Basal cell carcinoma (BCC) is the most common form of cutaneous neoplasia in humans, and dermoscopy may provide valuable information for histopathological classification of BCC, which allows for the choice of non-invasive topical or surgical therapy. Similarly, dermoscopy may allow for the identification of incipient forms of BCC that cannot be detected in clinical examination. The importance of early diagnosis using the dermoscopy of superficial BCC forms is proven by the fact that despite their indolent clinical appearance, they can be included in high-risk BCC forms due to the rate of postoperative recurrence. Nodular pigmentary forms of BCCs present ovoid gray-blue nests or multiple gray-blue dots/globules associated with arborized vessels, sometimes undetectable on clinical examination. The management of BCC depends on this, as pigmentary forms have been shown to have a poor response to photodynamic therapy. High frequency ultrasound examination (HFUS) aids in the diagnosis of BCC with hypoechoic tumour masses, as well as in estimating tumour size (thickness and diameter), presurgical margin delineation, and surgical planning. The examination is also useful for determining the invasion of adjacent structures and for studying local recurrences. The use of dermoscopy in combination with HFUS allows for optimisation of the management of the oncological patient.
Atopic dermatitis (AD) is a chronic inflammatory skin disease in which barrier impairment, immune dysregulation, and gut–skin dysbiosis intersect, prompting growing interest in probiotics as microbiota-modulating adjuncts. We conducted a narrative review of peer-reviewed articles indexed in PubMed, Scopus, and Google Scholar, restricted to publications from 1 January 2018 to 31 October 2025 (searches last run in December 2025). Eligible evidence included randomized controlled trials (RCTs), observational studies, and mechanistic or conceptual reviews addressing microbiome alterations and microbiota-modulating interventions in AD. Most pediatric RCTs using multistrain, Lactobacillus-dominant formulations (often combined with Bifidobacterium) reported modest improvements in AD severity and pruritus and in selected barrier- and inflammation-related biomarkers. However, direct cutaneous microbiome “restoration” outcomes were reported in a minority of studies, and most clinical evidence relies on clinical endpoints and gut–skin axis plausibility rather than longitudinal skin microbiome readouts. Single-strain regimens showed inconsistent effects, and evidence in adolescents and adults remained heterogeneous. Mechanistically, probiotics may enhance short-chain fatty acid (SCFA) signaling, dampen toll-like receptor 2/4 (TLR2/4)-nuclear factor kappa B (NF-κB) activation, and promote interleukin-10 (IL-10)- and transforming growth factor-β (TGF-β)-driven tolerance. Probiotics are a biologically plausible adjunct targeting the gut–skin axis in AD and are generally well tolerated; however, heterogeneity across trials, limited follow-up, inconsistent adverse-event reporting, and scarce skin microbiome endpoints preclude firm clinical recommendations.
Psoriasis vulgaris is a polygenic, immunomediated dermatological condition, characterized pathophysiologically by abnormal proliferation of the epidermis and immune response disorders, evidenced by the presence of a dermal inflammatory infiltrate accompanied by exocytosis. The prevalence of this disease is continuously increasing, and the significant impact on quality of life is determined by both the severity of the skin manifestations and the associated comorbidities, which underlines the importance of early diagnosis. Among the imaging methods useful in the diagnosis and monitoring of psoriasis vulgaris are dermatoscopy and high-frequency cutaneous ultrasonography (HFUS). Dermatoscopy is a valuable complementary imaging tool in assessing the therapeutic response in patients with psoriasis vulgaris. Although clinical lesions may show partial or complete remission, the persistence of the specific vascular architecture—characterized by dilated and branched capillaries—suggests the maintenance of disease activity and justifies the need for continued treatment. HFUS allows the identification of characteristic changes in psoriatic plaques, such as homogeneous thickening of the epidermis, visible as a hyperechoic band, the presence of a hypoechoic subepidermal band, and thickening of the dermis. Evaluation with 20 MHz probes can significantly contribute to monitoring therapeutic efficacy, since the first observable changes under topical and/or systemic treatment include a reduction in the thickness of the epidermis, dermis, and hypoechoic subepidermal band. The integration of dermatoscopy and HFUS within the clinical evaluation allows for a complex and precise approach to the management of patients with psoriasis vulgaris, facilitating objective monitoring of disease progression and appropriate adjustment of therapy.
Background and Objectives: Psoriasis (PsO) is a chronic autoimmune inflammatory skin disorder frequently associated with psychiatric and psychological burden. The objective of this study was to determine the incidence of psychiatric comorbidities in patients with PsO from a dermatology clinic of a university hospital in northeastern Romania, thereby providing physicians with evidence to support more holistic and integrated care approaches. Materials and Methods: This is a 10-year retrospective epidemiological study on 2219 patients diagnosed with PsOwho were admitted to a Romanian university hospital between January 2013 and December 2022. Psychiatric and dermatological diagnoses were extracted from medical records using International Classification of Diseases—Tenth Revision (ICD-10) codes. Relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models, with p < 0.05 considered statistically significant. Results: Among 2219 patients, the most common psychiatric comorbidities were unspecified depressive disorder (120 patients, 5.4%, p < 0.01), mixed anxiety-depressive disorder (34 patients, 1.5%, p < 0.01), and mild depression (24 patients, 1.1%, p < 0.01). Female PsO patients demonstrated a relative risk (RR) [95% confidence interval (CI)] of 1.55 [1.12–2.14] (p = 0.007) for developing psychiatric comorbidities compared to males. Patients aged less than 18 years exhibited an RR [95% CI] of 2.032 [1.297–3.186] (p = 0.002) for psycho-emotional stress, the highest among all age groups. Notably, patients with concurrent psoriatic arthritis (PsA) showed a significantly elevated risk with RR [95% CI] of 1.546 [1.06–2.20] (p = 0.002). Conclusions: Depression and anxiety represent substantial psychiatric comorbidities in PsO patients, particularly affecting female individuals, younger patients, and those with concurrent PsA. These findings underscore the necessity for integrated mental health screening and psychological support within dermatological care protocols.
Epithelial–mesenchymal transition (EMT) is one of the key steps in cutaneous carcinogenesis. At the molecular level, this cellular dedifferentiation is modulated by the interaction of signalling pathways that favour basement membrane degradation under the influence of proinflammatory cytokines and matrix metalloproteinases (MMPs). Given the intricate role of these endopeptidases in modulating extracellular matrix turnover, the present study aimed primarily to identify the MMP-2 expression profile during the early stages of cutaneous malignant transformation. Forty-eight lesions with malignant transformation potential were excised in healthy tissue. Following the histopathological diagnosis of keratoacanthoma, Bowen’s disease and actinic keratosis, the biological preparations were deparaffinised and homogenised in order to perform the FRET technique using the “MMP-2 Assay Kit Fluorometric”. The results of the previous part of this research indicate that MMP-2 expression is more intense in lesions of actinic keratosis compared to normal tissues and to keratoacanthoma or Bowen’s disease lesions, inversely proportional to the histopathological degree of dysplasia. Monitoring metalloproteinase activity in dysplastic epithelium may improve the detection of malignant transformation and guide treatment decisions.
Background/Objectives: Psoriasis is a chronic immune-mediated dermatosis with an important psychodermatologic burden, in which psychological stress, perceived disease impact, stigma, and attitudes toward mental health care may influence patient support needs. Although psychological and psychiatric interventions are increasingly discussed in dermatology, patient openness to different forms of supportive care, including music therapy, remains insufficiently characterized. This study aimed to characterize psychodermatologic burden and support-related attitudes among patients with psoriasis, with particular emphasis on openness to psychological counseling, psychiatric care, and music therapy-based support, and to explore the factors associated with these attitudes. Methods: In this single-center cross-sectional study, 102 adults with cutaneous or nail psoriasis completed an original self-administered questionnaire between July 2023 and January 2025. Results: Most participants perceived stress as related to psoriasis onset or worsening (86.3%) and considered dermatologist guidance toward psychological or psychiatric support beneficial (80.4%). Psychological counseling was the most accepted supportive intervention (75.5%), followed by music therapy (54.9%) and psychiatric consultation (48.0%), while previous psychological or psychiatric care was reported by 22.5%. Willingness to seek psychological support was independently associated with perceived psoriasis impact, whereas willingness to seek psychiatric support was associated with perceived stress impact. Awareness of music therapy was associated with higher educational level. Willingness to try music therapy was associated with high perceived stress impact, higher educational level, music listening, and awareness of music therapy. Conclusions: Patients with psoriasis frequently perceive stress as relevant to their disease and show variable openness to supportive care. These findings support an individualized psychodermatologic approach in which dermatologists may help identify patients receptive to psychological, psychiatric, or music therapy-based interventions.