Alopecia is caused by a variety of factors which affect the hair cycle and decrease stem cell activity and hair follicle regeneration capability. This process causes lower self-acceptance, which may result in depression and anxiety. However, an early onset of androgenic alopecia is associated with an increased incidence of the metabolic syndrome and an increased risk of the cardiac ischaemic disease. The ubiquity of alopecia provides an encouragement to seek new, more effective therapies aimed at hair follicle regeneration and neoregeneration. We know that stem cells can be used to regenerate hair in several therapeutic strategies: reversing the pathological mechanisms which contribute to hair loss, regeneration of complete hair follicles from their parts, and neogenesis of hair follicles from a stem cell culture with isolated cells or tissue engineering. Hair transplant has become a conventional treatment technique in androgenic alopecia (micrografts). Although an autologous transplant is regarded as the gold standard, its usability is limited, because of both a limited amount of material and a reduced viability of cells obtained in this way. The new therapeutic options are adipose-derived stem cells and stem cells from Wharton’s jelly. They seem an ideal cell population for use in regenerative medicine because of the absence of immunogenic properties and their ease of obtainment, multipotential character, ease of differentiating into various cell lines, and considerable potential for angiogenesis. In this article, we presented advantages and limitations of using these types of cells in alopecia treatment.

The natural course of psoriasis is the appearance of new lesions in the place of previous ones, which disappeared after a successful therapy. Recent studies of psoriasis etiopathogenesis showed that after psoriatic plaques have disappeared, in healthy skin we can still find a trace of inflammation in the form of tissue resident memory cells (TRM). They are originally responsible for protection against viral and bacterial infections in non-lymphatic tissues. In psoriatic inflammation, they are characterized by heterogeneity depending on their origin. CD8+ T cells TRM are abundantly present in psoriatic epidermis, while CD4+ TRM preferentially populate the dermis. In psoriasis, epidermal CD8+ TRM cells express CLA, CCR6, CD103 and IL-23R antigen and produce IL-17A during ex vivo stimulation. However, CD4+ CD103+ TRM can also colonize the epidermis and produce IL-22 during stimulation. Besides T cells, Th22 and epidermal DCs proved that epidermal cells in healed skin were still present and functioning after several years of disease remission. It explains the clinical phenomenon of the tendency of psoriatic lesions to relapse in the same location and it allows to develop new therapeutic strategies in the future.

Copper and zinc are micronutrients that play a crucial role in many cellular pathways, act as cofactors in enzymatic systems, and hence, modulate enzyme activity. The regulation of these elements in homeostasis is precisely controlled by various mechanisms. Superoxide dismutase (SOD) is an enzyme requiring both copper and zinc for proper functioning. Additionally, there is an interaction between the concentrations of copper and zinc. Dietary ingestion of large amounts of zinc augments intestinal absorption of this trace element, resulting in copper deficiency secondary to zinc excess. The presence of an overabundance of copper and zinc has a detrimental impact on the cardiovascular system; however, the impact on vascular contractility varies. Copper plays a role in the modulation of vascular remodeling in the cardiac tissue, and the phenomenon of cuproptosis has been linked to the pathogenesis of coronary artery disease. The presence of copper has an observable effect on the vasorelaxation mediated by nitric oxide. The maintenance of proper levels of zinc within an organism influences SOD and is essential in the pathogenesis of myocardial ischemia/reperfusion injury. Recently, the effects of metal nanoparticles have been investigated due to their unique characteristics. On the other hand, dietary introduction of metal nanoparticles may result in vascular dysfunction, oxidative stress, and cellular DNA damage. Copper and zinc intake affect cardiovascular function, but more research is needed.

Objectives: To assess and measure occurrence of sleep disorders in patients with psoriatic arthritis (PsA) and psoriasis (Ps).Material and methods: The study included 62 patients with psoriatic arthritis and 52 patients with psoriasis. The measurement of sleep quality was conducted using the Pittsburgh Sleep Quality Index (PSQI), the evaluation of fatigue by the fatigue subscale of the FACIT-F questionnaire and the patient’s quality of life by the Health Assessment Questionnaire (HAQ). The psoriasis severity was determined using the Psoriasis Area Severity Index (PASI) and the activity of arthritis by the disease activity score of 28 joints (DAS 28). The Visual Analogue Scale (VAS) was used to assess the severity of pain.Results: Poor sleep quality was found in 67.7% of PsA patients, 57.7% in Ps patients and 14.6% within the control group. Sleeping disorders in patients with PsA and Ps were related to worse quality of life and intense fatigue. Methotrexate treatment was not related to sleeping disorders, but an improvement in sleep quality was observed in both PsA and Ps patients who were treated with anti TNF- antibodies (p < 0.001 and p = 0.032 respectively). Following the use of the linear regression model, the following factors worsen the sleep quality in PsA: pain (R2 = 0.462, p < 0.001), tender joint count (R2 = 0.434, p < 0.001), C-reactive protein (CRP) concentration (R2 = 0.391, p < 0.001), patient’s age (R2 = 0.284, p = 0.003) and duration of psoriasis (R2 = 0.166, p = 0.006). In Ps patients the factors were: severity of skin lesions (R2 = 0.329, p < 0.001), duration of psoriasis (R2 = 0.290, p = 0.004) and patient’s age (R2 = 0.282, p = 0.019).Conclusions: Poor sleep quality in patients with PsA or Ps is a common symptom. Sleep disorders are more frequent in patients with PsA than in those with psoriasis.

Objective: Prolonged inflammation status due to psoriatic arthritis (PsA) may contribute to the loss of muscle mass, extending from muscle weakness, and increased risk of falls and fractures. The risk of fractures and their complications increases with concomitant osteoporosis. Material and methods: The study included 95 women aged 50–75 years. The presence of sarcopenia was evaluated in a group of 51 women with PsA, and 44 controls (without inflammatory joint disease). Measurements of muscle mass and lean body mass were made using the method of bioimpedance assessing ALM (Appendicular Lean Mass) index and SMI (Skeletal Muscle Index). The diagnosis of sarcopenia was made in women with low muscle mass and concomitant reduction of the efficiency of the assessed functional test Timed Up and Go (TUG). Bone density measurement was done by densitometry in the femoral neck and lumbar spine. (Ethics statement OIL 625/16/Bioet). Results: Sarcopenia, using ALM index and SMI, was diagnosed in 13.7% and 43.1% of PsA women, and in healthy women in 9% and 20.4%, respectively. In the group of PsA, sarcopenia was associated with a significant increase in the occurrence of disorders of bone mineralisation (72.7% vs. 41.3% in patients without a decrease in muscle mass). There was no correlation between the loss of muscle mass, bone density, and activity of PsA. Conclusions: The prevalence of sarcopenia in postmenopausal women suffering from PsA is associated with the occurrence of osteoporosis.

Aim of the Study. The aim of the study was to conduct an ultrasound (US) assessment of changes in fingernails in psoriatic patients with nail involvement. Material. A total of 69 patients with psoriatic changes in nails participated in the study, including 38 patients with psoriasis (Ps) and 31 with psoriatic arthritis (PsA) and 30 people in the control group. A total of 988 nails were examined. Results. The thickness of the nail plate, nail bed, and matrix as shown in an ultrasound examination increased with the mNAPSI index (r=0.328, p=0.021; r=0.219, p=0.036; and r=0.422, p=0.011, respectively). The thickness of nail plate, bed, and matrix in patients with onycholysis and hyperkeratosis-type changes (concomitant or present separately) was significantly greater than when only pitting-type changes occurred (p=0.007, p=0.035, and p=0.023, respectively). An examination of nails with only pitting-type changes showed an increase in the matrix thickness compared to the control group (p=0.018). The focal hyperechoic involvement of the dorsal plate (80%) was the change most often observed in an US examination in Ps patients, whereas loosening of the borders of the ventral plate was most often observed in PsA patients. The thickness of nail bed in PsA patients increased with the duration of arthritis (r=0.399, p=0.022) and was correlated with the number of swollen digits (r=0.278, p=0.041). Conclusions. The findings of this study may indicate an association of an inflammation in the nail bed with PsA development. Apart from a direct assessment of the described morphological changes of nails, a US examination could prove useful in an assessment of intensity of a local inflammation as a prognostic factor for PsA development.