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Popescu IA, Vata D, Temelie Olinici D, Tarcau BM, Patrascu AI, Halip IA, Gugulus DL, Mocanu M, Gheuca Solovastru L. Epidemiological Study of Autoimmune Bullous Dermatoses in Northeastern Romania. Diagnostics (Basel) 2023; 14:57. [PMID: 38201366 PMCID: PMC10871116 DOI: 10.3390/diagnostics14010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Autoimmune bullous diseases (ABDs) are a rare but significant group of dermatoses that pose great challenges to the treating dermatologist. ABDs are characterized by the presence of tissue-bound and circulating autoantibodies directed against disease-specific target antigens of the skin. Most epidemiological studies have focused on a single ABD. More than that, there are few data about the incidence and prevalence of autoimmune blistering diseases in Romania. METHODS In this study, between 2015 and 2019, we retrospectively investigated a total of 225 patients with autoimmune bullous diseases from the northeastern region of Romania. The diagnosis was based on the clinical and histo- and immunohistological findings. RESULTS Pemphigus was the most frequently encountered ABD, with an incidence of 8.16/1,000,000 inhabitants, representing 58.7% (132 cases), followed by 24% cases of bullous pemphigoid (54 cases), 15.4% of patients were diagnosed with dermatitis herpetiformis (37 cases), and 0.9% other subepidermal autoimmune bullous dermatoses. The average age of onset of pemphigus vulgaris was 59.4 years, the majority of patients being male, while the average age of patients diagnosed with bullous pemphigoid was 73.8 years, the majority being female. CONCLUSIONS Pemphigus vulgaris is the most frequently encountered ABDs in the northeast of Romania, with a higher incidence than in Western European countries, and this may be due to specific peculiarities of the geographical area, as well as to a genetic susceptibility of the population in this region.
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Affiliation(s)
- Ioana Adriana Popescu
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dan Vata
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Doinita Temelie Olinici
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Bogdan Marian Tarcau
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Ionela Patrascu
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Alina Halip
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dumitrita Lenuta Gugulus
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Madalina Mocanu
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laura Gheuca Solovastru
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Vata D, Tarcau BM, Popescu IA, Halip IA, Patrascu AI, Gheuca Solovastru DF, Mocanu M, Chiriac PC, Gheuca Solovastru L. Update on Obesity in Psoriasis Patients. Life (Basel) 2023; 13:1947. [PMID: 37895330 PMCID: PMC10608303 DOI: 10.3390/life13101947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin condition, with genetic, epigenetic, environmental, and lifestyle factors contributing to its onset and recurrence. Severe psoriasis has a great impact on quality of life, which is similar to that of insulin-dependent diabetes, depression, and ischemic heart disease, but with a lower mortality. There is an overlap between the rising incidences of autoimmune diseases and obesity. In recent years, research has shown that there is an association between psoriasis and obesity. Psoriasis is linked to obesity in a two-way manner, as each can precipitate the development of the other. Several adipose tissue-secreted adipokines were shown to be elevated in obese psoriasis patients, exhibiting similar mechanisms of action to those underlying the pathogenesis of psoriasis. Excess body weight can influence not only the treatment response in psoriasis, but also the adverse events, leading to decreased patient compliance. Specific human microbiome patterns have been identified for obesity and psoriasis and could represent a future therapeutic target in selected individuals.
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Affiliation(s)
- Dan Vata
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Bogdan Marian Tarcau
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Adriana Popescu
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Alina Halip
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Ionela Patrascu
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | | | - Madalina Mocanu
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | | | - Laura Gheuca Solovastru
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
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Grajdeanu IA, Vata D, Statescu L, Adriana Popescu I, Porumb-Andrese E, Ionela Patrascu A, Stincanu A, Taranu T, Crisan M, Gheuca Solovastru L. Use of imaging techniques for melanocytic naevi and basal cell carcinoma in integrative analysis (Review). Exp Ther Med 2020; 20:78-86. [PMID: 32508998 PMCID: PMC7271701 DOI: 10.3892/etm.2020.8620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 02/27/2020] [Indexed: 12/31/2022] Open
Abstract
Early detection of skin cancer is essential in order to obtain an improved prognosis. Clinicians need more objective and non-invasive examination methods to support their decision whether to biopsy or not tumoral lesions. These may include several imaging techniques such as dermoscopy, videodermoscopy, also known as sequential digital dermoscopy (SDD), computer-aided diagnosis (CAD), total body photography, imaging and high-frequency ultrasonography (HFUS), reflectance confocal microscopy, multiphoton tomography, electrical impedance spectroscopy, Raman spectroscopy, stepwise two-photon-laser spectroscopy and quantitative dynamic infrared. This review summarizes the current developments in the field of melanocytic lesions, such as naevi and basal cell carcinoma (BCC) imaging techniques. The aim was to collect and analyze data concerning types, indications, advantages and disadvantages of modern imaging techniques for in vivo skin tumor diagnosis. Two main methods were focused on, namely videodermoscopy and HFUS, which can be included in daily dermatologists' practice. In skin tumors HFUS allows the assessment of tumoral lesions with depth smaller than 1.5 cm, being described a correlation between ultrasonographic depth and the histologic index.
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Affiliation(s)
- Ioana-Alina Grajdeanu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania
| | - Dan Vata
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Laura Statescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Adriana Popescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Elena Porumb-Andrese
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Ionela Patrascu
- Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Alina Stincanu
- Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Tatiana Taranu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Dental Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, CF Iasi Hospital, 700506 Iasi, Romania
| | - Maria Crisan
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Laura Gheuca Solovastru
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
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Popescu IA, Statescu L, Vata D, Porumb-Andrese E, Patrascu AI, Grajdeanu IA, Solovastru LG. Pemphigus vulgaris - approach and management. Exp Ther Med 2019; 18:5056-5060. [PMID: 31819769 PMCID: PMC6895778 DOI: 10.3892/etm.2019.7964] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 08/06/2019] [Indexed: 12/26/2022] Open
Abstract
The place of pemphigus vulgaris (PV) among autoimmune bullous dermatoses is well known. In pemphigus, IgG autoantibodies are directed against desmogleins 1 and 3, which are part of the cadherin family of cell-cell adhesion molecules. These structures are responsible for maintaining the intercellular adherence in stratified squamous epithelia, such as the skin and oral mucosa. The incidence of autoimmune bullous dermatoses is steadily increasing, being associated with a high degree of morbidity. The pathophysiology of these dermatoses is very well understood, complemented by recent genetic studies. The gold standard for the diagnosis of pemphigus vulgaris is the detection of autoantibodies or complement component 3 by direct immunofluorescence microscopy of a perilesional biopsy. Early diagnosis and initiation of treatment are necessary in order to achieve a favorable prognosis. Although the first line of treatment is corticotherapy, there are no clear guidelines on dosing regimens, and long-term adverse effects are important. Corticosteroid-sparing adjuvant therapies have been employed in the treatment of PV, aiming to reduce the necessary cumulative dose of corticosteroids. In addition, therapies with anti-CD20 antibodies are used, but antigen-specific immune suppression-based treatments represent the future.
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Affiliation(s)
- Ioana Adriana Popescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania
| | - Laura Statescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Dan Vata
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Elena Porumb-Andrese
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Ionela Patrascu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana-Alina Grajdeanu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania
| | - Laura Gheuca Solovastru
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
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Grajdeanu IA, Statescu L, Vata D, Popescu IA, Porumb-Andrese E, Patrascu AI, Taranu T, Crisan M, Solovastru LG. Imaging techniques in the diagnosis and monitoring of psoriasis. Exp Ther Med 2019; 18:4974-4980. [PMID: 31819765 PMCID: PMC6895776 DOI: 10.3892/etm.2019.7957] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/09/2019] [Indexed: 12/23/2022] Open
Abstract
Plaque psoriasis is a chronic, immune-mediated disease, which has a multifactorial etiopathogenesis. Practical non-invasive techniques to monitor plaque psoriasis progression and treatment are necessary. Imaging techniques available for psoriasis assessment may vary in terms of resolution, depth of penetration and visual representation. This review summarizes the current developments in the field of psoriasis non-invasive imaging techniques, such as dermoscopy, conventional ultrasound and high frequency ultrasonography (HFUS), videocapillaroscopy (VC), reflectance confocal microscopy (RCM), optical microangiography (OMAG), laser Doppler imaging (LDI), multiphoton tomography (MPT) and optical coherence tomography (OCT). The aim was to collect and analyze data concerning types, indications, advantages and disadvantages of modern imaging techniques for in vivo psoriasis assessment. We focused on two main methods, videodermoscopy and HFUS, which can be included in daily dermatologists' practice and which may assist in establishing diagnosis, as well as monitoring response to topical and/or systemic therapy of psoriasis. Dermoscopy may be useful for a first evaluation and may offer an understanding of the type and distribution of blood vessels, as well as the color of the scale and the background of the lesion. Videodermoscopy allows magnification and offers a detailed evaluation of the vessel type. The utility of HFUS consists mainly in monitoring therapy response. These methods may be comparable with virtual histopathology.
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Affiliation(s)
- Ioana-Alina Grajdeanu
- Dermatology Department, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laura Statescu
- Dermatology Department, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Dan Vata
- Dermatology Department, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Adriana Popescu
- Dermatology Department, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Elena Porumb-Andrese
- Dermatology Department, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Ionela Patrascu
- Dermatology Department, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Tatiana Taranu
- Dermatology Department, Faculty of Dental Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Dermatology Clinic, CF Iasi Hospital, 700506 Iasi, Romania
| | - Maria Crisan
- Dermatology Department, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Laura Gheuca Solovastru
- Dermatology Department, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Dermatology Clinic, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
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