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Peri-articular bone formation involving the temporomandibular joint: a narrative summary and Delphi consensus of a new classification system. Int J Oral Maxillofac Surg 2024; 53:212-218. [PMID: 37777385 DOI: 10.1016/j.ijom.2023.09.003] [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: 03/21/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 10/02/2023]
Abstract
Heterotopic ossification (HO) is defined as 'bone where it does not belong'. Given the historical variety of nomenclature and eponyms, there is significant confusion about the etiology, pathogenesis, classification, and treatment of HO related to the temporomandibular joint (TMJ). The existing classifications for TMJ HO have shortcomings: they relate to specific populations, use differing imaging studies and demographic data, do not universally include alloplastic/autologous replacements, are based variously on radiological and/or clinical presentations that cannot always be combined, and were largely developed to assist oral and maxillofacial surgeons in surgical management. These deficiencies make it problematic to compare studies, draw valid conclusions, and pursue research. The aim of this study was to develop a new, more inclusive classification for TMJ HO. Currently available classifications were evaluated and a Delphi-type system used to build consensus from clinicians and researchers to develop a new system. Fourteen unique classifications for TMJ ankylosis/HO were identified. In light of the biological specifics related to heterotopic calcification of extracellular matrix versus heterotopic formation of actual bone, the group recommends a more unambiguous term - peri-articular bone formation - and proposes a new classification. This will help clinicians and researchers to study, describe, and manage various types of ectopic bone associated with the TMJ.
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Role of MALDI-TOF mass spectrometry and molecular typing methods in an outbreak investigation of Pseudomonas stutzeri acute endophthalmitis post-phacoemulsification. J Hosp Infect 2024; 144:146-149. [PMID: 37918527 DOI: 10.1016/j.jhin.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 11/04/2023]
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Which comorbid conditions and risk factors affect the outcome of and progression to total temporomandibular joint replacement? Int J Oral Maxillofac Surg 2023; 52:1265-1271. [PMID: 37277244 DOI: 10.1016/j.ijom.2023.05.011] [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: 08/04/2022] [Revised: 05/16/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
Surgery is an effective modality to reduce pain and increase range of motion (ROM) in TMJ disorders. The aim of this study was to determine which comorbidities and risk factors affect outcomes and progression to total joint replacement (TJR). A retrospective cohort study of patients who underwent TJR between 2000- 2018 at MGH was conducted. Primary outcome was successful vs unsuccessful surgery. Success was defined as pain score ≤ 4 and ROM ≥ 30 mm; failure was defined as lack of either or both. Secondary outcome was differences between patients undergoing TJR only (group A) and those undergoing multiple surgeries progressing to TJR (group B). 99 patients (82 females, 17 males) were included. Mean follow-up was 4.1 years; mean age at first surgery was 34.2 (range 14-71) years. Unsuccessful outcomes were associated with high preoperative pain, low preoperative ROM, and higher number of surgeries. Male sex favored successful outcome. 75.0% group A and 47.6% group B had successful outcome. Group B had more females, higher postoperative pain, lower postoperative ROM, and used more opioids compared to group A. High preoperative pain, low preoperative ROM, and more surgeries were associated with poorer outcomes and frequent opioid use.
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Role of Candida in the bioremediation of pollutants: a review. Lett Appl Microbiol 2023; 76:ovad103. [PMID: 37673682 DOI: 10.1093/lambio/ovad103] [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: 11/12/2022] [Revised: 06/30/2023] [Accepted: 09/04/2023] [Indexed: 09/08/2023]
Abstract
The population and modernization of society have increased dramatically from past few decades. In order to meet societal expectations, there has been a massive industrialization and resource exploitation. Anthropogenic practices like disposal of hazardous waste, large carbon footprint release variety of xenobiotic substances into the environment, which endanger the health of the natural ecosystem. Therefore, discovering proper long-term treatment approaches is a global concern. Various physical and chemical approaches are employed to remove contaminants. However, these technologies possess limitations like high cost and low efficacy. Consequently, bioremediation is regarded as one of the most promising remedies to these problems. It creates the option of either totally removing pollutants or transforming them into nonhazardous compounds with the use of natural biological agents. Several microorganisms are being utilized for bioremediation among which yeasts possess benefits such as high biodegradability, ease of cultivation etc. The yeast of Candida genus has the capability to effectively eliminate heavy metal ions, as well as to degrade and emulsify hydrocarbons which makes it a promising candidate for this purpose. The review highlights many potential uses of Candida in various remediation strategies and discusses future directions for research in this field.
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Biosurfactant from Candida: sources, classification, and emerging applications. Arch Microbiol 2023; 205:149. [PMID: 36995448 DOI: 10.1007/s00203-023-03495-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 03/13/2023] [Accepted: 03/19/2023] [Indexed: 03/31/2023]
Abstract
Biosurfactants are surface-active molecules that are synthesized by many microorganisms like fungi, bacteria, and yeast. These molecules are amphiphilic in nature, possessing emulsifying ability, detergency, foaming, and surface-activity like characteristics. Yeast species belongs to the genus Candida has gained globally enormous interest because of the diverse properties of biosurfactants produced by theme. In contrast to synthetic surfactants, biosurfactants are claimed to be biodegradable and non-toxic which labels them as a potent industrial compound. Biosurfactants produced by this genus are reported to possess certain biological activities, such as anticancer and antiviral activities. They also have potential industrial applications in bioremediation, oil recovery, agricultural, pharmaceutical, biomedical, food, and cosmetic industries. Various species of Candida have been recognized as biosurfactant producers, including Candida petrophilum, Candida bogoriensis, Candida antarctica, Candida lipolytica, Candida albicans, Candida batistae, Candida albicans, Candida sphaerica, etc. These species produce various forms of biosurfactants, such as glycolipids, lipopeptides, fatty acids, and polymeric biosurfactants, which are distinct according to their molecular weights. Herein, we provide a detailed overview of various types of biosurfactants produced by Candida sp., process optimization for better production, and the latest updates on the applications of these biosurfactants.
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No evidence of resistance to itraconazole in a prospective real-world trial of dermatomycosis in India. PLoS One 2023; 18:e0281514. [PMID: 36787305 PMCID: PMC9928099 DOI: 10.1371/journal.pone.0281514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/12/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The prevalence of superficial fungal infections in India is believed to have increased substantially in the past decade. We evaluated the treatment outcomes and risk factors associated with clinical response to a treatment course of itraconazole for the management of dermatomycosis in India. METHODS In this real-world, prospective pilot study (August 2019 to March 2020), adult participants (18-60 years), diagnosed with T. cruris or T. corporis, received itraconazole 200 mg/day (any formulation) orally for 7 days, and were followed for an additional 7 days. RESULTS The study was terminated early due to the COVID-19 pandemic. Of 40 enrolled participants (mean [SD] age, 35.5 [12.73] years; {62.5%}] male; 37 received itraconazole and 20 (50%) completed the study. The median (range) Clinical Evaluation Tool Signs and Symptoms total score at baseline was 5.5 (2-10). Clinical response of "healed" or "markedly improved" based on the Investigator Global Evaluation Tool at day 7 (primary objective) was 42.9% (12/28; 95% CI: 24.53%, 61.19%). Itraconazole minimum inhibitory concentration for identified microorganisms, T. mentagrophytes species complex (91.7%) and T. rubrum (8.3%), was within the susceptibility range (0.015-0.25 mcg/mL). At day 14, 8/13 (61.5%) participants achieved a mycological response, 2/13 participants (15.4%) had a mycological failure and 90% showed a clinical response. CONCLUSION COVID-19 pandemic affected patient recruitment and follow-up, so the findings call for a careful interpretation. Nevertheless, this real-world study reconfirmed the clinical efficacy and microbial susceptibility to itraconazole for the fungi causing dermatophytosis in India. TRIAL REGISTRATION Trial registration number: Clinicaltrials.gov NCT03923010.
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Association de l’hémoglobine glyquée (HbA1c) et rétinopathie diabétique (RD) : quel lien ? ANNALES D'ENDOCRINOLOGIE 2023. [DOI: 10.1016/j.ando.2022.12.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Risque podologique (RP) : facteurs associés. ANNALES D'ENDOCRINOLOGIE 2023. [DOI: 10.1016/j.ando.2022.12.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Syndrome de Turner : prévalence des maladies auto-immunes des patientes atteintes de syndrome de Turner, expérience du service d’endocrinologie CHU Fès (Étude rétrospective à propos de 18 cas). ANNALES D'ENDOCRINOLOGIE 2023. [DOI: 10.1016/j.ando.2022.12.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Pharmaceutical prospects of biosurfactants produced from fungal species. J Basic Microbiol 2022; 62:1307-1318. [PMID: 36257786 DOI: 10.1002/jobm.202200327] [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: 06/03/2022] [Accepted: 09/10/2022] [Indexed: 11/10/2022]
Abstract
The development of novel types of biogenic surface-active compounds is of greater interest for combating many diseases and infections. In this respect research and development of biosurfactant has gained immense importance. Substantially, biosurfactant is defined as a class of active amphiphilic chemical compounds that comprise hydrophobic and hydrophilic moieties on their surfaces. It is generally known that many kinds of microorganisms can be used to produce these surfactants or surface-active compounds. Hosting interesting features such as biodegradability, emulsifying/de-emulsifying capacity, low toxicity, and antimicrobial activities; these amphiphilic compounds in recent years have flourished as an ideal replacement for the chemically synthesized surfactant, and also have various commercial attractions. Both bacteria and fungi are the producers of these amphiphilic molecules; however, the pathogenicity of certain bacterial strains has caused a shift in interest toward fungi. Therefore, various fungi species have been reported for the production of biosurfactants amongst which Candida species have been the most studied strains. Biosurfactants uphold desired properties like antibacterial, antifungal, antiviral, antiadhesion, and anticancer activity which proves them an ideal candidate for the application in various fields like pharmaceutical, gene therapy, medical insertion safety, immunotherapy to fight against many chronic diseases, and so forth. Hence, this review article discusses the pharmaceutical prospects of biosurfactants produced from different fungal species, providing new directions toward the discovery and development of molecules with novel structures and diverse functions for advanced application in the medical field.
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Anticancer Biosurfactant-Loaded PLA-PEG Nanoparticles Induce Apoptosis in Human MDA-MB-231 Breast Cancer Cells. ACS OMEGA 2022; 7:5231-5241. [PMID: 35187338 PMCID: PMC8851644 DOI: 10.1021/acsomega.1c06338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Despite various advancements in cancer therapies, treating cancer efficiently without side effects is still a major concern for researchers. Anticancer drugs from natural sources need to be explored as a replacement for chemo drugs to overcome their limitations. In our previous studies, isolation, characterization, and anticancer properties of a novel biosurfactant from Candida parapsilosis were reported. In this study, we report the cytotoxicity of the polymeric nanoparticles of this novel biosurfactant toward breast cancer cells. Biosurfactant-encapsulated polymeric nanoparticles of polylactic acid-poly(ethylene glycol) (PLA-PEG) copolymers were synthesized by the double emulsion solvent evaporation method. Folic acid (FA) was used as a targeting ligand to actively deliver the anticancer cargo to the cancer site. The encapsulation efficiency of nanoparticles was observed as 84.9%, and Fickian diffusion was observed as a kinetic model for the release of biosurfactant from nanoparticles. The controlled delivery of the biosurfactant was noticed when encapsulated in PLA-PEG copolymer nanoparticles. Additionally, it was observed that FA enhanced the uptake and cytotoxicity of biosurfactant-loaded nanoparticles in MDA-MB-231 cancer cells compared to biosurfactant-loaded plain nanoparticles. Induction of apoptosis was observed in cancer cells by these nanoparticles. We explore a potential anticancer agent that can be further analyzed for its efficiency and can be used as an alternative tool.
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Addition of oral Fexofenadine to topical therapy leads to a significantly greater reduction in the serum IL-31 levels in mild to moderate pediatric atopic dermatitis. Clin Exp Dermatol 2021; 47:724-729. [PMID: 34826148 DOI: 10.1111/ced.15032] [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: 09/06/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent evidence has suggested that oral antihistamines could have a beneficial role in atopic dermatitis (AD) due to their anti-inflammatory action. Hence, we aimed to evaluate the effectiveness of adding an oral second generation, non-sedating, H1 antihistamine (Fexofenadine) to topical treatment in AD. MATERIALS AND METHODS In this prospective randomized study, a total of 50 patients with a diagnosis of mild to moderate atopic dermatitis were recruited and randomized into two groups A (appropriate topical treatment combined with oral fexofenadine) and B (appropriate topical treatment without oral fexofenadine). Both groups received the respective treatments for a duration of 8 weeks. RESULTS There was no significant difference between the two groups in terms of SCORAD and the 5-D Itch Score at any of the time points (2 weeks, 4 weeks, 8 weeks). However, the serum IL-31 (ng/ml) decreased significantly from baseline in the fexofenadine group after 8 weeks of treatment. CONCLUSIONS Although we could not conclusively confirm the clinical efficacy of adding oral fexofenadine to topical treatment in AD, serological evaluation indicates that fexofenadine treatment can lead to significant lowering of serum IL-31 levels in AD patients.
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Erythema nodosum, zoster duplex and pityriasis rosea as possible cutaneous adverse effects of Oxford-AstraZeneca COVID-19 vaccine: report of three cases from India. J Eur Acad Dermatol Venereol 2021; 36:e16-e18. [PMID: 34547126 PMCID: PMC8657518 DOI: 10.1111/jdv.17678] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Omalizumab: an underutilized treatment option in bullous pemphigoid patients with co-morbidities. J Eur Acad Dermatol Venereol 2021; 35:e469-e472. [PMID: 33725360 DOI: 10.1111/jdv.17229] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
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Severe epidermolysis bullosa/Kindler syndrome-like phenotype of an autoinflammatory syndrome in a child. Clin Exp Dermatol 2021; 46:795-799. [PMID: 33625737 DOI: 10.1111/ced.14557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 11/26/2022]
Abstract
A 5-year-old boy presented with generalized cutaneous erosions, severe scarring, depigmentation and contractures affecting major joints. The lesions had initially affected his ears, nose, feet, and the genital and ocular mucosa, leading to significant depigmentation, scarring, contractures and mutilation. The whole of the trunk and limbs were involved at the time of presentation, with the exception of some islands of spared skin on the proximal thighs, legs, nipples and external genitalia. Electron microscopy revealed a split in the sublamina densa with the absence of anchoring fibrils, suggestive of dystrophic epidermolysis bullosa (EB). Immunofluorescence antigen mapping demonstrated a broad reticulate pattern of staining with collagen IV, VII, and laminin 332 in the floor of the blister, suggestive of Kindler syndrome. Next-generation sequencing revealed a de novo heterozygous missense mutation (a variant of unknown significance) in exon 22 of the phospholipase-C gamma 2 gene (PLCG2), which resulted in a substitution of serine by asparagine at codon 798 (p.Asp798Ser), a result that was validated using Sanger sequencing. The child was diagnosed with PLCG2-associated antibody deficiency and immune dysregulation (PLAID)/autoinflammation and PLCG2-associated antibody deficiency and immune dysregulation (APLAID) syndrome. The cutaneous and corneal erosions, inflammation and scarring of this magnitude, and the eventual result of death have not been described previously for the PLAID/APLAID spectrum previously. In conclusion, this was an unusual acquired autoinflammatory severe EB-like disease that may be associated with de novo PLCG2 mutation.
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Acute coronary events in patients with myeloproliferative neoplasms- a nationwide analysis of patient characteristics and in-hospital outcomes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Myeloproliferative neoplasms (MPN) are characterized by clonal expansion of cells belonging to the erythroid and/or myeloid lineages. Concomitant platelet dysfunction and thrombocytosis predispose these patients to arterial thromboses, causing a high burden of morbidity and mortality. With improving survival, an increasing number of patients with MPN are presenting with acute coronary syndromes (ACS). However, data regarding in-hospital outcomes and revascularization strategies utilized in these patients is limited, due to lack of representation in trials and rarity of the disease.
Methods
We conducted a retrospective cohort study using the 2016 Nationwide Inpatient Sample.Adult patients with a primary diagnosis of ACS and a secondary diagnosis of MPN, including essential thrombocytosis, polycythemia vera, primary myelofibrosis or chronic myeloproliferative disorder, were identified using the International Classification of Diseases (ICD) 10th revision codes. Outcomes of interest were compared using a multivariate logistic regression model.
Results
Out of 677,304 patients admitted for ACS, 2,485 also had a secondary diagnosis of MPN. Patients with MPN were less frequently female and diabetic but were more likely to have heart failure. No statistical difference in race, smoking or obesity was noted between the two cohorts. There was no significant difference in the in-hospital mortality in ACS patients with or without MPN. In terms of revascularization, patients with MPN were less likely to undergo percutaneous coronary intervention (PCI) and more likely to undergo coronary arterial bypass grafting (CABG). In addition, patients with MPN had a higher odds of acute pulmonary embolism, cardiogenic shock, and acute kidney injury as well as increased length of stay (LOS) and hospitalization costs
Conclusion
In patients with ACS and concomitant MPN, CABG was the preferred mode of revascularization over PCI, which may account for the increased LOS and total cost. Although the in-hospital mortality was similar, patients with MPN had higher odds of In-hospital complications.
Funding Acknowledgement
Type of funding source: None
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Early detection of Pseudomonas aeruginosa and Escherichia coli. using zinc tetraphenylporphyrin. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The sensory characteristics of food are considerably effected by the metabolic processes of various micro-organisms in the food stored in the field or at ambient temperature. Also, this microbial contamination can pose serious health hazards to public health. Chemical analysis of the complex mixture of volatiles produced during bacterial growth and investigation methods of these microorganisms presents a big challenge. There remains major unmet need to shorten and improve detection methods. Therefore, early detection of the microorganisms will open many frontiers for quality control in the foodstuffs industry. Accordingly, the aim of this study was to assess the feasibility and performance of chemoreceptive sensors for the rapid detection of bacterial pathogens, specifically Pseudomonas aeruginosa and Escherichia coli.
In Uv/vis study, zinc tetraphenyl porphyrin solutions (in DMF) was tested with various volatile compounds, such as propanal, hexanal and heptanal which are commonly found to be released during the growth of bacteria. These sensors were used to detect the bacterial odours of two pathogenic species (E.coli and P.aeruginosa) during their growth cycle at 4 °C and ambient temperature.
Hypochromic shifts in Uv/vis and hydrogen bonding in FT-IR studies confirmed the interaction between the volatiles and porphyrin. The porphyrin used detected the presence of microorganisms after 12 hrs incubation and showed more sensitivity for volatiles released during aerobic activity P. aeruginosa as compared to E. coli at 4 °C and ambient temperature.
Zinc tetraphenyl porphyrin based chemoreceptive membranes has been proved successful for the detection of P. aeruginosa. Hence, the present study proves wide scope of improvement over current laboratory techniques for the detection of pathogens in terms of speed, ease of use, and cost.
Key messages
The developed technique allows rapid detection of spoiled food. Chemoreceptive property of porphyrin has been exploited for the early detection of bacteria.
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AB0013 HLA ASSOCIATION WITH SYSTEMIC SCLEROSIS (SSc) IN NORTH INDIAN POPULATION AND FAMILIAL INHERITANCE PATTERNS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:It is widely believed that SSc develops in an individual with a permissive genetic makeup.Genetic influences have long been suspected to impact SSc. In families with a history of SSc, the incidence of disease can range from 1.5 to 1.7% (1). There are several reports of familial occurrence and certain alleles of the HLA system have been associated with the disease (2).No Indian data pertaining to genetic basis of systemic sclerosis is present. Understanding the genetic basis of the disease will help us in defining the biomarkers of the disease in the population that can help in early diagnosis and prognosis.Objectives:To study HLA association with Systemic sclerosis (SSc) in North Indian Population and its genetic susceptibility to familial systemic sclerosis.Methods:A total of 150 SSc patients diagnosed by following ACR and EULAR criteria and 150 control subjects, were genotyped for HLA-A, B, DRB1, DQB1 loci by Luminex® 200 Instrument (USA). The association of alleles with disease susceptibility was tested by Chi-square test and Fisher’s exact test.HLA Typing for HLA class I (A, B, C) and II(DR,DQ,DP) for familial study of systemic sclerosis in 2 families was performed by Next Generation Sequencing(NGS) with illumina MiniSeq using MIA FORA NGS Kits from IMMUCOR. Antinuclear patterns (ANA) and specific antibodies were detected by indirect Immunofluorescence and Immunoblot (Euroline, Germany).Results:Strong disease associations were observed for haplotypes A*24(OR=1.7;< 0.02), A*32(OR=2.8;< 0.02), B*35(OR=1.7;< 0.03), DRB1*11(OR=2.1;< 0.007). The reduced frequencies of haplotypes A*68(P< 0.05), DRB1*10(P< 0.05), DRB1*12 (P<0.00) among patients suggested a protective association. There was no statistical association found with HLA DQB*1.Through NGS we observed that in the 1stfamily haplotypes HLA –A*11, 32, 24; B* 51, 55, 35; C*-14, 04; DRB1*15, 04; DQB1*05, 03; DPB1*04, 26 appears in affected family members with serological abnormalities.In the 2ndfamily both mother and daughter had same set of haplotypes except DQB1 with serological abnormalities. The haplotypes DPB1*04 was present in all the diseased individuals of both the families (Fig. 1 and table 1).Table 1.NGS HLA typing reportABCDRB1DQB1DPB1F111 2435 1504 0415 1505 0502 26F211 3251 5514 0415 0405 0304 04F311 2435 5504 0415 1505 0526 04F432 1151 1514 0415 0405 0302 04F524 3335 4404 0715 0705 0226 14F611 2435 5504 0415 1505 0504 26F711 2435 5504 0415 1505 0504 26F824 3251 3514 0404 1503 0526 04F911 3251 5514 0415 0405 0304 04F1011 3344 5207 1211 0702 0304 13F1111 3344 5207 1211 0703 0304 13Fig. 1Conclusion:The risk alleles A*24, 32; B*35; DRB1*11 were found to be associated with North Indian cohort of SSc, while the protecting alleles were A*68; DRB1*10, 12.These risk alleles were present in the SSc affected family members and the protective alleles were absent in the same. Surprisingly, even healthy members carried the same risk alleles but did not manifest the disease or have serological evidence of the same. We have not excluded occurrence of disease at a later age, as presently the healthy siblings are young. Thus our study indicates that though HLA association are found with SSc but many other factors like HLA (HLA *C, DPB1*) or non HLA genes as wells as epigenetic factors might also play a role in disease manifestation and severity.References:[1]Luo Y, Wang Y, Wang Q,et al. Systemic sclerosis: genetics and epigenetics. J Autoimmun.2013; 41:161–67.[2]de Juan MD1, Belzunegui J, Belmonte I, Barado J, Figueroa M, Cancio J, Vidal S, Cuadrado E. An immunogenetic study of familial scleroderma. Ann Rheum Dis. 1994 Sep; 53(9):614-7.Acknowledgments:The technical help of Mr.Manoj Kumar and Mr.Vinkesh are hereby gratefully acknowledged Indian Council of Medical Research(Funding of Fellowship)Disclosure of Interests:None declared
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Paediatric morphoea: a holistic review. Part 1: epidemiology, aetiopathogenesis and clinical classification. Clin Exp Dermatol 2020; 45:673-678. [PMID: 32472964 DOI: 10.1111/ced.14234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2020] [Indexed: 12/29/2022]
Abstract
Morphoea, also known as localized scleroderma, is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Paediatric-onset disease is not uncommon and is associated with frequent relapses. The disease has complex pathogenetic mechanisms and multiple clinical subtypes, and affects children of all ages. Recent research has focused on elucidating the disease pathophysiology and identifying measures of disease activity. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected, and results were analysed before being summarized. In the first of this two-part review, we provide a bird's-eye view of the current literature concerning the epidemiology, aetiopathogenesis and clinical classification of paediatric morphoea; in Part 2, we review the diagnosis, markers of disease activity, management and natural history.
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Paediatric morphoea: a holistic review. Part 2: diagnosis, measures of disease activity, management and natural history. Clin Exp Dermatol 2020; 45:679-684. [PMID: 32449205 DOI: 10.1111/ced.14236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2020] [Indexed: 12/01/2022]
Abstract
Paediatric morphoea is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Defining optimum management strategies in paediatric morphoea remains an ongoing challenge, owing to the varied presentations and a relative paucity of paediatric-specific studies. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected and results analysed before summarizing them. In Part 1 of this review, we described the epidemiology, aetiopathogenesis and clinical classification; in this part, we discuss the diagnosis, markers of disease activity, management and natural history in paediatric morphoea.
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The association of respiratory duration and anthropometric measures in a pediatric population with obesity. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Iris mammillations. QJM 2019; 112:625. [PMID: 30690575 DOI: 10.1093/qjmed/hcz025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Contact sensitization to hair colours in acquired dermal macular hyperpigmentation: results from a patch and photo‐patch test study of 108 patients. J Eur Acad Dermatol Venereol 2019; 33:1349-1357. [DOI: 10.1111/jdv.15576] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/27/2019] [Indexed: 11/30/2022]
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27
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28
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Cutaneous mycobacterial co-infection in a patient with systemic lupus erythematosus. Clin Exp Dermatol 2019; 44:797-800. [PMID: 30614035 DOI: 10.1111/ced.13884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2018] [Indexed: 11/30/2022]
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29
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Zosteriform lymphangitis carcinomatosis in the cervical area arising from pyriform fossa adenocarcinoma. Clin Exp Dermatol 2018; 44:708-711. [PMID: 30520088 DOI: 10.1111/ced.13849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2018] [Indexed: 11/30/2022]
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30
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Antimalarial resistance in lupus: a lesser-explored terrain. Lupus 2018; 28:145-146. [PMID: 30472916 DOI: 10.1177/0961203318815585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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31
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Fingernail involvement in pemphigus and its correlation with disease severity and other clinicodemographic parameters. Br J Dermatol 2018; 180:662-663. [DOI: 10.1111/bjd.17136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Acitretin: a promising therapy for localized childhood lichen myxoedematosus. Clin Exp Dermatol 2018; 44:574-576. [PMID: 30294933 DOI: 10.1111/ced.13799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2018] [Indexed: 12/01/2022]
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Bullous pyoderma gangrenosum secondary to underlying multiple myeloma: treated with ciclosporin. Clin Exp Dermatol 2018; 44:e13-e15. [PMID: 30294832 DOI: 10.1111/ced.13804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2018] [Indexed: 11/30/2022]
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34
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Secukinumab-induced paradoxical pustular psoriasis. Clin Exp Dermatol 2018; 44:72-73. [DOI: 10.1111/ced.13731] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2018] [Indexed: 11/30/2022]
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Utility of whole-exome sequencing in detecting novel compound heterozygous mutations in COL7A1 among families with severe recessive dystrophic epidermolysis bullosa in India - implications on diagnosis, prognosis and prenatal testing. J Eur Acad Dermatol Venereol 2018; 32:e433-e435. [PMID: 29512197 DOI: 10.1111/jdv.14909] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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36
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Hydroxyurea and acitretin as a novel combination therapy in severe plaque psoriasis. Br J Dermatol 2018; 179:1212-1213. [PMID: 29927478 DOI: 10.1111/bjd.16899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Disseminated filiform hyperkeratosis – a variant of porokeratosis? J Eur Acad Dermatol Venereol 2018; 32:e419-e421. [DOI: 10.1111/jdv.15008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Image Gallery: Generalized circinate cutaneous lesions simulating circinate balanitis. Br J Dermatol 2017; 177:e224. [PMID: 29192976 DOI: 10.1111/bjd.15955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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The factors that affect to the better compliance of mandibular advancement device when compared with continuous positive airway pressure in the patients with moderate to severe sleep apnea syndrome. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.1055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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41
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Response to: bullous pemphigoid inguinalis? J Eur Acad Dermatol Venereol 2017; 32:e197-e198. [PMID: 29178331 DOI: 10.1111/jdv.14709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/09/2017] [Indexed: 11/27/2022]
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42
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Identification of factors associated with treatment refractoriness of oral lesions in pemphigus vulgaris. Br J Dermatol 2017; 177:1583-1589. [PMID: 28498563 DOI: 10.1111/bjd.15658] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND The oral mucosal lesions of patients with pemphigus vulgaris are known to show more treatment refractoriness than skin lesions. OBJECTIVES To identify which clinical and laboratory parameters may indicate treatment refractoriness of oral lesions in pemphigus vulgaris. METHODS This was a prospective study of 50 adults with pemphigus vulgaris and oral lesions; patients were given treatment appropriate for overall disease severity. Treatment refractoriness was defined arbitrarily as less than 75% reduction in oral objective Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) after treatment for 6 months. RESULTS Of 46 patients who completed the study, 17 (37%) were treatment refractory whereas 29 (63%) were treatment responsive. At baseline, the treatment refractory group had a significantly longer mean duration of disease (P = 0·02) and mean duration of oral lesions (P = 0·01), a higher percentage of lesions in the retromolar trigone (P = 0·05) and on the occlusion line along the buccal mucosa (P = 0·04), a higher percentage of deep/crateriform ulcers (P < 0·001) and erosions with a lichenoid hue (P < 0·001). Herpes simplex virus (HSV) DNA positivity, assessed by polymerase chain reaction in oral tissue scrapings (P = 0·02), was also significantly higher in the treatment refractory group. No other factors we tested for were statistically significant. CONCLUSIONS Treatment refractoriness of oral lesions was significantly associated with duration of disease/oral lesions; specific morphology and location of oral lesions; and the presence of HSV DNA in the oral cavity. These factors may forewarn the treating physician about a refractory course of oral lesions that may help with counselling patients.
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A prospective observational study to compare efficacy of topical triamcinolone acetonide 0.1% oral paste, oral methotrexate, and a combination of topical triamcinolone acetonide 0.1% and oral methotrexate in moderate to severe oral lichen planus. Dermatol Ther 2017; 31. [DOI: 10.1111/dth.12563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/22/2017] [Accepted: 09/26/2017] [Indexed: 01/09/2023]
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44
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Paraneoplastic bullous pemphigoid associated with penile squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 32:e140-e141. [PMID: 29024082 DOI: 10.1111/jdv.14635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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The clinicoaetiological, hormonal and histopathological characteristics of melasma in men. Clin Exp Dermatol 2017; 43:36-41. [DOI: 10.1111/ced.13234] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2017] [Indexed: 11/29/2022]
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46
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Pigmented macular variant of chronic cutaneous lupus erythematosus: an under-recognized subset in dark skin. Clin Exp Dermatol 2017; 42:793-795. [PMID: 28590034 DOI: 10.1111/ced.13160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2016] [Indexed: 11/27/2022]
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47
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A recent-onset ulcerated nodular plaque on the scalp. Clin Exp Dermatol 2017; 42:564-566. [PMID: 28556201 DOI: 10.1111/ced.13107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 11/29/2022]
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48
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Multiple keratoacanthoma centrifugum marginatum in a young boy, and review of the literature. Clin Exp Dermatol 2017; 42:711-713. [DOI: 10.1111/ced.13136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 11/28/2022]
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49
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Correlation between salivary and serum anti-desmoglein 1 and 3 antibody titres using ELISA and between anti-desmoglein levels and disease severity in pemphigus vulgaris. Clin Exp Dermatol 2017; 42:648-650. [PMID: 28543318 DOI: 10.1111/ced.13124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 12/01/2022]
Abstract
ELISA for anti-desmoglein antibodies (Dsg) is commonly used for diagnosis and assessment of treatment response in pemphigus vulgaris (PV). The present study was conducted to assess the relationship between salivary and serum Dsg1 and Dsg3 levels, and whether salivary Dsg1 and Dsg3 levels correlate with clinical disease severity of oral mucosal lesions in PV. In total 43, patients with PV with predominantly mucosal involvement were recruited. Both serum and salivary samples were collected from the cases, and salivary samples were also collected from five controls. There was a statistically significant correlation between serum and salivary Dsg1 levels and between serum and salivary Dsg3 levels. There was no correlation between serum or salivary Dsg1 and Dsg3 levels with the objective component of the oral mucosal Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). Serum Dsg1 levels significantly correlated with cutaneous ABSIS, but there was no correlation between cutaneous ABSIS and either salivary Dsg1, salivary Dsg3 or serum Dsg3. As salivary Dsg titres correlate with serum levels, saliva can serve as a simple and noninvasive alternative to serum for Dsg ELISA.
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Haemorrhagic onychomadesis: a cutaneous clue to chronic selenosis - case series. J Eur Acad Dermatol Venereol 2017; 31:e425-e427. [DOI: 10.1111/jdv.14241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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