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Augustin M, Berardesca E, Blume-Peytavi U, Elsner P, Scafa D, Schmeel LC, Proksch E. Managing dry skin in patients with comorbidities or with advanced age: unmet needs and roles for products containing potential emollient-plus ingredients. J DERMATOL TREAT 2024; 35:2326171. [PMID: 38565198 DOI: 10.1080/09546634.2024.2326171] [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: 12/12/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024]
Abstract
In dry skin (DS), skin-barrier function is easily disturbed and moisturizing factors in the stratum corneum are reduced. Despite being a common condition, DS is often overlooked in patients with advanced age or comorbid diseases. In September 2022, specialists in dermatology and skin care met to discuss unmet needs and management of patients with DS with existing medical conditions or DS induced by ongoing pharmacological treatments. There was consensus about the need to improve the current understanding and management of DS in patients with comorbidities, including type 2 diabetes, chronic kidney disease, radiodermatitis, and photodamaged skin. Clinical guidance related to optimal treatment of DS in patients with advanced age or comorbid diseases is needed. Dexpanthenol-containing emollients have been shown to provide rapid relief from the symptoms and clinical signs of skin inflammation and are well-tolerated and effective in terms of moisturizing and soothing DS and maintaining skin-barrier function. Thus, dexpanthenol-containing emollients may play an important role in future management of DS. Further research is needed to elucidate the efficacy of dexpanthenol across the spectrum of DS, irrespective of comorbidity status or age.
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Affiliation(s)
| | - Enzo Berardesca
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Davide Scafa
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany
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Chang CT, Ticknor IL, Spinelli JA, Bhatia BK, Marwaha S, Mirmirani P, Seidler AM, Man JR, McCleskey PE. Comparison of large language models in generating patient handouts for the dermatology clinic: A blinded study. JAAD Int 2024; 15:152-154. [PMID: 38571697 PMCID: PMC10988028 DOI: 10.1016/j.jdin.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Affiliation(s)
- Crystal T. Chang
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Iesha L. Ticknor
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | | | - Bhavnit K. Bhatia
- Department of Dermatology, The Permanente Medical Group, Richmond, California
| | - Sangeeta Marwaha
- Department of Dermatology, The Permanente Medical Group, Napa, California
| | - Paradi Mirmirani
- Department of Dermatology, The Permanente Medical Group, Vallejo, California
| | - Anne M. Seidler
- Department of Dermatology, The Permanente Medical Group, Oakland, California
| | - Jeremy R. Man
- Department of Dermatology, Southern California Permanente Medical Group, Los Angeles, California
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Khosravi M, Avizeh R, Zayerzadeh A, Gharibi D, Razijalali M. Effect of Bacillus subtilis and Bacillus coagulans spores on induced allergic contact dermatitis in dogs. Vet Med Sci 2024; 10:e1410. [PMID: 38501344 PMCID: PMC10949178 DOI: 10.1002/vms3.1410] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/04/2024] [Accepted: 02/19/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Probiotic strains have the potential to modulate immune responses, reduce intestinal inflammation, normalize intestinal mucosal function and decrease allergic reactions. OBJECTIVE This study aimed to investigate the effect of oral probiotic supplements containing Bacillus subtilis and Bacillus coagulans spores on clinical symptoms, haematological factors and immune responses to allergic contact dermatitis in dogs induced by dinitrochlorobenzene (DNCB). METHODS DNCB was injected subcutaneously into the scapular region of 20 healthy adult dogs of both sexes, divided into four groups, to induce experimental allergic contact dermatitis. Dogs in Group 1 received food without probiotics or medication. Oral prednisolone was administered to Group 2 for 30 days at a dosage of 0.25 mg/kg every other day. The dogs in Group 3 were treated with a combination of oral prednisolone and probiotics. The dogs in Group 4 were fed daily with a mixture of 109 B. subtilis and B. coagulans bacteria for 30 days. The immune system responses and related gene expression were analysed in the treated animals. RESULTS The administration of probiotics for 30 days resulted in a reduction in clinical symptoms and duration of wound repair. The probiotics treatment also significantly increased the serum bactericidal effects against Staphylococcus aureus and Escherichia coli. It enhanced both the classic and alternative activity of the complement, as well as lysozyme activity. Additionally, the probiotics led to higher total immunoglobulin levels and significant reductions in anti-trypsin and C-reactive protein levels. Furthermore, the expression of IgE, induction of interferon-gamma and IL-4 genes were also reduced. CONCLUSIONS According to the results, B. subtilis and B. coagulans can be further investigated as a viable alternative to corticosteroids in treating allergic contact dermatitis in dogs.
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Affiliation(s)
- Mohammad Khosravi
- Department of PathobiologyFaculty of Veterinary MedicineShahid Chamran University of AhvazAhvazKhuzestanIran
| | - Reza Avizeh
- Department of Clinical SciencesFaculty of Veterinary MedicineShahid Chamran University of AhvazAhvazKhuzestanIran
| | - Akram Zayerzadeh
- DVSc of Small Animal Internal MedicineFaculty of Veterinary MedicineShahid Chamran University of AhvazAhvazKhuzestanIran
| | - Darioush Gharibi
- Department of PathobiologyFaculty of Veterinary MedicineShahid Chamran University of AhvazAhvazKhuzestanIran
| | - Mohammad Razijalali
- Department of Clinical SciencesFaculty of Veterinary MedicineShahid Chamran University of AhvazAhvazKhuzestanIran
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Afvari S, Zippin JH. Photodermatoses in patients with atopic dermatitis: A 10-year retrospective cohort study. J Am Acad Dermatol 2024; 90:1071-1074. [PMID: 38372681 DOI: 10.1016/j.jaad.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/26/2023] [Accepted: 01/14/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Shawn Afvari
- Department of Dermatology, Weill Cornell Medical College, New York, New York; New York Medical College School of Medicine, Valhalla, New York
| | - Jonathan H Zippin
- Department of Dermatology, Weill Cornell Medical College, New York, New York.
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Toledo LM, Rodriguez R, Sivesind TE, Vakirlis E, Kojima R, Dellavalle RP. From the Cochrane Library: Leukotriene Receptor Antagonists for Eczema. JMIR Dermatol 2024; 7:e50434. [PMID: 38607671 DOI: 10.2196/50434] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
| | - Ramiro Rodriguez
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Torunn E Sivesind
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Efstratios Vakirlis
- Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Reiji Kojima
- Department of Health Sciences, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Robert P Dellavalle
- University of Colorado School of Medicine, Aurora, CO, United States
- Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
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Li W, Santana D, Phillips C. Comprehensive management of challenging recurrent aortoiliac and lower extremity occlusive disease with simultaneous modified-covered endovascular reconstruction of the aortic bifurcation, inferior mesenteric artery snorkel, and lower extremity bypass. Vascular 2024:17085381241245874. [PMID: 38596896 DOI: 10.1177/17085381241245874] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Despite recent advancements in endovascular technology and proven durability of open surgeries, managing extensive aortoiliac occlusive disease (AIOD) with concurrent severe lower extremity (LE) arterial occlusion remains a formidable challenge. This paper introduces a comprehensive approach to addressing recurrent AIOD and LE occlusive diseases by employing modified-CERAB, inferior mesenteric artery (IMA) snorkel, and LE bypass in a challenging case. METHODS A 56-year-old male patient presented with subacute bilateral lower extremity rest pain with dry gangrene in the left great toe and a complex medical history. His history included a hostile abdomen stemming from past ischemic bowel episodes and multiple bowel resections through laparotomies. Furthermore, the patient had a persistent left ventricular thrombus (LVT), stage-2 chronic kidney disease (CKD), diabetes, and was currently experiencing bilateral LE rest pain and dry gangrene in the left great toe, accompanied by severe dermatitis in both LEs. RESULTS He successfully underwent modified-CERAB with a concurrent snorkel technique for IMA preservation, along with an LE bypass to resolve bilateral LE critical ischemia. CONCLUSION This comprehensive management approach, combining simultaneous modified-CERAB, IMA snorkel, and LE bypass, provides an effective alternative for addressing complex AIOD and LE occlusive disease patients with hostile abdomen.
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Affiliation(s)
- Wei Li
- Division of Vascular and Endovascular Surgery, Department of Surgery, SUNY Upstate University and Syracuse VA Hospital, Syracuse, NY, USA
- J.T. & Margaret Talkington Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Dixon Santana
- Department of Surgery, School of Medicine, Texas Tech Health Sciences Center, Lubbock, TX, USA
| | - Cooper Phillips
- Department of Anesthesiology, School of Medicine, Texas Tech Health Sciences Center, Lubbock, TX, USA
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7
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Richard E, Buzney E, Lebwohl M, Grimes PE, Desai SR. Narrowband UVB phototherapy: a consensus on standards of care. J Am Acad Dermatol 2024:S0190-9622(24)00626-1. [PMID: 38608866 DOI: 10.1016/j.jaad.2024.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/06/2024] [Accepted: 02/27/2024] [Indexed: 04/14/2024]
Affiliation(s)
- Elisabeth Richard
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth Buzney
- Department of Dermatology, Brigham and Women's Hospital. Havard Medical School, Boston, Massachusetts
| | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai in New York, New York
| | - Pearl E Grimes
- Division of Dermatology, Vitiligo & Pigmentation Institute of Southern California, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Seemal R Desai
- The University of Texas Southwestern Medical Center, Dallas, Texas; Innovative Dermatology, Plano, Texas.
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Li Y, Guan X, Xing X, Hu C. Survival outcomes and toxicity profiles among patients with nonmetastatic nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT) versus IMRT + carbon-ion radiotherapy: A propensity score-matched analysis. Head Neck 2024. [PMID: 38591178 DOI: 10.1002/hed.27771] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVES To compare survival outcomes and toxic effects among patients with newly diagnosed nonmetastatic nasopharyngeal carcinoma (NPC) when treated with intensity-modulated radiotherapy (IMRT) versus IMRT + carbon-ion radiotherapy (CIRT). METHODS We performed a retrospective propensity score matching analysis (1:1) of patients treated with IMRT and IMRT + CIRT. Descriptive statistics were used to examine the baseline characteristics of the patients. Survival was estimated using the Kaplan-Meier method. Univariate and multivariable logistic regression analysis were used to identify the independent predictors of survival. We examined the association between risk factors and adverse events (AEs) using chi-square tests. Cox model and logistic regression were used to analyze AEs. RESULTS Hundred and nine patients who received IMRT + CIRT were included and the median follow-up time was 20.6 months (range: 4.6-82 months). There were no statistically significant differences in locoregional failure-free survival, distant metastasis-free survival, disease-free survival, or overall survival between the two groups, but potentially better in IMRT + CIRT group (p > 0.05, respectively). Nodal boost was the only significant factor associated with LRFS and DFS on multivariable analysis. Thirty-seven patients (34.0%) developed grade 3 acute OMs and no grade 4 acute OMs were observed in IMRT + CIRT group. All patients in IMRT + CIRT group developed grade 1 dermatitis; while in the match group, 76 patients developed grade 1 dermatitis, 27 patients developed grade 2 dermatitis, 5 patients developed grade 3 dermatitis, 1 patient developed grade 4 dermatitis. IMRT + CIRT treatment was associated with a significant trend of lower grades of OM and dermatitis (p < 0.05, respectively). Any severe (i.e., grade 3) chronic AEs, such as xerostomia, skin fibrosis, temporal lobe necrosis, osteoradionecrosis, or radiation-induced optic neuropathy, was not observed. CONCLUSIONS In this study, IMRT + CIRT was associated with significantly reduced acute toxicity burden compared with full course of IMRT, with excellent survival outcomes. Patients with persistent disease after treatment and treated with nodal boost had a worse outcome. More accurate assessments of IMRT + CIRT to primary nonmetastatic NPC patients will be imperative.
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Affiliation(s)
- Yujiao Li
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
| | - Xiyin Guan
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Xing Xing
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
| | - Chaosu Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
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Saliba E, Estephan M. A whiplash-shaped acute eruption. J Am Coll Emerg Physicians Open 2024; 5:e13159. [PMID: 38571487 PMCID: PMC10989580 DOI: 10.1002/emp2.13159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Elie Saliba
- Department of DermatologyLebanese American University, Gilbert and Rose‐Marie Chagoury School of MedicineBeirutLebanon
| | - Michel Estephan
- Department of Emergency MedicineLebanese American University, Gilbert and Rose‐Marie Chagoury School of MedicineBeirutLebanon
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10
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Ximenes RRC, Chaves EMC, Girão ALA, Gonçalves MHRB, Ferreira SL, de Carvalho REFL. Knowledge of nursing staff before and after training on incontinence-associated dermatitis. Rev Esc Enferm USP 2024; 58:e20230272. [PMID: 38558025 PMCID: PMC11021019 DOI: 10.1590/1980-220x-reeusp-2023-0272en] [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: 09/15/2023] [Accepted: 01/31/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE To verify the knowledge of nursing staff before and after training on incontinence-associated dermatitis. METHOD A study before and after an educational intervention carried out with nursing staff from the medical and surgical clinics and intensive care unit of the university hospital in June 2023. The training took place over three meetings. Data was collected using a questionnaire administered immediately before and after the training. McNemar's test for dependent samples was used to compare before and after training. RESULTS 25 nurses and 14 nursing technicians took part. The items that showed statistical significance were related to the identification and correct differentiation of dermatitis associated with incontinence and pressure injury; and the correct way to sanitize the skin. CONCLUSION The training of the nursing team made it possible to assess their knowledge of how to identify, prevent and treat incontinence-associated dermatitis.
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Affiliation(s)
- Raelly Ramos Campos Ximenes
- Universidade Estadual do Ceará, Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde, Fortaleza, CE, Brazil
| | - Edna Maria Camelo Chaves
- Universidade Estadual do Ceará, Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde, Fortaleza, CE, Brazil
| | | | | | - Saionara Leal Ferreira
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Fortaleza, CE, Brazil
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Kasprzak-Drozd K, Niziński P, Hawrył A, Gancarz M, Hawrył D, Oliwa W, Pałka M, Markowska J, Oniszczuk A. Potential of Curcumin in the Management of Skin Diseases. Int J Mol Sci 2024; 25:3617. [PMID: 38612433 PMCID: PMC11012053 DOI: 10.3390/ijms25073617] [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: 02/27/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Curcumin is a polyphenolic molecule derived from the rhizoma of Curcuma longa L. This compound has been used for centuries due to its anti-inflammatory, antioxidant, and antimicrobial properties. These make it ideal for preventing and treating skin inflammation, premature skin ageing, psoriasis, and acne. Additionally, it exhibits antiviral, antimutagenic, and antifungal effects. Curcumin provides protection against skin damage caused by prolonged exposure to UVB radiation. It reduces wound healing times and improves collagen deposition. Moreover, it increases fibroblast and vascular density in wounds. This review summarizes the available information on the therapeutic effect of curcumin in treating skin diseases. The results suggest that curcumin may be an inexpensive, well-tolerated, and effective agent for treating skin diseases. However, larger clinical trials are needed to confirm these observations due to limitations in its in vivo use, such as low bioavailability after oral administration and metabolism.
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Affiliation(s)
- Kamila Kasprzak-Drozd
- Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (K.K.-D.); (A.H.)
| | - Przemysław Niziński
- Department of Pharmacology, Medical University of Lublin, Radziwiłłowska 11, 20-080 Lublin, Poland;
| | - Anna Hawrył
- Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (K.K.-D.); (A.H.)
| | - Marek Gancarz
- Institute of Agrophysics, Polish Academy of Sciences, Doświadczalna 4, 20-290 Lublin, Poland;
- Faculty of Production and Power Engineering, University of Agriculture in Krakow, Balicka 116B, 30-149 Krakow, Poland
| | | | - Weronika Oliwa
- Science Circle of the Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (W.O.); (M.P.); (J.M.)
| | - Magdalena Pałka
- Science Circle of the Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (W.O.); (M.P.); (J.M.)
| | - Julia Markowska
- Science Circle of the Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (W.O.); (M.P.); (J.M.)
| | - Anna Oniszczuk
- Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (K.K.-D.); (A.H.)
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Wilcox NC, Taheri G, Halievski K, Talbot S, Silva JR, Ghasemlou N. Interactions between skin-resident dendritic and Langerhans cells and pain-sensing neurons. J Allergy Clin Immunol 2024:S0091-6749(24)00270-7. [PMID: 38492673 DOI: 10.1016/j.jaci.2024.03.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/13/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
Various immune cells in the skin contribute to its function as a first line of defense against infection and disease, and the skin's dense innervation by pain-sensing sensory neurons protects the host against injury or damage signals. Dendritic cells (DCs) are a heterogeneous population of cells that link the innate immune response to the adaptive response by capturing, processing, and presenting antigens to promote T-cell differentiation and activation. DCs are abundant across peripheral tissues, including the skin, where they are found in the dermis and epidermis. Langerhans cells (LCs) are a DC subset located only in the epidermis; both populations of cells can migrate to lymph nodes to contribute to broad immune responses. Dermal DCs and LCs are found in close apposition with sensory nerve fibers in the skin and express neurotransmitter receptors, allowing them to communicate directly with the peripheral nervous system. Thus, neuroimmune signaling between DCs and/or LCs and sensory neurons can modulate physiologic and pathophysiologic pathways, including immune cell regulation, host defense, allergic response, homeostasis, and wound repair. Here, we summarize the latest discoveries on DC- and LC-neuron interaction with neurons while providing an overview of gaps and areas not previously explored. Understanding the interactions between these 2 defence systems may provide key insight into developing therapeutic targets for treating diseases such as psoriasis, neuropathic pain, and lupus.
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Affiliation(s)
- Natalie C Wilcox
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Golnar Taheri
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Katherine Halievski
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sebastien Talbot
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jaqueline R Silva
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Nader Ghasemlou
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.
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13
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Weber I, Zagona-Prizio C, Sivesind TE, Adelman M, Szeto MD, Liu Y, Sillau SH, Bainbridge J, Klawitter J, Sempio C, Dunnick CA, Leehey MA, Dellavalle RP. Oral Cannabidiol for Seborrheic Dermatitis in Patients With Parkinson Disease: Randomized Clinical Trial. JMIR Dermatol 2024; 7:e49965. [PMID: 38466972 DOI: 10.2196/49965] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Seborrheic dermatitis (SD) affects 18.6%-59% of persons with Parkinson disease (PD), and recent studies provide evidence that oral cannabidiol (CBD) therapy could reduce sebum production in addition to improving motor and psychiatric symptoms in PD. Therefore, oral CBD could be useful for improving symptoms of both commonly co-occurring conditions. OBJECTIVE This study investigates whether oral CBD therapy is associated with a decrease in SD severity in PD. METHODS Facial photographs were collected as a component of a randomized (1:1 CBD vs placebo), parallel, double-blind, placebo-controlled trial assessing the efficacy of a short-term 2.5 mg per kg per day oral sesame solution CBD-rich cannabis extract (formulated to 100 mg/mL CBD and 3.3 mg/mL THC) for reducing motor symptoms in PD. Participants took 1.25 mg per kg per day each morning for 4 ±1 days and then twice daily for 10 ±4 days. Reviewers analyzed the photographs independently and provided a severity ranking based on the Seborrheic Dermatitis Area and Severity Index (SEDASI) scale. Baseline demographic and disease characteristics, as well as posttreatment SEDASI averages and the presence of SD, were analyzed with 2-tailed t tests and Pearson χ2 tests. SEDASI was analyzed with longitudinal regression, and SD was analyzed with generalized estimating equations. RESULTS A total of 27 participants received a placebo and 26 received CBD for 16 days. SD severity was low in both groups at baseline, and there was no treatment effect. The risk ratio for patients receiving CBD, post versus pre, was 0.69 (95% CI 0.41-1.18; P=.15), compared to 1.20 (95% CI 0.88-1.65; P=.26) for the patients receiving the placebo. The within-group pre-post change was not statistically significant for either group, but they differed from each other (P=.07) because there was an estimated improvement for the CBD group and an estimated worsening for the placebo group. CONCLUSIONS This study does not provide solid evidence that oral CBD therapy reduces the presence of SD among patients with PD. While this study was sufficiently powered to detect the primary outcome (efficacy of CBD on PD motor symptoms), it was underpowered for the secondary outcomes of detecting changes in the presence and severity of SD. Multiple mechanisms exist through which CBD can exert beneficial effects on SD pathogenesis. Larger studies, including participants with increased disease severity and longer treatment periods, may better elucidate treatment effects and are needed to determine CBD's true efficacy for affecting SD severity. TRIAL REGISTRATION ClinicalTrials.gov NCT03582137; https://clinicaltrials.gov/ct2/show/NCT03582137.
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Affiliation(s)
- Isaac Weber
- Mercy Hopsital St. Louis, St. Louis, MO, United States
| | - Caterina Zagona-Prizio
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Torunn E Sivesind
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Madeline Adelman
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Mindy D Szeto
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Ying Liu
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Stefan H Sillau
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Jacquelyn Bainbridge
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Jost Klawitter
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Cristina Sempio
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Maureen A Leehey
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
- Dermatology Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
- Colorado School of Public Health, Aurora, CO, United States
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14
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Akiyama S, Hara S, Inokuma T. Varicella-Zoster Virus Esophagitis Prior to the Onset of Skin Lesions. Intern Med 2024:3235-23. [PMID: 38432988 DOI: 10.2169/internalmedicine.3235-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Affiliation(s)
- Shinsuke Akiyama
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Shigeo Hara
- Department of Diagnostic Pathology, Kobe City Medical Center General Hospital, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
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15
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Yi LG, Guerra R, Irwin L, Noland MM, Singh A, Gradecki S, Gru AA, Flowers RH. Myelodysplasia cutis masquerading as granulomatous dermatitis. J Cutan Pathol 2024; 51:221-225. [PMID: 38088468 DOI: 10.1111/cup.14571] [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: 05/15/2023] [Revised: 11/03/2023] [Accepted: 11/19/2023] [Indexed: 02/02/2024]
Abstract
Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic neoplasms resulting from mutations in stem cells. They carry a risk of transformation to acute myeloid leukemia. Cutaneous manifestations of MDS, including myelodysplasia cutis or infiltration by MDS tumor cells, are rare, but significantly associated with increased risk of progression to high-grade myeloid tumors. The clinical and histopathologic differential diagnosis for myelodysplasia cutis includes interstitial granulomatous dermatitis (IGD), a reactive granulomatous dermatitis (RGD) associated with systemic diseases including rheumatologic diseases, and hematologic malignancy like MDS. We report a patient with MDS who presented with myelodysplasia cutis masquerading as IGD both in a clinical and histopathological manner.
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Affiliation(s)
- Lauren G Yi
- Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Ricardo Guerra
- Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Lindsay Irwin
- Department of Dermatology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mary Margaret Noland
- Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Amrit Singh
- Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Sarah Gradecki
- Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Alejandro A Gru
- Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - R Hal Flowers
- Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
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16
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Gofman J, Shapiro L, Elias MD. Recognizing Flagellate Erythema in Skin of Color: A Case of Shiitake Dermatitis. Cureus 2024; 16:e55437. [PMID: 38567230 PMCID: PMC10985566 DOI: 10.7759/cureus.55437] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
Flagellate erythema, also known as flagellate dermatitis, flagellate hyperpigmentation, or shiitake dermatitis, is a rare multifocal cutaneous eruption characterized by linear erythematous lesions similar to flagellation wounds. This case report details the progressive onset of flagellate erythema in a 31-year-old African American male presenting with pruritic, erythematous, hyperpigmented, linear lesions of the face, trunk, and upper extremities following his consumption of shiitake mushrooms. Classically, this eruption arises subsequent to the ingestion of raw or undercooked shiitake mushrooms. This case underscores the importance of clinical diagnosis, as the role of biopsy as a diagnostic tool is limited due to the nonspecific nature of histological findings. Therefore, proper diagnosis is reliant upon careful history taking, including dietary changes, initiation of any new medications, and progression of symptoms. Most cases are self-limiting, with eruptions persisting for up to three weeks. Treatment aims to provide symptomatic relief through topical corticosteroids and oral antihistamines, reducing associated pruritus and skin changes.
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Affiliation(s)
- Joseph Gofman
- Dermatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Lucas Shapiro
- Dermatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Merrick D Elias
- Dermatology, Elias Dermatology, Pembroke Pines, USA
- Dermatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
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17
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Chow EY, Elliott JF. Presence/Absence of Propylene Glycol in Commonly Used Topical Products in the Dermatology Clinic. J Cutan Med Surg 2024; 28:192-193. [PMID: 38214444 PMCID: PMC11015700 DOI: 10.1177/12034754231223149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Affiliation(s)
- Eunice Y. Chow
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - John F. Elliott
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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18
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Rudsenske NE, Perkins JB. Assessing severity of COVID-19 and the development of multi system inflammatory syndrome in children (MIS-C) in pediatric patients with atopic disease. Allergy Asthma Proc 2024; 45:92-96. [PMID: 38449015 PMCID: PMC10926182 DOI: 10.2500/aap.2024.45.230087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Background: Research surrounding the coronavirus disease 2019 (COVID-19) pandemic and its impact on patients who are atopic has mainly focused on adults. After the delta variant showed increased rates of COVID-19 in children, the pediatric population needs to be assessed as well. Objective: The objective was to assess and report outcomes in patients with COVID-19 and with and without certain atopic diseases in our patient cohort at the University of Mississippi Medical Center. Methods: We conducted a retrospective review of patients by using a de-identified data base that allows querying via medical claims codes from the University of Mississippi Medical Center's Research Data Warehouse. We searched for patients who were COVID-19 positive and ages 0-21 years from January 1, 2020, to December 31, 2021. We then divided this population into two cohorts: an atopic population and a non-atopic population. The incidence of hospitalizations, intensive care unit (ICU) admissions, death, length of stay, inhaled corticosteroid prescription history, and the incidence of multi-system inflammatory syndrome in children (MIS-C) outcomes in the two populations were collected. Results: There were 5261 patients ages 0-21 years and with confirmed COVID-19. After exclusion criteria were applied, there were 1420 patients in the atopic cohort and 2525 patients in the non-atopic cohort. There were more hospitalizations and a longer length of stay in the atopic population. Mortality was equivalent in the atopic and non-atopic populations. There were more ICU admissions in the atopic population. There were 101 patients total with the diagnosis of MIS-C, and the incidence of MIS-C was similar in the atopic and non-atopic populations. There were more patients who were atopic on inhaled corticosteroid than were the patients who were non-atopic. Conclusion: This study sought to further elucidate whether asthma, atopic dermatitis, and allergic rhinitis in pediatric patients was associated with severe COVID-19. Our study showed increased hospitalizations, length of stay, and intensive care in the atopic population but similar outcomes in mortality and the development of MIS-C. Future longitudinal prospective studies are needed to assess the long-term effects on patient's atopic disease after COVID-19 infection.
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19
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Kondo A, Takenaka Y, Fujiwara A, Takahashi S, Kitade-Miyayama M, Morifuji M, Kawashima M, Ishiguro N. Changes in the composition of molecular species of covalently bound and free ceramides [EOS], and their correlation with disease severity in atopic dermatitis. Exp Dermatol 2024; 33:e15025. [PMID: 38450766 DOI: 10.1111/exd.15025] [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: 06/11/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 03/08/2024]
Abstract
Ceramides are major constituents of stratum corneum (SC) intercellular lipids involved in skin barrier function. The ratio of molecular species of ceramides and their correlation with disease severity was examined in patients with atopic dermatitis (AD). Thirty-eight patients with AD and 32 healthy controls (HCs) were assessed for transepidermal water loss, SC collection and clinical assessment. The ceramide content of different molecular species in the samples was quantified using high-performance liquid chromatography coupled with tandem mass spectrometry. Unsaturated acyl chains of both covalently bound and free ceramides [EOS] were higher in AD lesional skin than those in AD non-lesional or normal HC skin. The proportion of unsaturated acyl chains (C30:1, C32:1 and C34:1) was higher than other ceramide molecular species among covalently bound and free ceramides [EOS] in patients with AD. The proportion of unsaturated acyl chains in covalently bound ceramides was positively correlated with transepidermal water loss (r = 0.600) when considering the total number of non-lesional and lesional skin. Additionally, thymus and activation-regulated chemokine (TARC) showed a positive correlation with unsaturated acyl chains proportion in AD non-lesional (r = 0.676) and lesional (r = 0.503) skin. Our study is the first to show the increase in unsaturated acyl chains of both covalently bound and free ceramides [EOS] in lesional and non-lesional skin in AD for each molecular species. This increase is associated with dryness and impaired barrier function, which correlates with TARC levels, a marker for the degree of type 2 inflammation. We speculate that type 2 inflammation exacerbation leads to abnormal epidermal lipid metabolism in the skin of patients with AD.
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Affiliation(s)
- A Kondo
- Department of Dermatology, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - Y Takenaka
- Department of Dermatology, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - A Fujiwara
- Food Microbiology and Function Research Labs, Meiji Co., Ltd., Hachioji-city, Japan
| | - S Takahashi
- Food Microbiology and Function Research Labs, Meiji Co., Ltd., Hachioji-city, Japan
| | - M Kitade-Miyayama
- Food Microbiology and Function Research Labs, Meiji Co., Ltd., Hachioji-city, Japan
| | - M Morifuji
- Food Microbiology and Function Research Labs, Meiji Co., Ltd., Hachioji-city, Japan
| | - M Kawashima
- Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - N Ishiguro
- Department of Dermatology, Tokyo Women's Medical University, Shinjuku-ku, Japan
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20
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King A, Pope E. Dermatitis versus nonaccidental trauma: A systematic review of initial pediatric misdiagnoses. Pediatr Dermatol 2024; 41:215-220. [PMID: 38400817 DOI: 10.1111/pde.15556] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/27/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND/OBJECTIVES Pediatric dermatitis and nonaccidental trauma (NAT) may have overlapping cutaneous presentations, posing a risk of misdiagnosis and subsequent emotional distress and further harm. Through a systematic literature review, we reviewed pediatric (<18 years old) patients investigated for both dermatitis and NAT. METHODS EMBASE and MEDLINE databases were searched. English publications with original data involving pediatric patients investigated for both dermatitis and NAT were included. Nonhuman studies and incomplete articles/conference abstracts were excluded. Data extracted included the first author, year of publication, study design, participant count, sex of the population, age of the population, cutaneous presentation, timing of presentation, Child Protective Services involvement, and case relation to dermatitis and NAT. RESULTS This review included 21 case reports or series encompassing 29 patients. Among 26 patients initially investigated as NAT (26.9% involving Child Protective Services), final diagnoses included irritant contact dermatitis (53.8%), phytophotodermatitis (30.8%), allergic contact dermatitis (7.7%), perianal infectious dermatitis (3.8%), and atopic dermatitis (3.8%). Three patients initially diagnosed with nontraumatic dermatitis were later found to be victims of physical (2/3; 66.7%) or sexual abuse (1/3; 33.3%). CONCLUSIONS Effective history-taking and physical examinations should encompass a history of laxative use, contact with furocoumarin-containing plants/fruit, parallel family/peer cutaneous presentations, caregiver involvement, financial burden, patient discomfort, birthmark assessment, and lesions aligning with diaper borders or toilet seats. Limitations of this review include potential underreporting and the inclusion of low-quality study designs and evidence.
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Affiliation(s)
- Aliyah King
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Elena Pope
- Section of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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21
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Beehler MK, Painter MR, Peck CM. Recurrent episodes of oral mite anaphylaxis in a dog. J Vet Emerg Crit Care (San Antonio) 2024; 34:199-202. [PMID: 38412013 DOI: 10.1111/vec.13371] [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: 07/12/2022] [Revised: 11/11/2022] [Accepted: 12/18/2022] [Indexed: 02/28/2024]
Abstract
OBJECTIVE To describe the clinical presentation and response to management of a dog with presumed oral mite anaphylaxis. CASE SUMMARY A 2-year-old male intact Golden Retriever was evaluated for a history of recurrent anaphylactic episodes. Over a period of 19 months, the dog had a total of 8 anaphylactic episodes that occurred in 2 different residences within the same state. The episodes most commonly resulted in vomiting and labored breathing, but the dog developed ascites, hypotension, and gall bladder wall edema during the most severe episodes. Serological testing demonstrated high immunoglobulin E levels to storage mites (SMs), specifically Tyrophagus SM. The dog's kibble was transitioned to being stored in small quantities in airtight containers in the freezer. At the time of publication, the dog has not had an anaphylactic reaction since making this change 1 year ago. NEW OR UNIQUE INFORMATION PROVIDED Based on a literature search and to the best of the authors' knowledge, this is the first time that SMs have been associated with severe recurrent anaphylaxis in a dog.
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Affiliation(s)
- Michelle K Beehler
- Department of Internal Medicine, Angell Animal Medical Center, Boston, Massachusetts, USA
| | - Meagan R Painter
- Department of Dermatology, MSPCA-Angell West, Waltham, Massachusetts, USA
| | - Courtney M Peck
- Department of Emergency and Critical Care, MSPCA-Angell West, Waltham, Massachusetts, USA
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22
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Verma L, Turk T, Dennett L, Dytoc M. Teledermatology in Atopic Dermatitis: A Systematic Review. J Cutan Med Surg 2024; 28:153-157. [PMID: 38205736 PMCID: PMC11015705 DOI: 10.1177/12034754231223694] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Telemedicine use has been increasing especially during the COVID-19 pandemic. Various studies have outlined benefits of telemedicine including improving health equity, reducing wait times, and cost-effectiveness. Skin diseases such as atopic dermatitis (AD) may potentially be managed via telemedicine. However, there are no evidence-based recommendations for best practices in telemedicine for assessing AD patients. The objective of this review is to assess and summarize current evidence on telemedicine modalities for AD. This review will assess patient outcomes from various telemedicine models for AD. A review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Two reviewers independently screened potential studies and extracted data. Studies were included if they evaluated any telemedicine assessment for AD. Of 2719 identified records, 5 reports were included. Two reports used the direct-access online model, 1 used web-based consultation, 1 used e-health through a personal eczema portal, and 1 used an online platform and mobile application. All models were variations of the asynchronous, store and forward model. In all the included reports, teledermatology for the follow-up of patients with AD was effective and equivalent when compared to in-person appointments or standard treatment for their respective key outcome measures. However, it is unclear what the most effective teledermatology model is due to significant heterogeneity between studies. Teledermatology may serve as an important tool for triaging and follow-up of patients with AD. More studies are needed to determine which teledermatology models are most effective for virtual assessment of AD.
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Affiliation(s)
- Luvneet Verma
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tarek Turk
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Dermatology and Venereology, Syrian Arab Red Crescent Hospital, Ministry of Health, Damascus, Syria
| | - Liz Dennett
- Sperber Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Marlene Dytoc
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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23
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Bhushan G, Simmers J, Flamm A. Presence of bacteria in psoriatic lesions: A retrospective cohort study. JAAD Int 2024; 14:24-25. [PMID: 38054198 PMCID: PMC10694571 DOI: 10.1016/j.jdin.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Affiliation(s)
| | | | - Alexandra Flamm
- Department of Dermatology, Milton S. Hershey Medical Center, Hershey, Pennsylvania
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24
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Waitt Wolker LH, Black A, Lee JK. Dermatitis, cellulitis, and osteomyelitis caused by Aspergillus nidulans in a horse with pituitary pars intermedia dysfunction. J Vet Diagn Invest 2024; 36:248-253. [PMID: 38462742 DOI: 10.1177/10406387241226942] [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] [Indexed: 03/12/2024] Open
Abstract
Clinical and histologic examination of a 12-y-old client-owned Quarter Horse gelding with pituitary pars intermedia dysfunction revealed dermatitis, cellulitis, and osteomyelitis caused by Aspergillus nidulans, confirmed by a PCR assay. This novel presentation of a fungal disease in a horse was characterized by aggressive local invasion and failure to respond to all medical therapy attempted over a 1-y period. Treatments included systemic and topical antifungals, anti-inflammatories, and use of cellular matrices. Surgical excision was not attempted but should be strongly considered early in the disease process in similar cases if clean margins can be achieved. Postmortem findings were of locally aggressive disease with no dissemination.
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Affiliation(s)
- Laura H Waitt Wolker
- Departments of Equine Medicine and Surgery, College of Veterinary Medicine Animal Health Institute, Midwestern University, Glendale, AZ, USA
| | - Annalise Black
- Pathology, College of Veterinary Medicine Animal Health Institute, Midwestern University, Glendale, AZ, USA
| | - Jung Keun Lee
- Pathology, College of Veterinary Medicine Animal Health Institute, Midwestern University, Glendale, AZ, USA
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25
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Sánchez J, Álvarez L, Die S, Miquel-Miquel J, Velásquez M. Diagnostic accuracy of patch testing based in clinical response to contact allergen restrictions in allergic contact dermatitis. Eur Ann Allergy Clin Immunol 2024. [PMID: 38376473 DOI: 10.23822/eurannaci.1764-1489.331] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Summary Background. Patch testing (PT) is used to identify substances that cause allergic contact dermatitis (ACD). However, the clinical effects of allergen restrictions following PT have not been thoroughly investigated. This study aims to assess the diagnostic accuracy of PT in patients suspected of having ACD. Methods. Prospective study. PT were performed in patients with clinical diagnosis of ACD. Patients with a positive PT (case group) had a strict restriction of the suspected substance for one month. In patients with negative patch testing (control group), allergen restriction was based in clinical history. Clinical reduction (CR) of at least 50% in disease activity (CR50%) after one month of allergen restriction was considered clinically relevant. Total control was defined as clinical reduction of at least 90% (CR90%). Results. From 400 patients, 66.2% had a positive PT. The sensitivity of PT to identify CR50% was 84%, specificity 47%, PPV 53%, and NPV 81%. Only 10.5% of patients achieved CR90%. Conclusions. The PT had moderate diagnostic accuracy. It could be useful as a screening, but a positive result should be confirmed with controlled allergen restriction. The low number of patients who achieved a 90% CR invites to reconsider the allergens included in PT and the mechanistic processes of the disease.
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Affiliation(s)
- J Sánchez
- Group of Clinical and Experimental Allergy (GACE), Hospital "Alma Mater de Antioquia", University of Antioquia, Medellín, Colombia
| | - L Álvarez
- Group of Clinical and Experimental Allergy (GACE), Hospital "Alma Mater de Antioquia", University of Antioquia, Medellín, Colombia
- Academic Group of Clinical Epidemiology (GRAEPIC), University of Antioquia, Medellín, Colombia
- Technological Economics Evaluations Group, SURA Company, Medellín, Colombia
| | - S Die
- Group of Clinical and Experimental Allergy (GACE), Hospital "Alma Mater de Antioquia", University of Antioquia, Medellín, Colombia
| | - J Miquel-Miquel
- Department of Dermatology, Hospital Arnau de Vilanova, Valencia, Spain
| | - M Velásquez
- Dermatological Research Center, University of Antioquia, Medellín, Colombia
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26
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Pei X, Li B, Xu X, Zhang H. Spinal Caspase-6 Contributes to Intrathecal Morphine-induced Acute Itch and Contact Dermatitis-induced Chronic Itch Through Regulating the Phosphorylation of Protein Kinase Mζ in Mice. Neuroscience 2024; 539:21-34. [PMID: 38176610 DOI: 10.1016/j.neuroscience.2023.12.015] [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: 06/30/2023] [Revised: 12/08/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024]
Abstract
Patients receiving neuraxial treatment with morphine for pain relief often experience a distressing pruritus. Neuroinflammation-mediated plasticity of sensory synapses in the spinal cord is critical for the development of pain and itch. Caspase-6, as an intracellular cysteine protease, is capable of inducing central nociceptive sensitization through regulating synaptic transmission and plasticity. Given the tight interaction between protein kinase Mζ (PKMζ) and excitatory synaptic plasticity, this pre-clinical study investigates whether caspase-6 contributes to morphine-induced itch and chronic itch via PKMζ. Intrathecal morphine and contact dermatitis were used to cause pruritus in mice. Morphine antinociception, itch-induced scratching behaviors, spinal activity of caspase-6, and phosphorylation of PKMζ and ERK were examined. Caspase-6 inhibitor Z-VEID-FMK, exogenous caspase-6 and PKMζ inhibitor ZIP were utilized to reveal the mechanisms and prevention of itch. Herein, we report that morphine induces significant scratching behaviors, which is accompanied by an increase in spinal caspase-6 cleavage and PKMζ phosphorylation (but not expression). Intrathecal injection of Z-VEID-FMK drastically reduces morphine-induced scratch bouts and spinal phosphorylation of PKMζ, without abolishing morphine analgesia. Moreover, intrathecal strategies of ZIP dose-dependently reduce morphine-induced itch-like behaviors. Spinal phosphorylation of ERK following neuraxial morphine is down-regulated by ZIP therapy. Recombinant caspase-6 directly exhibits scratching behaviors and spinal phosphorylation of ERK, which is compensated by PKMζ inhibition. Also, spinal inhibition of caspase-6 and PKMζ reduces the generation and maintenance of dermatitis-induced chronic itch. Together, these findings demonstrate that spinal caspase-6 modulation of PKMζ phosphorylation is important in the development of morphine-induced itch and dermatitis-induced itch in mice.
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Affiliation(s)
- Xuxing Pei
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Bing Li
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Xiaodong Xu
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Hui Zhang
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
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Lee H, Choi EH, Shin JU, Kim TG, Oh J, Shin B, Sim JY, Shin J, Kim M. The Impact of Intervention Design on User Engagement in Digital Therapeutics Research: Factorial Experiment With a Mixed Methods Study. JMIR Form Res 2024; 8:e51225. [PMID: 38335015 PMCID: PMC10891489 DOI: 10.2196/51225] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/08/2023] [Accepted: 12/22/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND User engagement is crucial for digital therapeutics (DTx) effectiveness; due to variations in the conceptualization of engagement and intervention design, assessment and retention of engagement remain challenging. OBJECTIVE We investigated the influence of the perceived acceptability of experimental intervention components and satisfaction with core intervention components in DTx on user engagement, while also identifying potential barriers and facilitators to user engagement. METHODS We conducted a mixed methods study with a 2 × 2 factorial design, involving 12 outpatients with atopic dermatitis. Participants were randomized into 4 experimental groups based on push notification ("basic" or "advanced") and human coach ("on" or "off") experimental intervention components. All participants engaged in self-monitoring and learning courses as core intervention components within an app-based intervention over 8 weeks. Data were collected through in-app behavioral data, physician- and self-reported questionnaires, and semistructured interviews assessed at baseline, 4 weeks, and 8 weeks. Descriptive statistics and thematic analysis were used to evaluate user engagement, perceived acceptability of experimental intervention components (ie, push notification and human coach), satisfaction with core intervention components (ie, self-monitoring and learning courses), and intervention effectiveness through clinical outcomes. RESULTS The primary outcome indicated that group 4, provided with "advanced-level push notifications" and a "human coach," showed higher completion rates for self-monitoring forms and learning courses compared to the predetermined threshold of clinical significance. Qualitative data analysis revealed three key themes: (1) perceived acceptability of the experimental intervention components, (2) satisfaction with the core intervention components, and (3) suggestions for improvement in the overall intervention program. Regarding clinical outcomes, the Perceived Stress Scale and Dermatology Life Quality Index scores presented the highest improvement in group 4. CONCLUSIONS These findings will help refine the intervention and inform the design of a subsequent randomized trial to test its effectiveness. Furthermore, this design may serve as a model for broadly examining and optimizing overall engagement in DTx and for future investigation into the complex relationship between engagement and clinical outcomes. TRIAL REGISTRATION Clinical Research Information Service KCT0007675; http://tinyurl.com/2m8rjrmv.
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Affiliation(s)
- Hyerim Lee
- Department of Psychology, College of Liberal Arts, Yonsei University, Seoul, Republic of Korea
| | - Eung Ho Choi
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Tae-Gyun Kim
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jooyoung Oh
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bokyoung Shin
- Department of Integrative Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Yeon Sim
- Department of Medical Device Engineering and Management, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Jaeyong Shin
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Meelim Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, United States
- The Design Lab, University of California San Diego, San Diego, CA, United States
- Center for Wireless & Population Health Systems, Calit2's Qualcomm Institute, University of California San Diego, San Diego, CA, United States
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Aubry RL, Innes AM, Haber RM. Syndromic or non-syndromic congenital ichthyosis? A case report of two brothers with ichthyosis but microphthalmia and blindness in only one brother. SAGE Open Med Case Rep 2024; 12:2050313X241231386. [PMID: 38333515 PMCID: PMC10851717 DOI: 10.1177/2050313x241231386] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
We present the cases of two brothers with ichthyosis, born to consanguineous parents, with the eldest having extracutaneous manifestations in the form of microphthalmia and corneal opacities causing complete blindness. Initially, we were faced with the question of whether the phenotype in this family was due to the effects of a single pleiotropic, presumably autosomal recessive gene manifesting as a syndromic form of ichthyosis, or whether there were multiple causal genes, and the ichthyosis was non-syndromic. Ultimately, clinical follow-up of the family, combined with research-based exome sequencing established a diagnosis of NIPAL4 autosomal recessive congenital ichthyosis in both brothers, but the ocular abnormalities causing blindness in the older brother were due to coexisting autosomal recessively inherited loss of function mutations in peroxidasin, the latter finding also seen in a sister unaffected by ichthyosis.
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Affiliation(s)
- Rachel L Aubry
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - A. Micheil Innes
- Department of Medical Genetics, Alberta Children’s Hospital, Calgary, AB, Canada
| | - Richard M Haber
- Richmond Road Diagnostic and Treatment Centre (RRDTC), Calgary, AB, Canada
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Wu WT, Chen JM, Chang YY, Lin SD, Chen ST, Hung YT. Assessing the effectiveness of mitigating pesticide-related disease risk among pesticide-spraying drone operators in Taiwan. Am J Ind Med 2024; 67:110-118. [PMID: 37982326 DOI: 10.1002/ajim.23551] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the risk of pesticide poisoning, liver and renal failure, dermatitis, respiratory problems, hypersensitivity pneumonitis, keratitis, and epilepsy among pesticide-spraying personnel and to assess the effectiveness of a new method of aerial pesticide application in reducing this risk. METHODS A total of 2268 pesticide spraying operators (1651 ground-based field crop operators and 617 aerial pesticide spraying drone operators) who passed the national certification examination between 2010 and 2020 in Taiwan were included. Ground-based operators served as the positive control group, while 2463 farmer controls were matched from the Farmers' Health Insurance database as the negative control group. Data from the National Health Insurance Research Database were used to track possible pesticide-related disease cases. Logistic regression was employed to calculate odds ratios and 95% confidence intervals (95% CI). RESULTS Drone operators had significantly reduced risks of dermatitis, asthma and chronic bronchitis compared to ground-based operators. This was observed in allergic contact dermatitis (OR = 0.40, 95% CI: 0.24-0.68), unspecified contact dermatitis (OR = 0.58, 95% CI: 0.35-0.97), asthma (OR = 0.27, 95% CI: 0.12-0.60), and chronic bronchitis (OR = 0.24, 95% CI: 0.06-0.93), after adjusting for age, sex, working areas, and licensing years. However, no significant differences were found when comparing drone operators to matching farmers. CONCLUSIONS Aerial pesticide spraying using drones may contribute to a decreased risk of dermatitis, asthma and chronic bronchitis, suggesting potential health benefits for operators. Further field pesticide exposure surveys are recommended to validate these findings and assess health risk indicators.
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Affiliation(s)
- Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Institute of Environmental and Occupational Health Sciences, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Jyun-Ming Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Yu-Yin Chang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shian-Da Lin
- Animal and Plant Health Inspection Agency, Ministry of Agriculture, Executive Yuan, Taipei, Taiwan
| | - Shih-Tzong Chen
- Animal and Plant Health Inspection Agency, Ministry of Agriculture, Executive Yuan, Taipei, Taiwan
| | - Yu-Tang Hung
- Animal and Plant Health Inspection Agency, Ministry of Agriculture, Executive Yuan, Taipei, Taiwan
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Hall S, Chew CY, Kovitwanichkanont T, Ip KHK, Cahill J, Gin A, McLean CA, Gin D. Subcorneal pustular dermatosis induced by dupilumab: A novel case. Australas J Dermatol 2024; 65:74-76. [PMID: 38009895 DOI: 10.1111/ajd.14190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Sasha Hall
- Department of Dermatology, Alfred Health, Melbourne, Victoria, Australia
| | - Christopher Y Chew
- Department of Dermatology, Alfred Health, Melbourne, Victoria, Australia
| | | | - Ken Hiu-Kan Ip
- Department of Dermatology, Alfred Health, Melbourne, Victoria, Australia
| | - Jennifer Cahill
- Department of Dermatology, Alfred Health, Melbourne, Victoria, Australia
| | - Alexander Gin
- Department of Dermatology, Alfred Health, Melbourne, Victoria, Australia
| | - Catriona A McLean
- Department of Anatomical Pathology, Alfred Health, Melbourne, Victoria, Australia
| | - Douglas Gin
- Department of Dermatology, Alfred Health, Melbourne, Victoria, Australia
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Afvari S, Zippin JH. Type I hypersensitivity in photoallergic contact dermatitis. JAAD Case Rep 2024; 44:47-49. [PMID: 38292568 PMCID: PMC10825262 DOI: 10.1016/j.jdcr.2023.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Shawn Afvari
- Department of Dermatology, Weill Cornell Medical College, New York, New York
- New York Medical College School of Medicine, Valhalla, New York
| | - Jonathan H. Zippin
- Department of Dermatology, Weill Cornell Medical College, New York, New York
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Grześk-Kaczyńska M, Petrus-Halicka J, Kaczyński S, Bartuzi Z, Ukleja-Sokołowska N. Should Emollients Be Recommended for the Prevention of Atopic Dermatitis?-New Evidence and Current State of Knowledge. J Clin Med 2024; 13:863. [PMID: 38337555 PMCID: PMC10856443 DOI: 10.3390/jcm13030863] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/17/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic, pruritic skin disease with complex pathogenesis, which affects about 43 million children aged 1-4 years. One of the most known methods of alleviating symptoms of AD is emollient treatment, which varies depending on formulation and additional active ingredients. There is some evidence that emollients could be used in AD prevention in high-risk children. MATERIALS AND METHODS A search of the literature from Cochrane Library, PubMed and Medline was conducted between August and September 2023 with the following keywords: "atopic dermatitis", "emollients", and "prevention". Only randomised clinical trials published in the last 5 years were included into the meta-analysis. RESULTS Considering the inclusion criteria only 11 randomized clinical trials were taken into account, and six of them proved lack of effect of emollients in the prevention of atopic dermatitis among neonates from AD risk groups. CONCLUSIONS Emollient treatment has a good safety profile and most of the ingredients used in formulations are nonirritant for sensitive newborn and infant skin. There is some evidence of the positive effects of emollient treatment in prevention of AD in predisposed populations. The relatively high cost of emollient treatment (vs regular infant skin-care routine) would support the necessity for further evaluation of their effectiveness in nonpredisposed populations.
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Affiliation(s)
- Magdalena Grześk-Kaczyńska
- Department and Clinic of Allergy, Clinical Immunology and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland; (J.P.-H.); (N.U.-S.)
| | - Justyna Petrus-Halicka
- Department and Clinic of Allergy, Clinical Immunology and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland; (J.P.-H.); (N.U.-S.)
| | - Szymon Kaczyński
- Department of Obstetrics, Gynecology and Gynecological Oncology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland;
| | - Zbigniew Bartuzi
- Department and Clinic of Allergy, Clinical Immunology and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland; (J.P.-H.); (N.U.-S.)
| | - Natalia Ukleja-Sokołowska
- Department and Clinic of Allergy, Clinical Immunology and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland; (J.P.-H.); (N.U.-S.)
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Ganea M, Vicaș LG, Gligor O, Sarac I, Onisan E, Nagy C, Moisa C, Ghitea TC. Exploring the Therapeutic Efficacy of Parsley ( Petroselinum crispum Mill.) as a Functional Food: Implications in Immunological Tolerability, Reduction of Muscle Cramps, and Treatment of Dermatitis. Molecules 2024; 29:608. [PMID: 38338356 PMCID: PMC10856782 DOI: 10.3390/molecules29030608] [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: 12/27/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
The status of parsley as a well-known folk medicine noted for its nutritional and medicinal properties prompted the exploration of its potential as a functional food and natural remedy. The paper aims to investigate the potential of parsley to enhance muscle function and alleviate psoriasiform dermatitis, eventually establishing it as a natural, well-tolerated alternative with specific benefits for both muscles and skin. This study examines the tolerability of parsley in a cohort of 937 participants by assessing immunoglobulin G (IgG) reactions. The findings reveal high tolerability, as 96.26% of participants experienced no adverse effects. Among the 902 individuals lacking hypersensitivity, 37.02% reported muscle cramps, with a notable 15.02% reduction observed in the subgroup consuming parsley juice. In the subset of 32 subjects with dermatitis, the application of parsley extract ointment led to a significant decrease in dermatological parameters (redness, thickness, scaling). While the control group exhibited improvements, statistical significance was not observed. Notably, four categories of affected area reduction were identified, with scaling demonstrating the most pronounced impact. The results propose that parsley holds promise for favorable tolerability, contributing to the alleviation of muscle cramps and presenting an effective alternative in dermatitis treatment. Nonetheless, sustained validation through long-term studies is imperative to substantiate these preliminary findings.
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Affiliation(s)
- Mariana Ganea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (M.G.); (C.M.); (T.C.G.)
| | - Laura Grațiela Vicaș
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (M.G.); (C.M.); (T.C.G.)
| | - Octavia Gligor
- Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
| | - Ioan Sarac
- Department of Genetic Engineering, University of Life Sciences “King Mihai I Timișoara”, 300645 Timișoara, Romania; (I.S.); (E.O.)
| | - Emilian Onisan
- Department of Genetic Engineering, University of Life Sciences “King Mihai I Timișoara”, 300645 Timișoara, Romania; (I.S.); (E.O.)
| | - Csaba Nagy
- Independent Researcher, 417595 Tinca, Romania;
| | - Corina Moisa
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (M.G.); (C.M.); (T.C.G.)
| | - Timea Claudia Ghitea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (M.G.); (C.M.); (T.C.G.)
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Wang A, Fulton R, Hwang S, Margolis DJ, Mowery D. Patient Phenotyping for Atopic Dermatitis With Transformers and Machine Learning: Algorithm Development and Validation Study. JMIR Form Res 2024; 8:e52200. [PMID: 38277207 PMCID: PMC10858428 DOI: 10.2196/52200] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic skin condition that millions of people around the world live with each day. Performing research into identifying the causes and treatment for this disease has great potential to provide benefits for these individuals. However, AD clinical trial recruitment is not a trivial task due to the variance in diagnostic precision and phenotypic definitions leveraged by different clinicians, as well as the time spent finding, recruiting, and enrolling patients by clinicians to become study participants. Thus, there is a need for automatic and effective patient phenotyping for cohort recruitment. OBJECTIVE This study aims to present an approach for identifying patients whose electronic health records suggest that they may have AD. METHODS We created a vectorized representation of each patient and trained various supervised machine learning methods to classify when a patient has AD. Each patient is represented by a vector of either probabilities or binary values, where each value indicates whether they meet a different criteria for AD diagnosis. RESULTS The most accurate AD classifier performed with a class-balanced accuracy of 0.8036, a precision of 0.8400, and a recall of 0.7500 when using XGBoost (Extreme Gradient Boosting). CONCLUSIONS Creating an automated approach for identifying patient cohorts has the potential to accelerate, standardize, and automate the process of patient recruitment for AD studies; therefore, reducing clinician burden and informing the discovery of better treatment options for AD.
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Affiliation(s)
- Andrew Wang
- University of Pennsylvania, Philadelphia, PA, United States
| | - Rachel Fulton
- Lankenau Medical Center, Wynnewood, PA, United States
| | - Sy Hwang
- University of Pennsylvania, Philadelphia, PA, United States
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Yaghi M, McMullan P, Truong TM, Rothe M, Murase J, Grant-Kels JM. Safety of dermatologic medications in pregnancy and lactation: An Update - Part II: Lactation. J Am Acad Dermatol 2024:S0190-9622(24)00110-5. [PMID: 38280680 DOI: 10.1016/j.jaad.2023.10.071] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 01/29/2024]
Abstract
Multiple recently approved medications have been added to our treatment armamentarium for various dermatologic conditions. Herein, we have reviewed the literature, consolidated available safety data, and offered recommendations based upon available evidence as a reference guide for clinicians treating patients for dermatologic conditions during lactation.
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Affiliation(s)
- Marita Yaghi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL
| | - Patrick McMullan
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Thu M Truong
- School of Medicine, Rutgers New Jersey Medical School, Newark, NJ; Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ
| | - Marti Rothe
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL
| | - Jenny Murase
- Department of Dermatology, University of California, San Francisco, CA; Palo Alto Foundation Medical Group, Mountain View, CA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT; Department of Dermatology, University of Florida, Gainesville, FL.
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Felgendreff P, Lawrence JM, Hosseiniasl SM, Jacobs JF, Amiot BP, Felgendreff L, Minshew A, Sultan A, Ahmadzada B, Rahe MC, Nyberg SL. Clinical characterization of a hypersensitivity mixed bacterial and fungal dermatitis in a translational model of porcine NASH. Front Cell Infect Microbiol 2024; 13:1277045. [PMID: 38327680 PMCID: PMC10847572 DOI: 10.3389/fcimb.2023.1277045] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/28/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction The development of animal models of chronic liver disease via diet modification is a promising avenue for translational research but can lead to unexpected side effects that impact model adoption. While these side effects are well characterized in rodent models of nonalcoholic steatohepatitis (NASH), limited knowledge of these effects exists for novel porcine models of NASH. To close this gap, the present study investigates the side effects of diet-based NASH induction in pigs, with a systematic analysis of the pathologic mechanisms underlying dermatitis development and evaluation of treatment approaches. Method Twelve pigs (10 large domestic pigs, 2 Goettingen minipigs) were fed a methionine- and choline-deficient, high-fat diet for 8 weeks to induce NASH. A retrospective review of each animal's clinical record was performed to identify the side effects of the diet. Following the identification of diet-associated dermatitis, severity was judged by using a novel gradation system that characterized the individual lesions and body regions resulting in a cumulative evaluation. In addition to this clinical assessment, the etiology of the dermatitis was investigated via histopathologic and microbiologic testing. Furthermore, the success of prophylactic and therapeutic treatment approaches was evaluated by considering dermatitis development and clinical course. Results All study animals demonstrated unexpected side effects of the methionine- and choline-deficient, high fat diet. In addition to marked dermatitis, study pigs showed impaired weight gain and developed steatorrhea and anemia. Based on the skin gradation system, five animals developed severe dermatitis, four animals moderate dermatitis, and three animals mild diet-associated dermatitis. Histological and microbiological evaluation of the affected skin showed signs of a hypersensitivity reaction with secondary infection by bacteria and fungi. The analysis showed that preemptive bathing extended the lesion-free duration by nearly 20 days. Furthermore, bathing in combination with a targeted antibiotic treatment represented a helpful treatment approach for diet-associated dermatitis. Conclusion The provision of a methionine- and choline-deficient, high fat diet represents an effective approach for inducing NASH liver disease in pigs but predisposes study animals to multiple side effects. These side effects are universal to animals on study but can be adequately managed and do not represent a significant limitation of this model.
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Affiliation(s)
- Philipp Felgendreff
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
- Department of General, Visceral, and Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | | | | | - Julie F. Jacobs
- Department of Comparative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Bruce P. Amiot
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
| | - Lisa Felgendreff
- Center for Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Anna Minshew
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
| | - Ahmer Sultan
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
| | | | - Michael C. Rahe
- Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, IA, United States
- Population Health and Pathobiology, North Carolina State University, Raleigh, NC, United States
| | - Scott L. Nyberg
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
- William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, United States
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Subramanyam C, Becker A, Rizzo J, Afzal N, Nong Y, Sivamani R. Visibility of Board-Certified Dermatologists on TikTok. JMIR Dermatol 2024; 7:e46085. [PMID: 38180786 PMCID: PMC10799275 DOI: 10.2196/46085] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 09/13/2023] [Accepted: 10/01/2023] [Indexed: 01/06/2024] Open
Abstract
Tik Tok is an emerging social media platform that provides a novel opportunity for health practitioners such as dermatologists to disseminate accurate health information.
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Affiliation(s)
- Chaitra Subramanyam
- College of Osteopathic Medicine of the Pacific Northwest, Western University of Health Sciences, Lebanon, OR, United States
| | - Alyssa Becker
- John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Julianne Rizzo
- College of Medicine, University of California Davis, Sacramento, CA, United States
| | - Najiba Afzal
- College of Medicine, University of California Davis, Sacramento, CA, United States
| | - Yvonne Nong
- College of Human Medicine, Michigan State University, Flint, MI, United States
| | - Raja Sivamani
- Pacific Skin Institute, Sacramento, CA, United States
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Simpson DS, Anderton H, Yousef J, Vaibhav V, Cobbold SA, Bandala-Sanchez E, Kueh AJ, Dagley LF, Herold MJ, Silke J, Vince JE, Feltham R. Mind bomb 2 limits inflammatory dermatitis in Sharpin mutant mice independently of cell death. PNAS Nexus 2024; 3:pgad438. [PMID: 38156288 PMCID: PMC10753164 DOI: 10.1093/pnasnexus/pgad438] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023]
Abstract
Skin inflammation is a complex process implicated in various dermatological disorders. The chronic proliferative dermatitis (cpd) phenotype driven by the cpd mutation (cpdm) in the Sharpin gene is characterized by dermal inflammation and epidermal abnormalities. Tumour necrosis factor (TNF) and caspase-8-driven cell death causes the pathogenesis of Sharpincpdm mice; however, the role of mind bomb 2 (MIB2), a pro-survival E3 ubiquitin ligase involved in TNF signaling, in skin inflammation remains unknown. Here, we demonstrate that MIB2 antagonizes inflammatory dermatitis in the context of the cpd mutation. Surprisingly, the role of MIB2 in limiting skin inflammation is independent of its known pro-survival function and E3 ligase activity. Instead, MIB2 enhances the production of wound-healing molecules, granulocyte colony-stimulating factor, and Eotaxin, within the skin. This discovery advances our comprehension of inflammatory cytokines and chemokines associated with cpdm pathogenesis and highlights the significance of MIB2 in inflammatory skin disease that is independent of its ability to regulate TNF-induced cell death.
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Affiliation(s)
- Daniel S Simpson
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Holly Anderton
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Jumana Yousef
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Vineet Vaibhav
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Simon A Cobbold
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Esther Bandala-Sanchez
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Andrew J Kueh
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
- Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, VIC 3084, Australia
- School of Cancer Medicine, La Trobe University, Heidelberg, VIC 3084, Australia
| | - Laura F Dagley
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Marco J Herold
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
- Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, VIC 3084, Australia
- School of Cancer Medicine, La Trobe University, Heidelberg, VIC 3084, Australia
| | - John Silke
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - James E Vince
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
| | - Rebecca Feltham
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Melbourne, VIC 3050, Australia
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Hetzel JD, Diamond DC, Ramsey ZC, Henson JW, Powell MR. Postherpetic granulomatous dermatitis occurring in the setting of immune checkpoint inhibitor therapy: A case report. J Cutan Pathol 2024; 51:30-33. [PMID: 37589212 DOI: 10.1111/cup.14511] [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: 12/06/2022] [Revised: 04/21/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023]
Abstract
We report a case of a 72-year-old man presenting with a 2-month history of a persistent, painful rash of the chest, axilla, and back. He had a history of recently resolved varicella zoster virus reactivation in the same distribution of the current rash and metastatic malignant melanoma treated with nivolumab and ipilimumab. The histopathology was consistent with granulomatous dermatitis (GD), and a diagnosis of postherpetic isotopic response manifesting as GD was made. Given the paucity of reported cases of postherpetic GD in the setting of treatment with immune checkpoint inhibitors (ICIs), we discuss the clinicopathologic features of this case and potential mechanisms by which ICIs may contribute to the development of granulomatous disease.
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Affiliation(s)
- John D Hetzel
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Davis C Diamond
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Zachary C Ramsey
- Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - John W Henson
- Department of Neurology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
- Heme/Onc Division, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Matthew R Powell
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
- Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
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Gupta RK, Miller J, Croft M. TNF-like weak inducer of apoptosis inhibition is comparable to IL-13 blockade in ameliorating atopic dermatitis inflammation. Allergy 2024; 79:116-127. [PMID: 37650473 PMCID: PMC10840791 DOI: 10.1111/all.15879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/29/2023] [Accepted: 08/03/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Targeting IL-13 is highly efficacious in patients with Th2-biased atopic dermatitis (AD), but inhibition of other inflammatory molecules might also limit disease. We investigated the importance of the TNF family cytokine TNF-like weak inducer of apoptosis (TWEAK; TNFSF12) to keratinocyte dysregulation and the pathogenesis of AD in mice and also tested if blocking TWEAK has a similar therapeutic effect as targeting IL-13. METHODS Conditional knockout mice lacking Fn14 (TNFRSF12A), the receptor for TWEAK, only in keratinocytes, were repetitively sensitized with house dust mite allergen and analyzed for AD-like skin inflammation. To determine the translational potential, wild-type mice with AD were therapeutically treated with anti-TWEAK and/or anti-IL-13 antibodies, and skin inflammation was assessed. RESULTS Mice deficient in Fn14 in keratinocytes were resistant to developing maximal clinical features of AD, exhibiting reduced epidermal hyperplasia and dermal thickening, less skin infiltration of immune cells, and downregulated inflammatory gene expression. Moreover, therapeutic neutralization of TWEAK in wild-type mice with AD reduced all of the pathological features to a comparable extent as blocking IL-13. CONCLUSIONS The activity of TWEAK in keratinocytes contributes to AD development, and neutralizing TWEAK represents a future potential therapeutic option in human AD similar to targeting IL-13.
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Affiliation(s)
- Rinkesh K Gupta
- Center for Autoimmunity and Inflammation, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Jacqueline Miller
- Center for Autoimmunity and Inflammation, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Michael Croft
- Center for Autoimmunity and Inflammation, La Jolla Institute for Immunology, La Jolla, California, USA
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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Martinez-Cabriales S, Marcoux D, Liy-Wong C, Prajapati VH, Sibbald C, Cunningham N, Lansang P, Tonkin R, Joseph M, Wong L, Spring S, Gavigan G, Ramien M. Multicenter Canadian case series of pediatric patients less than 12 years of age with moderate-to-severe atopic dermatitis treated with dupilumab. Pediatr Dermatol 2024; 41:5-11. [PMID: 37906120 DOI: 10.1111/pde.15418] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/05/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Dupilumab is approved for moderate-severe atopic dermatitis (AD) in patients aged ≥6 months by the US Food and Drug Administration and Health Canada; however, there are little real-world data because providers have limited practical experience with this recently approved therapy. OBJECTIVES To describe the real-world effectiveness and safety in patients aged <12 years with moderate-severe AD currently receiving or previously having received dupilumab. METHODS A multicenter retrospective study was conducted at six Canadian sites. Cases were divided into Group 1 ≤2 years old, Group 2 >2 to <6 years old, and Group 3 ≥6 to <12 years old. Medical history and details of dupilumab treatment were collected. The primary outcome was to measure the improvement in eczema area and severity index. Secondary outcomes examined included the children's dermatology life quality index/infant's dermatitis quality of life, peak pruritus numerical rating scale, and delay to dupilumab access for patients who were considered off-label for dupilumab due to their age. RESULTS Sixty three pediatric patients (37 males) with moderate-to-severe AD were included; the mean age was 6.4 years old (range: 2-11) when dupilumab treatment was started. Overall, 75% (36/48) achieved EASI-75% and 71% (34/48) achieved EASI-90. EASI-75 and EASI-90 were achieved in 90% (17/19) and 73% (12/19) in patients <6 years old, and 76% (22/29) and 59% (17/29) in patients >6 years old, respectively. No serious adverse events were reported. CONCLUSIONS Dupilumab is safe and effective for patients under the age of 12. However, even for experienced providers, access to the medication was challenging.
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Affiliation(s)
- Sylvia Martinez-Cabriales
- Alberta Children's Hospital, Department of Pediatrics, University of Calgary, Calgary, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Danielle Marcoux
- Division of Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Canada
| | - Carmen Liy-Wong
- Department of Pediatrics, Division of Dermatology and Rheumatology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Vimal H Prajapati
- Dermatology Research Institute, Calgary, Canada
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Canada
- Section of Community Pediatrics, Department of Pediatrics, University of Calgary, Calgary, Canada
- Section of Pediatric Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Canada
- Skin Health & Wellness Centre, Calgary, Canada
- Probity Medical Research, Calgary, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
- The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Natalie Cunningham
- Division of Dermatology, Department of Medicine, IWK Health Centre, Dalhousie University, Halifax, Canada
| | - Perla Lansang
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
- The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Rochelle Tonkin
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Canada
| | - Marissa Joseph
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
- The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Lauren Wong
- Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - Shanna Spring
- Department of Pediatrics, Division of Dermatology and Rheumatology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Genevieve Gavigan
- Department of Pediatrics, Division of Dermatology and Rheumatology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Michele Ramien
- Alberta Children's Hospital, Department of Pediatrics, University of Calgary, Calgary, Canada
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Canada
- Section of Community Pediatrics, Department of Pediatrics, University of Calgary, Calgary, Canada
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Shah VK, Jaklitsch E, Agarwal A, Chen J, James AJ, Ferris LK, English JC, Nekooie B, Choudhary S. Descriptive and Concordance Data for Asynchronous Teledermatology Consultations for Dermatitis: A Retrospective Study. Telemed J E Health 2024; 30:204-213. [PMID: 37358607 DOI: 10.1089/tmj.2023.0079] [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] [Indexed: 06/27/2023] Open
Abstract
Background: Implementation of teledermatology for assessing dermatitis patients provides comparable diagnostic and management outcomes to in-person visits, but studies on consumer to physician asynchronous teledermatology (eDerm) consults submitted by patients in large dermatitis cohorts are limited. The objective of this study was to retrospectively assess associations of eDerm consults with diagnostic accuracy, management, and follow-up in a large cohort of dermatitis patients. Methods: One thousand forty-five eDerm encounters between April 1, 2020, and October 29, 2021, recorded in the University of Pittsburgh Medical Center Health System Epic electronic medical record were reviewed. Descriptive statistics and concordance were analyzed using chi-square. Results: Asynchronous teledermatology modified/changed treatment in 97.6% of cases and had the same diagnosis between teledermatology and in-person follow-up in 78.3% of cases. Patients following up in the time line requested were more likely to follow-up in person (61.2% vs. 43.8%) than those who did not. Patients with intertriginous dermatitis (p = 0.003), preexisting conditions (p = 0.002), who required follow-ups (<0.0001), and moderate-high severity scores of 4-7 (p = 0.019) were more likely to follow up in the time line requested. Limitations: Lack of similar in-person visit data did not allow us to compare descriptive and concordance data between eDerm and clinic visits. Conclusions: eDerm offers a quick accessible solution to provide comparable dermatologic care for patients with dermatitis.
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Affiliation(s)
- Vrusha K Shah
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Erik Jaklitsch
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Ashima Agarwal
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jeffrey Chen
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Alaina J James
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Laura K Ferris
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Joseph C English
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Batool Nekooie
- Department of Electrical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Sonal Choudhary
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Tancredi V, Buononato D, Caccavale S, Di Brizzi EV, Di Caprio R, Argenziano G, Balato A. New Perspectives in the Management of Chronic Hand Eczema: Lessons from Pathogenesis. Int J Mol Sci 2023; 25:362. [PMID: 38203533 PMCID: PMC10778876 DOI: 10.3390/ijms25010362] [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: 11/28/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Chronic hand eczema (CHE) is a common inflammatory skin condition that significantly impacts the quality of life. From work-related disabilities to social embarrassment, pain, and financial costs, the burden on society is substantial. Managing this condition presents challenges such as long-term treatment, poor patient compliance, therapy side effects, and economic feasibility. As a result, significant efforts have been made in this field in recent years. Specifically, the broader understanding of CHE pathogenesis has led to the development of new drugs, both topical and systemic. The aim of this narrative review is to summarize the current available data on hand eczema pathophysiology and explore the resulting developments in drugs for its treatment. A comprehensive search on PubMed and the other main scientific databases was conducted using keywords related to CHE and its pathogenesis. The most relevant pathways targeted by therapies include the JAK-STAT cascade, IL-4, and IL-13 axis, phosphodiesterase 4 enzyme, and chemo-attractant cytokines. In the near future, physicians will have a plethora of therapeutic alternatives. Consequently, they should be well-trained not only in how to use these alternatives but also how to combine these treatments to address the ongoing challenges related to efficacy, tolerability, and safety.
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Affiliation(s)
| | | | | | | | | | | | - Anna Balato
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (D.B.)
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Zvulunov A, Lenevich S, Migacheva N. A Mobile Health App for Facilitating Disease Management in Children With Atopic Dermatitis: Feasibility and Impact Study. JMIR Dermatol 2023; 6:e49278. [PMID: 38090787 PMCID: PMC10753416 DOI: 10.2196/49278] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/07/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Inadequate control of atopic dermatitis (AD) increases the frequency of exacerbations and reduces the quality of life. Mobile health apps provide information and communication technology and may increase treatment adherence and facilitate disease management at home. The mobile health app, Atopic App, designed for patients and their caregivers, and the associated web-based patient education program, Atopic School, provide an opportunity for improving patients' and caregivers' engagement and adherence to the management of AD. OBJECTIVE This noninterventional, observational study aimed to explore the feasibility and potential impact on the management of AD in children by caregivers using the Atopic App mobile health app. METHODS The patient-oriented eczema measure (POEM) and numerical rating scale for the grading of pruritus were used as severity scores (scale range: 0-28). The artificial intelligence model of the app was used to assess the severity of AD based on the eczema area and severity index approach. The deidentified data enabled the analysis of the severity of AD, treatment plan history, potential triggers of flare-ups, usage of available features of the app, and the impact of patient education. RESULTS During a 12-month period, of the 1223 users who installed the app, 910 (74.4%) registered users were caregivers of children with AD. The web-based Atopic School course was accessed by 266 (29.2%) caregivers of children with AD, 134 (50.4%) of whom completed the course. Usage of the app was significantly more frequent among those who completed the Atopic School program than among those who did not access or did not complete the course (P<.001). Users who completed a second POEM 21 to 27 days apart exhibited a significant improvement of AD severity based on the POEM score (P<.001), with an average improvement of 3.86 (SD 6.85) points. The artificial intelligence severity score and itching score were highly correlated with the POEM score (r=0.35 and r=0.52, respectively). CONCLUSIONS The Atopic App provides valuable real-world data on the epidemiology, severity dynamics, treatment patterns, and exacerbation-trigger correlations in patients with AD. The significant reduction in the POEM score among users of the Atopic App indicates a potential impact of this tool on health care engagement by caregivers of children with AD.
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Affiliation(s)
- Alex Zvulunov
- Sheba Medical Center, Reichman University, Herzliya, Ramat Gan, Israel
| | | | - Natalia Migacheva
- Department of Pediatrics, Samara State Medical University, Samara, Russian Federation
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Jan M, Coppin-Renz A, West R, Gallo CL, Cochran JM, Heumen EV, Fahmy M, Reuteman-Fowler JC. Safety Evaluation in Iterative Development of Wearable Patches for Aripiprazole Tablets With Sensor: Pooled Analysis of Clinical Trials. JMIR Form Res 2023; 7:e44768. [PMID: 38085556 PMCID: PMC10751624 DOI: 10.2196/44768] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 06/16/2023] [Accepted: 09/23/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Wearable sensors in digital health may pose a risk for skin irritation through the use of wearable patches. Little is known about how patient- and product-related factors impact the risk of skin irritation. Aripiprazole tablets with sensor (AS, Abilify MyCite; Otsuka America Pharmaceutical, Inc) is a digital medicine system indicated for the treatment of patients with schizophrenia, bipolar I disorder, and major depressive disorder. AS includes aripiprazole tablets with an embedded ingestible event marker, a wearable sensor attached to the skin through a wearable patch, a smartphone app, and a web-based portal. To continuously improve the final product, successive iterations of wearable patches were developed, including raisin patch version 4 (RP4), followed by disposable wearable sensor version 5 (DW5), and then reusable wearable sensor version 2 (RW2). OBJECTIVE This analysis pooled safety data from clinical studies in adult participants using the RP4, DW5, and RW2 wearable patches of AS and evaluated adverse events related to the use of wearable patches. METHODS Safety data from 12 studies in adults aged 18-65 years from May 2010 to August 2020 were analyzed. All studies evaluated safety, with studies less than 2 weeks also specifically examining human factors associated with the use of the components of AS. Healthy volunteers or patients with schizophrenia, bipolar I disorder, or major depressive disorder were enrolled; those who were exposed to at least 1 wearable patch were included in the safety analysis. Adverse events related to the use of a wearable patch were evaluated. Abrasions, blisters, dermatitis, discoloration, erythema, irritation, pain, pruritus, rash, and skin reactions were grouped as skin irritation events (SIEs). All statistical analyses were descriptive. RESULTS The analysis included 763 participants (mean [SD] age 42.6 [12.9] years; White: n=359, 47.1%; and male: n=420, 55%). Participants were healthy volunteers (n=269, 35.3%) or patients with schizophrenia (n=402, 52.7%), bipolar I disorder (n=57, 7.5%), or major depressive disorder (n=35, 4.6%). Overall, 13.6% (104/763) of the participants reported at least 1 SIE, all of which were localized to the wearable patch site. Incidence of ≥1 patch-related SIEs was seen in 18.1% (28/155), 14.2% (55/387), and 9.2% (28/306) of participants who used RP4, DW5, and RW2, respectively. Incidence of SIE-related treatment discontinuation was low, which is reported by 1.9% (3/155), 3.1% (12/387), and 1.3% (4/306) of participants who used RP4, DW5, and RW2, respectively. CONCLUSIONS The incidence rates of SIEs reported as the wearable patch versions evolved from RP4 through RW2 suggest that information derived from reported adverse events may have informed product design and development, which could have improved both tolerability and wearability of successive products. TRIAL REGISTRATION Clinicaltrials.gov NCT02091882, https://clinicaltrials.gov/study/NCT02091882; Clinicaltrials.gov NCT02404532, https://clinicaltrials.gov/study/NCT02404532; Clinicaltrials.gov NCT02722967, https://clinicaltrials.gov/study/NCT02722967; Clinicaltrials.gov NCT02219009, https://clinicaltrials.gov/study/NCT02219009; Clinicaltrials.gov NCT03568500, https://clinicaltrials.gov/study/NCT03568500; Clinicaltrials.gov NCT03892889, https://clinicaltrials.gov/study/NCT03892889.
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Affiliation(s)
- Michael Jan
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, United States
| | | | - Robin West
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, United States
| | - Christophe Le Gallo
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, United States
- Genmab US, Inc, Plainsboro, NJ, United States
| | - Jeffrey M Cochran
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, United States
| | | | - Michael Fahmy
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, United States
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Legiawati L, Yusharyahya SN, Astriningrum R, Pulungan AA, Kusumahapsari RW. Skin Disease Profile in Geriatric Inpatients at a Tertiary Referral Hospital. Malays J Med Sci 2023; 30:54-60. [PMID: 38239249 PMCID: PMC10793136 DOI: 10.21315/mjms2023.30.6.6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/10/2023] [Indexed: 01/22/2024] Open
Abstract
Background Elderly people are susceptible to various skin diseases. To monitor disease trends in the geriatric population, epidemiologic data on skin diseases are essential. However, studies on skin diseases in geriatric patients in Indonesia, particularly those who are hospitalised, are limited. Therefore, this retrospective study aims to determine the skin disease profile in geriatric patients at a tertiary referral hospital in Indonesia. Methods The subjects were all geriatric inpatients who were consulted at the Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo National General Hospital between 2017 and 2019. The patients were analysed according to sex, age and comorbidities. They were divided into 15 groups according to the diseases. Chi-square test or Fisher's exact test was used to compare categorical variables. Results The most common skin diseases were infections (35.8%), dermatitis (21.8%), ulcers (12.8%), age-related skin changes (8.4%) and vascular diseases (5.3%). Dermatitis was significantly more common in males (P < 0.05), whereas infections were significantly more common in females (P < 0.05). Conclusion Consistent with previous studies, our inpatient data showed that infections were significantly more common in females, whereas dermatitis was significantly more common in males. The data collected may contribute to epidemiologic data on skin diseases in the geriatric population.
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Affiliation(s)
- Lili Legiawati
- Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Shannaz Nadia Yusharyahya
- Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Rinadewi Astriningrum
- Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Amanda Andria Pulungan
- Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Ratih Wulan Kusumahapsari
- Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Alfouzan YA, Alhumaidan LS, Alsaif M, Alsaif H, Alharbi L, Almuhaymidi R, Almohaimeed FY, AlGhofaili FA. Patterns of Skin Diseases in Qassim Province, Saudi Arabia. Cureus 2023; 15:e50125. [PMID: 38186479 PMCID: PMC10771262 DOI: 10.7759/cureus.50125] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Objective Dermatological complaints are one of the most common reasons to see a physician. Identifying the incidence and prevalence of different skin conditions is essential to improve health outcomes. Only a few studies regarding the pattern of skin diseases have been conducted in Saudi Arabia, especially in the Qassim region. This study aims to identify, evaluate, and compare the pattern of skin conditions in the Qassim region regarding age and sex, and to compare the results with previous studies. Methods A retrospective record-based study included all Saudi patients who attended the dermatology clinics at Qassim University Medical City, for 12 months, from 2021/08/26 to 2022/07/1. Data were collected from the electronic medical records. Results The study included 2775 Saudi patients comprising 1654 (59.6%) females and 1121 (40.4%%) males, with a male-to-female ratio of 1: 1.475. Around 75% of patients were between 15 and 34 years of age. The top most common diagnoses were pilosebaceous disorders (49.2%), with acne vulgaris being the predominant condition, followed by hair disorders (15.6%), dermatitis (9.2%), pigmentary disorders (7.2%), infections (3.9%), and papulosquamous disorders (3%). The prevalence of dermatological conditions was significantly higher in females than males for pilosebaceous disorders (P=.01) and hair disorders (P=.02). Conclusion There is a changing trend in the prevalence of skin disorders in the Qassim province of Saudi Arabia. Pilosebaceous disorders are being diagnosed more frequently compared to previous years and females visit dermatology clinics more than males. Due to its hospital-based setting, this study only gives a rough estimate of the pattern of skin diseases, and extensive epidemiological studies are needed to estimate the prevalence accurately.
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Affiliation(s)
| | - Lulwah S Alhumaidan
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Buraydah, SAU
| | - Maha Alsaif
- College of Medicine, Qassim University, Buraydah, SAU
| | - Haitham Alsaif
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Buraydah, SAU
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48
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Kim C, Kim Y, Lim JY, Kim M, Zheng H, Kim M, Hwang SW. Pamoic acid-induced peripheral GPR35 activation improves pruritus and dermatitis. Br J Pharmacol 2023; 180:3059-3070. [PMID: 37501600 DOI: 10.1111/bph.16201] [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: 03/03/2022] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND AND PURPOSE Pruritic dermatitis is a disease with a considerable unmet need for treatment and appears to present with not only epidermal but also peripheral neuronal complications. Here, we propose a novel pharmacological modulation targeting both peripheral dorsal root ganglion (DRG) sensory neurons and skin keratinocytes. GPR35 is an orphan G-protein-coupled receptor expressed in DRG neurons and has been predicted to downregulate neuronal excitability when activated. Modulator information is currently increasing for GPR35, and pamoic acid (PA), a salt-forming agent for drugs, has been shown to be an activator solely specific for GPR35. Here, we investigated its effects on dermatitic pathology. EXPERIMENTAL APPROACH We confirmed GPR35 expression in peripheral neurons and tissues. The effect of PA treatment was pharmacologically evaluated in cultured cells in vitro and in in vivo animal models for acute and chronic pruritus. KEY RESULTS Local PA application mitigated acute non-histaminergic itch and, consistently, obstructed DRG neuronal responses. Keratinocyte fragmentation under dermatitic simulation was also dampened following PA incubation. Chronic pruritus in 1-chloro-2,4-dinitrobenzene and psoriasis models were also moderately but significantly reversed by the repeated applications of PA. Dermatitic scores in the 1-chloro-2,4-dinitrobenzene and psoriatic models were also improved by its application, indicating that it is beneficial for mitigating disease pathology. CONCLUSION AND IMPLICATIONS Our findings suggest that pamoic acid activation of peripheral GPR35 can contribute to the improvement of pruritus and its associated diseases.
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Affiliation(s)
- Chaeeun Kim
- Department of Biomedical Sciences and Department of Physiology, College of Medicine, Korea University, Seoul, Korea
| | - Yerin Kim
- Department of Biomedical Sciences and Department of Physiology, College of Medicine, Korea University, Seoul, Korea
| | - Ji Yeon Lim
- Department of Biomedical Sciences and Department of Physiology, College of Medicine, Korea University, Seoul, Korea
| | - Minseok Kim
- Department of Biomedical Sciences and Department of Physiology, College of Medicine, Korea University, Seoul, Korea
| | - Haiyan Zheng
- Department of Biomedical Sciences and Department of Physiology, College of Medicine, Korea University, Seoul, Korea
| | - Miri Kim
- Department of Biomedical Sciences and Department of Physiology, College of Medicine, Korea University, Seoul, Korea
| | - Sun Wook Hwang
- Department of Biomedical Sciences and Department of Physiology, College of Medicine, Korea University, Seoul, Korea
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Alturki BA, Almutairi R, Al-Mutairi AG, Alrajhi D, Binyousef FH, Alzamil F. The Effects of Smoking on the Severity of Atopic Dermatitis in Saudi Arabia. Cureus 2023; 15:e50315. [PMID: 38205469 PMCID: PMC10777615 DOI: 10.7759/cureus.50315] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 01/12/2024] Open
Abstract
Background Atopic dermatitis (AD) is a well-known inflammatory skin disease that is associated with a family history of other atopic diseases. Tobacco smoking has been found to affect AD as well as several other inflammatory skin diseases. In this study, we aimed to investigate this association and to elucidate the link between dose-dependent tobacco exposure and symptom severity. Methods This cross-sectional study was conducted on individuals from the general population of Riyadh, Saudi Arabia. Data were collected using an online questionnaire. All statistical analyses were performed using RStudio, version 1.1.363 (RStudio, PBC, Boston, Massachusetts, United States). Questions about the participants' age, sex, and occupational status were included. The participants were asked to report their daily handwashing habits and history of atopic diseases. Data on the smoking duration, number of cigarettes smoked per day, and passive exposure were collected. Results A total of 510 participants (41.3 %) reported having AD. Smoking was significantly associated with an increased prevalence of AD. The odds of having AD were 1.78 and 2.27 times higher in occasional smokers (odds ratio (OR) = 1.78, p < 0.05) and daily smokers (OR = 2.27, p < 0.001) than in non-smokers. Neither smoking frequency (p = 0.19) nor duration (p = 0.73) was significantly associated with AD prevalence. Conclusion Smoking is significantly associated with an increased prevalence of AD. Adults should be discouraged from smoking in order to prevent adult-onset AD. The level of nicotine exposure should be measured objectively in future studies.
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Affiliation(s)
- Basma A Alturki
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Rahaf Almutairi
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Atheer G Al-Mutairi
- Dermatology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Danah Alrajhi
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Fajer Alzamil
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Fleischman DA, Morris DO. Pilot study to determine the concordance between skin prick and intradermal test (IDT) reactivity to environmental allergens in atopic dogs using IDT as the gold standard. Vet Dermatol 2023; 34:505-513. [PMID: 37382082 DOI: 10.1111/vde.13187] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Prick testing is widely used as the first-line in vivo test for environmental allergens in people owing to its noninvasive nature and speed of performance. OBJECTIVES To determine concordance between skin prick testing (SPT) and intradermal testing (IDT) reactivity to environmental allergen mixes in dogs with atopic dermatitis (cAD). ANIMALS Forty client-owned dogs with cAD. MATERIALS AND METHODS Skin prick testing (GREER Pick System; Stallergenes Greer) and IDT were performed on 40 dogs using seven glycerinated and aqueous environmental allergen mixes, respectively (tree, grass and weed pollens, house dust mites and three mould mixes). Reactions for IDT and SPT were evaluated both subjectively and objectively (mean wheal diameter; MWD) and compared to saline and histamine controls. RESULTS Using IDT as the gold standard, with subjective scoring, SPT was 47.0% sensitive [95% confidence interval (CI) 36.0%-58.7%], 92.1% specific (95% CI 87.6%-95.3%) and agreement was moderate (79%, Cohen's kappa = 0.424). The positive predictive value of SPT was 36% and negative predictive value was 95%. Objective and subjective scores had only fair agreement. CONCLUSIONS AND CLINICAL RELEVANCE Skin prick testing with allergen mixes was specific yet poorly sensitive as compared to IDT. For both IDT and SPT, 95% (38 of 40) dogs failed to react to an allergen mix, despite showing a positive reaction to at least one component. Future studies comparing SPT and IDT should test individual allergens rather than mixes to prevent the dilution of individual components, which may have resulted in false negatives.
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Affiliation(s)
- Drew A Fleischman
- Department of Clinical Studies & Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel O Morris
- Department of Clinical Studies & Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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