Radiotherapy (RT) is a treatment method commonly used in oncology. A vast majority of patients undergoing RT suffer from radiation-induced skin injury (RISI), which results from complex biochemical reactions in the irradiated skin. Current strategies for preventing and managing RISI are insufficient for achieving full skin regeneration. Multiple studies have shown that alterations in the skin microbiome correlate with the development and severity of RISI. These studies suggest that dysbiosis is a crucial factor in promoting radiation-associated dermatitis. Targeting the skin microbiota presents a potential therapeutic approach that could significantly improve the quality of life for patients undergoing RT. This review aims to present current findings on the interplay between the skin microbiome and radiation-induced skin damage as well as to discuss potential therapeutic strategies for preventing and mitigating this condition.

Radiotherapy (RT) is a commonly used treatment method in oncology. A vast majority of patients undergoing RT suffer from radiation-induced skin injury (RISI), which results from complex biochemical reactions in the irradiated skin. Current strategies for preventing and managing RISI are insufficient for achieving full skin regeneration. Multiple studies have shown that alterations in the skin microbiome correlate with the development and severity of RISI. These studies suggest that dysbiosis is a crucial factor in promoting radiation-associated dermatitis. Targeting the skin microbiota presents a potential therapeutic approach that could significantly improve the quality of life for patients undergoing RT. This review aims to present current findings on the interplay between the skin microbiome and radiation-induced skin damage, as well as to discuss potential therapeutic strategies for preventing and mitigating this condition.

Background/Objectives: Pemphigus comprises a diverse group of disorders within the autoimmune bullous dermatoses (AIBDs) spectrum. Among these, pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are the most commonly encountered variants. Despite its rarity, this condition can pose a life-threatening risk. We aimed to assess clinical characteristics, comorbidities, medication, as well as the treatment of various types of pemphigus in pemphigus patients. Methods: We gathered data from 69 patients treated in the Department of Dermatology in the years 2016–2023. The investigation included sex, age at diagnosis, type of pemphigus, comorbidities and medications, presence of neoplasms and treatment of pemphigus, as well as enzyme-linked immunosorbent assay (ELISA) and direct immunofluorescence (DIF) results. The data were statistically analyzed with the p-value set at 0.05. Results: The study group comprised 69 patients, including 41 women and 28 men. The mean age at diagnosis was 56.89 years +/− 15.42 years. A total of 79.31% of the patients were diagnosed with PV and the following 26.09% with PF. The most common comorbidities were arterial hypertension, hypercholesterolemia, and diabetes mellitus. The dominant treatment regimen was the systemic use of glucocorticosteroids (GCSs; 90% and 94% of PV and PF patients, respectively). More than half of the patients received at least one GCS-sparing treatment, including dapsone and rituximab. We observed a significantly frequent presence of IgG deposits in DIF in patients with PF (p = 0.0217) and a subsequent correlation between the concurrent presence of IgG deposits in DIF and anti-DSG1 antibodies in ELISA testing (p = 0.0469). The combination of IgG, IgG1, IgG4, and C3 deposits was more often existent in PF patients (p = 0.0054) and the combination of IgG4 and C3 deposits in PV patients (p = 0.0339). We also found a positive correlation between the level of anti-DSG1 antibodies and the age at diagnosis (p = 0.0298). Conclusions: Patients with pemphigus are very often diagnosed with significant comorbidities and take diverse medication, which shows that the treatment of pemphigus should follow a multidisciplinary approach. Accurate analysis of the clinical condition of the patients, as well as the results of the ELISA panel or DIF, is crucial for a successful diagnostic and therapeutic process.

In the systemic treatment of modern oncology, novel anti-cancer therapies are becoming increasingly important. The toxicity profile of these therapies is different from that of standard chemotherapy and has become an emerging challenge for clinicians and patients. Among the most common adverse events are skin toxicities, including xerosis, that might be debilitating and have a negative effect on patients’ quality of life. Untreated or treated ineffectively can necessitate dose modification or treatment withdrawal. Xerosis is a symptom stemming from a skin barrier dysfunction caused by a variety of different mechanisms, which differ depending on the therapy. Patients indicate xerosis as an unexpected symptom that significantly decreases their quality of life. Even so, it is a complication often neglected in clinical practice. Prevention and treatment of xerosis include avoiding irritating factors, bathing in lukewarm water, and applying emollients. Early treatment prevents inflammation and secondary bacterial infections. In the systemic treatment of modern oncology, novel anti-cancer therapies are becoming increasingly important. The toxicity profile of these therapies is different from that of standard chemotherapy and has become an emerging challenge for clinicians and patients. Among the most common adverse events are skin toxicities, including xerosis, that might be debilitating and have a negative effect on patients’ quality of life. Untreated or treated ineffectively can necessitate dose modification or treatment withdrawal. Xerosis is a symptom stemming from a skin barrier dysfunction caused by a variety of different mechanisms, which differ depending on the therapy. Patients indicate xerosis as an unexpected symptom that significantly decreases their quality of life. Even so, it is a complication often neglected in clinical practice. Prevention and treatment of xerosis include avoiding irritating factors, bathing in lukewarm water, and applying emollients. Early treatment prevents inflammation and secondary bacterial infections.

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin condition. Emerging data suggest its link to metabolic comorbidities such as diabetes mellitus and metabolic syndrome, with overlapping pathophysiological mechanisms. Recent evidence highlights the potential use of antidiabetic medications, particularly metformin and glucagon-like peptide-1 (GLP-1) receptor agonists, in managing HS. Metformin, a first-line medication for type 2 diabetes, exerts anti-inflammatory, anti-fibrotic, and anti-angiogenic effects in addition to its glucose-lowering properties. Similarly, GLP-1 receptor agonists, widely used for glycemic control and weight management, have been shown to reduce inflammation and help control HS, particularly in patients with concurrent diabetes. This review critically examines the literature and investigates the potential epidemiological and molecular bidirectional links between glucose metabolism disorders and HS. The authors review studies and case reports that describe the successful use of antidiabetic medications in treating HS. Integrating metformin and GLP-1 receptor agonists represents a novel therapeutic option for patients with HS, especially those with concurrent metabolic comorbidities. Further, well-designed research and clinical trials are necessary to establish efficacy, optimal dosing, and patient selection criteria. This review also highlights the importance of a multidisciplinary approach to managing patients with HS. Keywords: diabetes insulin resistance obesity metabolic syndrome acne inversa GLP-1 analogues

Behçet’s disease (BD) is rare in European populations. Because clinical and immunological characteristics may differ between Caucasians and Middle Eastern patients, we analyzed BD patients from the Polish population. Data from eight patients with BD treated at a rheumatology clinic were analyzed and collected, including demographic data, clinical features, laboratory test results, comorbidities, and treatment options. The study included eight patients (mean age 38.2 ± 13.7 years; 75% female). None of the patients had a family history of the disease. The mean delay in diagnosis was 5.28 ± 4.6 years. The disease began with the development of mucosal ulcerations and a maculopapular rash, and some patients also developed anemia, alopecia, headaches, and arthritis. All patients had mucosal ulcerations and an erythematous or maculopapular rash; joint involvement occurred in 62.5%. Vascular complications (37.5%) included superior sagittal sinus thrombosis, ischemic stroke, and cephalic vein thrombosis. The most common comorbidities were hypertension (50%), dyslipidemia (37.5%), and depression (25%). Inflammatory markers were elevated in half of the patients and normalized after treatment. Antinuclear antibodies were positive in 62.5%, and antineutrophil cytoplasmic antibodies in 25%. Patients were treated with glucocorticosteroids (100%) in combination with azathioprine (62.5%), cyclosporine (25%), methotrexate (12.5%), and hydroxychloroquine (25%). Data from a single center indicate that BD in Caucasians is characterized by heterogeneity in clinical manifestations and develops predominantly in women. The presence of ANA and ANCA antibodiescan be misleading and requires differential diagnosis. The course is generally mild, but severe symptoms (especially thrombosis) require close monitoring by a multidisciplinary team.