The role of leptin in selected skin diseases.

Leptin is an adipokine, adipocyte-derived compound, which acts both as a hormone and cytokine. It is mainly synthesized by adipocytes of white adipose tissue. Leptin possesses pleiotropic functions including, among others, stimulation of angiogenesis and production of proinflammatory cytokines. The various types of leptin activity are related to the wide distribution of leptin receptors. This adipokine acts by activating intracellular signaling cascades such as JAKs (Janus kinases), STATs (signal transducers and activators of transcription), and others.In a course of obesity, an increased serum level of leptin coexists with tissue receptor resistance. It has been reported that enhanced leptin levels, leptin receptor impairment, and dysfunction of leptin signaling can influence skin and hair. The previous studies revealed the role of leptin in wound healing, hair cycle, and pathogenesis of skin diseases like psoriasis, lupus erythematosus, and skin cancers. However, the exact mechanism of leptin's impact on the skin is still under investigation. Herein, we present the current knowledge concerning the role of leptin in psoriasis and selected skin diseases.

Environmental risk factors and epigenetic alternations in psoriasis.

INTRODUCTION AND OBJECTIVE: Psoriasis isa quite common, chronic and immune-mediated skin disorder. The prevalence of psoriasis differs in various countries, but it is said to affect 2% of the world's population in general. Psoriasis has many different clinical features but all lesions have the same characteristic: erythema, thickening and scale, although other clinical features are also connected, such as psoriatic arthritis, obesity and metabolic syndrome. All of these may lead to conditions impairing the quality of life. This review is an attempt to summarize recent data regarding environmental factors, together with epigenetic markers and processes playing an important role in psoriasis. STATE OF KNOWLEDGE: Many different environmental factors play a role in genetically predisposed patients. This is causes epigenetic alternations which may be a linking part in the whole process. Many studies have indicated a connection between psoriasis and various genes and antigens. The presence of HLA-Cw6 is common as well a strong link between its presence and the onset of psoriasis being observed. The main alternations are DNA methylation, histone's modifications and the role of microRNA. Excessive reaction is usually not present without a triggering factor. Environmental factors are mostly rated, such as drugs, life style and habits (smoking, alcohol), diet, physical trauma (skin injury provoking Koebner phenomenon), stress, microorganism and infections. CONCLUSIONS: The correlation between pathogenesis of psoriasis and environmental risk factors, together with epigenetic alternations still require more investigation. Education about diet habits, nutrition, weight loss and healthy lifestyle seems to be important during the treatment of psoriasis.

Systemic sclerosis - multidisciplinary disease: clinical features and treatment.

Systemic sclerosis is a chronic autoimmune disease of still not fully understood pathogenesis. Fibrosis, vascular wall damage, and disturbances of innate and acquired immune responses with autoantibody production are prominent features. Systemic sclerosis has specific subsets with different autoantibodies, and differences in the affected skin areas. The suspicion of systemic sclerosis and establishing the diagnosis will be facilitated by the criteria created by EULAR/ACR experts. The treatment of this autoimmune disease remains a challenge for clinicians and new therapeutic options are constantly sought. The occurrence of various symptoms and the involvement of many organs and systems make systemic sclerosis a multidisciplinary disease and require a holistic approach. The present article summarizes different clinical features of systemic sclerosis and the profile of autoantibodies and discusses recent rules and future perspectives in disease management.

Potential occupational and environmental factors in SSc onset.

INTRODUCTION: Introduction and objective. Systemic sclerosis [SSc; scleroderma] is a rare, connective tissue disorder affecting all organs and systems. The primary feature of this disease is a chronic, progressive fibrosis due to excessive production of collagen and other components. There are two subsets of systemic sclerosis: 1) diffused SSc (dSSc), 2) limited SSc (lSSc) and 3) scleroderma without sclerosis (SSSC). The presented review is an attempt to summarize recent data regarding environmental and occupational factors in SSc onset. STATE OF KNOWLEDGE: There are many factors to be taken under consideration with SSc onset, although a strong correlation has been established for only a few. The most distinct factors are: crystalline silica and organic solvents (such as white spirit, aromatic, aliphatic-chain, chlorinated solvents, ketones, welding fumes). For other factors, which include abstestos, air pollution, other chemicals, silicone breast implants, tobacco smoking, drug reactions, diet influence and exposure to heavy metals, the jury is still out, and their position in SSc onset needs further studies. CONCLUSIONS: Conclusions. Although the pathogenesis of scleroderma remains unclear, there is a marked correlation between the onset of SSc and certain environmental or occupational factors.