1
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Haber R, Feghali J, Nadir U, Yi MD, Cahn BA. Acquired ichthyosis: a clinical review. Arch Dermatol Res 2023; 315:2529-2543. [PMID: 37422878 DOI: 10.1007/s00403-023-02668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 07/11/2023]
Abstract
Acquired ichthyosis (AI) is a rare, nonhereditary cutaneous disorder that has been associated with numerous neoplastic, infectious, drugs, endocrine, metabolic, autoimmune, and malabsorptive diseases. Review all demographical, clinical, histological, and therapeutic features of AI and focus on all reported associated diseases. We performed a systematic literature review in Pubmed/Medline, Embase, and Cochrane collaboration databases, searching for all articles on AI, with no limits on publication date, participant age, sex or nationality. Eighty-four articles were included. Total number of included patients was 167 patients with a mean age at presentation of 39 years [range 0.5-85] and a sex ratio M:F of 5:2. The most common malignancy associated with AI is Hodgkin's lymphoma. AI occurred before, simultaneously or after the onset of malignancy or systemic disease. The severity of AI depends on the severity of the underlying disorder and regresses once the disease goes into remission and may also be a marker of disease recurrence or relapse. 8% have been reported to be drug related and all occurred weeks to months after drug intake and resolved after stopping or decreasing the dose of the drug. Data were derived from case reports and observational studies. Limitations include the accuracy of published data, potential patient selection, and reporting bias. AI can be associated with numerous systemic diseases and drugs. Physicians should be particularly alert to these associations to provide adequate screening and management of patients with AI.
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Affiliation(s)
- Roger Haber
- Department of Dermatology, University of Illinois-Chicago, 808 South Wood Street (MC 624), Suite 380 College of Medicine East Tower, Chicago, IL, 60612, USA
| | - Joelle Feghali
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon
- Faculty of Medicine, Balamand University, El-Koura, Lebanon
| | - Umer Nadir
- Department of Dermatology, Feinberg School of Medicine, Chicago, IL, USA
| | - Michael D Yi
- Department of Dermatology, Feinberg School of Medicine, Chicago, IL, USA
| | - Brian A Cahn
- Department of Dermatology, University of Illinois-Chicago, 808 South Wood Street (MC 624), Suite 380 College of Medicine East Tower, Chicago, IL, 60612, USA.
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2
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Park JS, Saeidian AH, Youssefian L, Hsu S, Vahidnezhad H, Uitto J. Acquired ichthyosis, asteatotic dermatitis or xerosis? An update on pathoetiology and drug-induced associations. J Eur Acad Dermatol Venereol 2023; 37:47-56. [PMID: 36165597 DOI: 10.1111/jdv.18608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/14/2022] [Indexed: 12/15/2022]
Abstract
Acquired ichthyosis (AI) is a relatively rare cutaneous entity characterized by transient, generalized scaling and pruritus in the absence of family history of ichthyosis or atopic disease. The hyperkeratosis in AI can range from the mild, white-to-brown scaling resembling that in ichthyosis vulgaris (IV) to the more prominent dark brown scaling phenotype, similar to that found in lamellar ichthyosis. The disease can wax and wane in relation to endogenous and/or exogenous factors. Histopathology of AI is similar to that found in IV. AI is usually of cosmetic concern to patients but can, in some cases, reflect the presence of more serious conditions, including malignancies, autoimmune diseases or metabolic disorders. In some cases, AI can be an adverse effect of a medication or the cutaneous symptom of a toxic exposure. Other conditions, such as severe xerosis or eczema, can present with clinical findings similar to AI, making diagnosis a challenge. Furthermore, cases of AI are sporadic throughout the literature and have been documented across a wide variety of medical settings distinct from dermatology, which often contribute to misdiagnosis of this disease. Definitive management requires prompt identification and treatment of the inciting factors combined with conservative therapies, which can include topical emollients, keratolytics, retinoids or corticosteroids, and in rare cases, oral retinoids.
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Affiliation(s)
- Jason S Park
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Amir H Saeidian
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Leila Youssefian
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sylvia Hsu
- Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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3
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Kessler S, Marzooq A, Sood A, Beebe K, Walsh A, Montoya L, Price H. Alopecia in children undergoing chemotherapy, radiation, and hematopoietic stem cell transplantation: Scoping review and approach to management. Pediatr Dermatol 2022; 39:354-362. [PMID: 35416328 DOI: 10.1111/pde.14995] [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: 11/18/2021] [Revised: 03/01/2022] [Accepted: 03/23/2022] [Indexed: 01/07/2023]
Abstract
Alopecia is a common sequela in children undergoing chemotherapy, radiation, and hematopoietic stem cell transplantation. In most cases, this is a transient state in which full hair regrowth eventually occurs, but permanent or persistent alopecia, defined as the presence of incomplete hair regrowth more than 6 months after cessation of treatment, is possible and can be psychologically distressing. We sought to characterize the risk factors that can lead to permanent alopecia following the aforementioned treatments in pediatric populations, as well as diagnostic and treatment options that may be considered, as part of a scoping review of the literature. A general algorithm for approaching these patients was developed based on our findings.
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Affiliation(s)
- Stephen Kessler
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA.,Alta Dermatology/Phoenix Dermatology/Kansas City University Medical Center, Kansas City, Missouri, USA
| | - Ali Marzooq
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA.,Alta Dermatology/Phoenix Dermatology/Kansas City University Medical Center, Kansas City, Missouri, USA
| | - Arun Sood
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA.,Alta Dermatology/Phoenix Dermatology/Kansas City University Medical Center, Kansas City, Missouri, USA
| | - Kristen Beebe
- Phoenix Children's Hospital, Center for Cancer and Blood Disorders, Phoenix, Arizona, USA.,Mayo Clinic Arizona Bone Marrow Transplant Program, Phoenix, Arizona, USA
| | - Alexandra Walsh
- Phoenix Children's Hospital, Center for Cancer and Blood Disorders, Phoenix, Arizona, USA.,The University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Liliana Montoya
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA.,The University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Harper Price
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA.,The University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
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4
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Cho A, Paulitschke V, Just U, Knobler R. Cutaneous manifestations of acute and chronic graft-versus-host disease. GIORN ITAL DERMAT V 2020; 155:76-87. [PMID: 32100975 DOI: 10.23736/s0392-0488.19.06535-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Graft-versus-host disease (GvHD) is a commonly occurring immunological reaction and frequent complication following allogeneic hematopoietic stem cell transplantation. Its highly diverse manifestations including skin involvement as the most common appearance of GvHD, can dramatically influence patient's quality of life, in particular in the chronic stage, in addition to patient's decreased survival outcome. Hence, the role of the dermatologist has become very crucial in an interdisciplinary setting, particularly since appearances of GvHD in the skin can be multifaceted and challenging. Clinical manifestation of the acute GvHD (aGvHD) is limited to erythematous maculopapular rash and oral mucosal lesions while the chronic form manifests in a wider range in a localized area or disseminated including involvement of nail, scalp and genital area. This article aims to provide a comprehensive overview on the variable cutaneous presentations of acute and chronic GvHD for a proper and early diagnosis on the one hand, and to discuss updated therapeutic options for both acute and chronic GvHD on the other hand, to initiate an adequate treatment to obtain the most beneficial clinical outcome.
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Affiliation(s)
- Ara Cho
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Verena Paulitschke
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Ulrike Just
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Robert Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria -
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5
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Chan SL, Wood BA, Mesbah Ardakani N. Eczematous graft-vs-host disease: A report of three cases and review of the literature. J Cutan Pathol 2020; 47:1085-1095. [PMID: 32767402 DOI: 10.1111/cup.13836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/03/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Abstract
Graft-vs-host disease (GVHD) is the most common complication following hematopoietic cell transplantation, which affects skin frequently. Acute and chronic forms of GVHD manifest commonly as maculopapular to morbilliform eruptions and sclerotic or lichen-planus-like lesions, respectively; however, atypical presentations such as eczema-like GVHD may occur at times. We describe three cases of GVHD with diverse and polymorphous cutaneous eruptions including pompholyx-like and vasculitis-like rash as well as erythematous plaques and papulosquamous eruptions, with skin biopsy showing unifying histopathological findings with concurrent changes of spongiotic dermatitis and vacuolar interface reaction with apoptotic keratinocytes. In addition, the clinical and pathological features of previously reported cases of eczema-like GVHD are reviewed. It is emphasized that the course of the disease can be variable and successful management often involves a combination of multiple therapeutic modalities including immunosuppression with or without ultraviolet therapy. These cases highlight the importance of meticulous clinicopathological correlation with careful exclusion of mimicking conditions to arrive at the correct diagnosis.
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Affiliation(s)
- Su-Lin Chan
- Department of Dermatology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Benjamin Andrew Wood
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia, Australia.,School of Pathology and Laboratory Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Nima Mesbah Ardakani
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia, Australia.,School of Pathology and Laboratory Medicine, The University of Western Australia, Perth, Western Australia, Australia.,College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
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6
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Szlauer-Stefańska A, Kamińska-Winciorek G, Giebel S. Onychoscopy of non-infectious nail abnormalities in patients after allogeneic haematopoietic stem cell transplantation. J Eur Acad Dermatol Venereol 2018; 33:637-642. [PMID: 30468536 DOI: 10.1111/jdv.15357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022]
Abstract
Nail abnormalities after allogeneic haematopoietic stem cell transplantation procedure (alloHSCT) are often reported. Usually, they are related to chronic graft-versus-host disease (cGvHD). So far, only clinical manifestations of selected nail abnormalities have been described, without the presentation of dermoscopic images. In this article, we present morphologic and dermoscopic manifestations of potential non-infectious nail abnormalities in patients after alloHSCT procedure based on reviewed literature and our own experience with dermoscopic iconography. In majority of studies published till now, nail changes are not connected to severity of other cGvHD symptoms; however, e.g. the presence of pterygium inversum unguis may be an indicator of lung dysfunction. As nail changes may be an early sign of cGvHD and always present in association with other manifestations, routine clinical assessment should include nails examination. Knowledge of possible presentation of nail involvement after alloHSCT may be valuable for treating physician.
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Affiliation(s)
- A Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
| | - G Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
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7
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Wang JF, Orlow SJ. Keratosis Pilaris and its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options. Am J Clin Dermatol 2018; 19:733-757. [PMID: 30043128 DOI: 10.1007/s40257-018-0368-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Keratosis pilaris is a common skin disorder comprising less common variants and rare subtypes, including keratosis pilaris rubra, erythromelanosis follicularis faciei et colli, and the spectrum of keratosis pilaris atrophicans. Data, and critical analysis of existing data, are lacking, so the etiologies, pathogeneses, disease associations, and treatments of these clinical entities are poorly understood. The present article aims to fill this knowledge gap by reviewing literature in the PubMed, EMBASE, and CINAHL databases and providing a comprehensive, analytical summary of the clinical characteristics and pathophysiology of keratosis pilaris and its subtypes through the lens of disease associations, genetics, and pharmacologic etiologies. Histopathologic, genomic, and epidemiologic evidence points to keratosis pilaris as a primary disorder of the pilosebaceous unit as a result of inherited mutations or acquired disruptions in various biomolecular pathways. Recent data highlight aberrant Ras signaling as an important contributor to the pathophysiology of keratosis pilaris and its subtypes. We also evaluate data on treatments for keratosis pilaris and its subtypes, including topical, systemic, and energy-based therapies. The effectiveness of various types of lasers in treating keratosis pilaris and its subtypes deserves wider recognition.
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Affiliation(s)
- Jason F Wang
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA
| | - Seth J Orlow
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA.
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8
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Gandelman JS, Zic J, Dewan AK, Lee SJ, Flowers M, Cutler C, Pidala J, Chen H, Jagasia MH, Tkaczyk ER. The Anatomic Distribution of Skin Involvement in Patients with Incident Chronic Graft-versus-Host Disease. Biol Blood Marrow Transplant 2018; 25:279-286. [PMID: 30219700 DOI: 10.1016/j.bbmt.2018.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/06/2018] [Indexed: 01/15/2023]
Abstract
Little is known about the anatomic distribution of cutaneous chronic graft-versus-host disease (cGVHD). Using data from the cGVHD Consortium Improving Outcomes Assessment Study, we describe the frequency and extent of erythema and superficial and deep sclerosis in 8 anatomic sites in patients with incident disease (ie, new cGVHD diagnosis within 3 months of study entry) receiving systemic therapy. Of 339 patients with incident disease, 182 (54%) had skin involvement. When an extremity was involved, the same type of disease was present contralaterally in 92% of cases, revealing a high level of symmetry. As anticipated, erythema was the most common incident feature; however, sclerotic skin involvement at the time of cGVHD diagnosis was more common than has been suggested by previous studies. Erythema occurred in 155 (85%) and sclerosis in 53 (29%) of the patients with skin involvement (46% and 16%, respectively, of the entire cohort of 339 incident cGVHD cases). Erythema was least common on the lower extremities (n = 71; 39% of patients with skin involvement). Moveable sclerosis was rare on the head, neck, and scalp (n = 4; 2%). Deep sclerosis did not occur in this region, and instead was most likely to occur on the upper extremities (n = 14; 8%) and lower extremities (n = 14; 8%). More than one-half of patients with erythema (n = 107; 58.7%) had diffuse involvement (4 or more of 8 sites involved), compared with less than one-third of those with sclerosis (n = 16; 30.2%).
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Affiliation(s)
- Jocelyn S Gandelman
- Department of Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee; Vanderbilt University School of Medicine, Nashville, Tennessee
| | - John Zic
- Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Anna K Dewan
- Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mary Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Corey Cutler
- Stem Cell/Bone Marrow Transplantation Program, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Joseph Pidala
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Heidi Chen
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Madan H Jagasia
- Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Eric R Tkaczyk
- Department of Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee; Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.
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9
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Strong Rodrigues K, Oliveira-Ribeiro C, de Abreu Fiuza Gomes S, Knobler R. Cutaneous Graft-Versus-Host Disease: Diagnosis and Treatment. Am J Clin Dermatol 2018; 19:33-50. [PMID: 28656563 PMCID: PMC5797560 DOI: 10.1007/s40257-017-0306-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Graft-versus-host disease (GVHD) is an immunological reaction and a frequent complication following allogeneic hematopoietic stem cell transplantation. It is associated with high mortality rates and may have a significant negative impact on the patient's quality of life, particularly in the chronic-stage setting. Many different organs can be involved, which leads to a wide range of clinical manifestations. In this context, dermatologists play a key role by diagnosing and treating GVHD from the outset since cutaneous features are not just the most common but are also usually the presenting sign. Several skin-direct therapies are available and may be indicated as monotherapy or adjuvant treatment in order to allow faster tapering and withdrawal of systemic immunosuppression. Treatment of steroid-refractory patients remains a challenge and, to date, no consensus has been reached for one single agent in second-line therapy. This article aims to review skin involvement as well as provide and update discussion on therapeutic options for both acute and chronic cutaneous GVHD.
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Affiliation(s)
- Karla Strong Rodrigues
- Centro de Transplante de Medula Óssea-CEMO, Instituto Nacional de Câncer José Alencar Gomes da Silva-INCA, Rio de Janeiro, Brazil
| | - Carla Oliveira-Ribeiro
- Centro de Transplante de Medula Óssea-CEMO, Instituto Nacional de Câncer José Alencar Gomes da Silva-INCA, Rio de Janeiro, Brazil
| | | | - Robert Knobler
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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10
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Chong JH, Tawng K, Liew HM, Soh SY, Tan AM, Koh MJA. A Case of Eczematoid Graft-Versus-Host Disease. Pediatr Dermatol 2016; 33:e195-e197. [PMID: 27041366 DOI: 10.1111/pde.12840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 13-year-old boy underwent allogeneic hematopoietic stem cell transplantation (HSCT) for underlying acute lymphoblastic leukemia and achieved neutrophil engraftment 28 days after HSCT. He developed ichthyosis 6 weeks after HSCT and then keratotic follicular papules, palmoplantar keratoderma, and a seborrheic dermatitis-like eruption 18 weeks after HSCT. From skin biopsies he was diagnosed with eczematoid graft-versus host disease (GVHD), which showed spongiosis with scattered necrotic keratinocytes. He responded to oral and topical steroids and an increase in cyclosporine dose. Although uncommon, eczematoid GVHD must be considered in children who have undergone HSCT and then develop an atypical eczematous eruption, especially in the absence of a history of atopy.
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Affiliation(s)
- Jin Ho Chong
- Dermatology Service, KK Women's and Children's Hospital, Singapore
| | - Khawn Tawng
- Paediatric Haematology / Oncology, KK Women's and Children's Hospital, Singapore
| | - Hui Min Liew
- Dermatology Service, KK Women's and Children's Hospital, Singapore
| | - Shui Yen Soh
- Paediatric Haematology / Oncology, KK Women's and Children's Hospital, Singapore
| | - Ah Moy Tan
- Paediatric Haematology / Oncology, KK Women's and Children's Hospital, Singapore
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11
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IL-18 and Cutaneous Inflammatory Diseases. Int J Mol Sci 2015; 16:29357-69. [PMID: 26690141 PMCID: PMC4691115 DOI: 10.3390/ijms161226172] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 11/25/2015] [Accepted: 12/03/2015] [Indexed: 12/15/2022] Open
Abstract
Interleukin (IL)-18, an IL-1 family cytokine, is a pleiotropic immune regulator. IL-18 plays a strong proinflammatory role by inducing interferon (IFN)-γ. Previous studies have implicated IL-18 in the pathogenesis of various diseases. However, it is not well understood biologic activities of IL-18 in the diverse skin diseases. Here, we have reviewed the expression and function of IL-18 in skin diseases including inflammatory diseases. This article provides an evidence-based understanding of the role of IL-18 in skin diseases and its relationship with disease activities.
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12
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Weng J, Lai P, Geng S, Luo C, Wu S, Ling W, Deng C, Huang X, Lu Z, Du X. Role of Toll-like receptor 4 signaling in cutaneous chronic graft-versus-host disease. Clin Transplant 2015; 29:547-54. [PMID: 25845646 DOI: 10.1111/ctr.12551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2015] [Indexed: 12/31/2022]
Abstract
Cutaneous damage is one of the characterized manifestations in chronic graft-versus-host disease (cGVHD). When local effective immunity in the skin is altered to a dysimmune reaction, cutaneous injuries occur. Toll-like receptor 4 signaling is regarded as a central mediator of inflammation and organ injury. In this study, we found that TLR4 mRNA in peripheral blood from patients with cutaneous cGVHD was markedly increased compared with that from non-GVHD patients and healthy controls. In addition, NF-κB expression, TLR4 downstream signaling, and TLR4-mediated cytokines, including IL-6 and ICAM-1, were upregulated. Moreover, ICAM-1 was widely distributed in skin biopsies from patients with cutaneous cGVHD. We also found that LPS induced TLR4-mediated NF-κB activation and IL-6 and ICAM-1 secretion in human fibroblasts in vitro. Thus, TLR4, NF-κB, IL-6, and ICAM-1 contribute to the inflammatory response that occurs in cutaneous cGVHD, indicating the TLR4 pathway may be a novel target for cutaneous cGVHD therapy.
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Affiliation(s)
- Jianyu Weng
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Peilong Lai
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Suxia Geng
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chenwei Luo
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Suijing Wu
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Ling
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chengxin Deng
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xin Huang
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zesheng Lu
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xin Du
- Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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13
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Cornejo CM, Kim EJ, Rosenbach M, Micheletti RG. Atypical manifestations of graft-versus-host disease. J Am Acad Dermatol 2015; 72:690-5. [DOI: 10.1016/j.jaad.2014.12.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 12/14/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
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14
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Llamas-Velasco M, Solano-López Morel GE, Gruber-Wackernagel A, Concha-Garzón MJ, Requena L, Cerroni L. Comedonal graft-vs-host disease: a distinct clinical expression of a lichenoid follicular GVHD. J Cutan Pathol 2014; 41:853-8. [DOI: 10.1111/cup.12391] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/06/2014] [Accepted: 07/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Mar Llamas-Velasco
- Department of Dermatology; Hospital Universitario De La Princesa; Madrid Spain
| | | | | | | | - Luis Requena
- Department of Dermatology; Fundación Jimenez Diaz; Madrid Spain
| | - Lorenzo Cerroni
- Deparment of Dermatology; Medical University of Graz; Graz Austria
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15
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Kennedy F, Hilari H, Ferrer B, Garcia-Patos V. Lichenoid Chronic Graft-vs-Host Disease Following Blaschko Lines. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2012.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kennedy FE, Hilari H, Ferrer B, Garcia-Patos V. Lichenoid chronic graft-vs-host disease following Blaschko lines. ACTAS DERMO-SIFILIOGRAFICAS 2013; 105:89-92. [PMID: 23668622 DOI: 10.1016/j.ad.2012.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 12/10/2012] [Accepted: 12/27/2012] [Indexed: 10/26/2022] Open
Affiliation(s)
- F E Kennedy
- Servicio de Dermatología, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
| | - H Hilari
- Servicio de Dermatología, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - B Ferrer
- Servicio de Anatomía Patológica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - V Garcia-Patos
- Servicio de Dermatología, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
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Sicca symptoms and their impact on quality of life among very long-term survivors after hematopoietic SCT. Bone Marrow Transplant 2013; 48:988-93. [PMID: 23292241 DOI: 10.1038/bmt.2012.260] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 11/06/2012] [Accepted: 11/13/2012] [Indexed: 01/01/2023]
Abstract
The objective of this prospective cross-sectional case-control study was to examine the prevalence of dryness symptoms and its impact on quality of life (QoL) among very long-term survivors after hematopoietic SCT (HSCT) in comparison with their respective sibling donors. Forty-four allogeneic HSCT recipients with a long-term survival (median: 17.5; range: 11-26 years) were included. Their respective, HLA-identical sibling donors served as controls. Clinical examinations included saliva flow rates (SFR) and the Schirmer's test. The presence of sicca symptoms of mouth, eyes and skin were inquired. The social functioning (SF)-36 questionnaire was applied. Recipients had lower (P<0.01) unstimulated and stimulated mean SFR than donors. Schirmer's test results <5 mm was found in 45% of the recipients in comparison with 27% of the donors (P = 0.07). Xerostomia (34 vs 4 subjects), xerophtalmia (23 vs 3) and dry skin (32 vs 12) were reported more often by the recipients than donors (P<0.001). Sicca symptoms and their objective findings correlated with QoL. The mean SF-36 scores of the donors were significantly higher than those of the recipients for physical component summary. In conclusion, sicca symptoms are common amongst long-term survivors of HSCT and affect remarkably the QoL.
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