Psoriasis is a chronic, immune-mediated inflammatory disease that affects around 125 million people worldwide. Several studies concerning the gut microbiota composition and its role in disease pathogenesis recently demonstrated significant alterations among psoriatic patients. Certain parameters such as Firmicutes/Bacteroidetes ratio or Psoriasis Microbiome Index were developed in order to distinguish between psoriatic and healthy individuals. The “leaky gut syndrome” and bacterial translocation is considered by some authors as a triggering factor for the onset of the disease, as it promotes chronic systemic inflammation. The alterations were also found to resemble those in inflammatory bowel diseases, obesity and certain cardiovascular diseases. Microbiota dysbiosis, depletion in SCFAs production, increased amount of produced TMAO, dysregulation of the pathways affecting the balance between lymphocytes populations seem to be the most significant findings concerning gut physiology in psoriatic patients. The gut microbiota may serve as a potential response-to-treatment biomarker in certain cases of biological treatment. Oral probiotics administration as well as fecal microbial transplantation were most reported in bringing health benefits to psoriatic patients. However, the issue of psoriatic bacterial gut composition, its role and healing potential needs further investigation. Here we reviewed the literature on the current state of the relationship between psoriasis and gut microbiome.
Background Localized scleroderma (LoS) is an inflammatory fibrosing disease of the connective tissue, whose esthetic sequelae are atrophic skin lesions with hyperpigmentation. The key element of diagnostic and therapeutic procedures is the assessment of the disease's severity and damage. The study objective was to analyze the usefulness of narrow-band reflectance spectrophotometry (NBRS) to assess erythema and hyperpigmentation in LoS lesions. Materials and Methods Erythema indexes (EI) and melanin indexes (MI) were determined with the use of DermaLab Combo skin colour probe for LoS lesions and symmetrically located areas of normal skin. Then, relative percentage differences were determined for EI and MI, which were compared with the visual assessments of erythema and hyperpigmentation according to the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT). Results A total of 84 LoS lesions were studied in 41 patients. The study showed a moderate correlations between the spectrophotometric measurements and clinical assessments of erythema as well as hyperpigmentation (Spearman correlation coefficient, r), r = 0.37; p = 0.00047 and r = 0.55; p=0.0000001, respectively. Conclusion NBRS seems to be a useful tool to assess the severity of erythema and hyperpigmentation in LoS lesions. Further studies are required in order to compare the spectrophotometric results with other objective methods.
Inflammation and atherogenic dyslipidaemia are often observed in skin diseases and represent an increased risk of cardiovascular disorders. Proprotein convertase subtilisin/kexin type 9 plays an important role in the regulation of serum low-density lipoprotein cholesterol levels. Its biological role, however, seems to go much beyond the regulation of cholesterol metabolism. The article presents potential pathophysiological links between inflammatory process and lipid disorders based on the example of psoriasis and systemic lupus erythematosus.
Background Infrared thermography (IRT) is a useful method to detect activity/inflammation in localized scleroderma (LoS); however, inactive skin lesions with a severe degree of dermal and subcutaneous atrophy may show false-positive results. Narrow-band reflectance spectrophotometry (NBRS) is an objective, non-invasive technique of measuring erythema and hyperpigmentation severity, yet has not been extensively studied in LoS.Objectives The aim of this research was to compare the spectrophotometric results with thermographic examination of LoS lesions. MethodsThe lesions were assessed using the Localized Scleroderma Assessment Tool (LoSCAT), Dyspigmentation, Induration, Erythema, and Telangiectasias (DIET) score, NBRS and IRT. The difference in the erythema index (DEI), melanin index (DMI) and average temperature Tavg (DTavg) were calculated between each lesion and its normal control.Results Fifty-five patients with 49 active and 64 inactive LoS lesions were examined. The DEI strongly correlated with the erythema (r s = 0.62, P < 0.0000002) and DIET score (r s = 0.66, P < 0.0000001) and moderately correlated with the telangiectasias score (r s = 0.58, P < 0.00001). DMI showed strong correlation with the dyspigmentation score (r s = 0.65, P < 0.0000001). There was a strong correlation between the DTavg and the erythema score (r s = 0.7, P < 0.000001).A moderate correlation between the D EI and DTavg was found in active LoS lesions (r s = 0.53, P < 0.0001). ConclusionNarrow-band reflectance spectrophotometry may be a complementary method for determining erythema in LoS active lesions, although this technique remains inferior to IRT, because is unable to distinct between active and inactive lesions. However, NBRS enables to evaluate the severity of hyperpigmentation and telangiectasias, and it can be useful for the assessment of disease severity which is poorly evaluated by IRT.
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