Atopic dermatitis (AD) is a persistent inflammatory skin condition that impacts individuals of various age groups, including both children and adults. Its pathophysiology involves allergens penetrating a disrupted epidermal barrier, triggering the dermal cells to produce pro-inflammatory cytokines and eliciting a T-cell-mediated immune response. Notably, interleukins (ILs), particularly interleukin 4 (IL-4) and interleukin 13 (IL-13), play a key role in AD pathogenesis. Therapies directed at inflammatory mechanisms, including Dupilumab, have demonstrated notable effectiveness in enhancing skin lesions, alleviating subjective symptoms, and improving the overall quality of life for individuals with AD. Despite therapeutic advances, assessing AD severity remains challenging. The commonly used tools, such as the SCORAD and DLQI scores, rely on subjective patient responses. Paraclinically, the search for universal biomarkers continues, with efforts to identify reliable indicators reflecting disease severity and treatment response. Various biomarkers, including Th2-related chemokines and cytokines, have been explored, but none have gained universal recognition for routine clinical use. This study aims to investigate the dynamics of the plasma levels of IL-4 and IL-13 during Dupilumab treatment and establish correlations between these ILs and disease severity, as measured using the SCORAD and DLQI scores. The ultimate endpoint is to determine whether IL-4 and IL-13 can serve as reliable biomarkers, assessing their correlation with patient-reported feelings and disease activity and potentially influencing their inclusion or exclusion as diagnostic elements in routine clinical practice.

Significant gaps remain in the understanding of the etiology and pathogenesis of fibromyalgia (FM), and the COVID-19 pandemic has introduced even more unknowns. Social factors specific to that period, the viral infection itself, and/or vaccination are additional elements that can complicate the progression of the disease or the response to treatment. Aim: The primary hypothesis to be evaluated in this study is that an acute COVID-19 infection, even when considered recovered, may induce changes in the response to non-pharmacological treatment in FM patients, particularly concerning pain. Results: We included 128 patients diagnosed with FM before the pandemic began. The patients were divided based on their history of acute SARS-CoV-2 infection and COVID-19 vaccination status. All patients followed the same rehabilitation program (cognitive therapy, kinesitherapy). Perceived pain: The non-COVID-19 patient groups showed a statistically significant reduction in pain at the final evaluation compared to patients with a history of acute SARS-CoV-2 infection (p < 0.001). Algometric evaluation: Patients without COVID-19 infection and that were vaccinated exhibited the best improvement in pain threshold, both across evaluation times (p < 0.001) and compared to any of the other three groups studied (p < 0.001). Using the WHYMPI questionnaire, the same group of patients (those not having experienced acute COVID-19 and who were vaccinated) was the only group with a statistically significant improvement in pain severity (p = 0.009). In conclusion, to control and improve FM pain symptoms, in addition to appropriate medication, we propose paying additional attention to the history of acute SARS-CoV-2 infection and the COVID-19 vaccination status.

Dupilumab is the only available biological treatment for moderate-to-severe atopic dermatitis (AD). Even so, limited clinical data regarding its safety profile are available. Interactions with other drugs and the adverse effects of Dupilumab on patients with multiple comorbidities, such as chronic heart disease, diabetes, chronic kidney disease, etc., are not known yet. Moreover, there have been described cases of cutaneous lymphomas induced by Dupilumab. Therefore, the clinician that wants to start treatment for moderate-to-severe atopic dermatitis, which does not respond to conventional drugs, might be reluctant to choose biologic agents such as Dupilumab. In this paper, we reported a case of severe atopic dermatitis with multiple comorbidities in which the patient was successfully treated with Dupilumab despite numerous underlying conditions. We also conducted a review of the current literature on the safety profile of Dupilumab in special categories of patients with comorbidities, such as heart, kidney, and liver disease, oncologic conditions, and during pregnancy.

Background/Objectives: Fibromyalgia (FM) affects up to 5% of the global population and is a leading cause of significant social and economic consequences. Higher health literacy leads to better understanding of treatment plans, improved self-care, and adherence to recommendations, enhancing overall quality of life. This study aims to determine whether different aspects of the disease are influenced by patients’ education level and literacy when applying the same therapy and to assess how patients’ perceptions of therapy outcomes vary over time based on their educational level. Methods: This study involved 140 fibromyalgia (FM) patients diagnosed using the 2016 ACR criteria, with 128 completing the study. Participants attended three visits over 28 weeks and were stratified into four groups based on educational level: Group 1—secondary school or less; Group 2—high school graduates; Group 3—college graduates; Group 4—university graduates. Patients were assigned to groups (n = 32, 32, 30, and 34, respectively) after the initial evaluation (T0). The treatment was assessed (T1) and followed up three months later (T2) to evaluate changes in functional status and quality of life. All patients underwent the same rehabilitation program, cognitive therapy, and kinesiotherapy. Results: Significant differences in disease impact on the patient’s life (FIQ total score) were observed between groups from the initial evaluation (p = 0.000). The overall FIQ score was notably affected by non-pharmacological therapy in patients with higher education. These differences continued to be significant even three months after the treatment ended (p = 0.000). Functional limitations were evident from the start (p = 0.000) and improved significantly post-treatment in patients with higher education (p = 0.000). However, subjective evaluations of disease impact (assessed by the first item of FIQ) did not consistently align with objective findings (hand grip strength). Functional limitations did not significantly differ in subjective evaluations (F1Q1) across educational levels (p = 0.045), and inverse correlations were noted between functional status and SF-12 well-being components. Conclusions: This study underscores that higher education enhances fibromyalgia management and functional outcomes, particularly when combined with non-pharmacological therapies. However, subjective perceptions may not always align with objective improvements, indicating that factors beyond education, such as personal and external influences, also impact disease management. Thus, improving health literacy through educational interventions could further benefit FM patients’ quality of life.