Cutaneous manifestations in disorders of hepatobiliary system

Features of the ultrastructure of the skin of white rats 30 days after modeling of portal hypertension

The problem of skin repair under the conditions of systemic increased pressure in microvessels has a great importance. This is due to the fact that each year the incidence of this pathology has seen an increase during different operations, including plastic surgery. As the compensatory and reparative mechanisms occurring in the skin affected by vascular hyperbaria are still unidentified, the aim of the study was to investigate the features of the ultrastructure of the skin of white rats 30 days after modeling of portal hypertension. Objects of the study were anterior abdominal wall biopsies for electron microscopy research.

Our work demonstrated that the skin in intact animals (control group) was of typical structure before the beginning of the experiment and 30 days after a sham operation. Following 30 days modeling of portal hypertension, the ultrastructure of the epidermis was found to be intact, only slight thickening of the horny layer was revealed. However, in the basal epidermocytes, signs of crypts formation by cytolemma were revealed. Moreover, in the epidermocytes of the spinous and granular layers, the mitochondria, endoplasmic reticulum channels and ribosomes were almost non-evident. In addition, in the cytoplasm of the fibroblasts, a moderate amount of freely located ribosomes and a moderate number of polymorphic mitochondria were detected, while the lumens of the capillaries of the papillary layer of the dermis were narrowed. We also saw that the swelling of the cytoplasm in endothelial cells resulted in the narrowing of the microvessels lumen. What is more, the subendothelial zone was expanded – which is indicative of endothelial desquamation. Beyond the aforementioned, the nuclei of the endothelial cells were well contoured and had signs of chromatin condensation. Endothelial cells with signs of apoptosis were detected as well.

Comorbidity of viral hepatitis and chronic spontaneous urticaria: A systematic review

Chronic viral infections including those by hepatitis B (CHB) virus and hepatitis C (CHC) virus have been reported to be comorbidities of chronic spontaneous urticaria (CSU). Here, we performed the first comprehensive review of the peer-reviewed literature (PubMed, Web of Science and Google Scholar) on the prevalence of CHB and CHC in patients with CSU and vice versa. The prevalence of CHB and CHC in CSU does not appear to be increased. Less than 5% and 2% of patients with CSU have markers of CHB and CHC, respectively, according to most of the 32 studies reviewed. Urticarial rash including CSU occurs in ≤3% of patients with CHC as reported by most of 20 studies analysed. Very few patients have been assessed for the effects of antiviral hepatitis treatment on their CSU, and two but not all reportedly showed improvement. Hepatitis B/C infections appear unlikely to be linked to CSU. We suggest that routine screening for these infections in patients with CSU is not relevant or cost-effective and should not be performed unless liver function tests are abnormal, risk factors or symptoms of viral hepatitis are present, or urticarial vasculitis is suspected.