Paulina Rutecka

Background: Bimekizumab, secukinumab, and ixekizumab are IL-17-targeting biologics approved for the treatment of moderate-to-severe plaque psoriasis. While secukinumab and ixekizumab selectively inhibit IL-17A, bimekizumab targets both IL-17A and IL-17F, potentially providing greater anti-inflammatory efficacy. This study aimed to compare the real-world effectiveness, safety, and tolerability of these agents in a Polish dermatology center between 2019 and 2024. Methods: We conducted a retrospective analysis of 98 patients meeting at least one of the following criteria: PASI ≥ 10, BSA ≥ 10, DLQI ≥ 10, or involvement of special areas with inadequate response or contraindications to ≥2 systemic therapies. Patients with prior exposure only to IL-17 inhibitors were excluded. PASI, BSA, and DLQI scores were recorded at baseline, week 4, and week 12. Due to differences in dosing schedules, outcomes were aligned using standardized timepoints and exponential modeling of continuous response trajectories. Mixed-effects ANOVA was used to assess the influence of baseline factors (age, BMI, PsA status) on treatment outcomes. Adverse events were documented at each monthly follow-up visit. Results: Bimekizumab showed the greatest effect size for PASI reduction (Hedges’ g = 3.662), followed by secukinumab (2.813) and ixekizumab (1.986). Exponential modeling revealed a steeper response trajectory with bimekizumab (intercept = 0.289), suggesting a more rapid PASI improvement. The efficacy of bimekizumab was particularly notable in patients who were previously treated with IL-23 inhibitors. All three agents demonstrated favorable safety profiles, with no serious adverse events or discontinuations. The most frequent adverse events were mild and included upper respiratory tract infections and oral candidiasis. Conclusions: This real-world analysis confirmed that IL-17 inhibitors effectively improved PASI, BSA, and DLQI scores in moderate-to-severe psoriasis. Bimekizumab demonstrated the most rapid early improvements and a higher modeled likelihood of complete clearance, without significant differences at week 12. All agents were well tolerated, underscoring the need for further individualized, large-scale studies.

Background: Psoriasis is a chronic immune-mediated inflammatory disease with a complex pathogenesis involving immune and neurocutaneous pathways. While conventional treatments target immune dysregulation, emerging evidence suggests that botulinum toxin (BoNT) may modulate neurogenic inflammation and provide therapeutic benefits. Methods: A systematic literature review was conducted using Embase and MEDLINE databases, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The search included studies on BoNT in psoriasis, encompassing original research, case reports, case series, and reviews published in English until February 2025. A total of 49 articles were identified, and 18 met the inclusion criteria for analysis. Results: Eleven clinical studies involving 99 patients reported using BoNT for psoriasis treatment, with significant symptom improvement observed in all but one study. Botulinum toxin injections reduced erythema, scaling, infiltration, and patient-reported pain and pruritus without significant adverse effects. Additionally, three animal studies demonstrated that BoNT reduced epidermal thickening, immune cell infiltration, and pro-inflammatory cytokines, particularly interleukin (IL)-17A and IL-17F, through inhibition of neuropeptides such as substance P and calcitonin gene-related peptide (CGRP). Conclusions: Botulinum toxin has shown potential as a novel therapeutic option for psoriasis, particularly in cases of inverse and plaque psoriasis. Its mechanisms extend beyond sweat reduction, involving neuroimmune modulation. However, challenges such as dose standardization, treatment protocols, and cost-effectiveness remain. Further large-scale clinical trials are needed to validate BoNT’s efficacy and establish standardized treatment guidelines. Keywords: psoriasis botulinum toxin neurocutaneous pathways substance P calcitonin gene-related peptide (CGRP) neuroimmune modulation

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: To reduce the incidence of influenza, healthcare workers and medical students are recommended to receive annual seasonal vaccination. This study aimed to investigate the behavior of students regarding their willingness to be vaccinated against influenza and the attitudes influencing their approval or disapproval of influenza vaccination. Materials and Methods: This cross-sectional study was designed as an online survey among students of the Medical University of Silesia (MUS) of all years and specialties, as MUS is the largest medical college in Poland. A total of 302 students participated in the study and completed an online questionnaire. The collected data were analyzed using descriptive and analytical statistics. The significance of the differences was tested using the chi-square test. Results: The percentage of students who received influenza vaccinations in the past was 42.1%, and in the current influenza season (Autumn 2022) was 33.4%. The level of vaccination differed significantly depending on the study program (p < 0.001). An important variable affecting the decision to vaccinate was participation in clinical classes. Among the students taking practical classes, 59.4% were vaccinated. Most respondents had a positive opinion about influenza vaccination (98%). Belief in the effectiveness of vaccination (35.6%) was the main reason for vaccination against influenza, as indicated by the respondents. The main reason for not being vaccinated was a lack of fear of influenza infection (22.9%). Conclusions: The results obtained in this study indicate the need to introduce changes in the field of broader education regarding the effectiveness of vaccinations in reducing the number of influenza virus infections among medical students.