterized by immune disturbances leading to hyperproliferation and improper differentiation of keratinocytes. Gasdermin E (GSDME) is a protein from the gasdermin family involved in the processes of inflammation and cell death based on apoptosis, necroptosis and pyroptosis. It has never been studied in psoriatics' sera or urine before. Our study enrolled 60 patients with psoriasis and 30 volunteers without dermatoses as controls. Serum and urinary GSDME concentrations were examined by ELISA and tissue expression of GSDME by immunohistochemistry. Serum GSDME concentration was significantly higher in patients than controls (p < 0.05). There were no differences in urinary GSDME concentrations between patients and controls. GSDME expression was significantly higher in the psoriatic plaque than non-lesional patients' skin and compared to controls (both p < 0.001). There was no correlation between serum GSDME or its lesional expression and psoriasis severity, age or disease duration. GSDME serum concentration was significantly negatively correlated with BMI, triglycerides and glucose concentrations. The obtained results suggest the engagement of GSDME in psoriasis pathogenesis. It could potentially become a new non-invasive psoriasis marker. Considering its pro-apoptotic influence, GSDME could be compensatively elevated to direct cells towards apoptosis, whereas under other circumstances, it may lead to pyroptosis and sustain inflammation. GSDME may exert a protective influence on the metabolic complications in psoriasis which requires further studies.

Prospects for the use of adequate external therapy for atopic/allergic dermatitis in children

The article focuses on the most frequent skin diseases in young children. Atopic/allergic dermatitis is one of the most common diseases in children. Approximately 45% of patients develop their first symptoms within the first 6 months after birth, 60% show the onset of atopic dermatitis during the first year of life and 80-85% at the age of 1 to 5 years. The article also speaks about the issue of allergic contact dermatitis (diaper rash in newborns). The disease represents non-specific inflammatory skin changes in the contact area in infants, the onset of which occurs mostly at the age of 1 to 15 months. The factors responsible for causing these diseases, the pathogenesis of their development and the potential of topical therapy mainly targeted at the reduction of clinical manifestations and frequency of exacerbations, improvement of the quality of life and prevention of infectious complications are considered. As an initial treatment, the authors consider a drug containing methylprednisolone aceponate with ceramides of domestic manufacturing. Its effectiveness and safety in the combination therapy of young children suffering from atopic/allergic and contact dermatitis may be evaluated in clinical practice. Clinical case reports of treatment of children with dermatitis of various etiologies aged from 4.5 months up to 3 years are presented. The outcomes of the use of Komfoderm K in children with AD demonstrated a significant decrease in the severity of inflammation, reduction of the skin lesion area and the intensity of symptoms, decreased need for additional intake of antihistamines and anti-inflammatory drugs, and the ability to achieve stable clinical remission.

CHRONIC HYPERPLASTIC CANDIDIASIS AS A RARE ADVERSE EVENT OF SECUKINUMAB THERAPY

Secukinumab is an anti-IL-17A monoclonal antibody used for the treatment of psoriasis, a frequent chronic inflammatory skin disease. However, IL-17 is essential in immunity against oral opportunistic fungal pathogens; therefore, oral candidiasis can occur in patients treated with this drug, although adverse oral events are not widely described. A 72-year-old male patient with arthritis psoriasis managed with Secukinumab 300 mg once a month, for 90 days, presented a burning white plaque on the mid dorsal posterior tongue. Fungal culture was performed and a diagnosis of oral candidiasis was established. Systemic and topical antifungal medication led to regression of the lesion and burning sensation resolution. No symptoms or recurrence of the lesion were observed after six months of follow up. This case highlighted the importance of monitoring patients who are under treatment with IL-17 blockers due to the risk of opportunistic infections. Secukinumab is an anti-IL-17A monoclonal antibody used for the treatment of psoriasis, a frequent chronic inflammatory skin disease. However, IL-17 is essential in immunity against oral opportunistic fungal pathogens; therefore, oral candidiasis can occur in patients treated with this drug, although adverse oral events are not widely described. A 72-year-old male patient with arthritis psoriasis managed with Secukinumab 300 mg once a month, for 90 days, presented a burning white plaque on the mid dorsal posterior tongue. Fungal culture was performed and a diagnosis of oral candidiasis was established. Systemic and topical antifungal medication led to regression of the lesion and burning sensation resolution. No symptoms or recurrence of the lesion were observed after six months of follow up. This case highlighted the importance of monitoring patients who are under treatment with IL-17 blockers due to the risk of opportunistic infections.

A Review on Granulation of Trikuta Churna

The objective of this work is the conversion of trikutachurna into stable, palatable and patient acceptable granules to swallow conveniently by wet granulation method, using suitable binding agents. In Trikuta as essential ingredients of numerous prescription and formulations used for wide range of disorders. Ayurvedic system of medicine prescribes Trikatu for the management of tastelessness (Arocaka) disturbed digestion (Agnimandya and Amadosa), diseases of nose (Pinasa) and upper respiratory tract (Gala and swasaroga, Kasa), excess and frequent urination (Meha), edema (Gulma), obesity (Sthaulya), Filariasis (Slipada), and skin diseases (Tvakroga). Trikatu acts primarily by its effect on stomach, liver, and pancreas. In stomach, it increases production of digestive juices thereby stimulating digestion. In liver, it acts as Cholagogue and increases production of bile salts by stimulating gallbladder functioning. Trikatu also has its influence on pancreatic functioning.

Systemic treatment for severe atopic dermatitis in children: a case series.

Atopic dermatitis (AD) is children's most frequent chronic inflammatory skin disease. In most patients, this condition is controlled with topical treatments; however, some patients with severe AD do not respond to these treatments, requiring systemic therapy. There is insufficient information about the ideal dose, time of use, clinical response, and safety of systemic therapy in children with severe AD. This study described the clinical characteristics of patients with severe AD who required systemic treatment, drugs used, their clinical course, adverse effects, and associated complications. We conducted a retrospective review of the records of pediatric patients with severe AD treated in the Dermatology Clinic, Instituto Nacional de Pediatría (2000 to 2018), who required systemic treatment for more than 3 months. We included 21 patients. The mean age at disease onset was 3.31 years. The drugs used were methotrexate (57.1%), thalidomide (38%), prednisone (42.8%), azathioprine (19%), mycophenolate mofetil (9.5%), cyclosporine (4.7%), and systemic steroids as bridging therapy (42.8%). Adverse effects were mild and were observed in two patients (9.5%) treated with methotrexate and mycophenolate mofetil. Methotrexate was the most frequently used drug in > 50% of the patients, and most patients attained remission. Cyclosporine, azathioprine, and mycophenolate mofetil were also effective. Side effects were mild and infrequent. Comparative studies of systemic treatments for severe AD in the pediatric population are necessary.

Validation of a Questionnaire to Assess the Perception of Women with Atopic Dermatitis in Family Planning.

Introduction: Atopic dermatitis (AD) is a highly frequent chronic inflammatory skin disease. It is important to know how women with AD approach family planning together with their disease. The aim of the present research is to develop and validate a questionnaire for women diagnosed with AD in order to measure their level of desire and gestational information. Materials and Methods: A multicenter cross-sectional study was conducted. Women between 18 and 45 years old with mild, moderate, and severe forms of the disease were included and disease-free controls. An exploratory factorial analysis of the primary components and varimax rotation was used to measure the validity of the construct. Cronbach’s α was used to measure the reliability of the individual scales and the global questionnaire. Results: In total, 150 valid questionnaires were included. The final questionnaire consisted of 23 items that converged on six factors. The six scales had adequate reliability: “Pregnancy” (Cronbach’s alpha = 0.95), “Conception” (Cronbach’s alpha = 0.93), “Concern-information” (Cronbach’s alpha = 0.82), “Breastfeeding” (Cronbach’s alpha = 0.81), “Sexual life” (Cronbach’s alpha = 0.79), and “Family planning” (Cronbach’s alpha = 0.67). The total Cronbach’s alpha of the questionnaire was 0.94. Discussion: This questionnaire is the first specific measurement instrument developed for women with AD of childbearing age that has demonstrated adequate levels of reliability and construct validity. We consider it useful and valuable to study aspects such as family planning in this patient profile, and that can influence their decision to have offspring.

Serum autoantibody reactivity in bullous pemphigoid is associated with neuropsychiatric disorders and the use of antidiabetics and antipsychotics: a large, prospective cohort study.

Bullous pemphigoid (BP), the by far most frequent autoimmune blistering skin disease (AIBD), is immunopathologically characterized by autoantibodies against the two hemidesmosomal proteins BP180 (collagen type XVII) and BP230 (BPAG1 or dystonin). Several comorbidities and potentially disease-inducing medication have been described in BP, yet a systematic analysis of these clinically relevant findings and autoantibody reactivities has not been performed. To determine associations of autoantibody reactivities with comorbidities and concomitant medication. In this prospective multicenter study, 499 patients diagnosed with BP in 16 European referral centers were included. The relation between anti-BP180 NC16A and anti-BP230 IgG ELISA values at the time of diagnosis as well as comorbidities and concomitant medication collected by a standardized form were analysed. An association between higher serum anti-BP180 reactivity and neuropsychiatric but not atopic and metabolic disorders was observed as well as with the use of insulin or antipsychotics but not with dipeptidyl peptidase-4 (DPP4) inhibitors, inhibitors of platelet aggregation and L-thyroxine. The use of DPP4 inhibitors was associated with less anti-BP180 and anti-BP230 reactivity compared with BP patients without these drugs. This finding was even more pronounced when compared with diabetic BP patients without DPP4 inhibitors. Associations between anti-BP180 and anti-BP230 reactivities were also found in patients using insulin and antipsychotics, respectively, compared with patients without this medication, but not for the use of inhibitors of platelet aggregation, and L-thyroxine. Taken together, these data imply a relation between autoantibody reactivities at the time of diagnosis and both neuropsychiatric comorbidities as well as distinct concomitant medication suggesting a link between the pathological immune mechanisms and clinical conditions that precede the clinically overt AIBD.

Oral changes in patients with psoriasis.

Psoriasis is one of the most frequent skin diseases. The cause of psoriasis is not fully expained as there are many factors (infectious, traumatic, hormonal, and chemical) that may play a role in the manifestation of its symptoms. One of the factors that may contribute to the appearance of psoriatic lesions may be the lesions in the oral cavity. The occurrence of lesions in the oral cavity is defined as rare, what can be explained by their nonspecific clinical image, and also by the possibility of being overlooked. Most characteristic symptoms of psoriasis occurring in the oral cavity are the geographic tongue and fissured tongue. It is also believed that there is a correlation between psoriasis and oral health- the periodontal and teeth condition as well as changes in saliva secretion. The psoriasis arthritis changes can also affect temporomandibular joint and impair the function of stomatognathic system. Because of these reports, cooperation of dermatologists and dentists in psoriasis care seems to be necessary.