Bartosz Miziołek

Atopic dermatitis ( AD ) is a chronic inflammatory skin disease that markedly impairs quality of life. Janus kinase inhibitors (upadacitinib, abrocitinib, and baricitinib) are effective therapies for moderate‐to‐severe AD but are associated with viral reactivation, particularly herpes zoster ( HZ ), due to immunosuppressive effects on interferon signaling and natural killer cell activity. The objective of this study was to systematically evaluate the risk of HZ among AD patients treated with JAK inhibitors (JAKis), identify key risk factors, and assess the clinical outcomes and management of HZ in this population. A systematic review of PubMed , Embase, and the Cochrane Library evaluated HZ risk in adolescents and adults with moderate‐to‐severe AD treated with JAK . Searches followed PRISMA guidelines using MeSH and EMTREE terms. The protocol was registered in PROSPERO ( CRD420251070483 ). Eligible English‐language studies included randomized trials, cohort studies, pooled safety analyses, and case series with ≥ 5 participants; reviews, case reports, and pediatric, animal, or in vitro studies were excluded. Data extraction was performed independently by two reviewers. The certainty of evidence was assessed using the GRADE approach. Eleven studies were included. The risk of HZ incidence appears higher in older patients. In some cases, the risk correlates with higher doses of JAK inhibitors, and a trend toward increased HZ events has been observed in Asian populations. HZ is a relevant but generally manageable adverse event in AD patients on JAKis . Risk stratification by age, dose, and comorbidities is advised. Ongoing real‐world monitoring is crucial for optimizing outcomes.

Background: Lichen planus (LP) is a chronic, immune‐mediated inflammatory disorder affecting the skin, mucous membranes, hair, and nails. Conventional therapies such as corticosteroids and systemic immunosuppressants often demonstrate limited efficacy and are associated with undesirable side effects. The underlying inflammatory process is largely dominated by Th1/IFN‐ɣ cytokines and the activation of the Janus kinase (JAK)‐STAT pathway, highlighting JAK inhibitors as a novel, targeted therapeutic approach for recalcitrant forms of LP. Aim: The aim of the study was to systematically analyze the current scientific evidence regarding the efficacy and safety of JAK inhibitors in the treatment of various LP variants. Material and Methods: A comprehensive literature search was performed in accordance with PRISMA guidelines using PubMed, Scopus, and Cochrane databases from inception up to May 2026. Eighty‐four relevant studies were enrolled into the final analysis. The risk of bias and quality of evidence were assessed using the JBI critical appraisal tools. Results: The final analysis consisted predominantly of case reports, case series, and limited controlled trials. Both systemic agents (e.g., tofacitinib, upadacitinib, and baricitinib) and topical formulations (e.g., ruxolitinib) demonstrated rapid reductions in pruritus and pain, followed by clinical resolution of inflammatory lesions. High rates of complete and partial clinical responses were observed across diverse variants. Short‐term adverse effects were generally mild and manageable, although the overall certainty of the evidence was low. Conclusions: JAK inhibitors demonstrate a promising preliminary clinical response and acceptable short‐term safety for managing refractory LP variants. While these agents present a valuable alternative to conventional therapies, the current evidence relies heavily on observational data. Large, randomized controlled trials with long‐term follow‐up are needed to establish optimal dosing, confirm safety, and evaluate sustained efficacy in clinical practice.

Twardzina głęboka jest rzadką formą twardziny ograniczonej, charakteryzującą się występowaniem głębokich stwardnień, mogących obejmować mięśnie, powięzi, tkankę podskórną oraz głębokie warstwy skóry. Zmiany zwykle występują w linii przykręgosłupowej, a do ich powstawania mogą predysponować czynniki wyzwalające, takie jak infekcje, urazy, ekspozycja na promieniowanie lub stosowanie używek. Ze względu na niedostateczny poziom świadomości pracowników opieki zdrowotnej diagnoza może być znacznie opóźniona, a w konsekwencji może dochodzić do nieodwracalnych i okaleczających deformacji. W pracy przedstawiono opis przypadku 67-letniej pacjentki z twardziną głęboką, u której zmiany chorobowe występują w nietypowej lokalizacji w obrębie przedniej powierzchni klatki piersiowej. Przypadek ukazuje, jak ważne jest wczesne postawienie właściwej diagnozy oraz wprowadzenie odpowiedniej terapii w aktywnej fazie choroby, aby uniknąć tak poważnych powikłań.

Background: Hailey–Hailey disease (familial benign chronic pemphigus) is a rare autosomal dominant genodermatosis caused by ATP2C1 gene mutations, leading to defective calcium‐dependent ATPase. The function of this protein is to regulate calcium sequestration in the Golgi apparatus. While the mutation leads to impaired desmosome function, causing acantholysis of the suprabasal epidermis in the skin. Clinically, it presents with vesicles, erosions, fissures and weeping plaques, primarily in intertriginous areas. Symptoms worsen with heat, sweat, friction, and trauma, while treatment options remain limited. Objectives: The aim of this systematic review was to review the available literature to assess the efficacy and safety of botulinum toxin as a therapeutic option for the treatment of Hailey–Hailey disease. Methods: A literature review was conducted in Embase and MEDLINE using keywords like “Hailey–Hailey disease,” “pemphigus,” and “botulin toxin.” The search followed PRISMA guidelines, incorporating EMTREE and MESH terms. Inclusion criteria covered original trials, case reports, and case series in English until July 2025. Of 28 identified studies, 21 were included after further manual review. Results: Twenty‐one articles involving 68 patients described the use of botulinum toxin in HHD. Most patients achieved significant improvement and partial or complete remission of skin symptoms after injection or reinjection of botulinum toxin. Only one patient showed no improvement in target lesions. Combined botulinum toxin, photodynamic therapy, and dapsone yielded superior improvement with PDT + BoNT‐A showing better outcomes than BoNT‐A alone. No side effects were observed. Conclusions: Botulinum toxin appears to be a promising therapeutic alternative in HHD with a very good tolerability, both as a complementary treatment and as an adjuvant to other forms of therapy, such as PDT. Larger studies are required to confirm its efficacy, long‐term effects, and also to establish the optimal doses and number of botulinum toxin injections resulting in a standardized treatment regimen.

Introduction: Neutrophil gelatinase-associated lipocalin (NGAL) is believed to be involved in the pathogenesis of psoriasis, and its serum level was previously found to decline after administration of biologics, UV, and cyclosporine therapy. Aim: To investigate whether NGAL may serve as a...

A generalized damage to the microcirculation (microvasculopathy) is a cardinal feature of systemic sclerosis and its first manifestation is Raynaud’s phenomenon. Early detection of microvasculopathy enables to establish the right diagnosis at the very early stage of the disease and to identify those patients with the greater risk of internal organ involvement or developmental digital tip ulcers. Dynamic methods help to monitor the response to treatment that influences on the vasomotoric functions of the microcirculation. The gold standard for the assessment of microvascular involvement constitutes nailfold capillaroscopy, which can be performed using stereomicroscopy, videocapillaroscopy, or dermoscopy. Other non-invasive diagnostic methods include sidestream dark field imaging, optical coherence tomography, laser Doppler and laser-related methods, and thermography.

Neutrophil gelatinase-associated lipocalin (NGAL) may promote development of inflammation in psoriasis, whereas proprotein convertase subtilisin/kexin type 9 (PCSK9) may account for dyslipidemia in some psoriatic patients. The aim of the study was to analyze the influence of cyclosporine therapy on serum levels of NGAL and PCSK9 in patients with psoriasis vulgaris. Methods: Serum samples were obtained before and after three months cyclosporine therapy. Patients were grouped into responders and non-responders to cyclosporine depending on whether they achieved at least 50% reduction of Psoriatic Activity Score Index (PASI), or not. Serum levels of PCSK9 and NGAL were assayed using commercially available ELISA tests. Lipid levels were measured with an enzymatic method. Results: There were 40 patients enrolled. A significant decrease in serum NGAL level was seen in cyclosporine responders. No similar dependance was found for PCSK9. Serum PCSK9 concentration correlated with total cholesterol (TChol) and LDL at baseline and after three month treatment. Conclusions: Cyclosporine therapy contributes to the reduction of the NGAL serum but not the PCSK9 concentration. Correlation between the PCSK9 serum level and TChol as well as LDL concentration may help to understand drug induced dyslipidemia after cyclosporine.

Full Papers; Authors: B. Miziołek, C. Kruszniewska-Rajs, J. Gola, M. Bultrowicz, J. Miszczyk, R. Pieczyrak, A. Frątczak, K. Polak, E.J. Kucharz, B. Bergler-Czop

Introduction: An early distinction between “normal” and “abnormal” capillaroscopic pattern during the first visit to a dermatologist has a crucial significance for a diagnostic management of Raynaud's phenomenon (RP). There exists a question about the level of expertise sufficient to evaluate the microcirculation.Aim: To evaluate the utility of short courses on NFC among dermatologists and medical students in obtaining sufficient abilities for the identification of microvasculopathy in patients with RP using videocapillaroscope and handheld dermoscope.Methods: Both groups participated in 1‐h course on NFC. Before the course, participants were asked to classify 20 videocapillaroscopic and 10 dermoscopic capillaroscopic pictures into “normal” or “abnormal” pattern. Each picture was displayed on a separate slide MS PowerPoint for 10 s. The evaluation was repeated soon after the course.Results: A total of 36 dermatologists and 49 medical students were enrolled. The rate of properly classified dermoscopic and videodermoscopic pictures increased after the course in both groups, but students improved the accuracy of classification on dermoscopic pictures to the greater extent than dermatologists. The rate of correctly recognized pictures with “abnormal” pattern was significantly greater than ones with “normal” pattern at the baseline and after the course, independently of imagining tool.Conclusions: Short courses on NFC may improve the classification of capillaroscopic images, even in medical staff with no previous experience in NFC. The recognition of capillaroscopic abnormalities seems to be easier than obtaining the confidence that evaluated picture has “normal pattern.”

COVID‐19 pandemic raised many problems for patients with acne‐prone skin: a limited access to health care services, the necessity of developing telemedical consultations also in dermatology, and the usage of face masks. The aim of the study was to investigate the influence of respiratory protective measures (type of masks, wearing time during the day) on declared skin condition in patients already diagnosed with acne or reporting acne for the first time. The study was conducted in Poland among 1420 responders using the original authors' questionnaire, of which 1274 responders were included in the final sample. Acne exacerbations were reported as being more frequent and more severe in women than in men. Changing cosmetic products, facial skin decontamination before or after applying masks, the number of days per week that a mask was worn were related to acne exacerbation. The type of mask had no significant impact on the occurrence of acne lesions. Respondents noted that masks contribute significantly to skin condition worsening by exacerbating existing and causing new acne lesions. This phenomenon was particularly observable in women, in whom, according to the research results, new lesions appeared much more frequently. Therefore, there is a need to develop new ways of limiting acne exacerbation during COVID‐19 pandemic.