Vascular endothelial growth factor (VEGF) is a key growth factor, regulating the neovascularization, during embryogenesis, skeletal growth, reproductive functions and pathological processes. The VEGF receptors (VEGFR) are present in endothelial cells and other cell types, such as vascular smooth muscle cells, hematopoietic stem cells, monocytes, neurons, macrophages, and platelets.Angiogenesis is initiated by the activation of vascular endothelial cells through several factors. The excess dermal vascularity and VEGF production are markers of psoriasis.The pathological role of VEGF/VEGFR signaling during the psoriasis onset and evolution makes it a promising target for the treatment of psoriasis. Antibodies and other types of molecules targeting the VEGF pathway are currently evaluated in arresting the evolution of psoriasis.

Aim: To evaluate the morphostructural aspects and nail vascularity in the nail unit of patients with psoriasis, and to evaluate whether there are differences among psoriatic patients with and without nail involvement. Material and methods: Nail plates and nail bed changes, nailfold vessel resistance index (NVRI), power and color Doppler blood flow appearances were investigated in 23 patients with moderate-to-severe psoriasis, with and without nail involvement, and compared to those of 11 healthy participants. Results: Ventral nail plate deposits were present only in psoriasis patients. Irregular or totally fused nail plates and increased nail plate thickness was frequently observed in psoriasis patients compared to controls. NVRI was increased in psoriatic patients' nails compared to controls (0.62 vs. 0.57, p<0.0001). In the psoriasis patient group there was significant statistical difference in NVRI in patients with nail involvement compared to those without (0.66 vs. 0.55, p<0.0001). Conclusions: High-frequency gray scale sonography provides valuable information regarding morphostructural changes in nail unit structure in patients with psoriasis. Power Doppler imaging enables blood flow assessment in psoriasis nail induced changes.

Psoriasis is a chronic inflammatory skin disease with autoimmune pathogenic characteristics and is caused by chronic inflammation, which results in uncontrolled keratinocyte growth and defective differentiation. The link between the gut microbiota and immune system regulation opened a novel angle to understand the pathogenesis of many chronic multifactorial diseases, including psoriasis. Current evidence suggests that modulation of the gut microbiota, both through dietary approaches and through supplementation with probiotics and prebiotics, could represent a novel therapeutic approach. The present work aims to highlight the latest scientific evidence regarding the microbiome alterations of psoriatic patients, as well as state of the art insights in terms of microbiome-targeted therapies as promising preventive and therapeutic tools for psoriasis.

Although the therapeutic efficacy of antifungals is well known for dermatophytosis in general population, limited data exist for patients with chronic kidney disease. The objectives of this study were to determine the dermatophyte species causing infection in patients with end-stage renal disease (ESRD) and in vitro susceptibility of isolated dermatophytes to antifungals. A total of 87 patients with ESRD who undergoing haemodialysis and 105 patients with normal renal function suspected with dermatophytosis were included. Skin scrapings or nail clippings were examined by direct microscopy and cultured on Sabouraud agar. In vitro antifungal susceptibility tests were performed using a broth microdilution method. Dermatophyte infections were identified in 32.2% of haemodialysis patients and in 29.5% of controls (P > 0.05). In both groups, Trichophyton rubrum was the most frequently isolated. Mean MIC values of the all studied antifungals for all of isolated dermatophyte strains from patients with ESRD were similar to those obtained in control group (P > 0.05). Terbinafine (TBF) had the lowest mean MIC values for all tested dermatophytes in both groups. We consider that TBF should be the treatment of choice for dermatophytosis in patients with chronic kidney disease, but the dose should be adjusted according to creatinine clearance and should be monitored for side effects.

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.