Psoriasis is a systemic inflammatory skin disorder that can be associated with sleep disturbance and negatively influence the daily rhythm. The link between the pathomechanism of psoriasis and the circadian rhythm has been suggested by several previous studies. However, there are insufficient data on altered clock mechanisms in psoriasis to prove these theories. Therefore, we investigated the expression of the core clock genes in human psoriatic lesional and non-lesional skin and in human adult low calcium temperature (HaCaT) keratinocytes after stimulation with pro-inflammatory cytokines. Furthermore, we examined the clock proteins in skin biopsies from psoriatic patients by immunohistochemistry. We found that the clock gene transcripts were elevated in psoriatic lesions, especially in non-lesional psoriatic areas, except for rev-erbα, which was consistently downregulated in the psoriatic samples. In addition, the REV-ERBα protein showed a different epidermal distribution in non-lesional skin than in healthy skin. In cytokine-treated HaCaT cells, changes in the amplitude of the bmal1, cry1, rev-erbα and per1 mRNA oscillation were observed, especially after TNFα stimulation. In conclusion, in our study a perturbation of clock gene transcripts was observed in uninvolved and lesional psoriatic areas compared to healthy skin. These alterations may serve as therapeutic targets and facilitate the development of chronotherapeutic strategies in the future.

Bullous pemphigoid (BP) is an autoimmune blistering disease of elderly patients that has shown increasing incidence in the last decades. Higher prevalence of BP may be due to more frequent use of provoking agents, such as antidiabetic dipeptidyl peptidase-4 inhibitor (DPP4i) drugs. Our aim was to assess DPP4i-induced bullous pemphigoid among our BP patients and characterize the clinical, laboratory and histological features of this drug-induced disease form. In our patient cohort, out of 127 BP patients (79 females (62.2%), 48 males (37.7%)), 14 (9 females and 5 males) were treated with DPP4i at the time of BP diagnosis. The Bullous Pemphigoid Disease Area Index (BPDAI) urticaria/erythema score was significantly lower, and the BPDAI damage score was significantly higher in DPP4i-BP patients compared to the nonDPP4i group. Both the mean absolute eosinophil number and the mean periblister eosinophil number was significantly lower in DPP4i-BP patients than in nonDPP4i cases (317.7 ± 0.204 vs. 894.0 ± 1.171 cells/μL, p < 0.0001; 6.75 ± 1.72 vs. 19.09 ± 3.1, p = 0.0012, respectively). Our results provide further evidence that DPP4i-associated BP differs significantly from classical BP, and presents with less distributed skin symptoms, mild erythema, normal or slightly elevated peripheral eosinophil count, and lower titers of BP180 autoantibodies. To our knowledge, this is the first case series of DPP4i-related BP with a non-inflammatory phenotype in European patients.

Avoidance of ultraviolet (UV) exposure in early childhood is important for reducing the lifetime risk of developing skin cancer. The goal of the present prospective, multicenter pilot study was to assess the sun-protection practices in kindergartens and daycare centers and to evaluate sun protection knowledge and behavior among caregivers employed in the surveyed facilities. The study consisted of two parts. A baseline questionnaire was completed by the caregivers in relation to knowledge regarding basic sun protection and sun protection practices of the participating facilities. Afterward, a thirty-minute presentation was hosted in reference to this topic. Six months following the presentation, a follow-up questionnaire was distributed among the caregivers, evaluating the attitude-related and behavioral changes towards children. A total of 153 caregivers from five daycare centers (children between 6 months and 3 years of age) and sixteen kindergartens (children between 3 and 7 years of age) willfully participated in our study. According to our results, the main source of information regarding sun protection originated from different types of media. We found that staying in shaded areas and the use of protective clothing were not frequent in the facilities. Following our presentation regarding skin types and sunscreen use, protective measures improved, but not significantly (p = 0.222). The majority (92.31%) of caregivers distributed the information throughout their environment and also to parents. Sun protection knowledge is necessary; however, motivation among caregivers and parents and involvement of children is also relevant. Hence, a continuous, repetitive educational program regarding sun-smart behavior is deemed essential.

Zusammenfassung: Das Dermatoskop wurde ursprünglich in der Dermatologie eingesetzt, um zwischen pigmentierten und nicht pigmentierten, gut- und bösartigen Tumoren zu unterscheiden. In den letzten 2 Jahrzehnten hat sich der Anwendungsbereich der Technik jedoch erweitert, und diese Untersuchungsmethode hat bei der Diagnose von Nichttumorerkrankungen, insbesondere von entzündlichen Hauterkrankungen, zunehmend an Bedeutung gewonnen. Bei der Beurteilung allgemeiner entzündlicher Hauterkrankungen wird empfohlen, nach der klinischen Untersuchung eine dermatoskopische Untersuchung durchzuführen. In der folgenden Zusammenfassung beschreiben die Autoren die dermatoskopischen Merkmale der einzelnen entzündlichen Hauterkrankungen. Zu den detaillierten Parametern gehören die Gefäßstruktur, die Farbe, die Schuppung, das Follikelmuster und das mit jeder Krankheit verbundene spezifische Muster.

Background/Objectives: With the increasing use of immune checkpoint inhibitors (ICIs), their administration in pregnant patients is expected to become more frequent. Although immunotherapy has transformed melanoma treatment, its use during pregnancy remains complex and controversial. Methods: We present the case of a young female patient diagnosed with advanced melanoma in whom combination ICI therapy was initiated. Results: During maintenance nivolumab treatment, a routine staging CT scan revealed an incidental pregnancy. Immunotherapy was discontinued upon pregnancy detection. The pregnancy proceeded without significant complications related to melanoma or the immunotherapy. During follow-up, the patient remained in remission and delivered a healthy male infant at 38 weeks of gestation. Conclusions: The most frequently reported side effects of ICIs during in utero exposure include fetal growth restriction, premature delivery, fetal distress syndrome, and occasional congenital abnormalities such as hypothyroidism and hand malformations. While existing evidence highlights potential risks, isolated case reports—including the present case—demonstrate that favorable pregnancy and neonatal outcomes are possible with careful monitoring and multidisciplinary care. Given the limited literature on ICI use during pregnancy, our case adds meaningful clinical insights to the field and underscores the need for further research and data collection to establish definitive guidelines, with an emphasis on individualized risk assessment and multidisciplinary care.