1
|
Nusbaum KB, Boettler M, Korman AM, Alavi A, Alloo A, Dissemond J, French LE, Huang WW, Kolios AGA, Marzano AV, Micheletti RG, Mostaghimi A, Ortega-Loayza AG, Rosenbach M, Schreml S, Tolkachjov SN, Kaffenberger BH. Subjective assessments in pyoderma gangrenosum diagnostic frameworks undermine framework agreement. Int J Dermatol 2024; 63:e67-e69. [PMID: 38044552 DOI: 10.1111/ijd.16952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Kelsey B Nusbaum
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
| | - Michelle Boettler
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
| | - Abraham M Korman
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Allireza Alloo
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, New Hyde Park, NY, USA
| | - Joachim Dissemond
- Department of Dermatology, University of Essen-Duisburg, Essen, Germany
| | - Lars E French
- Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany
- Dr. Philip Frost, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - William W Huang
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Antonio G A Kolios
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Robert G Micheletti
- Department of Dermatology and Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex G Ortega-Loayza
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - Misha Rosenbach
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephan Schreml
- Department of Dermatology, University Medical Center Regensburg, Regensburg, Germany
| | - Stanislav N Tolkachjov
- Epiphany Dermatology, Dallas, TX, USA
- Texas A&M College of Medicine, Dallas, TX, USA
- University of Texas at Southwestern, Dallas, TX, USA
- Baylor University Medical Center, Dallas, TX, USA
| | | |
Collapse
|
2
|
Özcan A, Collado-Diaz V, Egholm C, Tomura M, Gunzer M, Halin C, Kolios AGA, Boyman O. CCR7-guided neutrophil redirection to skin-draining lymph nodes regulates cutaneous inflammation and infection. Sci Immunol 2022; 7:eabi9126. [PMID: 35119939 DOI: 10.1126/sciimmunol.abi9126] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neutrophils are the first nonresident effector immune cells that migrate to a site of infection or inflammation; however, improper control of neutrophil responses can cause considerable tissue damage. Here, we found that neutrophil responses in inflamed or infected skin were regulated by CCR7-dependent migration and phagocytosis of neutrophils in draining lymph nodes (dLNs). In mouse models of Toll-like receptor-induced skin inflammation and cutaneous Staphylococcus aureus infection, neutrophils migrated from the skin to the dLNs via lymphatic vessels in a CCR7-mediated manner. In the dLNs, these neutrophils were phagocytosed by lymph node-resident type 1 and type 2 conventional dendritic cells. CCR7 up-regulation on neutrophils was a conserved mechanism across different tissues and was induced by a broad range of microbial stimuli. In the context of cutaneous immune responses, disruption of CCR7 interactions by selective CCR7 deficiency of neutrophils resulted in increased antistaphylococcal immunity and aggravated skin inflammation. Thus, neutrophil homing to and clearance in skin-dLNs affects cutaneous immunity versus pathology.
Collapse
Affiliation(s)
- A Özcan
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - V Collado-Diaz
- Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
| | - C Egholm
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - M Tomura
- Laboratory of Immunology, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Osaka 584-8540, Japan
| | - M Gunzer
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany.,Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., Dortmund, Germany
| | - C Halin
- Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
| | - A G A Kolios
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - O Boyman
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Cazzaniga S, Anzengruber F, Augustin M, Boehncke WH, Borradori L, Conrad C, Cozzio A, Djamei V, French LE, Gilliet M, Häusermann P, Heidemeyer K, Itin P, Kolios AGA, Laffitte E, Maul JT, Mainetti C, Naldi L, Navarini AA, Rustenbach SJ, Simon D, Sorbe C, Streit M, Yawalkar N. Linkage between patients' characteristics and prescribed systemic treatments for psoriasis: a semantic connectivity map analysis of the Swiss Dermatology Network for Targeted Therapies registry. J Eur Acad Dermatol Venereol 2019; 33:2313-2318. [PMID: 31562785 DOI: 10.1111/jdv.15983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/05/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several treatment options are currently available for the treatment of psoriasis. OBJECTIVE To explore the main associations between patients' characteristics and systemic treatments prescribed for psoriasis in a large group of patients observed in real-life clinical practice. METHODS This was a retrospective analysis of baseline data collected within the Swiss Dermatology Network for Targeted Therapies registry in Switzerland between March 2011 and December 2017. Semantic map analysis was used in order to capture the best associations between variables taking into account other covariates in the system. RESULTS A total of 549 patients (mean age 46.7 ± 14.7 years) were included in the analysis. Conventional therapies such as retinoids and methotrexate were associated with no previous systemic therapies for psoriasis, a moderate quality of life (QoL) at therapy onset and older age (≥60 years). Fumaric acid derivatives were associated with mild psoriasis (psoriasis area severity index < 10) and long disease duration (≥20 years). On the other side, cyclosporine and psoralen and ultraviolet A/ultraviolet B treatments were linked to a more severe condition, including impaired QoL, hospitalization and inability to work. Regarding biological therapies, both infliximab and adalimumab were connected to the presence of psoriatic arthritis, severe disease condition and other comorbidities, including chronic liver or kidney diseases and tuberculosis. Etanercept, ustekinumab and secukinumab were all connected to a complex history of previous systemic treatments for psoriasis, moderate disease condition, overweight and university education. CONCLUSIONS The analysis shows multifaceted associations between patients' characteristics, comorbidities, disease severity and systemic treatments prescribed for psoriasis. In particular, our semantic map indicates that comorbidities play a central role in decision-making of systemic treatments usage for psoriasis. Future studies should further investigate specific connections emerging from our data.
Collapse
Affiliation(s)
- S Cazzaniga
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Centro Studi GISED, Bergamo, Italy.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - F Anzengruber
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - W H Boehncke
- Division of Dermatology and Venereology, University Hospital of Geneva, Geneva, Switzerland
| | - L Borradori
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Conrad
- Department of Dermatology and Venereology, Hôpital de Beaumont, Lausanne University Hospital Center, Lausanne, Switzerland
| | - A Cozzio
- Clinic of Dermatology and Allergology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - V Djamei
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - L E French
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - M Gilliet
- Department of Dermatology and Venereology, Hôpital de Beaumont, Lausanne University Hospital Center, Lausanne, Switzerland
| | - P Häusermann
- Department of Dermatology, University Basel Hospital, Basel, Switzerland
| | - K Heidemeyer
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - P Itin
- Department of Dermatology, University Basel Hospital, Basel, Switzerland
| | - A G A Kolios
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - E Laffitte
- Division of Dermatology and Venereology, University Hospital of Geneva, Geneva, Switzerland
| | - J-T Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - C Mainetti
- Department of Dermatology, Regional Hospital Bellinzona, Bellinzona, Switzerland
| | - L Naldi
- Centro Studi GISED, Bergamo, Italy.,Department of Dermatology, Azienda USL 8 Berica - San Bortolo Hospital, Vicenza, Italy
| | - A A Navarini
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - S J Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Streit
- Department of Dermatology and Allergology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - N Yawalkar
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
4
|
Kolios AGA, Hueber AJ, Michetti P, Mrowietz U, Mustak-Blagusz M, Sator PG, Reinshagen M, Wilsmann-Theis D, Gomis-Kleindienst S, Luckey U, Rössler A, Schiefke I. ALIGNed on adherence: subanalysis of adherence in immune-mediated inflammatory diseases in the DACH region of the global ALIGN study. J Eur Acad Dermatol Venereol 2018; 33:234-241. [PMID: 29998520 PMCID: PMC6585659 DOI: 10.1111/jdv.15179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/08/2018] [Indexed: 01/30/2023]
Abstract
Background Non‐adherence to medication is a challenging problem in daily clinical practice. Objective To assess reasons for non‐adherence in patients with chronic immune‐mediated inflammatory diseases (IMIDs) in a direct comparison including evaluation of treatment necessity and concerns. Methods ALIGN was a non‐interventional, multicountry, multicentre, self‐administered, cross‐sectional, epidemiologic survey study. Here, we investigate the German, Austrian and Swiss (DACH) cohort. Six hundred thirty‐one patients with different IMIDs (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, Crohn's disease and ulcerative colitis) under systemic therapies were evaluated concerning adherence, beliefs of necessity and concerns towards treatment in patients with IMIDs. Results The DACH cohort had significantly different levels of adherence depending on the IMID (P < 0.05) and the type of therapy (P < 0.05). Based on the significant influence of concerns on treatment adherence (P < 0.05) and the high belief of treatment necessity, patients could be classified in four attitudinal segments, which were unequally distributed throughout various IMIDs. High concerns had a significant influence on non‐adherence, whereas necessity did not. Older age, female sex, TNFi mono‐, conventional combination and TNFi combination therapy are positively associated with adherence. Conclusions In the DACH region, patients are less concerned about medication and believe in the necessity of treatment. Therefore, we suggest adapting the communication in the various patient groups.
Collapse
Affiliation(s)
- A G A Kolios
- Departments of Immunology and Dermatology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - A J Hueber
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - P Michetti
- Gastroentérologie La Source-Beaulieu and Division of Gastroenterology, Centre hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - U Mrowietz
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | | | - P-G Sator
- Department of Dermatology, Hospital Hietzing, Vienna, Austria
| | - M Reinshagen
- Department of Medicine I, Klinikum Braunschweig, Braunschweig, Germany
| | - D Wilsmann-Theis
- Department of Dermatology and Allergy, University Bonn, Bonn, Germany
| | | | - U Luckey
- Medical Department, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - A Rössler
- Medical Department, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - I Schiefke
- Department of Gastroenterology, Hepatology, Endocrinology and Diabetology, St. George Hospital, Leipzig, Germany
| |
Collapse
|
5
|
Adamo S, Nilsson J, Krebs A, Steiner U, Cozzio A, French LE, Kolios AGA. Successful treatment of SAPHO syndrome with apremilast. Br J Dermatol 2018; 179:959-962. [PMID: 29034454 DOI: 10.1111/bjd.16071] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 01/02/2023]
Abstract
SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a rare disease with inflammatory osteoarticular and skin involvement. The pathogenesis of SAPHO syndrome remains unclear, but evidence suggests it may be an autoinflammatory disease triggered upon exposure to infectious agents in genetically predisposed individuals. Induction of the interleukin (IL)-23/T helper 17 axis in addition to neutrophil activation seem to play a key role, and therapies targeting these immunological pathways, including tumour necrosis factor (TNF) inhibitors, ustekinumab, secukinumab and the IL-1 inhibitor anakinra, are potential treatment options that need further investigation. Here we report a case of a 24-year-old woman with SAPHO syndrome who presented at our clinic with palmoplantar pustulosis and sternoclavicular joint involvement. Previous treatments with topical steroids and keratolytics combined with nonsteroidal anti-inflammatory drugs, intravenous methylprednisolone, methotrexate and sulfasalazine had all failed to improve symptoms. Therapy with etanercept was not tolerated, and because of a previous demyelinating peripheral neuropathy, further treatment with TNF inhibitors was avoided. We initiated ustekinumab 45 mg, which improved skin manifestations but not joint pain. Dose escalation to 90 mg initially improved joint pain, but the dose had to be reduced to 45 mg again because of increased infections. During subsequent 45-mg ustekinumab treatment, joint pain exacerbated so we switched to adalimumab which caused an exacerbation of the disease, so we switched to secukinumab, which improved skin and joint symptoms significantly but was associated with a pustular hypersensitivity reaction. Finally, we began treatment with apremilast, a pan-cytokine approach, resulting in stabilization of the skin and joint symptoms without side-effects. To our knowledge, this is the first case report of apremilast as a treatment for SAPHO syndrome.
Collapse
Affiliation(s)
| | | | | | | | - A Cozzio
- Department of Dermatology, University Hospital, Zurich, Switzerland
| | - L E French
- Department of Dermatology, Venerology and Allergology, Kantonsspital, St. Gallen, Switzerland
| | - A G A Kolios
- Department of Immunology.,Department of Dermatology, Venerology and Allergology, Kantonsspital, St. Gallen, Switzerland
| |
Collapse
|
6
|
Kolios AGA, Hafner J, Luder C, Guenova E, Kerl K, Kempf W, Nilsson J, French LE, Cozzio A. Comparison of pyoderma gangrenosum and Martorell hypertensive ischaemic leg ulcer in a Swiss cohort. Br J Dermatol 2018; 178:e125-e126. [PMID: 28832960 DOI: 10.1111/bjd.15901] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- A G A Kolios
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland.,Department of Immunology, Zürich University Hospital, Zürich, Switzerland
| | - J Hafner
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - C Luder
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - E Guenova
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland.,Department of Dermatology, Venerology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - K Kerl
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - W Kempf
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland.,Kempf und Pfaltz Histologische Diagnostik, Zürich, Switzerland
| | - J Nilsson
- Department of Immunology, Zürich University Hospital, Zürich, Switzerland
| | - L E French
- Department of Dermatology, Zürich University Hospital, Zürich, Switzerland
| | - A Cozzio
- Department of Dermatology, Venerology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland
| |
Collapse
|
7
|
Kolios AGA, Biedermann L, Weber A, Navarini AA, Meier J, Cozzio A, French LE. Paradoxical ulcerative colitis during adalimumab treatment of psoriasis resolved by switch to ustekinumab. Br J Dermatol 2017; 178:551-555. [PMID: 28477389 DOI: 10.1111/bjd.15631] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2017] [Indexed: 12/16/2022]
Abstract
Here we report the case of a patient with psoriasis who developed ulcerative colitis most likely caused by adalimumab. After cessation of adalimumab, colitis improved significantly. However, as psoriasis worsened, the patient was switched to ustekinumab, which resulted in complete cessation of colitis. During the 2-year follow-up under ustekinumab therapy, no further gastrointestinal complaints occurred. Paradoxical psoriasis manifestations in inflammatory bowel disease (IBD) under tumour necrosis factor (TNF)-inhibitor therapy have been reported and paradoxical IBD occurred rarely (mostly Crohn disease) in patients with rheumatological conditions treated with infliximab or etanercept. Due to the highly probable association of adalimumab with the onset of colitis in this case, we would like to suggest the term 'paradoxical ulcerative colitis' (PUC) for this as yet extremely rarely reported phenomenon. To the best of our knowledge this is the first description of PUC in a patient with psoriasis and in adalimumab treatment. Our observation suggests that ustekinumab is an effective treatment option in patients with paradoxical anti-TNF-driven inflammatory reactions like psoriasis or IBD.
Collapse
Affiliation(s)
- A G A Kolios
- Department of Immunology, Zurich University Hospital, Zurich, Switzerland.,Department of Dermatology, Zurich University Hospital, Zurich, Switzerland
| | - L Biedermann
- Department of Gastroenterology and Hepatology, Zurich University Hospital, Zurich, Switzerland
| | - A Weber
- Department of Pathology and Molecular Pathology, Zurich University Hospital, Zurich, Switzerland
| | - A A Navarini
- Department of Dermatology, Zurich University Hospital, Zurich, Switzerland
| | - J Meier
- Ambulante Gastroenterologie Baden AG, Baden, Switzerland
| | - A Cozzio
- Department of Dermatology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - L E French
- Department of Dermatology, Zurich University Hospital, Zurich, Switzerland
| |
Collapse
|
8
|
Abstract
BACKGROUND Scleromyxedema is a rare connective tissue disease that may affect numerous internal organs in addition to the skin. The disease is almost exclusively associated with monoclonal gammopathy. MATERIAL AND METHODS This retrospective study summarizes the clinical characteristics of four patients with scleromyxedema. In all of the patients a systematic serological and apparative check-up was performed. RESULTS The mean age of the four patients (three women and one man) was 51 years. In all cases, monoclonal gammopathy (3 cases of IgG lambda and 1 case of IgG kappa) was involved. In one patient, skin lesions were restricted to the upper part of the body and three patients had generalized disease. The internal organs of all patients were affected with fibrosis of the lungs, myositis and arthritis, peripheral polyneuropathy and hypomotility of the esophagus. The most effective forms of treatment in this patient collective were dexamethasone-pulse therapy, intravenous immunoglobulins and bortezomib. All patients had recurrences after finishing therapy. The mean observation period after the initial diagnosis of scleromyxedena was 6.25 years (range 2-11 years). CONCLUSION Scleromyxedema is a rare multisystemic disease. The heterogeneous affection of internal organs necessitates a comprehensive check-up. The response to recently published treatment strategies is low and recurrences after finishing therapy are frequent.
Collapse
Affiliation(s)
- A Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum im St. Josef Hospital, Gudrunstr. 56, 44791, Bochum, Deutschland.
| | | | | | | | | |
Collapse
|