Local effects of adipose tissue in psoriasis and psoriatic arthritis.

The structure and physiological state of the local white adipose tissue (WAT) located underneath the lesional psoriatic skin and inside of the joints affected by psoriatic arthritis play an important role in the pathophysiology of these diseases. WAT pads associated with inflammatory sites in psoriasis and psoriatic arthritis are, correspondingly, dermal WAT and articular adipose tissue; these pads demonstrate inflammatory phenotypes in both diseases. Such local WAT inflammation could be the primary effect in the pathophysiology of psoriasis leading to the modification of the local expression of adipokines, a change in the structure of the basement membrane and the release of keratinocytes with consequent epidermal hyperproliferation during psoriasis.

Sarcoid sine sarcoidosis? A classificative, semantic and therapeutic dilemma.

Differentiation between sarcoidosis and sarcoid type reactions at the present time remains problematic, if not impossible. Criteria for clinical behavior and/or a systematic diagnostic approach in cases of proven epithelioid cell granulomas in lesional tissue do not currently exist. This is probably the main reason for chronicity of the sarcoid-type reactions within a specific disease or for their progression with the application of incorrect therapy.

Sarcoid-like pattern in a patient with tuberculosis.

For several decades the “mystery” of sarcoidosis has continued to evade revelation. Nowadays, due to medical progress and the opportunity of performing highly specialized tests which assist the identification of this condition as a separate disease, the understanding of the eternal mystery appears closer. Nevertheless, many contemporary studies focus on the putative link between sarcoidosis and infectious antigens isolated from skin lesions.