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Alexanian C, Liakos W, Toussi A, Kao J, Cheng MY, Wang EA, Nava J, Tran M, Marusina AI, Merleev AA, Leal AR, Fung MA, Le ST, Luxardi G, Maverakis E. Immune profiling of lupus miliaris disseminatus faciei and successful management with anti-tumour necrosis factor therapy. Clin Exp Dermatol 2021; 46:910-914. [PMID: 33864395 DOI: 10.1111/ced.14684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
Lupus miliaris disseminatus faciei (LMDF) is a chronic inflammatory dermatosis of unknown aetiology, most often seen in young adults. Although many treatments for LMDF exist, treatment guidelines have not been developed, and response to therapy is generally unpredictable. We present the results of transcriptomic analysis of LMDF lesional skin, which revealed a variety of differentially expressed genes linking LMDF to alterations in innate and adaptive T helper 1 immunity. Immunohistochemical analysis was also performed, identifying similar changes in T-cell immune responses. Given evidence for increased tumour necrosis factor (TNF) pathway activity, our patient, who had previously been refractory to multiple treatments, was initiated on TNF inhibitor therapy with excellent response. This characterization of the LMDF immune response may lead to improved treatment of this condition.
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Affiliation(s)
- C Alexanian
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - W Liakos
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - A Toussi
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - J Kao
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - M Y Cheng
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - E A Wang
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - J Nava
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - M Tran
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - A I Marusina
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - A A Merleev
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - A R Leal
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - M A Fung
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA.,Department of, Pathology, University of California, Davis, Sacramento, CA, USA
| | - S T Le
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - G Luxardi
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
| | - E Maverakis
- Departments of, Department of, Dermatology, University of California, Davis, Sacramento, CA, USA
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