35 GAŁĄZKA, Jakub Krzysztof, DOMAGALSKI, Łukasz, HOMA, Piotr & HOFFMAN, Zofia. Psoriasiform lesions as a side effect of SGLT-2 therapy. Quality in Sport. 2023;9(1):35-39. eISSN 2450-3118. DOI https://dx.doi.org/10.12775/QS.2023.09.01.004 https://apcz.umk.pl/QS/article/view/41832 The journal has had 20 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32582. Has a Journal's Unique Identifier: 201398. Scientific disciplines assigned: Economics and finance (Field of social sciences); Management and Quality Sciences (Field of social sciences). Punkty Ministerialne z 2019 - aktualny rok 20 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32582. Posiada Unikatowy Identyfikator Czasopisma: 201398. Przypisane dyscypliny naukowe: Ekonomia i finanse (Dziedzina nauk społecznych); Nauki o zarządzaniu i jakości (Dziedzina nauk społecznych). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.01.2023. Revised: 15.01.2023. Accepted: 17.01.2023. Psoriasiform lesions as a side effect of SGLT-2 therapy Jakub Krzysztof Gałązka1, Łukasz Domagalski2, Piotr Homa3, Zofia Hoffman4 1 – Students’ Scientific Association at the Department and Clinic of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; ORCID 0000-0003-3128-773X; e-mail: jakubgalazka2@wp.pl 2 – Students’ Scientific Association at Department and Clinic of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; ORCID 0000-0001-6910-4607; e-mail: lukdom4@gmail.com 3 – Students’ Scientific Association at the Department of Pediatric Hematology, Oncology and Transplantation, Medical University of Lublin, Gebali 6, 20-093 Lublin, Poland; ORCID 0000-0003-0751-7400; e-mail: p.k.homa@gmail.com 4 - Students’ Scientific Association at Chair of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland, ORCID: 0000-0001-7996-0706, e-mail: zofhof@gmail.com Abstract SGLT-2 inhibitors (flozins) are one of the new classes of anti-diabetic drugs, used from 2012. They are highly recommended in case of intolerance or contraindication of metformin, but in Poland they are used usually as third-line drug after metformin and sulfonylurea. They growing popularity is caused by their significance in cardiovascular risk reduction and preventive role in according to diabetes complications like chronic kidney https://dx.doi.org/10.12775/QS.2023.09.01.004 https://apcz.umk.pl/QS/article/view/41832 http://creativecommons.org/licenses/by-nc-sa/4.0/) mailto:jakubgalazka2@wp.pl mailto:lukdom4@gmail.com mailto:p.k.homa@gmail.com 36 disease, or diabetes-induced dementia. The aid of this article is to summarize the knowledge on the risk of psoriasis development in diabetic patients cured with flozins. In according to the newest studies, flozins may be considered as a pro-psoriatic factor, increasing the risk of this skin disease, especially in patients with diabetic kidney disease. But on the other hand, SGLT-2 inhibitors have significantly decreasing effect on cardiovascular risk, which is increased in psoriatic patients. Keywords: flozins, SGLT-2 inhibitors, psoriasis, diabetes, diabetic kidney disease, diabetology, dermatology Introduction SGLT-2 inhibitors (flozins) are one of the new classes of anti-diabetic drugs, used from 2012. They are highly recommended in case of intolerance or contraindication of metformin, but in Poland they are used usually as third-line drug after metformin and sulfonylurea[1]. They growing popularity is caused by their significance in cardiovascular risk reduction[2, 3] and preventive role in according to diabetes complications like chronic kidney disease[4], or diabetes-induced dementia[5]. In the courses of both diabetes and psoriasis, patient’s lifestyle have significant impact on[6–8]. Nevertheless, those disorders have significant impact on each other – due to diabetic chances in skin physiology [9–11] . An average prevalence of type 2 diabetes in psoriasis patients is 11.6%[12]. A crucial element of psoriasis etiopathogenesis is consent inflammation, which results up with keratinocytes damage[8], and may be caused by adipose tissue secretion of hormones (adipokines) and proinflammatory cytokines[13, 14]. The aid of this article is to summarize the knowledge on the risk of psoriasis development in diabetic patients cured with flozins. 37 Methods To collect necessary articles, the literature review was performed using two databases – PubMed and GoogleScholar. Used keywords included “SGLT2 inhibitors” and “psoriasis”, or synonyms of those two. Articles written in languages other than Polish and English were rejected. State of the art At first, the anti-inflammatory properties of SGLT-2 inhibitors were considered to play a key role in the treatment of both diabetes and other pathological conditions with inflammation [15] . Additionally, psoriasis is considered as an independent factor of cardiovascular diseases - and its risk reduction by flozins is evidenced, so the intake of SGLT- 2 inhibitors by psoriatic patients may be considered as useful[16, 17]. Flozins may have an anti-inflammatory effect by modulating the NLRP3 inflammasome and IL-17 and IL-23 inflammatory axis, which are involved in the etiopathogenesis of psoriasis[18, 19]. The first study on psoriatic risk in diabetic patients treated with flozins was performed in 2018. On the one hand, the study was performed using central Japanese database of drug adverse events, but on the other hand the skin lesions and disorders were analyzed in general (psoriasis was not analyzed in separation from another). In this study only the ipragliflozin was appointed as a plausible factor for skin disorders occurrence[20]. The newest study about the potential pro-psoriatic effect of SGLT-2 inhibitors is a population-based study conducted in Taiwan. The study results’ indicate that SGLT-2 inhibitors rises 2,7 times the risk of psoriasis in patients with diabetic renal disease[21]. On the other hand, in compare to other anti-diabetic agents, metformin and sulfonylurea drugs are considered to have bigger risk of cutaneous side effects, including psoriasiform[22]. Conclusion In according to the newest studies, flozins may be considered as a pro-psoriatic factor, increasing the risk of this skin disease, especially in patients with diabetic kidney disease. But on the other hand, SGLT-2 inhibitors have significantly decreasing effect on cardiovascular risk, which is increased in psoriatic patients. 38 References 1. Wróbel M, Rokicka D, Strojek K. Flozins — in the light of the latest recommendations. Endokrynol Pol. 2021;72:589–91. 2. Younis A, Wazni OM. SGLT2 Inhibition and Atrial Fibrillation: Faint Light at the End of the Tunnel. JACC Clin Electrophysiol. 2022;8:1405–6. 3. Capuano A, Clementi E, Paolisso G. 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