Publications by authors named "Zafiriou E"

Acute generalized exanthematous pustulosis is a severe cutaneous adverse reaction characterized by the rapid onset of nonfollicular, sterile pustules on an erythematous base, typically accompanied by fever (≥38 °C), neutrophilia (7.0 × 10⁹/L), and characteristic histopathological features. This case report presents the first documented instance of acute generalized exanthematous pustulosis after hyaluronic acid viscosupplementation.

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This literature review aims to comprehensively evaluate the clinical and dermoscopic presentations of common pediatric diseases among children with skin of color (SoC) while also addressing potential variations based on racial backgrounds. This review encompasses various conditions, such as nevi subtypes, viral infections, infestations, and inflammatory dermatoses, as well as hair diseases and abnormal vascular formations, occurring in pediatric populations. Overall, we identified 7 studies on nevi subtypes, 24 studies on skin infections, 6 on inflammatory dermatoses, 10 on hair diseases and disorders, and 14 on miscellaneous disorders that also satisfied our SoC- and race-specific criteria.

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The dermoscopic rainbow pattern (RP), also known as polychromatic pattern, is characterized by a multicolored appearance, resulting from the dispersion of polarized light as it penetrates various tissue components. Its separation into different wavelengths occurs according to the physics principles of scattering, absorption, and interference of light, creating the optical effect of RP. Even though the RP is regarded as a highly specific dermoscopic indicator of Kaposi's sarcoma, in the medical literature, it has also been documented as an atypical dermoscopic finding of other non-Kaposi skin entities.

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Helicobacter pylori (Hp) has been postulated as an infectious trigger of psoriatic disease, namely psoriasis (Ps) and psoriatic arthritis (PsA), but meticulous antibody (ab) reactivity against all dominant and subdominant Hp antigens in demographically matched PsA and Ps patients and healthy controls has not been performed so far. IgG anti-Hp ab testing was performed by combining immunoblotting and line assays in 263 serum samples from 89 patients with PsA, 114 patients with Ps, and 60 demographically matched healthy controls (HCs). Anti-Hp positivity did not differ between PsA, Ps, and HCs (P > 0.

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Article Synopsis
  • Diagnosing basal cell carcinoma (BCC) in individuals with darker skin tones (dark phototypes IV-VI) is difficult due to varied presentations and fewer identifiable clues; dermoscopy can aid in identifying BCC in these patients.
  • This review provides a comparison of BCC's clinical and dermoscopic patterns in people of color to those in lighter-skinned individuals, identifying common mimickers like squamous cell carcinoma and melanoma.
  • Key dermoscopic features of BCC in darker skin include blue, black, and gray dots, with arborizing vessels being the primary indicator, while unique conditions in darker skin such as dermatosis papulosa nigra are also considered in differential diagnosis.
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Generalized pustular psoriasis (GPP) presents as a severe variant of psoriasis featuring painful, sterile pustules on red skin and can lead to life-threatening complications if left untreated. The disease course is typically unpredictable, with periods of improvement, followed by relapses over extended periods. Managing GPP flares is challenging due to their potential to endanger the patient's life, underscoring the need for treatments that are both fast-acting and highly effective in the case of severe and systematically ill GPP patients.

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The Koebner phenomenon (KP), also known as the isomorphic response, describes the process by which new lesions that are clinically and histologically identical to a patient's existing skin disease develop following trauma. Many skin diseases exhibit this characteristic, with variations that include possible, questionable, and pseudo-Koebner reactions, with the latter category occurring due to infectious agents seeding at a trauma site. Laser application, a type of controlled skin injury used for improving cutaneous lesions and skin rejuvenation, is also considered a form of trauma.

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  • - This survey is the first attempt to evaluate the clarity of dermoscopic language using an AI chatbot, highlighting the interaction between dermatologists and AI in understanding complex dermoscopic terms.
  • - Thirty dermatologists reviewed hypothetical skin lesion descriptions generated by the chatbot, focusing on various skin cancers and inflammatory conditions, and assessed the chatbot’s ability to suggest differential diagnoses.
  • - Results showed that while the chatbot generated extensive differential diagnoses, it performed better on basal cell carcinoma (BCC) cases compared to squamous cell carcinoma (SCC) and inflammatory conditions, indicating dermatologists are more familiar with BCC dermoscopic signs.
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Introduction: Circulating T follicular helper (cTfh) cells and circulating T peripheral helper (cTph) cells (which share common characteristics with the cTfh population) are implicated in the pathogenesis of immune-mediated and autoimmune diseases such as psoriasis (Ps). Their close interplay with the interleukin 17 (IL-17) axis and the ex vivo effect of IL-17-targeting biologic agents used to treat Ps on them are elusive. This study aimed to investigate the effect of biologics targeting IL-17 on cTfh and cTph cell subpopulations isolated from the blood of patients with Ps.

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Article Synopsis
  • The Western diet, which has a lot of sugar, meat, and unhealthy fats, can mess up the good bacteria in your gut and increase the chances of getting autoimmune diseases.
  • The Mediterranean Diet, which is full of healthy fats, fruits, and vegetables, helps keep good gut bacteria balanced and reduces inflammation.
  • Studies show that the Mediterranean Diet can lower the risk of autoimmune diseases and heart problems, helping people stay healthier overall.
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Introduction: The introduction of Janus Kinase inhibitors (JAKi) seems to revolutionize the field of alopecia areata (AA) therapeutics. However, real-world data are still missing.

Objectives: To provide evidence about effectiveness and safety of tofacitinib and baricitinib in AA in real-world settings and describe baseline disease characteristics and patients profiles that are considered good candidates for JAKi in the daily practice.

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  • - Keratoacanthoma (KA) is a rapidly growing skin tumor that can appear as single or multiple lesions, particularly in certain rare genetic syndromes like Ferguson-Smith syndrome and others.
  • - Treatment of these syndromes is complex because of the presence of numerous lesions and other skin cancers, exemplified by a case involving a 40-year-old woman with multiple treatment-resistant keratoacanthomas and invasive squamous cell carcinoma.
  • - The woman was successfully treated with a combination of oral acitretin and topical Fluorouracil for her keratoacanthomas, while surgical intervention was used for her ulcerated cancer, and the study included a review of literature on diagnosis and treatment of similar syndromes
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Moderate-to-severe psoriasis (Ps) treatment includes systemic drugs and biological agents. Apremilast, a small molecule primarily metabolized by cytochrome CYP3A4, modulates the immune system by specifically inhibiting phosphodiesterase type 4 (PDE4) isoforms and is currently used for the treatment of Ps and psoriatic arthritis (PsA). Clinical trials and real-world data showed variable efficacy in response among Ps patients underlying the need for personalized therapy.

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The diverse patient population and widespread vaccination in the COVD-19 era make vaccine-triggered episodes of psoriasis an ideal model of exposome research. This scenario explores the fine balance between protective and exacerbating factors, providing insights into the complex relationship between environmental exposure and psoriasis immunopathogenesis when a trigger appears, such as that of the hyperinflammatory state induced by the COVID-19 vaccine. Analyzing interactions between vaccine-induced phenomena and exposome parameters may provide clinically relevant information important for personalized medicine decision-making.

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Biologics approved for psoriasis exhibit favorable safety profiles, and serious adverse events have rarely been reported. In this report, we present the case of a patient treated with ixekizumab, an anti-interleukin (IL)-17 agent, who 8 months later developed multiple sclerosis (MS). We also review the available literature regarding the use of anti-IL-17 agents in the context of psoriasis and pre-existing or new-onset demyelination.

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  • - The BrIDGE study examined the real-world effectiveness of brodalumab in treating moderate-to-severe plaque psoriasis in Greece, focusing on the percentage of patients achieving complete clearance (PASI100) over 24 weeks and beyond.
  • - Results showed that 42% of patients reached PASI100 at Week 24, with this number increasing to 65% by Week 104, while significant improvements were noted in other assessment scores (PASI75, PASI90, and sPGA).
  • - Additionally, patients reported improved quality of life, with average scores on the Dermatology Life Quality Index (DLQI) decreasing significantly over the study period, indicating better overall well-being as a result of brodalumab treatment
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Cannabidiol (CBD), a substance that belongs to the phytocannabinoids, appears to exert antioxidant, neuroprotective, antipsychotic, anticonvulsant, and anticancer properties. Recent evidence supports the immunoregulatory effect of CBD on autoimmune and/or inflammatory disease. Psoriasis is a chronic skin disease.

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Objectives: Psoriasis of the scalp is challenging to manage. The only approved oral tyrosine kinase 2 and phosphodiesterase 4 inhibitors for psoriasis are deucravacitinib and apremilast. The aim of this study was to explore their efficacy for scalp psoriasis utilizing data from randomized controlled trials.

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  • - Cutaneous tuberculosis (TB) remains a significant global health issue, with Tuberculosis verrucosa cutis (TBVC) being a specific form caused by reinfection in individuals previously sensitized to TB, usually presenting as a single lesion.
  • - The first case of multifocal TBVC in an 81-year-old Greek man has been documented, adding to a total of 14 cases reported, with an average patient age of 47.64 years and most responding well to treatment.
  • - Notably, a history of skin microtrauma was found in 71.4% of cases, underscoring it as a key risk factor, while the tuberculin skin test was positive in most instances and tissue
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Background: Palmoplantar psoriasis (PP) represents a localized type of disease. While controversy over its' classification exists, a hyperkeratotic type, a pustular type and palmoplantar pustulosis (PPP) have been recognized. PP management is regularly supported by biologic agents.

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From the beginning of public vaccinations until the relaxation of COVID-19 measures, many case reports, case series and case-control studies have been published indicating cutaneous side effects of COVID-19 vaccination. Post-vaccination pustular eruption was reported as well, with a challenging differential diagnosis between pustular psoriasis, AGEP (acute generalized exanthematous pustulosis) and neutrophil pustular eruptions. We report a case of 56-year-old woman presented with acute generalized pustular flare up culminated 5 days after the second dose of BNT162b2(Pfizer) vaccination.

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Introduction: Many patients with chronic inflammatory dermatosis such as psoriasis usually ask about the safety of COVID-19 vaccination and if it would affect the course of their disease. Indeed, many case reports, case series and clinical studies, reporting psoriasis exacerbation following vaccination against COVID-19, were published during the pandemic. Also, many questions arise regarding the existence of exacerbating factors of these flare ups, including environmental triggers such as the insufficiency of vitamin D levels.

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UV radiation (UVR) is responsible for inducing both harmful and beneficial effects on skin health. Specifically, it has been reported to disrupt oxidant and antioxidant levels, leading to oxidative stress conditions in skin tissue. This phenomenon might trigger photo-carcinogenesis, resulting in melanoma, NMSC (non-melanoma skin cancer), such as BCC (basal cell carcinoma) and SCC (squamous cell carcinoma), and actinic keratosis.

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  • Interleukin-17 (IL-17) has gained attention for its significant role in causing proinflammatory immune responses, making it a key target for drug development.
  • Researchers are developing monoclonal antibodies to inhibit IL-17, which shows promise in treating inflammatory diseases.
  • This review focuses on the results from clinical trials of IL-17 inhibitors specifically for conditions like psoriasis and psoriatic arthritis, mentioning drugs like secukinumab, ixekizumab, bimekizumab, and brodalumab.
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The clinical heterogeneity regarding the response profile of the antitumor necrosis factor (anti-TNF) in patients with Crohn's disease (CD) and psoriasis (PsO) is attributed, amongst others, to genetic factors that influence the regulatory mechanisms which orchestrate the inflammatory response. Here, we investigated the possible associations between the rs2910164 and rs767649 variants and the response to anti-TNF therapy in a Greek cohort of 103 CD and 100 PsO patients. We genotyped 103 CD patients and 100 PsO patients via the PCR-RFLP method, utilizing the de novo formation of a restriction site for the SacI enzyme considering the rs2910164, while Tsp45I was employed for the rs767649 variant.

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