CIndU is a common inflammatory skin condition characterized by the recurrence of itchy wheals and/or angioedema that lasts more than 6 weeks and is induced by specific physical or environmental stimuli (cold, heat, exercise, pressure, sunlight, vibration, water, etc.) (1-7). The more common types include dermographism, cholinergic urticaria, and delayed-pressure urticaria/angioedema, whereas rare disorders are urticaria/angioedema caused by heat, exercise, water, sunlight, or vibration.According to the current international classification, there are two types of CIndU: physical urticarias and non-physical urticarias (Table 2) (4, 8-14). The physical urticaria group includes dermographism (the most common), delayed-pressure urticaria (the third most frequent type), exercise-induced urticaria, cold urticaria, heat urticaria, solar urticaria, and vibratory urticaria. The non-physical urticaria group comprises cholinergic urticaria (the second most frequent type), contact urticaria, and aquagenic urticaria (4,(8)(9)(10)(11)(12)(13)(14). Physical urticarias are generally more common and occur in 10 to 50% of chronic urticaria patients and in up to 5% of the general population (12). The most frequent types in the physical urticaria group are dermographism and delayed-pressure urticaria ( 12). According to study data, in comparison to chronic spontaneous urticaria, CIndU equally often affects men and women, but it is generally more common in the younger population; less frequently, it is associated with angioedema (1).With respect to diagnostics, CIndU can often be diagnosed on the basis of patient history and physical examination, as well as provocation testing (2, 9, 12). Management begins with accurate identification and avoidance of triggers. The initial treatment includes primarily non-sedating H1 antihistamines (e.g., desloratadine, fexofenadine, bilastine, levocetirizine, loratadine, cetirizine, etc.). Therefore many patients require doubling of the standard dose. In cases unresponsive to antihistamines, a stepwise approach is suggested: H2 antihistamines, first-generation H1 antihistamines, systemic corticosteroids (for a short time), and omalizumab (a humanized monoclonal anti-immunoglobulin E, approved for refractory chronic urticarias). In persistent refractory cases, other therapies may include phototherapy, physical desensitization, and immunomodulatory agents.

Recent studies have linked gut microorganism composition and chronic urticaria (CU); however, the underlying mechanisms responsible for this connection are unknown. Since the human immune system is in homeostasis with microbiota, and the composition of the microbiome regulates the development and function of the immune system, it is likely that an alteration of microbiota components (a dysbiosis) could influence the course of chronic spontaneous urticaria (CSU), including disease severity, patient quality of life and treatment outcome. To date, several studies have identified changes in the gut microbiota composition of patients with CSU, though only a few have exhibited metabolic abnormalities associated with gut dysbiosis. The studies on CSU patients predominantly showed that the relative abundance of beneficial bacteria was decreased (Firmicutes and Bacteroides), while that of opportunistic bacteria was increased (Enterobacteria and Proteobacteria). In addition, serum metabolome analysis revealed that gut microbiota-associated alterations in unsaturated fatty acids and the butanoate metabolism pathway may play a role in CSU. These findings are potentially associated with inflammation mediated by the imbalance of Th1/Th2/Th17 cytokines, which might contribute to CSU pathogenesis. Further research in this field could improve clinical, diagnostic, and therapeutic approaches to patients with CSU. By applying new knowledge on gut microbial communities and metabolomics, future CSU therapies could modify the microbiota composition using agents such as probiotics or other similar agents, which, in combination with current standard therapies, could hopefully lead to a reduction in symptoms and an improved quality of life for CSU patients.

ObjectivesTo determine prevalence of undesirable, work-related skin lesions and their localizations in dental professionals and students, and to collect data about diagnostic procedures they undergo and skin care they take when these lesions occur.Subjects and methodsOur research included 444 respondents (dentists, dental assistants, dental technicians, dental students) who filled out a questionnaire. They were asked to specify if they had observed any lesions on their skin and where; if they had undergone any treatments and in what way; if they had undergone any allergy tests; and if they had taken any protective measures.ResultsOf all the respondents that took part in the survey, 249 (56.1%) reported undesirable skin reactions commonly on their hands and fingers (96%). Before our survey, only 15% of them had seen a dermatologist, while 33% had undergone allergy tests (without a dermatologists’ clinical examination). Also, 45% of them sometimes used soaps for sensitive skin and the majority (61%) of them used protective hand creams 1-2 times per day.ConclusionAlthough a large number of dental professionals and students have noticed work-related skin lesions, only some of them sought dermatologists’ professional help and most of them did not take care of their skin adequately when those lesions occurred. According to the results of this study, it is necessary to take additional preventive measures to increase dental professionals’ and students’ awareness of occupational dermatoses and adequate skin care.

Background: This research looks at the connection between psychological stress and the prevalence of hand eczema (HE) among physicians and dentists (surgeons, non-surgeons). Methods: This cross-sectional field study involved 185 participants: physicians (surgeons, non-surgeons), dentists (surgeons, non-surgeons) and controls. Hand lesions were examined using the Osnabrueck Hand Eczema Severity Index (OHSI), and participants answered the Nordic Occupational Skin Questionnaire (NOSQ) and Perceived Stress Scale (PSS). Patch tests were performed using commercial contact allergens. Results: The estimated prevalence of HE (self-reported) was 43.9% (physicians 44.6%; dentists 43.2%). HE was significantly more reported by surgeons than controls (p < 0.004; V = 0.288). Degrees of perceived stress (PSS) did not differ significantly between the groups, though physicians non-surgeons most exhibited high stress (50%), and physicians surgeons most exhibited low stress (22.5%). High stress was associated with 2.5 higher odds for self-reported HE (p = 0.008). Low stress was greater among physicians/dentists who did not report eczema (41.0% vs. 24.6%); moderate stress was more common among those who reported eczema (72.3% vs. 51.8%; p = 0.038; V = 0.210). Conclusions: Since high stress levels may negatively influence physicians’/dentists’ work and quality of life, measures to decrease stress could be introduced into the treatment of healthcare workers who are prone to it.

Introduction: There has been a lot of talk lately about the importance of reduced serum vitamin D levels and their supplementation for patients with inflammatory skin diseases such as atopic dermatitis (AD) and other allergic diseases. Serum vitamin D values are associated with a number of factors such as limited sunlight exposure (modern lifestyle, extended indoor stay, enhanced sun protection, etc.) which can affect different diseases. Aim: To evaluate serum vitamin D values in patients with inflammatory skin diseases, comparing them on the basis of other parameters (age, gender/sex, residential areas, total serum IgE), and establishing whether vitamin D supplementation would affect the improvement of the clinical picture of the disease. Patients and methods: A total of 157 patients participated in this prospective study: 51 patients with AD, 55 with chronic urticaria (CU) and 51 with contact dermatitis (CD): 38 with irritant CD (ICD) and 13 with allergic CD (ACD). In all patients, the values of serum vitamin D were determined by chemiluminescence microparticle immunoassay (CMIA) and compared by diagnosis, age, sex, living environment, values of total IgE. In patients with reduced values of vitamin D, its supplementation for 3 months was recommended, after which the second evaluation of D vitamin values and disease status were determined and compared with an untreated/unsupplemented group with normal vitamin D values. Results: Vitamin D deficiency was often observed in patients with AD, CU and CD, most frequently in the ICD group, and least frequently in the ACD group. No significant differences were found in terms of age, gender or living environment, nor was any correlation with total IgE found. In the subjects supplemented with vitamin D, their levels increased significantly and, after its supplementation, improvement of the clinical condition was more common than in the untreated group; however, the differences were not statistically significant (69.8 vs. 58.1, p=0.428). Conclusions: Although serum vitamin D levels of the groups did not differ significantly, the supplementation of vitamin D in patients with prominent vitamin D deficiency may be useful and crucial for improving the prognosis of the disease.