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Affiliation(s)
- Xinxing Jin
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
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Chaiyabutr C, Dawe R, Lesar A, Ibbotson SH. A retrospective comparison of early- and late-onset chronic actinic dermatitis: characteristics and management. Br J Dermatol 2024; 190:923-925. [PMID: 38625063 DOI: 10.1093/bjd/ljae101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/29/2024] [Indexed: 04/17/2024]
Abstract
Our study highlights the high prevalence of early-onset chronic actinic dermatitis (CAD; age < 40 years at diagnosis), particularly in patients with atopic diseases and those with darker skin phototypes. Disease characteristics, photodiagnostic investigations and outcomes did not significantly differ between those with early-onset vs. late-onset disease, although younger patients more frequently required systemic therapy. We also show that marked UVA sensitivity and positive baseline series patch testing are negative prognostic factors for outcomes in CAD.
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Affiliation(s)
- Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Scottish Photobiology Service, Photobiology Unit, University of Dundee and NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK
| | - Robert Dawe
- Scottish Photobiology Service, Photobiology Unit, University of Dundee and NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK
| | - Andrea Lesar
- Scottish Photobiology Service, Photobiology Unit, University of Dundee and NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK
| | - Sally H Ibbotson
- Scottish Photobiology Service, Photobiology Unit, University of Dundee and NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK
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He L, Liu L, Xu D, Tu Y, Yang C, Zhang M, Wang H, Nong X. Deficiency of N6-Methyladenosine Demethylase ALKBH5 Alleviates Ultraviolet B Radiation-Induced Chronic Actinic Dermatitis via Regulating Pyroptosis. Inflammation 2024; 47:159-172. [PMID: 37740102 DOI: 10.1007/s10753-023-01901-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/24/2023]
Abstract
Pyroptosis is an inflammatory programmed cell death (PCD) and is reported to be associated with N6-methyladenosine (m6A) modification. This study aimed to investigate the mechanism of m6A demethylase AlkB homolog 5 (ALKBH5) in pyroptosis in the process of chronic actinic dermatitis (CAD). Changes of m6A-related genes were evaluated between CAD and normal samples using quantitative reverse-transcription polymerase chain reaction (qRT-PCR). Human keratinocytes (HaCaT cells) exposed to ultraviolet B (UVB; 10, 20, and 30 mJ/cm2), followed by evaluation of cell proliferation, cell apoptosis, inflammatory cytokines (interleukin (IL)-1β, IL-18, and tumor necrosis factor (TNF-α)), and pyroptosis-related proteins (gasdermin D (GSDMD), Caspase-1, and Caspase-4). Small interfering RNA (siRNA) targeting ALKBH5 was transfected into HaCaT cells to assess the effect of si-ALKBH5 on CAD. A CAD mice model was induced after exposure to UVB (250 mJ/cm2 per day) to confirm the role of ALKBH5 in CAD. AKKBH5 was highly expressed in CAD patients. UVB also promoted ALKBH5 expression, increased cell apoptosis, and induced the release of inflammatory cytokines (IL-1β, IL-18, and TNF-α) as well as pyroptosis-related proteins (GSDMD, Caspase-1, and Caspase-4). Silencing ALKBH5 repressed cell apoptosis and suppressed UVB-induced pyroptosis and inflammatory response. Meanwhile, silencing ALKBH5 attenuated UVB-induced skin damage of CAD mice, accompanied with the reduction in expression of inflammatory cytokines and pyroptosis-related proteins. This study helps to further understand the mechanism of ALKBH5 in CAD-induced pyroptosis and provides novel ideas for the research and management of CAD.
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Affiliation(s)
- Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China
| | - Lan Liu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China
| | - Dan Xu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China
| | - Ying Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China
| | - Chenling Yang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China
| | - Mei Zhang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China
| | - Hongyun Wang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China
| | - Xiang Nong
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming City, Yunnan Province, 650032, China.
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Pappa G, Sgouros D, Kanelleas A, Koumaki D, Bozi E, Katoulis A. JAK-ing up chronic actinic dermatitis with upadacitinib. Clin Exp Dermatol 2024; 49:173-175. [PMID: 37831411 DOI: 10.1093/ced/llad348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Indexed: 10/14/2023]
Abstract
We describe a unique and significant case of a 75-year-old man successfully treated with upadacitinib for chronic actinic dermatitis.
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Affiliation(s)
- Georgia Pappa
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, 'ATTIKON' General University Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, 'ATTIKON' General University Hospital, Athens, Greece
| | - Antonios Kanelleas
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, 'ATTIKON' General University Hospital, Athens, Greece
| | - Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, Heraklion, Greece
| | - Evangelia Bozi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, 'ATTIKON' General University Hospital, Athens, Greece
| | - Alexandros Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, 'ATTIKON' General University Hospital, Athens, Greece
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Maguire J, Gleeson D, Corso R, Pink A, Smith C, Ferguson J. Remission of chronic actinic dermatitis on baricitinib: A case report. SKIN HEALTH AND DISEASE 2023; 3:e243. [PMID: 38047267 PMCID: PMC10690658 DOI: 10.1002/ski2.243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 12/05/2023]
Abstract
Chronic actinic dermatitis (CAD) is an immune-mediated photodermatosis characterised by eczematous, pruritic changes to sun-exposed skin. The pathophysiology of CAD is poorly understood, with current explanations including a hypersensitivity reaction and cross-reactivity to contact allergens. The disease is often refractory to immunosuppressive treatment and has a marked impact on patient quality of life. Janus kinase inhibitors (JAKi) are a novel class of small molecules licenced for the management of certain inflammatory conditions, including atopic dermatitis We present the case of a 69-year-old gentleman with a history of severe CAD, unresponsive to standard therapies, who was prescribed baricitinib, a janus kinase (JAK) inhibitor as a single agent treatment for his disease. The patient experienced a dramatic clinical improvement with this therapy. In addition, normalisation of photo test and improvement of patch test results following treatment were observed. There is one previous case report in the literature describing the clinical response of patients with CAD to JAK inhibitor therapy, but no comment on pre or post treatment photo testing, patch testing or photo-patch testing results was made. In this case report, we discuss our understanding of the role of JAK inhibitors in CAD and highlight a potential new therapeutic avenue for this disabling disease.
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Affiliation(s)
- Jessica Maguire
- St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - David Gleeson
- St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - Roberto Corso
- St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - Andrew Pink
- St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - Catherine Smith
- St John's Institute of DermatologyKings College London and Guy's and St Thomas' NHS Foundation TrustLondonUK
| | - John Ferguson
- St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation TrustLondonUK
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Taboada Paz L, Sánchez García V, García Miñarro ÁM, Ramos Rincón JM, Gil Pallares P, Vicente Basanta E, Silvestre Salvador JF. Chronic actinic dermatitis and fragrance sensitization: Case report with good response to dupilumab. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:670-672. [PMID: 37485724 DOI: 10.1111/phpp.12902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/27/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
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Wang L, Tu Y, Wu W, Tu Y, Yang Z, Chai Y, Yang X, He L. Role of interleukin-36γ induced by ultraviolet radiation in chronic actinic dermatitis. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:598-606. [PMID: 37545106 DOI: 10.1111/phpp.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Chronic actinic dermatitis (CAD) is an immune-mediated photodermatosis characterized by a high eosinophil count and total immunoglobulin E (IgE) in the peripheral blood of patients. At present, however, the reasons for their elevation remain unclear. OBJECTIVE The current study aimed to detect changes in inflammatory cytokines in CAD and explore their role in this disease. METHODS Enzyme-linked immunosorbent assay and Luminex assay were conducted to measure inflammatory factor levels. Immunohistochemical analysis and quantitative real-time polymerase chain reaction were performed to evaluate the expression levels of interleukin-36γ (IL-36γ), IL-8, chemokine (C-C motif) ligand 17 (CCL17), and CCL18. CCK8 kits were used to assess cell proliferation. Immunofluorescence was used to detect nuclear factor κB (NF-κB) p65 nuclear translocation. Western blot analysis was performed to detect the protein expression level of phosphorylated NF-κB (p-NF-κB) p65. Hematoxylin and eosin and Masson trichrome staining were applied to observe histological changes in a chronic photo-damaged mouse model. RESULTS Eosinophils, total IgE, IL-36γ, IL-8, tumor necrosis factor α, CCL17, and CCL18 were elevated in CAD. Of note, IL-36γ promoted the proliferation of eosinophilic cells (EOL-1) and the production of IgE in peripheral blood mononuclear cells. IL-36γ also promoted the production of IL-8 and CCL18 in immortalized human keratinocytes (HaCaT cells), while ultraviolet radiation (UVR)-induced IL-36γ via activation of the NF-κB signaling pathway. CONCLUSIONS IL-36γ was involved in the pathogenesis of CAD and UVR contributed to the production of IL-36γ, which may provide a novel therapeutic target for CAD.
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Affiliation(s)
- Li Wang
- Department of Dermatology, Wuhan No. 1 Hospital, Hubei, China
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yunhua Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
- Department of Dermatology, Second People's Hospital of Guiyang, Guiyang, China
| | - Wenjuan Wu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ying Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhenghui Yang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yanjie Chai
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xinwang Yang
- Department of Anatomy and Histology & Embryology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
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Dev A, Bishnoi A, Narang T, Vinay K. Recalcitrant chronic actinic dermatitis responding to tofacitinib: A case report. Indian J Dermatol Venereol Leprol 2023; 89:600-602. [PMID: 37067139 DOI: 10.25259/ijdvl_744_2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/04/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Anubha Dev
- Department of Dermatology Venereology & Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology Venereology & Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Tarun Narang
- Department of Dermatology Venereology & Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology Venereology & Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Isaacs T, Lehloenya R. HIV-associated photodermatitis in African populations. FRONTIERS IN ALLERGY 2023; 4:1159387. [PMID: 37216149 PMCID: PMC10192905 DOI: 10.3389/falgy.2023.1159387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Photosensitive dermatoses are seen in 5% of HIV-infected persons. These include drug- and chemical-induced photoallergic and phototoxic reactions, chronic actinic dermatitis of HIV, photo lichenoid drug eruptions, and porphyria. Data on photodermatitis in HIV are limited to case reports and series. The pathogenesis is not completely understood and includes a th2 phenotype in HIV which results in impaired barrier function and resultant allergen sensitisation as well as immune dysregulation. The objective of this manuscript is to review the literature on the clinical phenotype, pathogenesis, role of photo and patch testing, outcomes, and treatment of photodermatitis in HIV in an African population.
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Chimbetete T, Buck C, Choshi P, Selim R, Pedretti S, Divito SJ, Phillips EJ, Lehloenya R, Peter J. HIV-Associated Immune Dysregulation in the Skin: A Crucible for Exaggerated Inflammation and Hypersensitivity. J Invest Dermatol 2023; 143:362-373. [PMID: 36549954 PMCID: PMC9974923 DOI: 10.1016/j.jid.2022.07.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/24/2022]
Abstract
Skin diseases are hallmarks of progressive HIV-related immunosuppression, with severe noninfectious inflammatory and hypersensitivity conditions as common as opportunistic infections. Conditions such as papular pruritic eruption are AIDS defining, whereas delayed immune-mediated adverse reactions, mostly cutaneous, occur up to 100-fold more during HIV infection. The skin, constantly in contact with the external environment, has a complex immunity. A dense, tightly junctioned barrier with basal keratinocytes and epidermal Langerhans cells with antimicrobial, innate-activating, and antigen-presenting functions form the frontline. Resident dermal dendritic, mast, macrophage, and innate lymphoid cells play pivotal roles in directing and polarizing appropriate adaptive immune responses and directing effector immune cell trafficking. Sustained viral replication leads to progressive declines in CD4 T cells, whereas Langerhans and dermal dendritic cells serve as viral reservoirs and points of first viral contact in the mucosa. Cutaneous cytokine responses and diminished lymphoid populations create a crucible for exaggerated inflammation and hypersensitivity. However, beyond histopathological description, these manifestations are poorly characterized. This review details normal skin immunology, changes associated with progressive HIV-related immunosuppression, and the characteristic conditions of immune dysregulation increased with HIV. We highlight the main research gaps and several novel tissue-directed strategies to define mechanisms that will provide targeted approaches to prevention or treatment.
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Affiliation(s)
- Tafadzwa Chimbetete
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Chloe Buck
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Phuti Choshi
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Rose Selim
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Sarah Pedretti
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - Sherrie Jill Divito
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Rannakoe Lehloenya
- Division of Dermatology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; Combined Drug Allergy Clinic, Groote Schuur Hospital, Cape Town, South Africa
| | - Jonny Peter
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa; Combined Drug Allergy Clinic, Groote Schuur Hospital, Cape Town, South Africa.
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McFeely O, Doyle C, Blasco MC, Beatty P, Murphy L, O'Mahony S, Andrawis M, Salim A. Chronic actinic dermatitis successfully treated with methotrexate and dupilumab. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:172-174. [PMID: 36537705 DOI: 10.1111/phpp.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/01/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | - Lisa Murphy
- Tallaght University Hospital, Dublin, Ireland
| | | | | | - Asad Salim
- Tallaght University Hospital, Dublin, Ireland
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Curcumin Improves Keratinocyte Proliferation, Inflammation, and Oxidative Stress through Mediating the SPAG5/FOXM1 Axis in an In Vitro Model of Actinic Dermatitis by Ultraviolet. DISEASE MARKERS 2022; 2022:5085183. [PMID: 36118675 PMCID: PMC9481376 DOI: 10.1155/2022/5085183] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/13/2022] [Accepted: 08/18/2022] [Indexed: 11/20/2022]
Abstract
Background Chronic actinic dermatitis (CAD) is an abnormally proliferating photoallergic skin disease. Dysregulated inflammation and oxidative stress are the immediate factors in the abnormal proliferation of keratinocytes. This study aimed to investigate the effect of curcumin on the aberrant proliferation of keratinocytes in an in vitro (actinic dermatitis) AD model and the possible molecular mechanisms. Methods The keratinocytes were irradiated with ultraviolet (UV) to construct an in vitro AD model and then processed with different concentrations of curcumin. Cell viability, oxidative stress markers (SOD, GSH-PX, and MDA), activated oxygen species (ROS), and inflammation markers (IL-1β, IL-6, IL-18, and TNFα) were determined, respectively. Western blot was applied to assay the profiles of apoptosis-related proteins (Bax, Bcl-xL, Caspase3, Caspase8, and Caspase9), oxidative stress proteins (Keap1, Nrf2, HO-1, COX2, and iNOS), and inflammatory proteins (NF-κB, MMP1, and MMP9) and SPAG5/FOXM1. Functionally, SPAG5 or FOXM1 overexpression and knockdown models were constructed in keratinocytes to characterize their influence on UV irradiation-mediated keratinocyte dysfunction. Results Curcumin weakened UV-mediated inflammation, proliferation, and oxidative stress and impaired apoptosis in keratinocytes. UV boosted SPAG5/FOXM1 expression in cells, while curcumin concentration-dependently retarded SPAG5/FOXM1 expression. Overexpression of SPAG5/FOXM1 fostered UV-mediated inflammation, proliferation, oxidative stress, and intensified apoptosis, whereas curcumin mostly reversed the SPAG5/FOXM1-mediated effects. In addition, knocking down SPAG5/FOXM1 ameliorated UV-mediated keratinocyte dysfunction, whereas curcumin failed to exert further protective effects in cells with knockdown of SPAG5/FOXM1. Conclusion Curcumin modulated proliferation, inflammation, oxidative stress, and apoptosis of keratinocytes by restraining the SPAG5/FOXM1 axis.
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Majid I, Akhtar S. Tofacitinib in resistant chronic actinic dermatitis: A case series. Dermatol Ther 2022; 35:e15467. [PMID: 35315968 DOI: 10.1111/dth.15467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Imran Majid
- Cutis Institute of Dermatology, Srinagar, Jammu and Kashmir, India
| | - Saniya Akhtar
- Cutis Institute of Dermatology, Srinagar, Jammu and Kashmir, India
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Ali K, Wu L, Lou H, Zhong J, Qiu Y, Da J, Shan J, Lu K. Clearance of Chronic Actinic Dermatitis With Dupilumab Therapy in Chinese Patients: A Case Series. Front Med (Lausanne) 2022; 9:803692. [PMID: 35280879 PMCID: PMC8907828 DOI: 10.3389/fmed.2022.803692] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/14/2022] [Indexed: 12/01/2022] Open
Abstract
Chronic actinic dermatitis (CAD) is a rare chronic immunological photo-dermatosis resulting in pruritic eczematous eruption on sun-exposed skin to ultraviolet (UV) light. The disease mechanism may include a delay-type hypersensitivity reaction to an endogenous photo-induced antigen, postulated to be UVR-altered DNA, but the exact pathophysiology is unknown. Minimum erythema dosing and patch testing are diagnostic tools of CAD. There are limited safe and effective treatment options for CAD. Herein, a case series of three patients with severe recalcitrant CAD is presented after being treated with dupilumab off-label. The patients in this study had persistent severe disease and taken the first-line management plan, which consists of topical calcineurin inhibitors (TCI), topical corticosteroids (TCS), and strict photoprotection. However, the above treatment options were not able to control the symptoms. The patients were treated with dupilumab 600 mg first dose, 300 mg biweekly subcutaneously (SC), and hydroxychloroquine. Dupilumab showed excellent clinical benefits, including safe and well-tolerated in chronic actinic dermatitis. Further studies are required to be carried out before being applied in clinical practice.
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Affiliation(s)
- Kamran Ali
- Department of Dermatology, International Education College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Liming Wu
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - HaiYue Lou
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbo Zhong
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - YunMi Qiu
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - JiaYang Da
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - JingPeng Shan
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - KaiNing Lu
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Chen J, Li H, Zhu H. Successful Treatment of Chronic Actinic Dermatitis with Dupilumab: A Case Report and Review of the Literature. Clin Cosmet Investig Dermatol 2021; 14:1913-1917. [PMID: 35002273 PMCID: PMC8722565 DOI: 10.2147/ccid.s342401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022]
Abstract
Chronic actinic dermatitis (CAD) is a rather rare photosensitive disease characterized by a persistent eczematous eruption in sun-exposed sites. The pathogenesis of CAD has not been completely elucidated. The clinical treatment of CAD is still challenging and not standardized. Some patients with severe CAD have achieved satisfactory clinical results with dupilumab when conventional therapies have failed. We herein report the case of a 45-year-old male with severe CAD who responded rapidly to combined treatment with dupilumab (600 mg for 1 week, and then 300 mg every 2 weeks) in 2 months. The patient experienced continuous improvement and no side effects from dupilumab (300 mg every month), having ceased other systemic medications. Dupilumab could be considered as an alternative or adjunctive treatment for CAD.
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Affiliation(s)
- Jiaoquan Chen
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, 510095, People’s Republic of China
| | - Huaping Li
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, 510095, People’s Republic of China
| | - Huilan Zhu
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, 510095, People’s Republic of China
- Correspondence: Huilan Zhu Department of Dermatology, Guangzhou Institute of Dermatology, 56 Hengfu Road, Guangzhou, 510095, People’s Republic of China Email
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García Castro R, Velasco Tirado V, Alonso Sardón M, González de Arriba M. Standard photopatch test battery? Proposal based on current epidemiology and experience in our Skin Allergy Unit. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 37:449-453. [PMID: 33738844 DOI: 10.1111/phpp.12680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/22/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The diagnosis of photoallergic contact dermatitis (PACD) is confirmed by photopatch testing (PPT). In Spain, the latest recommendation on which allergens to test in PPT dates from 1995. METHODS In the last 4 years, we studied 455 patients with epicutaneous tests and performed PPT on 33 of those patients (7.3%). RESULTS The most prevalent allergens in PPT were as follows: non-steroidal anti-inflammatory drugs (NSAIDs) (46%), fragrances (21%), and solar filters (18%). DISCUSSION In our country, the most common photoallergens continue to be NSAIDs (ketoprofen). The increasingly common use of sunscreens has led to a growing involvement of solar filters in PACD, which can be also contained in other cosmetics. In our experience, PACD due to fragrances is nonetheless at least similar in frequency. CONCLUSIONS The PPT battery must adapt to the prescription, use, and exposure habits of each country. We propose a diagnostic model to guide which allergens to test in PPT, which in our experience should also include fragrances.
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Passeron T, Lim HW, Goh CL, Kang HY, Ly F, Morita A, Ocampo Candiani J, Puig S, Schalka S, Wei L, Dréno B, Krutmann J. Photoprotection according to skin phototype and dermatoses: practical recommendations from an expert panel. J Eur Acad Dermatol Venereol 2021; 35:1460-1469. [PMID: 33764577 PMCID: PMC8252523 DOI: 10.1111/jdv.17242] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/10/2021] [Indexed: 12/14/2022]
Abstract
Increasing evidence on the impact of the different wavelengths of sunlight on the skin demonstrates the need for tailored recommendations of sunscreen according to skin phototype and dermatoses, which is now possible due to advances in the filters and formulations of sunscreens. A selective literature search was performed by an international expert panel, focusing on the type of sunscreen to recommend for photoaging, skin cancers, photodermatoses, pigmentary disorders and skin inflammatory disorders. Protection against ultraviolet (UV)B is especially important for light skin as there is a high risk of sunburn, DNA damage and skin cancers. Darker skin may be naturally better protected against UVB but is more prone to hyperpigmentation induced by visible light (VL) and UVA. Protection against UVA, VL and infrared A can be helpful for all skin phototypes as they penetrate deeply and cause photoaging. Long‐wave UVA1 plays a critical role in pigmentation, photoaging, skin cancer, DNA damage and photodermatoses. Adapting the formulation and texture of the sunscreen to the type of skin and dermatoses is also essential. Practical recommendations on the type of sunscreen to prescribe are provided to support the clinician in daily practice.
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Affiliation(s)
- T Passeron
- Department of Dermatology, Côte d'Azur University, Nice University Hospital Center, Nice, France.,INSERM U1065, C3M, Côte d'Azur University, Nice, France
| | - H W Lim
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - C-L Goh
- National Skin Centre, Singapore, Singapore
| | - H Y Kang
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
| | - F Ly
- Department of Dermatology, Cheikh Anta Diop Dakar University, EPS Institute of Social Hygiene, Dakar, Senegal
| | - A Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - J Ocampo Candiani
- Department of Dermatology, Medical Faculty University Hospital of Nuevo León, Monterrey, Mexico
| | - S Puig
- Melanoma Unit, Dermatology Department, Barcelona University Hospital Clinic, Barcelona, Spain
| | - S Schalka
- Medcin Skin Research Center and Biochemistry Department, Chemistry Institute of São Paulo University, São Paulo, Brazil
| | - L Wei
- Department of Dermatology, The General Hospital of Air Force PLA, Beijing, China
| | - B Dréno
- Department of Dermato-Oncology, CIC 1413, CRCINA, Nantes University Hospital Center, Nantes, France
| | - J Krutmann
- IUF Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany.,Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany
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18
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Photodistributed Rash Progressing to Erythroderma: Answer. Am J Dermatopathol 2021; 42:463-465. [PMID: 32433320 DOI: 10.1097/dad.0000000000001413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Lin N, Huang X, Ma C, Han J. Clinical and pathological findings of chronic actinic dermatitis. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 37:313-320. [PMID: 33404164 DOI: 10.1111/phpp.12654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic actinic dermatitis (CAD) is a recurrent photosensitive disease occurs predominantly in elderly men on sun-exposed areas, which seriously affect the patient's life quality. The etiology of CAD remains unknown. METHODS Sixty-six CAD patients, 66 atopic dermatitis (AD) patients, and 46 healthy people were enrolled into this study. Patient-level data were obtained from the electronic medical record and laboratory databases. We also obtained 29 tissue samples including 16 lichenoid lesions, 7 minimal erythematous dose (MED) analysis induced lesions, and 6 normal skin samples. Histopathologic and immunohistochemical analysis were performed. RESULTS In the clinical characteristics, albumin was lower and uric acid was higher significantly in patients diagnosed as CAD. The infection rate of CAD patient after skin biopsy was considerably high (23.3%). The serum allergen test was prone to be negative in CAD patients. Lymphocytes were the dominate infiltrating cells in early and late CAD lesions, while more CD4+, CD8+, CD69+, and CD103 + cells were found in the late lesions. There is no difference in CD4+/CD8 + ratio and CD69+/CD103 + ratio among groups. More mast cells were observed in the early-stage lesions, and more dendritic cell was observed in the late-stage lesions. CONCLUSIONS CAD patients have certain oxidative stress and are prone to be infected after skin biopsy. Serum allergen detection is of little significance for CAD diagnosis. Mast cells may be involved in the early process of CAD, while dendritic cells and tissue-resident memory T cell (TRM) may be related to the chronic process of the disease.
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Affiliation(s)
- Naiyu Lin
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaobao Huang
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chunguang Ma
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiande Han
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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20
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Kaushik A, Narang T, Handa S. Successful use of apremilast as a steroid-sparing agent in chronic actinic dermatitis. Dermatol Ther 2020; 33:e13809. [PMID: 32530535 DOI: 10.1111/dth.13809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/22/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Akanksha Kaushik
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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21
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Patel N, Konda S, Lim HW. Dupilumab for the treatment of chronic actinic dermatitis. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2020; 36:398-400. [PMID: 32320500 DOI: 10.1111/phpp.12566] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/08/2020] [Accepted: 04/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Nayha Patel
- School of Medicine, Tulane University, New Orleans, Louisiana, USA.,Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - Sasank Konda
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
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22
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Konnov PE, Orlov EV, Mostovaya LI, Arsenyeva AA. Diagnostics of anxiety and dermatological index of life quality in patients with chronic actinic dermatitis. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/0042-4609-2019-95-6-37-43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- P. E. Konnov
- Samara State Medical University, Ministry of Health of the Russian Federation
| | - E. V. Orlov
- Samara State Medical University, Ministry of Health of the Russian Federation
| | - L. I. Mostovaya
- Samara State Medical University, Ministry of Health of the Russian Federation
| | - A. A. Arsenyeva
- Samara State Medical University, Ministry of Health of the Russian Federation
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23
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Bourgaux M, Marcaillou M, Matei I, Delaumenie S, Prud'homme R, Souyri N, Bedane C. Man of stone: A case of a chronic actinic dermatitis mimicking a cutis verticis gyrata. J Eur Acad Dermatol Venereol 2019; 34:e129-e130. [PMID: 31715028 DOI: 10.1111/jdv.16068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Bourgaux
- Dermatology Department, CHU Dupuytren, 2 av. Martin Luther King, Limoges, F-87000, France
| | - M Marcaillou
- Dermatology Department, CHU Dupuytren, 2 av. Martin Luther King, Limoges, F-87000, France
| | - I Matei
- Dermatology Department, CHU Dupuytren, 2 av. Martin Luther King, Limoges, F-87000, France
| | - S Delaumenie
- Dermatology Department, CHU Dupuytren, 2 av. Martin Luther King, Limoges, F-87000, France
| | - R Prud'homme
- Dermatology Department, CHU Dupuytren, 2 av. Martin Luther King, Limoges, F-87000, France
| | - N Souyri
- Dermatology Department, CHU Dupuytren, 2 av. Martin Luther King, Limoges, F-87000, France
| | - C Bedane
- Dermatology Department, CHU Dupuytren, 2 av. Martin Luther King, Limoges, F-87000, France
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24
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Abstract
Ultraviolet light (UV) and visible light are important components in the diagnosis of photodermatoses, and UV has the unique ability to also be used to manage photodermatoses. Phototesting, provocative light testing, and photopatch testing can provide important information in diagnosing patients with photodermatoses; phototesting can be used to determine the starting dose for phototherapy in these patients. Once photosensitivity is established, narrowband UVB and UVA1 therapy have helped to improve the quality of life of photosensitive patients, such as those with polymorphous light eruption, chronic actinic dermatitis, and solar urticaria.
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Affiliation(s)
- Angela J Jiang
- Department of Dermatology, Henry Ford Health System, 3031 West Grand Boulevard, Suite 800, Detroit, MI 48202, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health System, 3031 West Grand Boulevard, Suite 800, Detroit, MI 48202, USA.
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25
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Langenderfer L, Giesey R, Rothbaum R, Delost GR. Umbilicated papules in an immunocompetent patient. JAAD Case Rep 2019; 5:757-759. [PMID: 31516989 PMCID: PMC6728834 DOI: 10.1016/j.jdcr.2019.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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27
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Nahhas AF, Oberlin DM, Braunberger TL, Lim HW. Recent Developments in the Diagnosis and Management of Photosensitive Disorders. Am J Clin Dermatol 2018; 19:707-731. [PMID: 29959757 DOI: 10.1007/s40257-018-0365-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Photodermatoses occur in males and females of all races and ages. Onset can be variable in timing and influenced by genetic and environmental factors. Photodermatoses are broadly classified as immunologically mediated, chemical- and drug-induced, photoaggravated, and genetic (defective DNA repair or chromosomal instability) diseases. Advances in the field have led to improved recognition and treatment of many photodermatoses. The purpose of this focused review is to provide an update on the diagnosis and management of a variety of photodermatoses, both common and less common, with review of recent updates in the literature pertaining to their diagnosis and management.
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Affiliation(s)
- Amanda F Nahhas
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - David M Oberlin
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - Taylor L Braunberger
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA.
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28
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Affiliation(s)
- Christina M Huang
- School of Medicine (Huang); Division of Dermatology (Asai), Department of Medicine, Queen's University, Kingston, Ont
| | - Yuka Asai
- School of Medicine (Huang); Division of Dermatology (Asai), Department of Medicine, Queen's University, Kingston, Ont.
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29
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Genome-Wide Analysis of mRNA and Long Noncoding RNA Profiles in Chronic Actinic Dermatitis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7479523. [PMID: 29359156 PMCID: PMC5735319 DOI: 10.1155/2017/7479523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/11/2017] [Accepted: 09/28/2017] [Indexed: 01/15/2023]
Abstract
Chronic actinic dermatitis (CAD), a photosensitive dermatosis, is characterized by inflammatory lesions, especially on sun-exposed skin. However, its pathogenesis remains unclear. In this study, second-generation RNA sequencing and comprehensive bioinformatics analyses of mRNAs and long noncoding RNAs (lncRNAs) were performed to determine the transcriptome profiles of patients with CAD. A total 6889 annotated lncRNAs, 341 novel lncRNAs, and 65091 mRNAs were identified. Interestingly, patients with CAD and healthy controls showed distinct transcriptome profiles. Indeed, 198 annotated (81.48%) and 45 novel (18.52%) lncRNAs were differentially expressed between the two groups. GO, KEGG, and RGSEA analyses of lncRNAs showed that inflammatory and immune response related pathways played crucial roles in the pathogenetic mechanism of CAD. In addition, we unveiled key differentially expressed lncRNAs, including lncRNA RP11-356I2.4 which plays a role probably by regulating TNFAIP3 and inflammation. qRT-PCR data validated the differentially expressed genes. The newly identified lncRNAs may have potential roles in the development of CAD; these findings lay a solid foundation for subsequent functional exploration of lncRNAs and mRNAs as therapeutic targets for CAD.
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30
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Ma L, Zhang Q, Hu Y, Luo X. Evaluation of narrow band ultraviolet B phototherapy in the treatment of chronic actinic dermatitis in Chinese patients. Dermatol Ther 2017; 30. [PMID: 29047198 DOI: 10.1111/dth.12528] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/11/2017] [Accepted: 06/29/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Li Ma
- Department of Dermatology; Huashan Hospital, Fudan University; Shanghai 200040 China
| | - Qiaoan Zhang
- Department of Dermatology; Huashan Hospital, Fudan University; Shanghai 200040 China
| | - Yue Hu
- Department of Dermatology; Huashan Hospital, Fudan University; Shanghai 200040 China
| | - Xiaoqun Luo
- Department of Dermatology; Huashan Hospital, Fudan University; Shanghai 200040 China
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31
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Abstract
PURPOSE OF REVIEW The photodermatoses represent a group of disorders of sensitivity to light that continue to pose difficulties in diagnosis and management. Photodermatoses are of interest to allergists because many photosensitive skin disorders have immunologic underpinnings, and patients often present to clinic complaining of "allergy" to the sun. We provide a concise reference for allergists on the clinical recognition and management of photodermatitis. RECENT FINDINGS New developments in the understanding of immunomodulatory effects of light have demonstrated normally immunosuppressive responses in the skin to light exposure, and a blunted immunosuppressive response in the pathogenesis of many photodermatoses. Vitamin D plays an important role in immunomodulation and itself may be affected by photodermatoses due to the impact of photoprotective treatment strategies on circulating vitamin D levels. The elucidation of the immunological basis of many photodermatoses may provide guidance for developing new treatment modalities. Further research is necessary to determine the optimal management of vitamin D metabolism in patients with photodermatoses.
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Affiliation(s)
- Samuel L Coffin
- Division of Dermatology, Augusta University, 1004 Chafee Ave, FH-100, Augusta, GA, 30904, USA
| | - Jake E Turrentine
- Division of Dermatology, Augusta University, 1004 Chafee Ave, FH-100, Augusta, GA, 30904, USA.
| | - Ponciano D Cruz
- Department of Dermatology, The University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX, 75390-9069, USA.,North Texas Veterans Affairs Medical Center, Dallas, TX, USA
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32
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Photodermatoses in the Pigmented Skin. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 996:111-122. [DOI: 10.1007/978-3-319-56017-5_10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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33
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Vesely MD, Imaeda S, King BA. Tofacitinib citrate for the treatment of refractory, severe chronic actinic dermatitis. JAAD Case Rep 2017; 3:4-6. [PMID: 28050588 PMCID: PMC5192094 DOI: 10.1016/j.jdcr.2016.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - Brett A. King
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
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34
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Charli-Joseph YV, Gatica-Torres M, Pincus LB. Approach to Cutaneous Lymphoid Infiltrates: When to Consider Lymphoma? Indian J Dermatol 2016; 61:351-74. [PMID: 27512181 PMCID: PMC4966394 DOI: 10.4103/0019-5154.185698] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cutaneous lymphoid infiltrates (CLIs) are common in routine dermatopathology. However, differentiating a reactive CLI from a malignant lymphocytic infiltrate is often a significant challenge since many inflammatory dermatoses can clinically and/or histopathologically mimic cutaneous lymphomas, coined pseudolymphomas. We conducted a literature review from 1966 to July 1, 2015, at PubMed.gov using the search terms: Cutaneous lymphoma, cutaneous pseudolymphoma, cutaneous lymphoid hyperplasia, simulants/mimics/imitators of cutaneous lymphomas, and cutaneous lymphoid infiltrates. The diagnostic approach to CLIs and the most common differential imitators of lymphoma is discussed herein based on six predominant morphologic and immunophenotypic, histopathologic patterns: (1) Superficial dermal T-cell infiltrates (2) superficial and deep dermal perivascular and/or nodular natural killer/T-cell infiltrates (3) pan-dermal diffuse T-cell infiltrates (4) panniculitic T-cell infiltrates (5) small cell predominant B-cell infiltrates, and (6) large-cell predominant B-cell infiltrates. Since no single histopathological feature is sufficient to discern between a benign and a malignant CLI, the overall balance of clinical, histopathological, immunophenotypic, and molecular features should be considered carefully to establish a diagnosis. Despite advances in ancillary studies such as immunohistochemistry and molecular clonality, these studies often display specificity and sensitivity limitations. Therefore, proper clinicopathological correlation still remains the gold standard for the precise diagnosis of CLIs.
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Affiliation(s)
- Yann Vincent Charli-Joseph
- Cutaneous Hematopathology Clinic, Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Michelle Gatica-Torres
- Cutaneous Hematopathology Clinic, Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Laura Beth Pincus
- Department of Dermatology and Pathology, University of California, San Francisco, United States of America
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35
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Orlov EV, Konnov PE. The role of antihistamines in chronic actinic dermatitis treatment. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-1-81-84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Inveterate actinic dermatitis is an immunologically mediated photodermatosis characterized by itchy eczematous dermhelminthiasis exposed to sunlight. The disease proceeds in the same way as the atopic eczema or atopic dermatitis. The treatment of patients with inveterate actinic dermatitis is similar to the treatment of patients with atopic dermatitis and eczema. Administration of the modern antihistaminic preparation desloratadine (Aerius) in the treatment has a positive effect on the skin process relief and on some cellular and humoral immunity factors.
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36
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Duncan JR, Kaffenberger BH, Gru A. The necessity of clinicopathologic correlation: syphilis that could have been missed. J Cutan Pathol 2015; 43:295-7. [PMID: 26479164 DOI: 10.1111/cup.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 09/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Alejandro Gru
- Wexner Medical Center, Division of Dermatology, The Ohio State University, Gahanna, OH, USA
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37
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Honari G. Photoallergy. REVIEWS ON ENVIRONMENTAL HEALTH 2014; 29:233-242. [PMID: 25274941 DOI: 10.1515/reveh-2014-0067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/01/2014] [Indexed: 06/03/2023]
Abstract
Abstract Photoallergic contact dermatitis (PACD) is a hypersensitivity reaction mounting from skin exposure to generally harmless amounts of ultraviolet and/or visible light in the presence of a photoreactive allergen. These reactions are typically delayed type (Gell and Coombs type IV) reactions and require pre-sensitization to photoallergens. Phototoxic reactions are clinically similar and often difficult to differentiate from photoallergies, but they are caused by interaction of light with photoirritants and do not require sensitization. The main investigative technique to diagnose PACD is photopatch testing, which is not commonly used; therefore, PACD may be overlooked in many patients. Currently, leading contact photosensitizers are sunscreens and topical non-steroidal anti-inflammatory drugs. This article provides an overview on photocontact allergies.
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