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Zhang B, Chen T. Local and systemic mechanisms that control the hair follicle stem cell niche. Nat Rev Mol Cell Biol 2024; 25:87-100. [PMID: 37903969 DOI: 10.1038/s41580-023-00662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 11/01/2023]
Abstract
Hair follicles are essential appendages of the mammalian skin, as hair performs vital functions of protection, thermoregulation and sensation. Hair follicles harbour exceptional regenerative abilities as they contain multiple somatic stem cell populations such as hair follicle stem cells (HFSCs) and melanocyte stem cells. Surrounding the stem cells and their progeny, diverse groups of cells and extracellular matrix proteins are organized to form a microenvironment (called 'niche') that serves to promote and maintain the optimal functioning of these stem cell populations. Recent studies have shed light on the intricate nature of the HFSC niche and its crucial role in regulating hair follicle regeneration. In this Review, we describe how the niche serves as a signalling hub, communicating, deciphering and integrating both local signals within the skin and systemic inputs from the body and environment to modulate HFSC activity. We delve into the recent advancements in identifying the cellular and molecular nature of the niche, providing a holistic perspective on its essential functions in hair follicle morphogenesis, regeneration and ageing.
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Affiliation(s)
- Bing Zhang
- School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China.
| | - Ting Chen
- National Institute of Biological Sciences, Beijing, China.
- Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing, China.
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Baenas I, Etxandi M, Fernández-Aranda F. [Medical complications in anorexia and bulimia nervosa]. Med Clin (Barc) 2024; 162:67-72. [PMID: 37598049 DOI: 10.1016/j.medcli.2023.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/21/2023]
Abstract
Anorexia nervosa and bulimia nervosa are eating disorders associated with life-threatening multisystemic medical complications. This narrative review aimed to present the medical complications most related to these disorders. In anorexia nervosa, many of them are linked to malnutrition and underweight, usually reversible with renutrition and weight restoration, although refeeding can also be linked to some medical complications. Purging behaviors observed in the anorexia nervosa binge-purging subtype and bulimia nervosa have been mainly related to hydrolectrolyte and acid-base disturbances, in addition to local complications. Thus, an early identification and therapeutic intervention of these disorders is considered crucial. Integral medical monitoring should be ensured to prevent potential serious complications from the early stages, with the involvement of physicians, psychologists, nutritionists, and other specialists in a multidisciplinary approach according to the patient's needs.
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Affiliation(s)
- Isabel Baenas
- Unidad de Psicología Clínica, Hospital Universitario de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; Grupo de Investigación de Psiconeurobiología de los Trastornos de la Conducta Alimentaria y Adicciones Comportamentales, Programa de Neurociencias, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, España; Programa de Doctorado en Medicina e Investigación Traslacional, Universidad de Barcelona (UB), Barcelona, España
| | - Mikel Etxandi
- Unidad de Psicología Clínica, Hospital Universitario de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; Programa de Doctorado en Medicina e Investigación Traslacional, Universidad de Barcelona (UB), Barcelona, España; Servicio de Psiquiatría, Hospital Universitario Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, España
| | - Fernando Fernández-Aranda
- Unidad de Psicología Clínica, Hospital Universitario de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; Grupo de Investigación de Psiconeurobiología de los Trastornos de la Conducta Alimentaria y Adicciones Comportamentales, Programa de Neurociencias, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, España; Departamento de Ciencias Clínicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España.
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Smith LL. Similarities and differences regarding acute anorexia nervosa and semi-starvation: does behavioral thermoregulation play a central role? Front Behav Neurosci 2023; 17:1243572. [PMID: 37953827 PMCID: PMC10634530 DOI: 10.3389/fnbeh.2023.1243572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/22/2023] [Indexed: 11/14/2023] Open
Abstract
Objective To clarify the association between acute anorexia nervosa (AN) and semi-starvation (SS) by focusing on similarities and differences in physiology, mood, and behavior. Method A comparison of published literature between these two groups. Results Both groups show similar hormonal and metabolic changes in response to caloric restriction and extreme weight loss (~25%). Associated changes result in a reduced body temperature (Tcore-low). Maintenance of body temperature within a specific range is crucial to survival. However, both groups cannot activate autonomic strategies to maintain their Tcore-low, such as increasing metabolic rate, constricting skin blood vessels, or shivering. Furthermore, Tcore-low increases the individuals' "coldness sensations" throughout the body, hence the frequent reports from ANs and SSs of "feeling cold." To eliminate these uncomfortable "coldness sensations" and, importantly, to maintain Tcore-low, ANs, and SSs "select" different thermoregulatory behavioral strategies. It is proposed that the primary differences between AN and SS, based on genetics, now manifest due to the "selection" of different thermo-regulatory behaviors. AN patients (ANs) "select" hyperactive behavior (HyAc), which increases internal metabolic heat and thus assists with maintaining Tcore-low; in harmony with hyperactive behavior is a lively mood. Also related to this elevated arousal pattern, ANs experience disrupted sleep. In contrast, SS individuals "select" a passive thermo-behavioral strategy, "shallow torpor," which includes reduced activity, resulting in energy conservation. In addition, this inactivity aids in the retention of generated metabolic heat. Corresponding to this lethargic behavior, SS individuals display a listless mood and increased sleep. Conclusion Initial similarities between the two are attributable to physiological changes related to extreme weight loss. Differences are most likely attributable to genetically programmed "selection" of alternate thermoregulatory strategies, primarily to maintain Tcore-low. However, if acute AN is prolonged and evolves into a chronic condition, AN will more closely align with starvation and more precisely reflect SS symptomology.
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Affiliation(s)
- Lucille Lakier Smith
- Human Performance Laboratory, Department of Kinesiology, School of Health Sciences, East Carolina University, Greenville, NC, United States
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Hamatani S, Matsumoto K, Andersson G, Tomioka Y, Numata S, Kamashita R, Sekiguchi A, Sato Y, Fukudo S, Sasaki N, Nakamura M, Otani R, Sakuta R, Hirano Y, Kosaka H, Mizuno Y. Guided Internet-Based Cognitive Behavioral Therapy for Women With Bulimia Nervosa: Protocol for a Multicenter Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49828. [PMID: 37725414 PMCID: PMC10548332 DOI: 10.2196/49828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/24/2023] [Accepted: 08/24/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Individual face-to-face cognitive behavioral therapy is known to be effective for bulimia nervosa (BN). Since foods vary considerably between regions and cultures in which patients live, cultural adaptation of the treatment program is particularly important in cognitive behavioral therapy for BN. Recently, an internet-based cognitive behavioral therapy (ICBT) program was developed for Japanese women with BN, adapted to the Japanese food culture. However, no previous randomized controlled trial has examined the effectiveness of ICBT. OBJECTIVE This paper presents a research protocol for strategies to examine the effects of guided ICBT. METHODS This study is designed as a multicenter, prospective, assessor-blinded randomized controlled trial. The treatment groups will be divided into treatment as usual (TAU) alone as the control group and ICBT combined with TAU as the intervention group. The primary outcome is the total of binge eating and purging behaviors assessed before and after treatment by an independent assessor. Secondary outcomes will include measures of eating disorder severity, depression, anxiety, quality of life, treatment satisfaction, and working alliances. Treatment satisfaction and working alliances will be measured post assessment only. Other measures will be assessed at baseline, post intervention, and follow-up, and the outcomes will be analyzed on an intention-to-treat basis. RESULTS This study will be conducted at 7 different medical institutions in Japan from August 2022 to October 2026. Recruitment of participants began on August 19, 2022, and recruitment is scheduled to continue until July 2024. The first participants were registered on September 8, 2022. CONCLUSIONS This is the first multicenter randomized controlled trial in Japan comparing the effectiveness of ICBT and TAU in patients with BN. TRIAL REGISTRATION University Hospital Medical Information Network UMIN000048732; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000055522. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49828.
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Affiliation(s)
- Sayo Hamatani
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Kazuki Matsumoto
- Division of Clinical Psychology, Kagoshima University Hospital, Kagishima, Japan
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Yukiko Tomioka
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Rio Kamashita
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Atsushi Sekiguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yasuhiro Sato
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
| | - Shin Fukudo
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
| | - Natsuki Sasaki
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masayuki Nakamura
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryoko Otani
- Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Ryoichi Sakuta
- Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
- Department of Neuropsychiatry, University of Fukui, Fukui, Japan
| | - Yoshifumi Mizuno
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
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Veronese S, Zoccante L, Smania N, Sbarbati A. Stretch marks: a visible expression of connective's involvement in autism spectrum disorders. Front Psychiatry 2023; 14:1155854. [PMID: 37448494 PMCID: PMC10338011 DOI: 10.3389/fpsyt.2023.1155854] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
In autism spectrum disorders (ASDs) in the pediatric population, skin manifestations are generally attributable to the concomitance of allergic forms or to accidental, self-inflicted or abusive lesions. However, clinical evidence has highlighted the presence of an increasing number of abdominal stretch marks, probably caused by the increase in the number of obesity cases in the pediatric population, in general, and therefore also among children with ASD. Stretch marks are often attributed to obesity, as they have an incidence of more than 50% in obese individuals. In the first part of this article we hypothesized that in addition to obesity there are other factors, such as a structural alteration on the skin in people with ASD, which can contribute/aggravate the phenomenon of stretch marks. Despite the high frequency with which stretch marks are found in children with ASD, this aspect has never been studied, the structure of the skin of children with ASD is not known. Furthermore, it is not known whether this structure is different from that of subjects without ASD. In the second part of the article, we hypothesized the mechanisms of the negative impact of simple abdominal stretch marks on the symptomatic picture of children with ASD. The presence of stretch marks, altered tactile perception, altered sensitivity to clothing fabrics can be a combination that influences development and determines negative consequences in the neurological picture of a child with ASD, as it is already known that the altered sensory perception in children with ASD contributes to the deterioration of social behavior. Furthermore, the presence of stretch marks may play a role in the postural and motor defects of children with ASD.
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Affiliation(s)
- Sheila Veronese
- Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, Italy
| | - Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, Verona, Italy
- Autism Spectrum Disorders Regional Centre of Verona, Verona, Italy
| | - Nicola Smania
- Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, Italy
| | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, Italy
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Vitagliano T, Garieri P, Lascala L, Ferro Y, Doldo P, Pujia R, Pujia A, Montalcini T, Greco M, Mazza E. Preparing Patients for Cosmetic Surgery and Aesthetic Procedures: Ensuring an Optimal Nutritional Status for Successful Results. Nutrients 2023; 15:nu15020352. [PMID: 36678221 PMCID: PMC9867292 DOI: 10.3390/nu15020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
Aesthetic and cosmetic medical practices have attracted considerable consumer attention globally. However, possible complications vary and range from mild, self-resolving ecchymoses or edema to more persistent complications. The aim of this review is to identify the nutritional deficits or excesses associated with the major complications of reconstructive surgery, aesthetic surgery, and mini-invasive aesthetic procedures. An additional goal is to provide a bundle of actions for professionals working in the industry in order to reduce the risks of aesthetic procedures and improve the clinical outcomes. Granulomas, hypertrophic scars and keloids, seromas, infections and xerosis, hyperpigmentation, petechiae, livedo reticularis, slower wound healing, and other poor outcomes are frequently associated with nutritional deficiencies. Nutritional status can markedly affect wound healing and tissue repair following surgical interventions, as well as the outcomes of aesthetic and cosmetic medical practices. Professionals working in this industry, therefore, need to consider the nutritional aspects of their patients to obtain the best results.
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Affiliation(s)
- Tiziana Vitagliano
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
| | - Pietro Garieri
- Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo, 20900 Monza, Italy
| | - Lidia Lascala
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
| | - Yvelise Ferro
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
| | - Patrizia Doldo
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
| | - Roberta Pujia
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100 Catanzaro, Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100 Catanzaro, Italy
| | - Manfredi Greco
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy
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Zagami M, Klepper E, Wienecke E, Andrzejewski M, Sikder A, Ahmed A, Robinson H. A review of psychocutaneous disorders from a psychotherapeutic perspective—Toolkit for the dermatologist. SKIN HEALTH AND DISEASE 2023. [PMID: 37538328 PMCID: PMC10395638 DOI: 10.1002/ski2.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Introduction The study of psychocutaneous disorders requires a multidisciplinary approach. It is of paramount importance that dermatologists understand the psychiatric premise for these disorders. Mental health professionals can also benefit from a better understanding of the dermatologic manifestations of psychiatric disorders they may encounter in their practice. Aim The aim of this study is to elevate the level of understanding regarding psychotherapeutic treatment of psychocutaneous disorders. Methods We performed a literature review using the major databases. Four researchers reviewed English, full text, peer-reviewed articles that were published after 2000 using our specific search terms and inclusion/exclusion criteria. Results The majority of psychocutaneous disorders seem to be clustered among three DSM-5 disorders: depressive disorders, anxiety disorders, and obsessive-compulsive related disorders. Conclusions Better recognition of the underlying psychiatric comorbidities may lead to improved patient outcomes.
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Affiliation(s)
- Mary Zagami
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Edward Klepper
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Eric Wienecke
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | | | - Ahmed Sikder
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Ali Ahmed
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Howard Robinson
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
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Silva V, Schukow CP, Restini CBA. Striae distensae as a diagnostic indicator for eating disorder pathologies. Int J Dermatol 2022; 62:715-722. [PMID: 35543453 DOI: 10.1111/ijd.16223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/31/2022] [Accepted: 03/22/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This manuscript provides a review of the relationship between patients with an underlying eating disorder (ED) and the presence of striae distensae (SD). Researchers and clinicians have recognized many different skin manifestations associated with EDs. According to the Diagnostic and Statistical Manual of Mental Disorders, EDs include, but are not limited to, anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). The presence of specific skin findings often helps clinicians conclude whether or not a patient may have an underlying ED and require further evaluation. One skin finding associated with an ED with little current literature focus is SD. SD arises from a combination of hormonal imbalances and stretching of the dermis, triggering a local inflammatory response. The presence of SD leaves patients with diminished quality of life. There is no single guideline treatment for SD; however, topical and/or light and laser therapies can be utilized. METHOD Using online medical literature databases and the PRISMA guidelines, 11 out of 574 articles met the acceptable criteria to be analyzed, emphasizing the lack of current literature on this subject. RESULTS Anxiety and depression were comorbidities demonstrated to be strongly related to AN and obesity, secondary to BED, in patients who developed SD. Higher degrees of suicidal ideation and insomnia, along with lower self-esteem levels, were more likely to be present in these patients. CONCLUSION Altogether, this review highlights the importance of continued evaluation of SD and its overall impact on patient's mental health, emphasizing an underlying ED.
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Affiliation(s)
- Vixey Silva
- Michigan State University, College of Osteopathic Medicine, Macomb University Center, Clinton, Michigan, USA
| | - Casey P Schukow
- Michigan State University, College of Osteopathic Medicine, Detroit Medical Center, Detroit, Michigan, USA
| | - Carolina B A Restini
- Michigan State University, College of Osteopathic Medicine, Macomb University Center, Clinton, Michigan, USA.,Department of Pharmacology & Toxicology, Michigan State University, East Lansing, Michigan, USA
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9
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Skin signs in eating disorders: a literature review. Eat Weight Disord 2022; 27:867-879. [PMID: 34142354 DOI: 10.1007/s40519-021-01241-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To summarize and describe the available knowledge on dermatological manifestation of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders IV-TR and 5th edition. METHODS We searched in PubMed, Scopus and Web of Science databases from January 1, 1980 through May 1, 2020 for papers in English language on the skin manifestation of eating disorders. Results were screened using the PRISMA tool. RESULTS The study yielded 207 results. According with PRISMA guidelines, 26 papers were included in the review. More than 73% of screened papers (19/26) were case reports. Cross-sectional studies represented the 19.2% of screened papers (5/26). Each eligible study has been screened and analyzed. CONCLUSION Huge heterogeneity of skin signs of eating disorders were identified. The number of controlled studies available is very limited, and most papers of interest are case reports or narrative review articles. Larger, more methodologically rigorous studies to evaluate the presence of dermatological issue in eating disorder patients are needed. LEVEL OF EVIDENCE Level IV. Evidence obtained from multiple time series analysis such as case studies.
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10
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Johansson AK, Mjanger Øvretvedt T, Reinholtsen KK, Johansson A. Eating Disorders: An Analysis of Self-Induced Vomiting, Binge Eating, and Oral Hygiene Behavior. Int J Clin Pract 2022; 2022:6210372. [PMID: 35685564 PMCID: PMC9159179 DOI: 10.1155/2022/6210372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/11/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Self-induced vomiting (SIV) is often present in patients with eating disorders (ED) and potentially damaging for oral health. Related behaviors, such as binge eating and oral hygiene habits, may equally increase the risk for dental damage. This study aimed to investigate behaviors and habits in patients with ED and SIV in relation to oral health. METHODS All patients enlisting for treatment in an ED clinic for 1 year were offered to take part in the study. Fifty-four of 65 patients were accepted to participate, and a questionnaire included questions on dietary and oral hygiene habits was included. A subgroup consisting of only those 17 ED patients who reported SIV during the previous six months comprised the sample for this study and received additional questions related to other compensatory behaviors and oral hygiene habits in relation to oral health. RESULTS Binge eating before SIV was common (14/17 patients). Time point for SIV after binge eating and the procedures performed after vomiting varied. Tooth brushing after vomiting was common (7/17). Food and drinks during binge eating included mainly items rich in calories (sugar/fat) or acid. All 17 patients believed that vomiting could damage their teeth, but only one of them had informed the dentist about having an ED. A number of oral symptoms were reported. Ten patients considered their oral health to be good/fairly good, while the remaining seven patients reported their oral health as not so good/bad/very bad. Information on how ED could affect their teeth was commonly received from the media. CONCLUSIONS The dental team should be made aware of the likely detrimental effects of binge eating and vomiting on oral health in patients with eating disorders. The team should also be aware of the cyclical nature of the disease and the similarities and diversities that exist within this group of ED patients. Since ED patients hide their disease from the dental team, this stresses the importance of open and trustful communication between patients and health workers. An organized collaboration between ED clinics and dental professionals is suggested as well as a development of avenues for information about ED and oral health.
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Affiliation(s)
- Ann-Katrin Johansson
- Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Tonje Mjanger Øvretvedt
- Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Karen Knudsen Reinholtsen
- Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Anders Johansson
- Department of Clinical Dentistry-Prosthodontics, Faculty of Medicine, University of Bergen, Bergen, Norway
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11
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Smith LL. The Central Role of Hypothermia and Hyperactivity in Anorexia Nervosa: A Hypothesis. Front Behav Neurosci 2021; 15:700645. [PMID: 34421554 PMCID: PMC8377352 DOI: 10.3389/fnbeh.2021.700645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022] Open
Abstract
Typically, the development of anorexia nervosa (AN) is attributed to psycho-social causes. Several researchers have recently challenged this view and suggested that hypothermia and hyperactivity (HyAc) are central to AN. The following hypothesis will attempt to clarify their role in AN. Anorexia nervosa patients (ANs) have significantly lower core temperatures (Tcore) compared to healthy controls (HCs). This reduced temperature represents a reset Tcore that needs to be maintained. However, ANs cannot maintain this Tcore due primarily to a reduced basal metabolic rate (BMR); BMR usually supplies heat to sustain Tcore. Therefore, to generate the requisite heat, ANs revert to the behavioral-thermoregulatory strategy of HyAc. The majority of ANs (~89%) are reportedly HyAc. Surprisingly, engagement in HyAc is not motivated by a conscious awareness of low Tcore, but rather by the innocuous sensation of "cold- hands" frequently reported by ANs. That is, local hand-thermoreceptors signal the brain to initiate HyAc, which boosts perfusion of the hands and alters the sensation of "cold-discomfort" to one of "comfort." This "rewarding" consequence encourages repetition/habit formation. Simultaneously, hyperactivity increases the availability of heat to assist with the preservation of Tcore. Additionally, HyAc induces the synthesis of specific brain neuromodulators that suppress food intake and further promote HyAc; this outcome helps preserve low weight and perpetuates this vicious cycle. Based on this hypothesis and supported by rodent research, external heat availability should reduce the compulsion to be HyAc to thermoregulate. A reduction in HyAc should decrease the production of brain neuromodulators that suppress appetite. If verified, hopefully, this hypothesis will assist with the development of novel treatments to aid in the resolution of this intractable condition.
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Affiliation(s)
- Lucille Lakier Smith
- Human Performance Laboratory, Department of Kinesiology, School of Health Sciences, East Carolina University, Greenville, NC, United States
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12
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Öner Ü, Hacınecipoğlu F. Could acne be a risk factor for developing eating disorders? Acne vulgaris and eating disorders. J Cosmet Dermatol 2021; 21:2176-2182. [PMID: 34214235 DOI: 10.1111/jocd.14330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/07/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Skin findings such as acne, hypertrichosis, and hyperpigmentation may be a clue for the diagnosis of eating disorders. There are studies on skin findings in eating disorders, but there is no study evaluating eating disorders in acne patients. We aimed to investigate eating disorders in acne patients and evaluate the effect of acne severity, quality of life, and body mass index (BMI) on eating disorders. METHODS Two hundred thirty-two acne patients and 314 healthy controls were enrolled. Acne severity was detected according to Grading Acne Severity Scale (GAGS) by the dermatologists. Eating Attitude Test-40 (EAT) and Acne Quality of Life Scale (AQLS) were filled out by patients. The controls filled out EAT. Individuals scoring EAT≥30 points were considered at risk for eating disorders. RESULTS The median EAT score (15 vs. 13) and the number of patients scoring EAT ≥30 (14.2% vs. 2.2%) were found to be significantly higher in the patients' group compared with control group (p: 0.005, p < 0.001). There was a significant positive correlation between EAT score and AQLS score but no significant relationship between acne severity and EAT score. A significant positive correlation was found between EAT scores and BMI. CONCLUSION Eating disorders and acne are mostly seen in adolescence, and both have high biopsychosocial morbidity. Also eating disorders can even be mortal sometimes. There are common psychopathological mechanisms in eating disorders and acne.
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Affiliation(s)
- Ümran Öner
- Department of Dermatology, Erzurum Mareşal Çakmak State Hospital, Erzurum, Turkey
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13
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Mateos-Mayo A, Anderson-Vildósola J, Morón-Nozaleda MG, Camarneiro R, Escribano E, Colmenero I, Torrelo A, Hernández-Martín Á. Diffuse reticulate purpura in two adolescents with anorexia nervosa and severe malnutrition. Pediatr Dermatol 2021; 38:667-669. [PMID: 33856062 DOI: 10.1111/pde.14601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Anorexia nervosa is an eating disorder frequently associated with cutaneous manifestations. A rare type of purpura, known as diffuse reticulate purpura, has been described in patients with anorexia nervosa and severe malnutrition. Typical characteristics of this condition include a purpuric reticulate rash predominantly affecting the trunk that rapidly resolves with adequate feeding. We report two male adolescent patients with anorexia nervosa and severe malnutrition who developed diffuse reticulate purpura.
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Affiliation(s)
- Ana Mateos-Mayo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | | | - Ricardo Camarneiro
- Department of Psychiatry, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Eva Escribano
- Department of Pediatrics, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Isabel Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Antonio Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Chien Yin GO, Siong-See JL, Wang ECE. Telogen Effluvium - a review of the science and current obstacles. J Dermatol Sci 2021; 101:156-163. [PMID: 33541773 DOI: 10.1016/j.jdermsci.2021.01.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/25/2022]
Abstract
Telogen effluvium (TE) is a common cause of diffuse non-scarring hair loss that is usually precipitated by physiological stress such as childbirth or sudden weight loss. Despite its high rate of remission, this phenomenon of sudden excessive hair loss can be very worrisome and upsetting for affected individuals and may significantly impact their quality of life. Due to the multifactorial causes and precipitants of TE, it is often challenging to diagnose and manage. Further, the mechanisms through which physiological stress influences the human hair cycle is unknown, and there are no targeted treatments for the management of TE. This review will describe the approach in making a diagnosis of TE, summarize the latest developments made in understanding the mechanisms of TE, outline the treatments tried, and recommend ways for advancing the study of this dermatological condition.
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Affiliation(s)
- Ginny Oong Chien Yin
- Newcastle University, Newcastle Upon Tyne, UK; Belfast Health and Social Care Trust, Belfast, UK
| | | | - Etienne C E Wang
- National Skin Centre, Singapore; Skin Research Institute of Singapore, Singapore.
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15
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Hornberger LL, Lane MA. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics 2021; 147:peds.2020-040279. [PMID: 33386343 DOI: 10.1542/peds.2020-040279] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Eating disorders are serious, potentially life-threatening illnesses afflicting individuals through the life span, with a particular impact on both the physical and psychological development of children and adolescents. Because care for children and adolescents with eating disorders can be complex and resources for the treatment of eating disorders are often limited, pediatricians may be called on to not only provide medical supervision for their patients with diagnosed eating disorders but also coordinate care and advocate for appropriate services. This clinical report includes a review of common eating disorders diagnosed in children and adolescents, outlines the medical evaluation of patients suspected of having an eating disorder, presents an overview of treatment strategies, and highlights opportunities for advocacy.
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Affiliation(s)
- Laurie L Hornberger
- Division of Adolescent Medicine, Children's Mercy Kansas City and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri; and
| | - Margo A Lane
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
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Antimicrobial peptides in patients with anorexia nervosa: comparison with healthy controls and the impact of weight gain. Sci Rep 2020; 10:22223. [PMID: 33335229 PMCID: PMC7746688 DOI: 10.1038/s41598-020-79302-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/07/2020] [Indexed: 11/08/2022] Open
Abstract
Clinical observations show that patients with anorexia nervosa (AN) are surprisingly free from infectious diseases. There is evidence from studies in Drosophila melanogaster that starvation leads to an increased expression of antimicrobial peptides (AMPs). AMPs are part of the innate immune system and protect human surfaces from colonization with pathogenic bacteria, viruses and fungi. We compared the expression of AMPs between patients with AN and healthy controls (HC) and investigated the influence of weight gain. Using a standardized skin rinsing method, quantitative determination of the AMPs psoriasin and RNase 7 was carried out by ELISA. Even though non-significant, effect sizes revealed slightly higher AMP concentrations in HC. After a mean weight gain of 2.0 body mass index points, the concentration of psoriasin on the forehead of patients with AN increased significantly. We could not confirm our hypotheses of higher AMP concentrations in patients with AN that decrease after weight gain. On the contrary, weight gain seems to be associated with increasing AMP concentrations.
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Rosen J, Darwin E, Tuchayi SM, Garibyan L, Yosipovitch G. Skin changes and manifestations associated with the treatment of obesity. J Am Acad Dermatol 2019; 81:1059-1069. [DOI: 10.1016/j.jaad.2018.10.081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 11/28/2022]
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Abstract
Anorexia nervosa and bulimia nervosa are mental illnesses with associated complications affecting all body systems with arguably the highest mortality of all mental health disorders. A comprehensive medical evaluation is an essential first step in the treatment of anorexia nervosa and bulimia nervosa. Weight restoration and cessation of purging behaviors are often essential components in the management of medical complications of these illnesses.
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Affiliation(s)
- Dennis Gibson
- ACUTE @ Denver Health, 777 Bannock Street, Denver, CO 80204, USA; Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Cassandra Workman
- Eating Recovery Center, 7351 East Lowry Boulevard, Suite 200, Denver, CO 80230, USA
| | - Philip S Mehler
- ACUTE @ Denver Health, 777 Bannock Street, Denver, CO 80204, USA; Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA; Eating Recovery Center, 7351 East Lowry Boulevard, Suite 200, Denver, CO 80230, USA.
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Abstract
Eating disorders affect millions of children, adolescents, and their families worldwide, and the pediatric primary care provider is often the first line of evaluation for these patients. Eating disorders affect nearly every system in the body, and signs and symptoms vary depending on patient behaviors (restrictive eating, binge eating, purging). Because the diagnosis is not always straightforward, a clinician's ability to recognize the potential medical complications of eating disorders early in their course can help facilitate timely treatment and an appropriate level of support. Most of these medical complications improve or resolve with nutritional rehabilitation and cessation of eating disorder behaviors. Refeeding severely underweight patients should be approached with caution as there is potential for significant fluid and electrolyte derangement that may worsen a patient's clinical status. Prompt recognition of the medical complications of eating disorders can improve short-term and long-term health in these children and adolescents. [Pediatr Ann. 2018;47(6):e238-e243.].
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21
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Claudel JP, Auffret N, Leccia MT, Poli F, Dréno B. Acne and nutrition: hypotheses, myths and facts. J Eur Acad Dermatol Venereol 2018; 32:1631-1637. [PMID: 29633388 DOI: 10.1111/jdv.14998] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/15/2018] [Indexed: 12/28/2022]
Abstract
Acne is an inflammatory and multifactorial skin disease. Different external and internal factors, including air pollution, aggressive skincare products, medication, mechanical, hormonal and familial factors and, more recently, lifestyle and stress, have been suggested as having an impact on acne. Moreover, for many years nutrition was believed to cause or worsen acne. Over the last decades, however, it has become a dermatological doctrine that there is no direct association between diet and acne. Even if recent research has allowed to identify certain nutritional elements and behaviour that may impact on acne, including the excessive intake of dairy products and hyperglycaemic food, modern lifestyle nutrition, obesity and eating disorders, knowledge about the role of nutrition in the physiopathology of acne still remains sparse and hypotheses and myths continue to dominate the debate. Thus, further clinical and translational research is necessary to investigate and confirm the association between nutrition and acne.
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Affiliation(s)
| | | | - M T Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A Michallon, Grenoble, France
| | - F Poli
- Private Practice, Paris, France
| | - B Dréno
- Department of Dermatology, CIC 1413, CRCINA Inserm 1232, Nantes University Hospital, Nantes, France
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22
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Gabler G, Olguín P, Rodríguez A. COMPLICACIONES MÉDICAS DE LOS TRASTORNOS DE LA CONDUCTA ALIMENTARIA. REVISTA MÉDICA CLÍNICA LAS CONDES 2017. [DOI: 10.1016/j.rmclc.2017.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Abstract
OBJECTIVE This manuscript examined the prevalence and extrinsic risk factors for dental erosion (DE) in early and middle adolescents in Pasto, Colombia. STUDY DESIGN Dental erosion was evaluated in a random sample of 384 individuals aged 10-15 years attending three primary and high schools in this cross-sectional study. Clinical dental assessment for DE was done using O'Sullivan index. Data on general sociodemographic variables and extrinsic risks factors were obtained. Descriptive and univariate binary logistic regression analyses were performed. RESULTS Dental erosion was observed in 57.3% of individuals. The univariate binary logistic regression analysis showed that frequency of drinking natural fruit juices (OR 2.670, 95% CI 1.346 - 5.295, P=0.004) and their pH (OR 2.303, 95% CI 1.292 - 4.107, P=0.004) were more associated with the odd of DE in early adolescence. However, a high SES (OR 10.360, 95% CI 3.700 - 29.010, P<0.001) and frequency of snacks with artificial lemon taste (OR 3.659, 95% CI 1.506 - 8.891, P=0.003) were highly associated with the risk of DE in middle adolescence. CONCLUSIONS The results suggest that DE is a prevalent condition in adolescents living in a city in southern Colombia. The transition from early to middle adolescence implies new bio-psychosocial changes, which increase the risk for DE.
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Kuhn H, Mennella C, Magid M, Stamu-O'Brien C, Kroumpouzos G. Psychocutaneous disease: Clinical perspectives. J Am Acad Dermatol 2017; 76:779-791. [PMID: 28411771 DOI: 10.1016/j.jaad.2016.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/26/2016] [Accepted: 11/03/2016] [Indexed: 01/03/2023]
Abstract
Psychocutaneous disease, defined in this review as primary psychiatric disease with skin manifestations, is commonly encountered in dermatology. Dermatologists can play an important role in the management of psychocutaneous disease because patients visit dermatology for treatment of their skin problems but often refuse psychiatric intervention. This review describes common psychocutaneous syndromes, including delusional, factitious, obsessive-compulsive and related, and eating disorders, as well as psychogenic pruritus, cutaneous sensory (pain) syndromes, posttraumatic stress disorder, and sleep-wake disorders. The updated classification of these disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition is included. Strategies for management are reviewed.
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Affiliation(s)
- Helena Kuhn
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Constance Mennella
- Division of Child/Adolescent Psychiatry, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Michelle Magid
- Department of Psychiatry at Dell Medical School, University of Texas at Austin, Austin, Texas; Department of Psychiatry, University of Texas Medical Branch at Galveston, Galveston, Texas; Department of Psychiatry, Texas A&M Health Science Center, Round Rock, Texas
| | | | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island; Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil; GK Dermatology, PC, South Weymouth, Massachusetts.
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25
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Garlapow ME, Everett LJ, Zhou S, Gearhart AW, Fay KA, Huang W, Morozova TV, Arya GH, Turlapati L, St Armour G, Hussain YN, McAdams SE, Fochler S, Mackay TFC. Genetic and Genomic Response to Selection for Food Consumption in Drosophila melanogaster. Behav Genet 2017; 47:227-243. [PMID: 27704301 PMCID: PMC5305434 DOI: 10.1007/s10519-016-9819-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 09/16/2016] [Indexed: 12/21/2022]
Abstract
Food consumption is an essential component of animal fitness; however, excessive food intake in humans increases risk for many diseases. The roles of neuroendocrine feedback loops, food sensing modalities, and physiological state in regulating food intake are well understood, but not the genetic basis underlying variation in food consumption. Here, we applied ten generations of artificial selection for high and low food consumption in replicate populations of Drosophila melanogaster. The phenotypic response to selection was highly asymmetric, with significant responses only for increased food consumption and minimal correlated responses in body mass and composition. We assessed the molecular correlates of selection responses by DNA and RNA sequencing of the selection lines. The high and low selection lines had variants with significantly divergent allele frequencies within or near 2081 genes and 3526 differentially expressed genes in one or both sexes. A total of 519 genes were both genetically divergent and differentially expressed between the divergent selection lines. We performed functional analyses of the effects of RNAi suppression of gene expression and induced mutations for 27 of these candidate genes that have human orthologs and the strongest statistical support, and confirmed that 25 (93 %) affected the mean and/or variance of food consumption.
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Affiliation(s)
- Megan E Garlapow
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695-7614, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Logan J Everett
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695-7614, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
- Initiative for Biological Complexity, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Shanshan Zhou
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695-7614, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
- Initiative for Biological Complexity, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Alexander W Gearhart
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Kairsten A Fay
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Wen Huang
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695-7614, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
- Initiative for Biological Complexity, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Tatiana V Morozova
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Gunjan H Arya
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Lavanya Turlapati
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Genevieve St Armour
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Yasmeen N Hussain
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Sarah E McAdams
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
| | - Sophia Fochler
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Trudy F C Mackay
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695-7614, USA.
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695-7614, USA.
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695-7614, USA.
- Initiative for Biological Complexity, North Carolina State University, Raleigh, NC, 27695-7614, USA.
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Gupta MA, Jarosz P, Gupta AK. Posttraumatic stress disorder (PTSD) and the dermatology patient. Clin Dermatol 2017; 35:260-266. [PMID: 28511822 DOI: 10.1016/j.clindermatol.2017.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Dermatologic symptoms can be associated with posttraumatic stress disorder (PTSD) in several situations: (1) as features of some core PTSD symptoms, such as intrusion symptoms manifesting as cutaneous sensory flashbacks, as autonomic arousal manifesting as night sweats and idiopathic urticaria, and as dissociation manifesting as numbness and dermatitis artefacta; (2) the cutaneous psychosomatic effects of emotional and physical neglect and sexual abuse (eg, infantile eczema, cutaneous self-injury, and body-focused repetitive behaviors such as trichotillomania and skin picking disorder) and eating disorders, which can have dermatologic effects; (3) the direct effect of physical or sexual abuse or catastrophic life events (eg, earthquakes) on the skin; and (4) as a result of significant alterations in hypothalamic-pituitary-adrenal and sympatho-adrenal medullary axes, which can affect neuroendocrine and immune functions, and can lead to exacerbations of stress-reactive inflammatory dermatoses such as psoriasis, chronic urticaria, and atopic dermatitis. Elevated levels of inflammatory biomarkers and impaired epidermal barrier function have been reported in situations involving sustained psychologic stress and sleep deprivation. Some PTSD patients show hypothalamic-pituitary-adrenal axis hyporesponsiveness and higher circulating T lymphocytes, which can exacerbate immune-mediated dermatologic disorders. PTSD should be considered an underlying factor in the chronic, recurrent, or treatment-resistant stress-reactive dermatoses and in patients with self-induced dermatoses.
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Affiliation(s)
- Madhulika A Gupta
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada.
| | - Patricia Jarosz
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
| | - Aditya K Gupta
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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27
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Latzer IT, Agmon-Levin N, Somech R, Stein D. Eruption of urticaria and angioedema induced by binging and purging in an anorexia nervosa patient. Int J Eat Disord 2016; 49:822-5. [PMID: 27038089 DOI: 10.1002/eat.22514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 12/20/2015] [Accepted: 01/06/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Anorexia nervosa is a perplexing psycho-biological disorder with a systemic nature, which can present in almost every organ and system of the body. Among the different presentations of starvation, several immunological and dermatological manifestations have been documented. To the best of our knowledge the occurrence of urticaria and angioedema in patients with binge or purge behaviors has yet to be documented. CASE PRESENTATION We present a 16-year-old female patient diagnosed with anorexia nervosa binge/purge type, who presented with urticaria and angioedema shortly after binge/purge episodes that subsided when these behaviors ceased. Other possible causes for the urticaria were ruled out. DISCUSSION This finding may represent a form of inducible urticaria, exacerbated in low-weight patients by the occurrence of binge/purge behaviors. We wish to report this observation in an attempt to widen the scope of the physical signs that may accompany eating disorders and bring this specific phenomenon into awareness. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:822-825).
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Affiliation(s)
- Itay Tokatly Latzer
- Department of Pediatrics A, Edmond and Lily Safra Children's Hospital, the Chaim Sheba Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nancy Agmon-Levin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Raz Somech
- Department of Pediatrics A, Edmond and Lily Safra Children's Hospital, the Chaim Sheba Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Psychosomatic Department, Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
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28
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Garlapow ME, Huang W, Yarboro MT, Peterson KR, Mackay TFC. Quantitative Genetics of Food Intake in Drosophila melanogaster. PLoS One 2015; 10:e0138129. [PMID: 26375667 PMCID: PMC4574202 DOI: 10.1371/journal.pone.0138129] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 08/25/2015] [Indexed: 12/16/2022] Open
Abstract
Food intake is an essential animal activity, regulated by neural circuits that motivate food localization, evaluate nutritional content and acceptance or rejection responses through the gustatory system, and regulate neuroendocrine feedback loops that maintain energy homeostasis. Excess food consumption in people is associated with obesity and metabolic and cardiovascular disorders. However, little is known about the genetic basis of natural variation in food consumption. To gain insights in evolutionarily conserved genetic principles that regulate food intake, we took advantage of a model system, Drosophila melanogaster, in which food intake, environmental conditions and genetic background can be controlled precisely. We quantified variation in food intake among 182 inbred, sequenced lines of the Drosophila melanogaster Genetic Reference Panel (DGRP). We found significant genetic variation in the mean and within-line environmental variance of food consumption and observed sexual dimorphism and genetic variation in sexual dimorphism for both food intake traits (mean and variance). We performed genome wide association (GWA) analyses for mean food intake and environmental variance of food intake (using the coefficient of environmental variation, CVE, as the metric for environmental variance) and identified molecular polymorphisms associated with both traits. Validation experiments using RNAi-knockdown confirmed 24 of 31 (77%) candidate genes affecting food intake and/or variance of food intake, and a test cross between selected DGRP lines confirmed a SNP affecting mean food intake identified in the GWA analysis. The majority of the validated candidate genes were novel with respect to feeding behavior, and many had mammalian orthologs implicated in metabolic diseases.
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Affiliation(s)
- Megan E. Garlapow
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695–7614, United States of America
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695, United States of America
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695, United States of America
| | - Wen Huang
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695–7614, United States of America
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695, United States of America
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695, United States of America
| | - Michael T. Yarboro
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695, United States of America
| | - Kara R. Peterson
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695, United States of America
| | - Trudy F. C. Mackay
- Program in Genetics, North Carolina State University, Raleigh, NC, 27695–7614, United States of America
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695, United States of America
- W. M. Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, 27695, United States of America
- * E-mail:
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Garrido Colmenero C, Aneiros Fernández J. Diffuse reticulate purpura in a boy with anorexia nervosa. CMAJ 2015; 187:E514. [PMID: 26283721 DOI: 10.1503/cmaj.141543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Cristina Garrido Colmenero
- Department of Dermatology and Venereology (Garrido Colmenero); Department of Pathology (Aneiros Fernández), Virgen de Las Nieves Hospital, Granada, Spain
| | - José Aneiros Fernández
- Department of Dermatology and Venereology (Garrido Colmenero); Department of Pathology (Aneiros Fernández), Virgen de Las Nieves Hospital, Granada, Spain
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Abstract
As with anorexia nervosa, there are many medical complications associated with bulimia nervosa. In bulimia nervosa, these complications are a direct result of both the mode and the frequency of purging behaviours. For the purposes of this article, we will review in detail the many complications of the two major modes of purging, namely, self-induced vomiting and laxative abuse; these two account for more than 90% of purging behaviours in bulimia nervosa. Some of these complications are potentially extremely dangerous and need to be well understood to effectively treat patients with bulimia nervosa. Other methods of purging, such as diuretic abuse, are much less frequently utilized and will only be mentioned briefly. In a subsequent article, the treatments of these medical complications will be presented.
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Affiliation(s)
- Philip S Mehler
- Department of Medicine, University of Colorado Health Sciences Center, ACUTE at Denver Health, Denver, CO, 777 Bannock Street, MC4000, Denver, CO 80204 USA.,Department of Medicine, University of Colorado Health Sciences Center, Eating Recovery Center, 7351 E Lowry Blvd, Suite 200, Denver, CO 80230 USA
| | - Melanie Rylander
- Department of Medicine, University of Colorado Health Sciences Center, ACUTE at Denver Health, Denver, CO, 777 Bannock Street, MC4000, Denver, CO 80204 USA
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