Introduction:Latex allergy remains a significant occupational and clinical challenge in healthcare environments. Aim:The aim of this review study was to systematically analyse existing scientific data on the allergenic potential of latex, the clinical typology of allergic reactions, diagnostic capabilities, and preventive strategies in the medical environment. Methods:The review included systematic reviews, clinical and epidemiological studies as well as case reports. All publications appeared in peer-reviewed journals between 2013 and 2025. Results:The analysis showed that latex allergy is predominantly immunoglobulin E-mediated hypersensitivity to latex proteins (Hevea brasiliensis allergen b 1-15) and chemical compounds used in its production. Hevea brasiliensis allergens b 5 and b 6.02 demonstrate the highest allergenic potency among healthcare workers. In patients with congenital abnormalities, particularly those undergoing multiple surgical procedures, sensitization is more frequently associated with Hevea brasiliensis allergens b 1 and b 3. Sensitization may occur through dermal contact, inhalation exposure, or parenteral routes. Clinical manifestations range from urticaria and rhinitis to anaphylaxis. Diagnosis is based on skin prick tests, specific immunoglobulin E determination, and molecular diagnostics. The frequency of sensitization among healthcare workers reaches 22%, especially with frequent contact with gloves with a high protein content and aerosol latex (up to 9.4 ng/m3). A reliable relationship between the level of exposure and the risk of sensitization has been established (p-trend = 0.03). Prevention includes switching to gloves with reduced protein content, avoiding powdered products, using latex-alternative materials, training staff, and applying latex-free protocols in patients at risk. Conclusions:The results confirm the need for a comprehensive strategy for the prevention of latex allergy in healthcare settings, with an emphasis on protecting staff health, reducing allergen exposure, and ensuring patient safety.
Introduction:Vitiligo is a chronic skin condition characterised by progressive depigmentation. The visibility of skin lesions, their location, and perceived social stigma can exacerbate emotional stress and reduce life satisfaction. For this reason, the condition can significantly affect mental well-being and social functioning. Aim:The aim of the study was to assess the relationship between life satisfaction in individuals with vitiligo and the level of social support and degree of acceptance of illness. Material and methods:The study involved 215 individuals diagnosed with vitiligo. The Standardised Satisfaction with Life Scale (SWLS) was used to assess life satisfaction, the Acceptance of Illness Scale (AIS) was used to assess illness acceptance and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess the perceptions of social support. Results:Women (88.8%), city dwellers (82.8%) and people with higher education (65.6%) constituted the majority of the study group. The majority of participants demonstrated a high level of acceptance of their disease and satisfaction with life. Suicidal thoughts and feelings of ostracism were rare, but 41.8% of participants reported long-term low mood. A higher level of social support and acceptance of illness was significantly associated with greater life satisfaction. Conclusions:Despite their declared acceptance of their own appearance, patients with vitiligo often experience low mood and undertake strategies to hide their skin lesions. The results emphasise the need for holistic care, combining dermatological treatment with psychological and social support to increase patients' life satisfaction.
Introduction:Seborrheic keratoses (SKs) are common benign epidermal tumours that frequently require removal for cosmetic reasons and are located on the head and neck. Conventional destructive methods may cause scarring or dyspigmentation. High-frequency (20 MHz) high-intensity focused ultrasound (HIFU) is a novel non-invasive modality, but evidence for SK is limited. Aim:To assess the effectiveness and safety of HIFU for head-and-neck SKs and to identify baseline dermoscopic predictors of complete clearance, including anatomical site effects. Material and methods:In this single-centre retrospective study, 178 SK lesions from 38 patients treated with 20 MHz HIFU were analysed. Outcomes were derived from clinical and photographic follow-up. Mixed-effects logistic regression was used to identify independent predictors of complete clearance, with anatomical location as a fixed effect and patient as a random intercept. Results:Complete clearance was achieved in 74.7% (133/178) of lesions and 14.0% showed near-complete response. Clearance differed by location, with lower complete clearance on the scalp (40%) compared with the face and neck (78%). Overall cosmetic outcomes were favourable (good/excellent in 86.0%). Adverse effects were common but mostly mild, with hypopigmentation being the most frequent. In mixed-effects models, a sharp border (OR ≈ 2.5, p < 0.001) and a cerebriform pattern (OR ≈ 3.6, p < 0.01) increased the odds of complete clearance, whereas higher dermoscopic colour count reduced clearance (OR ≈ 0.6 per additional colour, p = 0.014). Conclusions:HIFU is a promising treatment for SKs in cosmetically sensitive areas, providing high clearance with favourable cosmetic outcomes. Anatomical location and baseline dermoscopy can support patient selection and treatment-parameter tailoring.
Introduction:Natural latex allergy poses significant risks in medicine due to widespread use of the material and potential for severe reactions. Aim:To examine latex allergy causes, clinical manifestations, and contemporary diagnostic approaches through systematic literature review. Methods:Systematic analysis of 67 publications published between 2019 and 2024, conducted from August to December 2024, using multiple databases, defined inclusion/exclusion criteria, and comparative content analysis. Results:Fresh latex comprises 60% water, 35% polyisoprene, and 5% proteins/lipids, with Hev b proteins being highly sensitising. Medical personnel demonstrate 5-17% allergy prevalence; industrial workers show up to 12% sensitisation. Key risk factors include atopy, tropical fruit cross-reactivity, and multiple childhood surgeries. Skin tests, specific IgE detection, and provocation tests demonstrate high diagnostic efficacy. Conclusions:Unified allergenicity assessment standards and enhanced regulatory control are essential. Transitioning to synthetic alternatives and improving early diagnostic protocols can reduce complications and enhance safety.
Pathological scars, including hypertrophic scars and keloids, remain a significant clinical challenge due to the limitations of current treatments. Botulinum neurotoxin type A (BTX-A) has emerged as a transformative therapy, but its efficacy has often been narrowly attributed to its canonical function of reducing mechanical tone through muscle paralysis. This review synthesises extensive evidence to propose a more comprehensive, macrophage-centric framework for explaining the potent antifibrotic effects of BTX-A. We propose that the mechanism is rooted in two profoundly synergistic pathways of macrophage function. Established indirect pathways involve BTX-A creating mechanically and neurogenetically quiescent microenvironments. This action prevents pathologic extracellular matrix sclerosis and removes key stimuli that drive macrophage polarization toward a sustained profibrotic M2 phenotype. To complement this, we explored a highly plausible direct pathway by which BTX-A might be internalized by macrophages to enzyme digest SNARE proteins such as SNAP-25 and SNAP-23. This would directly compromise the cellular machinery responsible for the secretion of key profibrotic mediators, particularly TGF-β1. Together, these indirect environmental reprogramming and direct cellular interventions constitute a constitute a multiprilled attack to systematically dismantle the self-perpetuating feedback loop of fibrosis. By positioning macrophages as the central convergence point for these pleiotropic effects, this unified model provides a strong mechanistic basis for the clinical success of BTX-A and a clear pathway for optimizing treatment regimens and developing new combination strategies.
Aim:The aim of the study was to evaluate the predictive value of baseline serum periostin and other T helper cell type 2 (Th2)-related biomarkers for early response to dupilumab in patients with moderate-to-severe atopic dermatitis (AD), and to develop a machine learning model integrating clinical and laboratory features. Material and methods:A single-centre prospective cohort of 200 adults with moderate-to-severe AD treated with dupilumab (2020-2023) was used for model development, with an independent prospective cohort of 60 patients (2024) for external validation. Baseline clinical characteristics and serum biomarkers, including periostin, eosinophil count, total immunoglobulin E (IgE), and lactate dehydrogenase (LDH), were collected. Multivariate logistic regression and three machine learning models were constructed and evaluated using receiver operating characteristic analysis, calibration, decision curve analysis, and SHapley Additive exPlanations. Results:In the modelling cohort, 62.5% of patients achieved EASI-75 at 16 weeks. Responders had significantly lower baseline periostin, eosinophil count, and IgE levels than non-responders (all p < 0.05). LASSO identified 10 key predictors, with periostin showing the strongest contribution. In multivariate logistic regression, periostin was the strongest independent predictor (OR = 0.34, p < 0.001) and improved discrimination. Among machine learning models, XGBoost performed best (AUC = 0.83). SHAP analysis confirmed periostin as the most influential feature. In external validation, the XGBoost model maintained good performance (AUC = 0.81; sensitivity = 0.917) with favourable calibration and clinical net benefit. Conclusions:Baseline serum periostin is a robust and independent biomarker for predicting early response to dupilumab in moderate-to-severe AD. A machine learning model integrating periostin with clinical and Th2-related biomarkers enables accurate and interpretable pre-treatment patient stratification.
Introduction:Long-term real-life data on the efficacy of dupilumab in atopic dermatitis (AD) patients, especially within the paediatric population, are limited. Aim:We aimed to evaluate in real life the effectiveness and safety of dupilumab in the treatment of adults and paediatric patients (6-17 years) with a special focus on the (hyper)eosinophilia trend during treatment. Material and methods:A monocentric retrospective study was conducted at the Department of Dermatology, Venereology, and Allergology in Gdansk, Poland. Results:A total of 70 patients were included, comprising 44 adults and 26 paediatric patients. In paediatric patients, Eczema Area and Severity Index (EASI) decreased by 86.65%, pruritus (P-NRS) by 72.40%, sleep disturbances (SD-NRS) by 73.44%, and Children's Dermatology Life Quality Index (cDLQI) by 76.82% at week (W) 52. In adults, EASI decreased by 95.66%, P-NRS by 79.66%, SD-NRS by 92.12%, and Dermatology Life Quality Index (DLQI) by 87.54% at W104. Among the paediatric patients, 17 experienced (hyper)eosinophilia at baseline (17/25, 68.0%), and 22 experienced (hyper)eosinophilia during the treatment period (22/26, 84.62%). Among adults, 24 experienced (hyper)eosinophilia at baseline (24/44, 54.55%), and 35 experienced (hyper)eosinophilia during the treatment period (35/44, 79.55%). No one discontinued treatment due to hypereosinophilia. Conclusions:Our results demonstrate that dupilumab is an effective and safe treatment for AD in both paediatric and adult populations in real-life settings, with significant and lasting improvements in disease severity and quality of life.
The aim of this review was to summarise current scientific evidence on the impact of nutrition on skin condition and common dermatological diseases. An electronic literature search was conducted in PubMed and Scopus for articles published between 2008 and 2025 using relevant keywords including nutrition, skin disorders, acne vulgaris, rosacea, psoriasis, atopic dermatitis, and urticaria. Meta-analyses, randomised controlled trials, cohort studies, case-control studies, relevant animal studies, and narrative reviews evaluating dietary patterns and specific nutrients' contribution to skin diseases were included. Essential information on study design, population characteristics, dietary interventions, and dermatological outcomes was systematically extracted and summarised. Evidence suggests that selected dietary components and specific dietary patterns may positively influence skin condition and alleviate symptoms in patients with dermatological diseases.
Introduction: Systemic sclerosis (SSc, scleroderma) is a rare autoimmune disease characterized by fibrosis of the skin and internal organs. Skin sclerosis, especially around the joints, may lead to functional impairment. Dysfunction of internal organs, particularly of the respiratory and cardiovascular systems, significantly affects the patient's physical performance. Aim: To analyse hand joint function, strength, chest expansion, exercise tolerance using the 6-minute walk test (6MWT), and the range of temporomandibular joint (TMJ) movements in patients with systemic sclerosis treated at the Dermatology Clinic of PIM MSWiA following 2 years of physiotherapy. Material and methods: The study initially included 55 patients-42 women and 13 men-aged 27 to 80 years (mean: 56.4). The mean disease duration was 8 years. Ultimately, 45 participants completed the project: five changed treatment facilities, one switched to alternative methods, two developed cancer (prostate and breast), and two discontinued rheologic therapy due to treatment of other comorbidities. Results: The final sample comprised 35 women and 10 men aged 28 to 80 years (mean: 57.6). Patients at the Dermatology Clinic received cyclic rheologic treatment. For 2 years, therapy was supported by physiotherapy involving individually adjusted facial mimic exercises, manual hand exercises, and self-massage of affected areas, performed at home and tailored to the patient's range of motion. Before, during, and after the 2-year rehabilitation program, all patients were assessed for: Chest expansion, Six-minute walk test (6MWT), Left hand strength, Right hand strength, Mandibular abduction, Mandibular protrusion, Left lateral mandibular movement, Right lateral mandibular movement. Conclusions: The study confirmed significant limitations in TMJ movement, hand joint mobility, grip strength, and chest expansion. When interpreting the 6MWT results, one must consider gait disturbances caused by lower leg and foot skin involvement, as well as organ dysfunction and musculoskeletal abnormalities.
Introduction:Vitiligo substantially impairs health-related quality of life (HRQoL). However, mechanisms linking disease severity to HRQoL in low-resource and conflict-affected settings remain insufficiently understood. Aim:To assess whether psychological distress mediates the association between vitiligo severity and HRQoL among patients in Kandahar, Afghanistan. Material and methods:In this cross-sectional study, 402 adult patients with vitiligo were recruited from eight dermatology clinics between September 2024 and July 2025. Disease severity was measured using the Vitiligo Area Severity Index (VASI); psychological distress using the General Health Questionnaire-12 (GHQ-12); anxiety using the Hamilton Anxiety Rating Scale (HAM-A); depression using the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16); and HRQoL using the Dermatology Life Quality Index (DLQI). Mediation analysis was performed using a regression-based framework, with indirect effects assessed by the Sobel test. Results:Mean age of the patients was 30.4 ±10.5 years; 59.5% of them screened positive for psychological distress. Vitiligo severity showed a weak correlation with DLQI (r = 0.135, p = 0.007) and a moderate correlation with psychological distress (r = 0.496, p < 0.001). In multivariable models, psychological distress, anxiety severity, and depressive symptom severity were independently associated with poorer HRQoL. After adjustment for psychological distress, the association between vitiligo severity and HRQoL was no longer significant. The indirect effect was significant (Sobel Z = 7.94, p < 0.001). Conclusions:Psychological distress substantially mediates the relationship between vitiligo severity and HRQoL. Integrating routine psychological assessment into dermatologic care may improve patient outcomes in low-resource settings.
Introduction:Nail involvement in atopic dermatitis (AD) remains an underrecognized and understudied manifestation, despite its potential to significantly contribute to disease burden. Aim:This study objective was to characterize the prevalence, types, and patterns of nail abnormalities in patients with severe AD and to explore clinical factors associated with their occurrence. Material and methods:This single-centre, cross-sectional study included adult patients with severe AD (EASI > 21) diagnosed according to the Hanifin and Rajka criteria. Demographic, clinical, and laboratory data were collected, and hand nails were examined for abnormalities. Statistical analyses included Fisher's exact test, χ2 test, Mann-Whitney U test, Kruskal-Wallis test with post-hoc Bonferroni correction, Spearman's correlation, principal component analysis (PCA), and hierarchical clustering. Multiple comparisons were controlled using the Benjamini-Hochberg procedure. Results:Forty-seven participants (28 males, median age 37.0 years) were included. Glossy nails were the most frequent abnormality (94%), followed by paronychia (40%) and Beau's lines (36%). Higher EASI scores were significantly associated with Beau's lines, onychomadesis, eczema of nail folds, petechiae, and paronychia (p BH < 0.05). Correlation analysis revealed strong associations between paronychia and Beau's lines (R = 0.73), eczema (R = 0.61), and petechiae (R = 0.43). PCA and clustering identified three phenotypic subgroups: destructive-type, mild-type, and onychoschisis-type. The destructive-type was associated with older age and more severe disease. Conclusions:Nail abnormalities are highly prevalent in severe AD and closely related to disease severity. Distinct phenotypic patterns of nail involvement may reflect varying degrees of structural damage and could have implications for clinical management. Systematic nail assessment should be incorporated into routine AD evaluation.
Introduction: It has been shown that patients with hair loss may experience reduced confidence, increased selfconsciousness, and low self-esteem. However, data concerning patients with lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) remain limited. Aim: The aim of the study was to assess the quality of life and psychological status of patients with LPP and FFA. Material and methods: In 83 patients with LPP and 79 patients with FFA, we assessed the health-related quality of life, disease perception, depression, anxiety and stress using dedicated questionnaires: DLQI, IPQ-B and DASS-21. Results: In 34% (28/83) of patients with LPP and 19% (15/79) of patients with FFA, the disease had at least a moderate effect on the patient's quality of life. In patients with LPP and FFA, positive correlations were observed between the DLQI and LPPAI (r = 0.406, p < 0.001 and r = 0.317, p < 0.01, respectively). Moderate or high threat was experienced by 59% (49/83) of patients with LPP and 61% (48/79) of patients with FFA. A moderate or severe stress level was noted in 42% (35/83) and 31% (24/79) of patients with LPP and FFA, respectively. In 29% (25/83) of patients with LPP and 20% (17/79) of patients with FFA, at least a mild depression level was observed. Only 10% (8/83) of patients with LPP reported a mild or moderate anxiety level. Stress was considered as the most common cause of the disease by 42% (35/83) of patients with LPP and 42% (33/79) of patients with FFA. Conclusions: Patients with LPP and FFA may experience a substantial impairment of the quality of life and stress, which, in their opinion, is a cause of their condition.
Introduction:Hybrid and gel manicures which gain popularity raise concerns about potential health risks. Aim:This review explores safety and health implications of hybrid and gel manicures. Methods:A literature search was conducted in PubMed, Scopus, and Google Scholar following PRISMA guidelines. Results:Twenty eight studies published between 2011 and 2024 addressed nail plate changes, allergic and non-allergic diseases, UV-related cancer risks, and hand hygiene implications. The most common side effects included nail brittleness and splitting. Allergic contact dermatitis was reported in six publications, while non-allergic conditions included paronychia and pterygium inversum unguis, each reported in one study. Rare cases of squamous cell carcinoma were linked to UV lamps, though most studies suggest minimal cancer risk. One study found that hybrid varnish did not significantly increase microbial presence in the healthcare workers. Conclusions:UV-cured manicures pose limited health risks. Further research is needed to establish safe application guidelines, UV exposure limits and infection-related considerations.
