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1.  Apprehension of the disease by patients suffering from psoriasis 
Introduction
Psoriasis affects about 1–2% of the entire population. Due to its chronicity and relapsing course, psoriasis has a great influence on patients’ quality of life and psychological status.
Aim
To evaluate apprehensaion of the disease by psoriatic patients.
Material and methods
One hundred psoriasis patients (36 females, 64 males; mean age 47.3 ±15.8 years) were enrolled. Mean psoriasis severity assessed according to PASI was 17.1 ±10.0 points. Each participant underwent a careful physical examination and completed a specially designed questionnaire containing questions about perception of psoriasis severity, disease aggravating factors, most bothersome symptoms, possible causes of psoriasis and treatment efficacy.
Results
A correlation between patients’ psoriasis assessment and objective measurement of disease intensity by PASI was weak, albeit significant (ρ = 0.37, p < 0.001). A total of 49% of patients indicated that psoriasis had an enormous negative impact on their life and 40% declared that psoriasis decreased their self-esteem. Patients with decreased self-esteem were significantly younger and more frequently employed. A marked portion of patients believed that their disease will be cured in the future. Patients expecting a rapid cure of disease had experienced a later disease onset and suffered from psoriasis significantly shorter. The most burdensome symptoms of psoriasis were intense epidermal scaling (66% of responders), itching (65%), skin redness (51%), burning (44%), dandruff (38%), and nail abnormalities (37%).
Conclusions
Psoriasis may negatively affect patients’ everyday life, but the degree of that influence and the level of psoriasis understanding depend on various clinical parameters as well as on demographic characteristics.
doi:10.5114/pdia.2014.44010
PMCID: PMC4221352  PMID: 25395924
patients' beliefs; psoriasis; quality of life
2.  Disturbed skin barrier in children with chronic kidney disease 
Background
There are limited data on skin lesions in children with end-stage renal failure. The aim of the study was an evaluation of the skin barrier in children with different stages of chronic kidney disease (CKD). The prevalence of xerosis, its severity, as well as its link selected demographic factors, were examined.
Methods
The study included 103 children: 72 with CKD stages 3–5 (38 on conservative treatment and 34 on dialysis) and 31 patients with primary monosymptomatic nocturnal enuresis as a control group. Initially, the study subjects described the localisation and severity of dry skin by themselves. Next, clinical evaluation of xerosis, non-invasive corneometric assessment of epidermis moisturising and the measurement of transepidermal water loss were performed.
Results
Most CKD children reported dry skin. The problem of xerosis was identified more frequently in patients on dialysis (67.6 %) than on conservative treatment (42.1 %) (p = 0.01). CKD patients divided according to skin dryness did not differ with regards to age, sex, initial kidney disease and CKD duration.
Conclusions
Disturbed skin barrier is an important concern of children with CKD, intensifying as the disease progresses. This symptom occurs on early stages of CKD and it should be taken into consideration in the CKD management.
doi:10.1007/s00467-014-2932-2
PMCID: PMC4282711  PMID: 25127919
Dry skin; Chronic kidney disease; Dialysis; Conservative treatment; Children
3.  Prevalence of Demodex spp. in eyelash follicles in different populations 
Archives of Medical Science : AMS  2014;10(2):319-324.
Introduction
The pathologic relevance of Demodex infestation in blepharitis is still controversial. The aim of the study was to determine the prevalence of Demodex spp. in eyelash follicles and its relationship to eye symptoms.
Material and methods
A total of 290 individuals were studied for the presence of Demodex folliculorum and Demodex brevis within eyelash follicles. Participants belonged to one of four groups: inpatients, drug abusers, health professionals, and medical students. Ten eyelashes were epilated from each subject, placed on microscope slides and examined for parasites. The sample was defined as positive if at least one parasite or parasite's ova were present. The presence of parasites was analyzed according to age, gender, place of living, reported eye problems, and use of contact lenses or glasses.
Results
The prevalence of Demodex spp. infestation among all studied subjects was 41%, with the highest infestation rate among inpatients (p < 0.01) and elderly people (p < 0.001). No difference regarding the presence of Demodex was found between women and men (p = 0.76). Demodex folliculorum was about 2.4 times more frequent than D. brevis. The prevalence of Demodex spp. in subjects with and without eye complaints suggesting blepharitis was similar (41.6% vs. 40.2%, respectively, p = 0.9). On the other hand, wearing glasses was linked to Demodex infestation (48.4% vs. 32.3%, p < 0.01).
Conclusions
Demodex is a common saprophyte found in human eyelash follicles. Its presence might be related to some ocular discomfort; however, in the vast majority of cases the infestation seems to be asymptomatic.
doi:10.5114/aoms.2014.42585
PMCID: PMC4042053  PMID: 24904668
blepharitis; Demodex; demodicosis; mites; prevalence
4.  Altered expression of Bcl-2, c-Myc, H-Ras, K-Ras, and N-Ras does not influence the course of mycosis fungoides 
Introduction
Data about genetic alterations in mycosis fungoides (MF) are limited and their significance not fully elucidated. The aim of the study was to explore the expression of various oncogenes in MF and to assess their influence on the disease course.
Material and methods
Skin biopsies from 27 MF patients (14 with early MF and 13 with advanced disease) and 8 healthy volunteers were analyzed by real-time polymerase chain reaction (PCR) to detect Bcl-2, c-Myc, H-Ras, K-Ras and N-Ras expression. All PCR reactions were performed using an Applied Biosystems 7900HT Fast Real-Time PCR System and interpreted using Sequence Detection Systems software which utilizes the comparative delta Ct method. The level of mRNA was normalized to GAPDH expression. All data were analyzed statistically.
Results
All evaluated oncogenes were found to be expressed in the skin from healthy controls and MF patients. Bcl-2 (–4.2 ±2.2 vs. –2.2 ±1.1; p = 0.01), H-Ras (–3.0 ±3.3 vs. 0.6 ±2.6; p = 0.01) and N-Ras (–3.6 ±2.0 vs. –1.1 ±2.4; p = 0.03) were expressed at significantly lower levels in MF. No relationships between oncogene expression and disease stage, presence of distant metastases and survival were observed (p > 0.05 for all comparisons).
Conclusions
The pathogenic role and prognostic significance of analyzed oncogenes in MF seem to be limited and further studies are needed to establish better prognostic factors for patients suffering from MF.
doi:10.5114/aoms.2013.38684
PMCID: PMC3832835  PMID: 24273576
cutaneous T-cell lymphoma; oncogenes; dermato-oncology; pathogenesis
5.  Mediators of Pruritus in Lichen Planus 
Autoimmune Diseases  2013;2013:941431.
Lichen planus (LP) is an inflammatory mucocutaneous disease, showing a wide variety of clinical subtypes. The classic presentation of LP involves the appearance of polygonal, flat-topped, violaceous papules and plaques with reticulated white lines, termed “Wickham's striae”. Cutaneous lesions tend to be extremely pruritic, and this symptom does not subside after common antipruritic treatment. Moreover, based on our previous pilot study, it could be stated, that itch is the most unpleasant and bothersome symptom of LP for majority of patients suffering from this disease. However, the underlying mechanisms of itch in lichen planus remain still unknown. In addition, there is no study on mediators of this sensation, but taking into account pathogenesis of LP there are some possible mediators implicated to transmit or modulate itch. In pathogenesis of LP important are such mechanisms as apoptosis, autoimmune reaction, and role of stress. With these pathways some, previously described in other diseases, itch mediators such as cytokines, proteases, and opioid system are connected. Whether these mechanisms are involved in pruritus accompanying LP requires further investigation. Limited knowledge of pruritus origin in lichen planus is responsible for the lack of the effective antipruritic treatments. Here, we describe possible mechanisms participating the pathogenesis of pruritus in lichen planus.
doi:10.1155/2013/941431
PMCID: PMC3736511  PMID: 23970959
6.  Effects of Narrow Band UVB (311 nm) Irradiation on Epidermal Cells 
Ultraviolet radiation (UVR) is known to be one of the most important environmental hazards acting on the skin. It was revealed that chronic exposure to UVR accelerates skin aging, induces immunosuppression and may lead to the development of skin cancers. On the other hand, UVR has been shown to be effective in the treatment of numerous skin diseases and thus, various phototherapy modalities have been developed to date. Narrow-band ultraviolet B (NB-UVB) emitting a light with a peak around 311 nm has been demonstrated to be effective in the treatment of various skin disorders; currently it is one of the most commonly used phototherapy devices. Despite NB-UVB has been developed more than 30 years ago, the exact mechanism of its therapeutic action remains poorly understood. To date, most of NB-UVB effects were attributed to its influence on immune cells; however, nearly 90% of NB-UVB irradiation is absorbed by epidermis and keratinocytes seem to be important players in mediating NB-UVB biological activity. Here, we have reviewed the current data about the influence of NB-UVB on epidermal cells, with a special emphasis on cell proliferation and death.
doi:10.3390/ijms14048456
PMCID: PMC3645754  PMID: 23594996
cell death; epidermis; keratinocytes; NB-UVB; phototherapy
8.  The lupus band test in systemic lupus erythematosus patients 
The lupus band test (LBT) is a diagnostic procedure that is used to detect deposits of immunoglobulins and complement components along the dermoepidermal junction in patients with lupus erythematosus (LE). The LBT is positive in about 70%–80% of sun-exposed non-lesional skin specimens obtained from patients with systemic LE (SLE), and in about 55% of SLE cases if sun-protected nonlesional skin is analyzed. In patients with cutaneous LE only, the lesional skin usually shows a positive LBT. The LBT helps in differentiating LE from other similar skin conditions and may also be helpful in making the diagnosis of SLE in subjects with no specific cutaneous lesions. Furthermore, a positive LBT may be applied as a prognostic parameter for LE patients. However, the correct interpretation of this test requires detailed knowledge of the site of the biopsy, deposit components, morphology and brightness of the immunofluorescent band, and other associated serologic findings, as well as the response to treatment. It must be emphasized that LBT is a laboratory procedure that should always be interpreted in conjunction with clinical findings and other serological and immunopathological parameters.
doi:10.2147/TCRM.S10145
PMCID: PMC3039011  PMID: 21339940
lupus erythematosus; dermoepidermal junction; diagnostics
9.  Mediators of Pruritus in Psoriasis 
Mediators of Inflammation  2007;2007:64727.
The pathogenesis of pruritus in psoriasis remains unclear. Many possible mediators were implicated to transmit or modulate this sensation in psoriasis, but none has been clearly proven to be a causative agent of itching. The most often discussed theory mentioned the importance of impaired innervations and neuropeptides imbalance in psoriatic skin. Other possible causes of itching might be increased expression of interleukin 2 or vascular abnormalities. Recent data indicated that pruritus could be also evoked by opioid system, prostanoids, interleukin 31, serotonin, or proteases. Whether these mechanisms are also involved in pruritus accompanying psoriasis requires further investigation. Limited knowledge of pruritus origin in psoriasis is responsible for the lack of the effective antipruritic treatments for psoriatics. Here, we summarize the current knowledge about the pathogenesis of pruritus in psoriasis and point out possible directions of future studies aiming the pathogenesis of this symptom in psoriasis.
doi:10.1155/2007/64727
PMCID: PMC2221678  PMID: 18288273
10.  Enhanced Enzymatic Activity of Yeast-like Fungi Responsible for Onychomycosis in Renal Transplant Recipients 
Background:
Renal transplant recipients (RTR) are regarded as a group especially predisposed to onychomycosis. The exact mechanism of increased frequency of onychomycosis in RTR is however not fully understood.
Objectives:
This study was undertaken to evaluate activity of hydrolitic enzymes of fungi most commonly causing fungal nail infections in RTR and to compare it with enzymatic activity of the same fungi isolated from lesional nails in immunocompetent patients.
Material and methods:
28 strains of yeast-like fungi cultured from lesional nails in RTR and 25 strains of yeasts isolated from changed nails in immunocompetent patients were included into the study. All fungi were identified on the basis of routine mycological procedures. Activity of 19 hydrolytic enzymes was assessed by API ZYMÒ test (bioMerieux).
Results:
Fungi cultured from RTR showed activity of 16 out of 19 enzymes, whereas fungi isolated from immunocompetent patients only 11 out of 19 enzymes. Moreover, yeast-like fungi isolated from RTR showed higher generally higher activity of detected enzymes compared to yeast strains obtained from the lesional nails of immunocompetent patients.
Conclusions:
This study shows for the first time enhanced enzymatic activity of yeast-like fungi isolated from lesional nails in RTR in comparison to fungi cultured from changed nails in immunocompetent patients. It is hypothesized that this enhanced enzymatic activity may be responsible for higher incidence of onychomycosis in RTR.
PMCID: PMC3614566  PMID: 23674963
onychomycosis; renal transplantation; enzymatic activity; yeasts

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