Atopic dermatitis is associated with an increased risk of cardiovascular diseases: A large-scale, propensity-matched US-based retrospective study.

BACKGROUND: Atopic dermatitis is a chronic relapsing inflammatory skin disease characterized by intense itch impacting heavily on patients' and caregivers' quality of life. Its clinical presentation is accompanied by a variety of type 2 comorbidities, e.g. asthma, hay fever, food allergies. However, current data on cardiovascular comorbidities are inconsistent. OBJECTIVES: To identify risk of cardiovascular diseases in patients with atopic dermatitis. METHODS: Data from Electronic Health Records (EHRs) of 1,070,965 atopic dermatitis patients and equally propensity score matched controls were retrieved from the US Collaborative Network part of the federated TriNetX network. Hazard ratios for risk of onset of cardiovascular diseases with a prevalence of ≥1% in both cohorts within 20 years after diagnosis were determined. RESULTS: A total of 55 cardiovascular diseases belonging to 8 major cardiovascular groups were identified. Of those, 53 diagnoses displayed a significantly increased risk in atopic dermatitis patients. Different diagnoses of heart failure and heart disease were found most often, followed by valve insufficiencies, arrhythmia, tachycardia, atrial fibrillation, flutter, but also MACE and venous thromboembolism. The individual diagnoses venous insufficiency, atherosclerosis of native arteries of the extremities, and unspecified diastolic (congestive) heart failure displayed highest hazard ratios. CONCLUSION: Atopic dermatitis is associated with an increased risk for multiple cardiovascular diseases.

Surgical Treatment of Vitiligo.

Vitiligo is described as a dermatological condition characterized by pigmentation disorders in both the skin and mucous membranes. Clinically, this disease is characterized by the presence of well-defined white areas of various shapes and sizes, which are a manifestation of a reduced number of melanocytes. Due to the fact that vitiligo can be a significant cosmetic problem for patients, a number of methods are currently available to help fight for a better skin appearance. If all the available non-invasive procedures turn out to be ineffective, surgery can help, which is a very good alternative in the case of difficult-to-treat but stable changes. Both the development of new techniques and modifications to the already available treatment of cell and tissue transplantation give hope to numerous patients around the world. The effectiveness of a particular method is determined by its appropriate selection depending on the lesions undergoing therapy. Each form of surgical intervention has its advantages and disadvantages, which, along with the location or size of the treated hypopigmentation area, should be analyzed by a doctor and discussed with their patient. This article is an overview of the currently available methods of surgical treatment of vitiligo and a comparison of their pros and cons.

The Role of TRM Cells in the Pathogenesis of Vitiligo-A Review of the Current State-Of-The-Art.

Vitiligo is the most common hypopigmentation disease affecting both the skin and mucous membranes. The pathogenesis of this disorder is complex and involves the influence of genetic and environmental factors, oxidative stress, and autoimmune responses. Recent studies have indicated that skin lesions observed in vitiligo tend to recur in the same places where they were found before treatment. This phenomenon is explained by the presence of recently discovered tissue-resident memory T cells (TRM), whose primary function is to provide antiviral and antibacterial protection in non-lymphoid tissues. TRM cells show the presence of CD49a, CD69, and CD103 markers on their surface, although not all of them express these particles. Due to their ability to produce and secrete perforin, IFN-γ, and granzyme B, TRM cells demonstrate a cytotoxic effect on melanocytes, thus inducing depigmented lesions in the course of the vitiligo. It has been proved that the occurrence of TRM cells largely depends on IL-15, which promotes the TRM function ex vivo. The findings above, as well as their reference to the pathogenesis of autoimmune skin diseases will have a considerable influence on the development of new therapeutic strategies in the near future. This article presents an up-to-date review of information regarding the role of TRM cells in the development and progression of vitiligo.