Background: Psoriasis can be described as a T-cell-mediated disease, with a complex role for variety of cytokines and other factors. Among the inflammatory molecules influencing the keratinocites, TNF-α appears critical in sustaining most of the clinical manifestations of psoriasis. It is postulated that changes in cytokine production both locally and systemically could be useful in monitoring disease activity. Objective: The aim of the study was to evaluate serum levels of tumor necrosis factor alpha (TNF-α) in patients with psoriasis and the healthy subjects, and also to assess a possible association between TNF-α, clinical type and severity of disease. Methods: We studied the levels of serum TNF-α in 60 patients with psoriasis and in the serum of helthy 20 controls. According to the clinical type of disease, patients with psoriasis were divided into four groups: chronic plaque psoriasis (CPP), erythrodermic psoriasis (EP), pustular psoriasis (PP) and psoriatic arthritis (PA). Blood samples were collected from all psoriasis patients and from healthy control subjects. Serum level of TNF-α were measured by an enzyme-linked immunosorbent assay (ELISA) technique. The severity of CPP was assessed by Psoriasis Area and Severity Index (PASI). Results: Serum levels of TNF-α in patients with psoriasis were significialy higher than in the control group (3.25+1.74 pg/mL vs 0.20+0.01pg/mL, respectively). Significantly elevated serum TNF-α was in patients with PP type (7.39+6.92 pg/mL). There was statistically significant difference between the mean level of TNF-ɑ compared to the clinical type of psoriasis (p<0.05). The mean PASI score in patients with CPP was 0.56±12.45. It was not found statistically significant correlation between serum level of TNF-ɑ and PASI score in patients with CPP (p>0,05). Conclusion: Our results have demonstrated the imortance of determining serum levels of TNF-ɑ in patients with psoriasis. Further investigations are required to clarify the pathogenic role and clinical significance of TNF-ɑ, and these findings may provide important clues to assist in the development of new therapeutic strategies for patients with psoriasis.

Introduction: Basal cell carcinoma (BCC) is a non-melanocytic skin malignancy arising from basal cells of epidermis or follicular structures. Etiology of BCC is a multifactorial combination of genotype, phenotype, and environmental factors. There are several clinical variants of BCC including nodular, cystic, superficial, morphoeic, keratotic, pigmented and micronodular. Aim: The aim of our study was to analyze the recent clinical trends of basal cell carcinoma by reviewing a single institution’s experience. Methods: Total number of 422 patients clinically diagnosed with basal cell carcinoma were included in the study. Data on age, gender, skin type, personal and family history, duration of disease, localization of lesions, clinical type of lesions, and recurrence rate were collected and analyzed. The data were statistically evaluated. Results: More than 80% of all BCC’s were located on sun-exposed skin areas (p<0.05).The male /female ratio was 1:0.92. The nodular BCC was the most frequent type (59.2%), followed by the superficial (16.1%), pigmented (15.2%) and morphoeic (9.5%) types. The nodular and pigmented types were predominant located on the head and neck, whereas the trunk was the most common location for the superficial type (p<0.05). The tumor is commonly found in concomitance with skin lesion related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. During this study period, 41 cases showed recurrence of the cancer as the overall recurrence rate was 9.7%. There were no cases with metastasis or fatal outcome. Conclusions: The factors related to the development of BCC were older age and exposure to ultraviolet rays both in recreational and in occupational form. The prevention of BCC is based on the knowledge of risk factors, early diagnosis and treatment, particularly in susceptible populations.

Alopecia areata (AA) is a non-scarring inflammatory disease of the hair follicle. Although it usually presents as asymptomatic localized hair loss, it is a disese of very broad spectrum. Alopecia universalis (AU) is an uncommon form of AA that involves the loss of all haed and body hair and is estimated to account approximately 5% of all alopecia cases [1]. The cause of disease is unknown, although there is evidence to suggest that the link between lymphocytic infiltration of the follicle and the disruption of the hair follicle cycle in AA may be provided by a combination of factors, including cytokine release, cytotoxic T-cell activity, and apoptosis [2,3]. It is also considered that a disequilibrium in the production of cytokines, with a relative excess of proinflammatory and Th1 types, vs. anti-inflammatory cytokines may be involved in the persistence of AA lesions, as shown in human scalp biopsies [4]. The immune response presented in AU is associated with aberrant lesional expression of interferon-gamma (IFN-γ), interleukin-2 (IL-2) and IL-1β, and overexpression of ICAM-1 and MHC molecules on hair follicle keratinocytes and dermal papilla cells [5].

Background: Alopecia areata (AA) is a disease characterized by focally, nonscarring hair loss on the scalp or any hair-bearing surface. The etiology is unknown, although the evidence suggests that AA is an immunologically mediated disease. In the pathogenesis of AA, Th1 immune response is predominant. A special cytokine profile is created by Th1 cells, which disturbs the natural balance of the cytokine networks and leads to inflammatory reaction and follicle damage. Objective: The aim of our study was to evaluate serum concentrations of IL-2 in patients with AA and healthy subjects. We also examined a possible association between serum levels of IL-2, disease severity, and duration of AA. Methods: Sixty patients with AA and 20 healthy controls were enrolled in the study. Serum concentrations of IL-2 were measured using enzyme-linked immunoassay techniques. Results: Comparison of mean values of IL-2 has showed that serum concentrations of this cytokine are significantly higher in serum samples of AA patients in relation to the control group (22.2 ± 1.19 vs. 21.1 ± 2.68 pg/mL, respectively; p = 0.0142). No correlations were found between clinical type, duration of the disease, and serum levels of IL-2. Conclusion: Our findings support the evidence that elevation of serum IL-2 is associated with AA. The exact role of serum IL-2 in AA should be additionally investigated in future studies.

Introduction: chronic urticaria (CU) is a skin disorder characterized by transient, pruritic wheals persisting for longer than 6 weeks. The etiopathogenesis of the disease is still unclear, but there is evidence that autoimmunity and endocrine dysfunction may be involved. Aim: the aim of this study was to determine whether chronic urticaria is statistically associated with thyroid autoimmunity. Patients and methods: in a prospective case-control study, we compared the frequency of thyroid auto-antibodies (thyroglobulin antibody, anti-Tg and thyroid peroxidase antibody, anti-TPO) in 70 patients with chronic urticaria and in 70 healthy volunteers. Thyroid auto-antibodies and thyroid hormones (thyroxine (T4), triiodthyronine (T3) and thyroid stimulating hormone (TSH) were measured in all subjects. Results: thyroid functional abnormalities were found in 8 (11.43%) patients. Anti-Tg and anti-TPO were positive in 16 (23%) and 21 (30%) patients, respectively. In control group, only one subject (1.42%) had abnormalities in thyroid hormonal status, and two subjects (2.86%) had positive thyroid auto-antibodies. Compared with the control group, the frequency of both anti-Tg and anti-TPO was significantly higher in those with chronic urticaria (P < 0.05). Conclusion: this study shows a significant association between chronic urticaria and thyroid autoimmunity, and that tests to detect thyroid auto-antibodies are relevant in patients with chronic urticaria.

Investigation of Candida yeast prevalence in patients with psoriasis has been performed with the aim of determining their possible role as a trigger factor in the pathogenic process of this disease. The purpose of our study was to investigate the prevalence of Candida species on the skin of intertriginous areas and psoriasis lesions as well as the prevalence of Candida species in the stool of patients with psoriasis. This study also examines a possible correlation between the severity of psoriasis and prevalence of isolated Candida species. The patients with psoriasis were divided into two groups according to the clinical type of psoriasis; a group with plaque psoriasis (PP) and psoriasis inversa (PI) (G1) and a group with psoriasis erythrodermica (PE) and psoriasis pustulosa (PPS) (G2). The group of patients with PP and PI (G1) was divided according to score on the Psoriasis Area Severity Index test (PASI) according to severity of disease into the clinical subgroup with PASI <50 and another subgroup with PASI >50. Mycological analysis of skin samples in patients of the clinical group with PP and PI showed a statistically significant difference as well as correlation between the results of isolated specimens of Candida species from the skin of intertriginous areas and psoriasis lesions, the clinical form of psoriasis, and the PASI score.

Background: Vitiligo is a common skin disorder characterized by macular depigmentation of the skin. Although the etiopathogenesis of the disease is still unclear, several studies have shown that within the cascade of pathogenesis of vitiligo, cytokines play an important role. Objectives: The aim of our study was to evaluate serum concentrations of interleukin- IL-2 (IL-2) and interleukin-2 soluble receptor (IL-2 sR) in patients with vitiligo and healthy subjects and also to asses a possible association between these cytokines and duration of the disease. were measured using enzyme-linked immunoassay techniques. Results: Both IL-2 (median 22.600 pg/ml, range 20.900-76.100) and IL-2sR (median 76.100 pg/ml, range 15.700-183.800) in the patient group were significantly higher when compared with that of the normal controls. When the serum cytokine level in vitiligo group were compared to total disease duration (Spearman correlation ρ ), serum IL-2 was negatively ( ρ = -0.000573, P = 0.9980) and IL-2 sR was positively ( ρ =0.241, P = 0.2797) correlated with total disease duration, but it is of borderline significance. Conclusions: Our results showed hight serum levels of IL-2 and IL2 sR among vitiligo patients which may highligth a functional role of these cytokines in the pathogenesis of this disease.

Introduction: Vitiligo is an acquired skin disorder characterized by depigmented maculae resulting from a reduction of the number and function of melanocytes. The etiopathogenesis of the disease is still unclear, but there is evidence that autoimmunity and endocrine disfunction may be involved. Objective: The aim of this study was to evaluate serum levels of anti-thyroglobulin antibody (anti-Tg) in vitiligo patients and control subjects, and also to assess the difference between the localized and generalized forms of the disease. Methods: In this prospective study we investigated serum level of anti-Tg in 33 patients with vitiligo and 33 healthy controls. We also examined a possible association between serum levels of anti-Tg and disease severity. Results: Comparison of median values of anti-Tg has showed that serum concentrations of anti-Tg are significantly higher (p<0.05) in serum samples of vitiligo patients in relation to control group. Statistically significant difference was also found in values of anti-Tg between patients with generalized and patients with localized vitiligo (p<0.05). Conclusion: This study shows a significant association between vitiligo and thyroid autoimmunity, and that tests to detect anti-Tg are relevant in patients with vitiligo.

Effluvium capillorum is a form of nonscarring alopecia characterized by diffuse hair shedding. This condition occurs when the normal balance of hairs in growth and rest phases is disrupted. Trichoscan is a computerized program used for digital measurement of hair growth and hair loss. This study was performed to describe the TrichoScan as a method, which combines standard epiluminiscence microscopy with automatic digital image analysis for the measurement of human hair. The study included 30 patients with effluvium capillorum (16 women and 14 men). A control group consisted of 30 generally healthy patients (14 women and 16 men). For the measurement of hair density and anagen/telogen ratio, a commercially available software (TrichoScan) was used. The results of digital image analysis from the patients showed a highly increased proportion of telogen hair roots. The authors' results indicate that TrichoScan represents a very useful tool in the evaluation of hair loss.

Introduction: Psoriasis is a chronic inflammatory skin disease that affects about 2% of general population. Clinically, disease can present with cutaneous and nails lesions. Nail abnormalities can be seen in up to two-thirds of patients with psoriasis and both fingernails and toenails may be affected. Objective: The objectives of our study were to evaluate the frequency and clinical presentations of nail abnormalities in patients with psoriasis. Also, we aimed to find correlation between nail changes and some clinical parameters. Methods: One hundred and ten patients with psoriasis were included in this study. A detailed history and examination was recorded for all study subjects, including the age and gender of the patients, type of psoriasis, duration, and extent of disease. Finger and toe nails were clinically examined and nail changes were noted. In the case of clinically suspected of fungal infection, further mycological investigations were performed. Results: Nail abnormalities were present in 67 patients (60.9%) with psoriasis. Nail pitting was the most common lesion observed on fingernails, followed by discoloration of nail plate. Subungual hyperkeratosis of nail plates were significantly more frequent on the toenails. Positive mycological culture was in 14 (20.8%) psoriatic patients with nail involvement. Also, positive correlation between nail abnormalities and duration of psoriasis was found. Conclusions: Nail involvement is common in patients with psoriasis and accompanies skin lesions on the body surface. Pitting and subungual hyperkeratosis are the most frequent nail abnormality in psoriatic patients.

BACKGROUND Vitiligo is an acquired skin disorder characterized by depigmented maculae resulting from a reduction of the number and function of melanocytes. The etiopathogenesis of the disease is still unclear, but there is evidence that autoimmunity may be involved. OBJECTIVE The aim of this study was to determine the prevalence and significance of antinuclear (ANA) and thyroid peroxidase (anti-TPO) antibodies in patients with vitiligo and control group. METHODS In a prospective case-control study, we compared the frequency of antibodies (ANA and anti-TPO) in 40 patients with vitiligo and in 40 healthy volunteers. RESULTS ANA were positive in 7 (17%) patients, which was insignificantly higher than control group, 2 (5%). Anti-TPO were positive in 11 (27%) patients. In control group, only two subjects (5%) had positive anti-TPO. Compared with the control group, the frequency anti-TPO were significantly higher in those with vitiligo (p < 0.05). CONCLUSION Our findings show a significant association between vitiligo and thyroid autoimmunity, and that tests to detect anti-TPO are useful markers in patients with vitiligo. In contrary, ANA seems to have limited diagnostic relevance in routine clinical practice. Additional studies of a wider sample are warranted to confirm these findings and allow a detailed analysis.

Introduction: Alopecia areata (AA) is disease characterized by focally, nonscarring hair loss on the scalp or other parts of the body. It affects 1-2% population of both genders and occurs at all age groups. The etiology is unknown, although most evidence supports the hypothesis that AA is a T-cell-mediated autoimmune disease of the hair follicle and that cytokines play an important role. Objective: The aim of our study was to evaluate serum concentrations of IL-1α and IL-1β in patients with AA and healthy subjects and also to asses a possible association between these cytokines and duration of the disease. Methods: Forty six patients with AA and 20 healthy controls were enrolled in the study. Serum concentrations of IL-1α and IL-1β were measured using enzyme-linked immunoassay techniques. Results: The serum level of IL-1α in patients with AA was significantly higher than that in the control group (4.34±0.86 pg/mL vs 3.66±0.35 pg/mL, respectively). IL-1β levels were greater in patients with AA than in controls (2.35±0.17 pg/mL vs 2.24±0.30, respectively) but the difference was not significant (p>0.05). No correlations were found between duration of disease and the serum levels of IL-1α and IL-1β. Conclusion: Our results have demonstrated the importance of determining IL-1a concentration in serum in patients with AA. This research could contribute to the interpretation of insufficiently well known views of the pathogenesis role and significance of IL-1α in AA. Streszczenie Wstep: Łysienie plackowate to choroba charakteryzująca sie ogniskowym, niebliznowaciejącym lysieniem skory glowy lub tez innych okolic ciala. Choroba ta dotyka 1-2% populacji, bez predylekcji plci ani tez wieku. Etiologia choroby pozostaje nieznana, jednakze najwiecej dowodow potwierdza hipoteze, ze AA jest chorobą autoimmunologiczną mediowaną za pomocą komorek T, zajmującą korzen wlosa oraz ze cytokiny pelnią w tym procesie wazną role. Cel: Celem naszego badania bylo oszacowanie stezenia w surowicy interleukin: IL-1α i IL-1β u pacjentow z AA oraz u osob zdrowych by wykazac mozliwe związki pomiedzy tymi cytokinami a dlugością trwania choroby. Metody: Do badania zakwalifikowano 46 pacjentow z AA oraz 20 osob zdrowych. Stezenia cytokin IL-1α i IL-1β byly mierzone za pomocą techniki EIA. Wyniki: Poziomy IL-1α u chorych na AA byl znacznie wyzszy niz ten w grupie kontrolnej (4.34±0.86 pg/mL vs 3.66±0.35 pg/mL, odpowiednio). Poziomy IL-1β byly wieksze u pacjentow z AA niz w grupie kontrolnej (odpowiednio 2.35±0.17 pg/mL vs 2.24±0.30) jednak statystycznie nieistotne (p>0.05). Nie znaleziono korelacji pomiedzy trwaniem choroby a poziomami interleukin IL-1α i IL-1β w surowicy krwi. Wnioski: Nasze wyniki badan dowodzą wagi pomiaru stezenia IL-1a w surowicy krwi osob chorych na AA. To badanie moze przyczynic sie do nie do konca poznanej roli IL-1α w patogenezie oraz odkryciu pelnego znaczenia w Alopecia Areata.

Background. Vitiligo is a common skin disorder characterized by macular depigmentation of the skin. The etiopathogenesis of the disease is still unclear, but there is evidence that autoimmunity and endocrine disfunction may be involved. Objective. The aim of this study was to determine whether vitiligo is statistically associated with thyroid autoimmunity. Method. In a prospective case-control study, we compared the frequency of thyroid autoantibodies (thyroglobulin antibody, anti-Tg and thyroid peroxidase antibody, and anti-TPO) in 33 patients with vitiligo and in 33 healthy volunteers. Thyroid autoantibodies and thyroid hormones (thyroxine (T4), triiodothyronine (T3), and thyroid stimulating hormone (TSH) were measured in all subjects. Results. Thyroid functional abnormalities were found in 6 (18.18%) patients. Anti-Tg and anti-TPO were positive in 9 (27.27%) and 8 (24.24%) patients, respectively. In control group, only one subject (3.03%) had abnormalities in thyroid hormonal status, and two subjects had positive thyroid autoantibodies. Compared with the control group, the frequency of both anti-Tg and anti-TPO was significantly higher in those with vitiligo (P < .05). Conclusion. This study shows a significant association between vitiligo and thyroid autoimmunity, and that tests to detect thyroid autoantibodies are relevant in patients with vitiligo.