Galectin-3 as a Novel Multifaceted and Not Only Cardiovascular Biomarker in Patients with Psoriasis with Regard to Systemic Treatment—Preliminary Data

Galectin-3 (gal-3) is a multifunctional regulator of various biological processes and diseases, which are common comorbidities in psoriasis. Data regarding potential diagnostic role of gal-3 in psoriasis are insufficient. Serum gal-3 levels were evaluated before and after twelve weeks of treatment with acitretin or methotrexate in 31 patients with plaque-type psoriasis and compared to 11 healthy control group. The mean serum galectin-3 level in patients with psoriasis was significantly higher compared to the control group (p < 0.01). In patients with obesity and long-lasting psoriasis (>20 years) positive relations of gal-3 and PASI were noted. In psoriatics with low gal-3 levels, positive correlations between the gal-3 and BMI, glucose level, and with the latter in short-lasting psoriasis (<20 years) were noted. In the long history of psoriasis, gal-3 was negatively correlated with lipids levels. The Gal-3 level might be a multifaceted modulator of the course of psoriasis and predictive factor of cardiometabolic comorbidities’ development, especially in patients with a long history of the disease or obesity. Patients with low serum gal-3 and short history of psoriasis are presumably at greater risk of diabetes. In patients with long-lasting psoriasis and concomitant obesity, gal-3 may exert a protective role against dyslipidemia or perhaps further CMD development.

Exacerbation of Psoriasis Following COVID-19 Vaccination: Report From a Single Center

The temporal association had been reported between vaccination and exacerbation of psoriasis, and episodes of psoriasis flare-up have recently been attributed to COVID-19 vaccines. We recruited 32 unimmunized controls and 51 vaccinated psoriasis patients, 49 of whom were under biological therapy, with regular clinic visits receiving a total of 63 shots of vaccines, including 30 doses of Moderna mRNA-1273 and 33 doses of AstraZeneca-Oxford AZD1222. Fifteen episodes of exacerbation attacked within 9.3 ± 4.3 days, which is higher than two episodes in the control group (p = 0.047). The mean post-vaccination severity of the worsening episodes increased from PASI 3.1 to 8.0 (p &lt; 0.001). Three patients showed morphologic change from chronic plaque-type to guttate psoriasis. Deterioration of psoriasis following COVID-19 vaccination was not associated with age, sex, disease duration, psoriatic arthritis, family history of psoriasis, history of erythroderma, current biologics use, comorbidities, vaccine types, human leukocyte antigen (HLA)-C genotypes, baseline PASI nor pre-vaccination PASI. For those who received two doses of vaccination, all but one patient aggravated after the first shot but not the second. The mechanism of psoriasis exacerbation in immunized individuals is unclear, but Th17 cells induced by COVID-19 vaccines may play a role. In the pandemic era, psoriasis patients and physicians should acknowledge the possibility of fluctuation of disease activity when vaccinated against COVID-19. Nevertheless, compared to a treatable dermatologic disease with rapid resolution of exacerbation, psoriasis patients who do not have contraindications to vaccination should benefit from COVID-19 vaccines in the prevention of severe COVID-19 infection and fatality.

Symmetrisches juveniles Riesenxanthogranulom vom Plaque-Typ im Gesicht: Fallbericht und Literaturübersicht

Das juvenile Xanthogranulom (JXG) ist die häufigste Form der Non-Langerhans-Zell-Histiozytose. Es handelt sich um einen seltenen, angeborenen oder im späteren Alter auftretenden gutartigen Tumor. Die klassische Form des JXG ist durch rötlich-gelbe benigne Papeln oder Knötchen mit Prädilektion am Kopf, Hals und Rumpf gekennzeichnet, doch können auch den Extremitäten oder extrakutanen Stellen Läsionen auftreten. In den meisten Fällen findet sich nur eine solitäre Läsion, allerdings können auch multiple Papeln oder Knötchen vorliegen. Sonderformen sind unter anderem das gemischte, riesige, subkutane, eruptive, gruppierte und plaqueartige JXG, und das JXG wurde überdies mit systemischen Erkrankungen in Verbindung gebracht. Die Diagnose wird im Wesentlichen auf Grundlage des klinischen Erscheinungsbildes gestellt und in der Regel durch die histologische Untersuchung bestätigt. In der vorliegenden Arbeit berichten wir über einen sehr seltenen Fall eines symmetrischen juvenilen Riesenxanthogranuloms vom Plaque-Typ im Gesicht (symmetrical giant facial plaque-type juvenile xanthogranuloma, SGFP-JXG); außerdem nehmen wir einen Vergleich mit der klassischen Form des JXG sowie JXG-Varianten vor und diskutieren die Differentialdiagnosen. Vorgestellt wurde uns ein 4-jähriges Mädchen kaukasischer Abstammung mit plaqueartigen Läsionen auf beiden Wangen, die aus gelblichen konfluierenden Papeln bestanden. Die histologische Untersuchung zeigte eine histiozytäre Läsion mit Bildung von Touton-Riesenzellen, und die immunhistochemischen Ergebnisse bestätigten die Diagnose SGFP-JXG. Im Vergleich zum klassischen JXG tritt das SGFP-JXG in manchen Fällen später auf, und die spontane Abheilung kann länger dauern. Begleiterkrankungen und eine systemische Beteiligung wurden nicht festgestellt. Die histopathologische Untersuchung ist erforderlich, um diese Form des JXG von anderen Histiozytosen abzugrenzen. Unseres Wissens wurden bisher nur vier Fälle von SGFP-JXG in der Literatur beschrieben.

New in the etiology, pathogenesis, prevention and treatment of atherosclerosis. The two different types of cholesterol plaques have nothing to do with each other

The article is presented in the form of a review and analysis of the literature, which additionally helps to reveal the mechanisms of the pathogenesis of the development of atherosclerosis. This article provides a completely new understanding of the stages and sequence of atherosclerosis development. The modern vision is refuted, which states that all types of lesions in atherosclerosis are developed successively, one after another. The article sheds a light on a significant difference between type IV atherosclerotic lesions and between types V and VI atherosclerotic lesions. Type IV atherosclerotic lesions consists of one lipid core with molten extracellular lipid. Stretches the middle and outer layers of an artery from one side and protrudes beyond the anatomical artery dimensions over the years. In contrast, type V atherosclerotic lesions type is a long, concentric, soft, strong, elastic, yellow, uniform structure, in the form of a tube with a hole in the middle, located in the lumen, which is easily removed from the artery. This types V and VI atherosclerotic lesions - the author suggests calling “cylindrical cholesterol plaque”. Type V atherosclerotic lesions (cylindrical cholesterol plaque) has nothing to do with types I-V atherosclerotic lesions. There are many “coincidences” that make it impossible to see the difference between them. Type V atherosclerotic lesions (cylindrical cholesterol plaque) is an independent pathological structure that appears in a short period of time (few minutes) in the lumen of a healthy artery in case of artery spasm and appearance of a strong obstruction to blood flow. Low density lipoproteins are retained within the wall, in front of the site of arterial narrowing, and quickly create a CCP in the form of a hollow cylinder. All subsequent forms of types V and VI atherosclerotic lesions - concentric and eccentric, are the result of the destruction of the original concentric structure of the type V atherosclerotic lesions (cylindrical cholesterol plaque).