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Lefevre MA, Nosbaum A, Mosnier A, Lenief V, Salque S, Pichot M, Maheux L, Bertolotti L, Hacard F, Graveriau C, Zukervar P, Breton Guitarian AL, Boisleve F, Elbaz M, Nicolas JF, Vocanson M. Gene profiling in active dermatitis lesions strengthens the diagnosis of allergic contact dermatitis. J Am Acad Dermatol 2024; 90:953-962. [PMID: 38215793 DOI: 10.1016/j.jaad.2023.11.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/06/2023] [Accepted: 11/29/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Distinguishing between allergic and nonallergic forms of Contact Dermatitis (CD) is challenging and requires investigations based on patch-testing. Early detection of allergy biomarkers in active CD lesions could refine and simplify the management of CD patients. OBJECTIVE To characterize the molecular signatures of active CD lesions. METHODS We studied the expression of 12 allergy biomarkers by qRT-PCR in active lesions of 38 CD patients. Allergic CD (ACD) was diagnosed based on patch test (PT) results and exposure assessment. Molecular signatures of active lesions, as well as positive PT reactions, were compared with those of reference chemical allergens and irritants. RESULTS Nineteen of the 38 CD patients reacted positively upon patch-testing and exposure assessment confirmed ACD diagnosis for 17 of them. Gene profiling of active CD lesions revealed 2 distinct molecular patterns: patients harboring signatures similar to reference allergens (n = 23) or irritants (n = 15). Among the 23 patients with an "allergy signature," we found the 17 patients with confirmed ACD, while no culprit allergen was identified for the 6 other patients. Interestingly, the 15 patients without biomarker induction had negative PT, suggesting that they developed nonallergic CD reactions. CONCLUSION Molecular signatures from active skin lesions may help to stratify CD patients and predict those suffering from ACD.
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Affiliation(s)
- Marine-Alexia Lefevre
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France; Department of Dermatology and Allergy, Centre Hospitalier Universitaire de St Etienne, Saint-Priest-en-Jarez, France.
| | - Audrey Nosbaum
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France; Department of Allergy and Clinical Immunology, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
| | - Amandine Mosnier
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France
| | - Vanina Lenief
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France
| | - Samuel Salque
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France
| | - Marie Pichot
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France
| | - Lea Maheux
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France
| | - Lea Bertolotti
- Department of Allergy and Clinical Immunology, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
| | - Florence Hacard
- Department of Allergy and Clinical Immunology, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
| | | | | | | | | | | | - Jean-François Nicolas
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France; Department of Allergy and Clinical Immunology, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
| | - Marc Vocanson
- CIRI, Centre International de Recherche en Infectiologie, Team Epidermal Immunity and Allergy, INSERM, U1111, Univ Lyon, Université de Lyon 1, Ecole Normale Supérieure de Lyon, CNRS, UMR, Lyon, France.
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Reynaert G, Rey AC, Graveriau C, Hesse S, Denoeux JP. Impétigo streptococcique apparu sur les sites d’application du tacrolimus chez une jeune atopique. Ann Dermatol Venereol 2007; 134:261-3. [PMID: 17389853 DOI: 10.1016/s0151-9638(07)91821-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We report a case of staphylococcal impetigo in a girl treated with tacrolimus ointment (Protopic) for atopic dermatitis. OBSERVATION A 15 year-old girl was receiving treatment with tacrolimus 0.03% (Protopic) for an episode of atopic dermatitis. On reduction of applications of tacrolimus, a vesicular-pustular rash appeared and was treated with pristinamycin and valaciclovir. At the end of antibiotic and antiviral therapy, the vesicular-pustular rash recurred while the goal was receiving treatment once more with tacrolimus ointment 0.1%. The bacteriological and virological skin samples revealed B-haemolytic streptococcus group A. The negative results for cutaneous virological samples ruled out Kaposi-Juliusberg syndrome and a diagnosis of staphylococcal impetigo was made. The intrinsic imputability of tacrolimus was I3 (C3 S2). DISCUSSION The most obvious specific feature of this impetigo was its limitation to areas of eczema treated by application of tacrolimus. In prospective studies in large patient cohorts, tacrolimus ointment has been associated with two types of adverse effect: local irritations and skin infections chiefly caused by Staphylococcus aureus. To date, there have been no reports in the literature of impetigo due to haemolytic B streptococcus following application of tacrolimus. Because of its immunodepressant effect, tacrolimus ointment may result in increased incidence of skin infections even though a number of studies have shown a reduction in such infections.
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Affiliation(s)
- G Reynaert
- Service de Dermatologie et Vénéréologie, CHU, Groupe Hospitalier Sud, Amiens.
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