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Tirone B, Cazzato G, Ambrogio F, Foti C, Bellino M. Lichen Amyloidosis in an Atopic Patient Treated with Dupilumab: A New Therapeutic Option. Diseases 2024; 12:94. [PMID: 38785749 PMCID: PMC11119208 DOI: 10.3390/diseases12050094] [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: 03/25/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
Lichen amyloidosis (LA) is a type of cutaneous amyloidosis characterized by brownish hyperkeratotic and itchy papules on the lower leg, back, forearm, or thigh. It is associated with itching and atopic dermatitis (AD) according to an etiopathogenetic mechanism that has not yet been fully elucidated. Currently, the available therapies for this condition include oral antihistamines, laser, cyclosporine, topical corticosteroids, and phototherapy, but, in light of the overlap with AD, Dupilumab may also be indicated. We report the case of a female, 52 years old, who had been suffering from AD and LA for about 27 years. She had lesions attributable to both diseases on the trunk and lower limbs associated with severe itching and had proved resistant to cyclosporine therapy. It was decided to opt for Dupilumab with the induction of 2 fl of 300 mg and maintenance with 1 fl every other week. The therapy proved to be effective, returning a total resolution of both diseases one year after the beginning of the treatment. Dupilumab demonstrated efficacy and safety in the LA related to AD and led to clinical and quality of life improvements in this patient. Therefore, Dupilumab should be considered when treating LA. Further studies should be conducted focusing on the efficacy of the drug on LA (whether or not related to AD), changes in the skin lesions after discontinuation, and the safety of long-term application.
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Affiliation(s)
- Benedetta Tirone
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (B.T.); (F.A.); (C.F.); (M.B.)
| | - Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesca Ambrogio
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (B.T.); (F.A.); (C.F.); (M.B.)
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (B.T.); (F.A.); (C.F.); (M.B.)
| | - Marco Bellino
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (B.T.); (F.A.); (C.F.); (M.B.)
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Zhu Q, Gao BQ, Zhang JF, Shi LP, Zhang GQ. Successful treatment of lichen amyloidosis coexisting with atopic dermatitis by dupilumab: Four case reports. World J Clin Cases 2023; 11:2549-2558. [PMID: 37123319 PMCID: PMC10131001 DOI: 10.12998/wjcc.v11.i11.2549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/02/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Lichen amyloidosis (LA) is a chronic, severely pruritic skin disease, which is the most common form of primary cutaneous amyloidosis. The treatment of LA has been considered to be difficult. LA may be associated with atopic dermatitis (AD), and in this setting, the treatment options may be more limited. Herein, we report four cases of LA associated with AD successfully treated by dupilumab.
CASE SUMMARY In this article, we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus, diagnosed with refractory LA coexisting with chronic AD. Previous treatments had not produced any apparent improvement. Thus, we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter. Their lesions all markedly improved.
CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.
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Affiliation(s)
- Qing Zhu
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
| | - Bing-Quan Gao
- Department of Burns and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
| | - Jin-Fang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
| | - Li-Ping Shi
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
| | - Guo-Qiang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
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Liu H, Qiu B, Yang H, Zheng W, Luo Y, Zhong Y, Lu P, Chen J, Luo Y, Liu J, Yang B. AHNAK, regulated by the OSM/OSMR signaling, involved in the development of primary localized cutaneous amyloidosis. J Dermatol Sci 2023:S0923-1811(23)00111-1. [PMID: 37100691 DOI: 10.1016/j.jdermsci.2023.04.004] [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: 01/12/2023] [Revised: 04/09/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Primary localized cutaneous amyloidosis (PLCA) is a chronic skin disease characterized by aberrant keratinocyte differentiation, epidermal hyperproliferation, and amyloid deposits. Previously, we demonstrated OSMR loss-function mutants enhanced basal keratinocyte differentiation through the OSMR/STAT5/KLF7 signaling in PLCA patients. OBJECTIVE To investigate the underlying mechanisms involved in basal keratinocyte proliferation in PLCA patients that remain unclear. METHODS Patients with pathologically confirmed PLCA visiting the dermatologic outpatient clinic were involved in the study. Laser capture microdissection and mass spectrometry analysis, gene-edited mice, 3D human epidermis culture, flow cytometry, western blot, qRT-PCR and RNA sequencing were used to explore the underlying molecular mechanisms. RESULTS In this study, we found that AHNAK peptide fragments were enriched in the lesions of PLCA patients, as detected by laser capture microdissection and mass spectrometry analysis. The upregulated expression of AHNAK was further confirmed using immunohistochemical staining. qRT-PCR and flow cytometry revealed that pre-treatment with OSM can inhibit AHNAK expression in HaCaT cells, NHEKs, and 3D human skin models, but OSMR knockout or OSMR mutations abolished this down-regulation trend. Similar results were obtained in wild-type and OSMR knockout mice. More importantly, EdU incorporation and FACS assays demonstrated the knockdown of AHNAK could induce G1 phase cell cycle arrest and inhibit keratinocyte proliferation. Furthermore, RNA sequencing revealed that AHNAK knockdown regulated keratinocyte differentiation. CONCLUSION Taken together, these data indicated that the elevated expression of AHNAK by OSMR mutations led to hyperproliferation and overdifferentiation of keratinocytes, and the discovered mechanism might provide insights into potential therapeutic targets for PLCA.
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Affiliation(s)
- Huiting Liu
- Institute of Dermatology and Venereology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Biying Qiu
- Institute of Dermatology and Venereology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Huan Yang
- Institute of Dermatology and Venereology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Wen Zheng
- Institute of Dermatology and Venereology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Yingying Luo
- Institute of Dermatology and Venereology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Yadan Zhong
- Department of Dermatology, The First People's Hospital of Foshan, Foshan 528010, China
| | - Ping Lu
- Department of Science & Education, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Junyi Chen
- Institute of Dermatology and Venereology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Ying Luo
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Jun Liu
- Institute of Dermatology and Venereology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China; Joint Laboratory of Dermatology Hospital, Southern Medical University and China Resources Sanjiu Medical & Pharmaceutical Co., Ltd, Guangzhou 510091, China.
| | - Bin Yang
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China; Joint Laboratory of Dermatology Hospital, Southern Medical University and China Resources Sanjiu Medical & Pharmaceutical Co., Ltd, Guangzhou 510091, China; Guangdong-Hong Kong Joint Laboratory of Dermatology Research, Guangzhou 510091, China.
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Tey H, Nattkemper L, Cao T, Pramono Z, Yosipovitch G. Interleukin-31 receptor and pruritus associated with primary localized cutaneous amyloidosis: reply from the authors. Br J Dermatol 2016; 175:433-4. [DOI: 10.1111/bjd.14774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H.L. Tey
- National Skin Centre; Singapore
- Lee Kong Chian School of Medicine; Singapore
| | - L.A. Nattkemper
- Department of Dermatology and Temple Itch Center; Temple University School of Medicine; Philadelphia PA U.S.A
| | - T. Cao
- National Skin Centre; Singapore
| | | | - G. Yosipovitch
- Department of Dermatology and Temple Itch Center; Temple University School of Medicine; Philadelphia PA U.S.A
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