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Burningham KM, Swali RN, Rady PL, Patel AB, Tyring SK. Resolution of painful trichodysplasia spinulosa with topical cidofovir: case report. J DERMATOL TREAT 2024; 35:2328180. [PMID: 38493799 DOI: 10.1080/09546634.2024.2328180] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Purpose: Trichodysplasia spinulosa (TS) is a rare, disfiguring skin condition which presents with widespread asymptomatic or pruritic, skin-colored papules with white protruding keratin spiculations in immunocompromised individuals. Due to its rarity, there is little data to guide treatment decisions. The purpose of this article is to report a case of TS that completely resolved after treatment with topical cidofovir.Materials and methods: A 19-year-old immunosuppressed female presented with widespread painful, itchy bumps on the nose and face. Upon examination, there were erythematous papules with hyperkeratinized spicules affecting the central face. Biopsy of the lesions was consistent with TS which was confirmed via PCR analysis. The tenderness of this patient's eruption was highly atypical for TS. Once daily topical application of compounded 1% cidofovir cream was prescribed.Results: The patient's symptoms resolved completely after 4 weeks of therapy with topical cidofovir 1% cream, without reduction of immunosuppression.Conclusions: Topical cidofovir 1% cream may be a valuable treatment for this rare disease.
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Affiliation(s)
| | - Ritu N Swali
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
- Dermatology and Laser Center, Houston, Texas, USA
| | - Peter L Rady
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
| | - Anisha B Patel
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Stephen K Tyring
- Center for Clinical Studies, LTD, Webster, Texas, USA
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
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Liu S, Zhang F, Bai Y, Huang L, Zhong Y, Li Y. Therapeutic effects of acupuncture therapy for kidney function and common symptoms in patients with chronic kidney disease: a systematic review and meta-analysis. Ren Fail 2024; 46:2301504. [PMID: 38189090 PMCID: PMC10776068 DOI: 10.1080/0886022x.2023.2301504] [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: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose: The number of clinical reports of acupuncture therapy in chronic kidney disease (CKD) is gradually increasing. This systematic review and meta-analysis aim to examine the therapeutic role of acupuncture therapy in kidney function and common symptoms in CKD patients.Methods: We searched Embase, PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, WanFang, and WeiPu for randomized controlled trials comparing acupuncture treatment with control or placebo groups. We assessed the effect of acupuncture therapy in CKD patients using a meta-analysis with the hartung-knapp-sidik-jonkman random effects model. In addition, we visualized keyword co-occurrence overlay visualization with the help of VOSviewer software to describe the research hotspots of acupuncture therapy and CKD.Results: A total of 24 studies involving 1494 participants were included. Compared to the control group, acupuncture therapy reduced serum creatinine levels (standardized mean difference [SMD]: -0.57; 95% CI -1.05 to -0.09) and relieved pruritus (SMD: -2.20; 95% CI -3.84, -0.57) in patients with CKD, while the TSA showed that the included sample size did not exceed the required information size. The included studies did not report acupuncture-related adverse events.Conclusions: Acupuncture is an effective and safe treatment for improving kidney function and relieving pruritic symptoms in patients with CKD, but the very low evidence may limit this conclusion. The TSA suggests that high-quality trials are needed to validate the efficacy of acupuncture therapy.
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Affiliation(s)
- Shan Liu
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fan Zhang
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liuyan Huang
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yifei Zhong
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi Li
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Del Papa J, Pucchio AC, Schneider M, Wang A. Perineural Inflammation as a Novel Feature in Lichen Sclerosus: A Case Series of Histologic and Clinical Features. Am J Dermatopathol 2024; 46:287-291. [PMID: 38457688 DOI: 10.1097/dad.0000000000002640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
ABSTRACT Lichen sclerosus (LS) is a frequently encountered inflammatory skin disorder characterized by whitened, atrophic patches that can cause pain and pruritus. The underlying cause of this condition remains unknown. Primarily affecting the genital area, this condition carries an increased risk of developing cutaneous cancers and frequently co-occurs with autoimmune disorders. Our retrospective study aimed to explore histologic features of LS, with a particular focus on a newly established finding and its potential implications. We examined 53 histologic cases of LS collected over 2 years. Experienced pathologists evaluated and reached a consensus on the assignment of histologic features. Patient charts were manually reviewed to gather relevant demographic and clinical data. Statistical analysis was performed using IBM SPSS Statistics (2021). Of the 53 total patients identified as meeting criteria for inclusion in this study, only 8 (15%) were male. Eight cases (15%) demonstrated perineural inflammatory infiltrate. Notably, half of all samples from male patients exhibited perineural inflammatory infiltrate. A statistically significant increase ( P < 0.01) in the presence of dermal plasma cells was identified in cases with perineural inflammation versus cases without this feature. The findings of our study highlight the recurrent nature of perineural inflammation in LS, providing valuable insights into this condition. Furthermore, we observed a notable correlation between perineural inflammation, male patients, and the presence of dermal plasma cells. These discoveries contribute to a better understanding of the underlying mechanisms of LS and suggest avenues for future research into the condition.
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Affiliation(s)
- Joshua Del Papa
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada ; and
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Aine Celestina Pucchio
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada ; and
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Mark Schneider
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada ; and
| | - Ami Wang
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada ; and
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Yi X, Cao Q, Peng C, Jia Q, Li J. Baseline eosinophil level may be a predictive indicator for the effectiveness of dupilumab in patients with prurigo nodularis: A single-center, real-world prospective study. J Am Acad Dermatol 2024; 90:1076-1078. [PMID: 38296194 DOI: 10.1016/j.jaad.2024.01.036] [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: 10/01/2023] [Revised: 01/07/2024] [Accepted: 01/14/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Xiaoqing Yi
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, People's Republic of China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Furong Laboratory, Changsha, People's Republic of China
| | - Qiaozhi Cao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, People's Republic of China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Furong Laboratory, Changsha, People's Republic of China
| | - Cong Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, People's Republic of China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Furong Laboratory, Changsha, People's Republic of China
| | - Qiqi Jia
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, People's Republic of China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Furong Laboratory, Changsha, People's Republic of China
| | - Jie Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, People's Republic of China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People's Republic of China; Furong Laboratory, Changsha, People's Republic of China.
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He Y, Liu L, Yang K, Sun K, Zhang Q, Yang M, Chang J. Quality of life and burden of disease of vulvar lichen sclerosus: A single-center retrospective study in China. Int J Gynaecol Obstet 2024; 165:672-676. [PMID: 38146751 DOI: 10.1002/ijgo.15300] [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: 09/12/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE This study examined the quality of life and burden of disease of vulvar lichen sclerosus (VLS) patients in three states of menstruation to better understand VLS. METHODS A total of 607 VLS patients were enrolled into this retrospective study. According to the ages of onset, menarche and menopause, the patients were divided into three groups: prepubertal group (n = 96), reproductive group (n = 400) and postmenopausal group (n = 111). Data were collected by direct interview and clinical examination. RESULTS A total of 93% of patients had itching, with a median numerical rating scale score of five. In the prepubertal group, the median score was three. Nocturnal itching occurred in 49.6% patients. Nearly half of the patients (45.9%) thought the itching affected their sleep. However, this ratio was very different in the prepubertal group (20.7%). Some patients (12.8%) cleaned their vulva more than seven times per week. Only 17.2% of patients experienced no effect on their sex life. The median dermatology life quality index score in all patients was six, but it was only three in the prepubertal group. The median number of hospital visits was two times, and the number of clinic visits was three times. Previous expenses, in median, were 2000 RMB. For 84.3% patients, the gynecologic clinic was their first choice. CONCLUSION VLS places great physical, mental and economic burdens on patients. Patients in the prepubertal group had milder symptoms and dermatology life quality index score. VLS should arouse the attention of patients and specialists.
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Affiliation(s)
- Yuexi He
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lin Liu
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kun Yang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kailv Sun
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qiuli Zhang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Min Yang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jianmin Chang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Wen X, Yu H, Zhang L, Li L, Wang X, Fu X, Sun Z, Zhang X, Zhu L, Wu X, Yan J, Shi C, Zhang M, Zhang M, Li X. The relationship and clinical significance of serum cytokine expression level and skin pruritus in patients with Hodgkin lymphoma and angioimmunoblastic T-cell lymphoma. Int Immunopharmacol 2024; 131:111777. [PMID: 38489975 DOI: 10.1016/j.intimp.2024.111777] [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: 10/20/2023] [Revised: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 03/17/2024]
Abstract
Pruritus of lymphoma is commonly associated with both Hodgkin lymphoma (HL) and angioimmunoblastic T cell lymphoma (AITL) and critically affects the life quality of patient. Recent evidence suggests that the pruritogenic cytokines seem to play a significant role in the genesis of chronic. This study aims to investigate the cytokines associated with itching in lymphoma patients and provide the basis for potential therapeutic targets. Serum samples were collected from 60 lymphoma patients, including 47 with Hodgkin lymphoma (HL) and 13 with angioimmunoblastic T-cell lymphoma (AITL), serving as the observation group (lymphoma group, LP group, n = 60). Additionally, serum samples from 8 healthy donors (HD group, n = 8) were collected for comparison. Within the lymphoma group, patients were stratified into those with pruritus (LWP group, n = 30) and those without pruritus (LWOP group, n = 30) based on the presence of skin pruritus symptoms. Elevated levels of multiple cytokines were significantly observed in the LP group in comparison to the HD group (p < 0.01). Patients in LWP group exhibited higher serum levels of IL-31 (p < 0.001), IL-1β (P = 0.039), and IL-1α (P = 0.037) compared to LWOP group. Notably, serum IL-31 levels were higher in advanced AITL patients (stage IV) than in early AITL patients (stage I-Ⅲ, P < 0.05). In subgroup analysis, patients with pruritus in the AITL group exhibited higher serum levels of MIG and CTACK compared to HL group, whereas PDGF-BB levels were significantly lower (p < 0.05). Elevated serum levels of IL-31, IL-1β, and IL-1α are linked to lymphoma-associated pruritus. Differences in serum cytokine profiles between HL and AITL subgroups are also highlighted. These findings offer valuable insights for clinical intervention in managing lymphoma-related pruritus.
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Affiliation(s)
- Xin Wen
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Hui Yu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Lei Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Ling Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Xinhua Wang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Xiaorui Fu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Zhenchang Sun
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Xudong Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Linan Zhu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Xiaolong Wu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Jiaqin Yan
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Cunzhen Shi
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Mengjuan Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China.
| | - Xin Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Henan 450052 Zhengzhou, China; Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, China.
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Yao QH, Xia XJ, Zhi HL, Liu ZH. Pruritic Erythema in a Child with Undifferentiated Connective Tissue Disease. Mycopathologia 2024; 189:31. [PMID: 38578559 DOI: 10.1007/s11046-024-00840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/24/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Qi-Hao Yao
- Department of Dermatology, Hangzhou Third People's Hospital, Zhejiang University School of Medicine, No.38, West Lake Rd, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Xiu-Jiao Xia
- Department of Dermatology, Hangzhou Third People's Hospital, Zhejiang University School of Medicine, No.38, West Lake Rd, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Hui-Lin Zhi
- Department of Dermatology, Hangzhou Third People's Hospital, Zhejiang University School of Medicine, No.38, West Lake Rd, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Ze-Hu Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Zhejiang University School of Medicine, No.38, West Lake Rd, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China.
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Aydin E, Callahan DL, Chong L, Azizoglu S, Gokhale M, Suphioglu C. The Plight of the Metabolite: Oxidative Stress and Tear Film Destabilisation Evident in Ocular Allergy Sufferers across Seasons in Victoria, Australia. Int J Mol Sci 2024; 25:4019. [PMID: 38612830 PMCID: PMC11012581 DOI: 10.3390/ijms25074019] [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: 02/28/2024] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Ocular allergy (OA) is characterised by ocular surface itchiness, redness, and inflammation in response to allergen exposure. The primary aim of this study was to assess differences in the human tear metabolome and lipidome between OA and healthy controls (HCs) across peak allergy (spring-summer) and off-peak (autumn-winter) seasons in Victoria, Australia. A total of 19 participants (14 OA, 5 HCs) aged 18-45 were recruited and grouped by allergy questionnaire score. Metabolites and lipids from tear samples were analysed using mass spectrometry. Data were analysed using TraceFinder and Metaboanalyst. Metabolomics analysis showed 12 differentially expressed (DE) metabolites between those with OA and the HCs during the peak allergy season, and 24 DE metabolites were found in the off-peak season. The expression of niacinamide was upregulated in OA sufferers vs. HCs across both seasons (p ≤ 0.05). A total of 6 DE lipids were DE between those with OA and the HCs during the peak season, and 24 were DE in the off-peak season. Dysregulated metabolites affected oxidative stress, inflammation, and homeostasis across seasons, suggesting a link between OA-associated itch and ocular surface damage via eye rubbing. Tear lipidome changes were minimal between but suggested tear film destabilisation and thinning. Such metabolipodome findings may pave new and exciting ways for effective diagnostics and therapeutics for OA sufferers in the future.
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Affiliation(s)
- Esrin Aydin
- NeuroAllergy Research Lab (NARL), School of Life and Environmental Sciences, Deakin University, Geelong 3217, Australia
- School of Medicine, Deakin University, Waurn Ponds 3216, Australia
| | - Damien L Callahan
- School of Life and Environmental Sciences, Deakin University, Burwood 3125, Australia
| | - Luke Chong
- School of Medicine, Deakin University, Waurn Ponds 3216, Australia
| | - Serap Azizoglu
- School of Medicine, Deakin University, Waurn Ponds 3216, Australia
| | - Moneisha Gokhale
- School of Medicine, Deakin University, Waurn Ponds 3216, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Lab (NARL), School of Life and Environmental Sciences, Deakin University, Geelong 3217, Australia
- School of Medicine, Deakin University, Waurn Ponds 3216, Australia
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Cheng Q, Lyu B, Hu J, Zhang Z, Huang Y, Wang Z. Research on the antipruritic active ingredients of Mikania micrantha. Fitoterapia 2024; 174:105837. [PMID: 38286314 DOI: 10.1016/j.fitote.2024.105837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/02/2024] [Accepted: 01/24/2024] [Indexed: 01/31/2024]
Abstract
Mikania micrantha is a perennial liana of the genus Mikania of the Asteraceae family. It is a commonly used medicine in South America for treating fever, malaria, dysentery, snake bites, etc. Because of its strong adaptability and ability to inhibit the growth of its associated plants, Mikania micrantha is considered an invasive species in China and is known as a plant killer. Preliminary studies have shown that Mikania micrantha has an antipruritic effect, but the antipruritic active substance is not yet clear. In this study, a 4-aminopyridine-induced itching model in mice was used to determine the antipruritic effects of petroleum ether, ethyl acetate, ethanol extraction site, and Mikania micrantha volatile oil. GC-MS was used to analyze the components of the antipruritic fractions, combined with mice itch-causing models to study the antipruritic effects of β-caryophyllene and humulene. The safety of β-caryophyllene was preliminarily evaluated through the acute toxicity test of mice skin. The ethyl acetate and volatile oil of Mikania micrantha have apparent antipruritic effects. Humulene and β-caryophyllene have a quantitative-effective relationship to inhibit itching in mice. The acute toxicity test of mouse skin showed that β-caryophyllene has no acute toxicity. This study indicated that the main antipruritic active ingredients of Mikania micrantha are β-caryophyllene and humulene.
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Affiliation(s)
- Qianqian Cheng
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Bin Lyu
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Jingweng Hu
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Zhiqiang Zhang
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Yusheng Huang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Zhenhua Wang
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
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Zhu J, Hassler C, Villena FB, Papadopoulou A, Navarini AA, Mueller SM. Reverse underwear sign as an indicator of alloknesis. J Dtsch Dermatol Ges 2024; 22:574-575. [PMID: 38368270 DOI: 10.1111/ddg.15320] [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: 06/26/2023] [Accepted: 11/03/2023] [Indexed: 02/19/2024]
Affiliation(s)
- Jie Zhu
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Caterina Hassler
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | | | | | | | - Simon M Mueller
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
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11
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Yosipovitch G, Kim B, Luger T, Lerner E, Metz M, Adiri R, Canosa JM, Cha A, Ständer S. Similarities and differences in peripheral itch and pain pathways in atopic dermatitis. J Allergy Clin Immunol 2024; 153:904-912. [PMID: 38103700 DOI: 10.1016/j.jaci.2023.10.034] [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: 07/03/2023] [Revised: 09/22/2023] [Accepted: 10/12/2023] [Indexed: 12/19/2023]
Abstract
Atopic dermatitis (AD) is predominantly characterized by intense itching, but concomitant skin pain is experienced by more than 40% of patients. Patients with AD display considerable somatosensory aberrations, including increased nerve sensitivity to itch stimuli (hyperknesis), perception of itch from innocuous stimuli (alloknesis), or perception of pain from innocuous stimuli (allodynia). This review summarizes the current understanding of the similarities and differences in the peripheral mechanisms underlying itch and pain in AD. These distinct yet reciprocal sensations share many similarities in the peripheral nervous system, including common mediators (such as serotonin, endothelin-1, IL-33, and thymic stromal lymphopoietin), receptors (such as members of the G protein-coupled receptor family and Toll-like receptors), and ion channels for signal transduction (such as certain members of the transient receptor potential [TRP] cation channels). Itch-responding neurons are also sensitive to pain stimuli. However, there are distinct differences between itch and pain signaling. For example, specific immune responses are associated with pain (type 1 and/or type 3 cytokines and certain chemokine C-C [CCL2, CCL5] and C-X-C [CXCL] motif ligands) and itch (type 2 cytokines, including IL-31, and periostin). The TRP melastatin channels TRPM2 and TRPM3 have a role in pain but no known role in itch. Activation of μ-opioid receptors is known to alleviate pain but exacerbate itch. Understanding the connection between itch and pain mechanisms may offer new insights into the treatment of chronic pain and itch in AD.
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Affiliation(s)
- Gil Yosipovitch
- Miami Itch Center, Miller School of Medicine, University of Miami, Miami, Fla.
| | - Brian Kim
- Center for the Study of Itch and Sensory Disorders, Washington University School of Medicine, St Louis, Mo
| | | | - Ethan Lerner
- Massachusetts General Hospital, Charlestown, Mass
| | - Martin Metz
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Roni Adiri
- Pfizer Pharmaceuticals Israel Ltd, Herzliya Pituach, Israel
| | | | | | - Sonja Ständer
- Center for Chronic Pruritus, Münster University Hospital, Münster, Germany
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Wollenberg A, Simon D, Kulthanan K, Figueras-Nart I, Misery L, Tangsirisap N, Spina L, Lu N, Grond S, Eyerich K. Baricitinib treatment rapidly improves the four signs of atopic dermatitis assessed by Eczema Area and Severity Index (EASI) clinical subscores. J Eur Acad Dermatol Venereol 2024; 38:695-702. [PMID: 38041556 DOI: 10.1111/jdv.19669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/23/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Baricitinib treatment in adults with moderate-to-severe atopic dermatitis (AD) has demonstrated rapid improvements in itch as well as AD sign severity and affected body surface area as assessed by the Eczema Area and Severity Index (EASI) total score, whether administered as monotherapy or in combination with topical corticosteroids (TCS). As EASI clinical signs differ in time course and associated antecedents, the effects of baricitinib on each individual clinical sign are of interest. OBJECTIVES In this post hoc analysis, we aimed to investigate the effects of baricitinib on individual EASI subscores, namely excoriation, oedema/papulation, erythema and lichenification, in both monotherapy and TCS combination therapy trials. METHODS We analysed the percent change from baseline in individual EASI subscores from three phase-III, double-blind, 16-week trials of baricitinib in monotherapy (BREEZE-AD1/BREEZE-AD2) and TCS combination therapy (BREEZE-AD7) cohorts via mixed model repeated measures (MMRM). RESULTS Baricitinib 4 mg showed rapid and sustained improvements in all four clinical signs in both cohorts. Significant effects emerged at week 1 for excoriation, oedema/papulation and erythema scores in monotherapy (p < 0.001) and TCS combination therapy (p < 0.001, p < 0.01, p < 0.001), plateaued at week 4, and remained significant versus placebo through week 16. The effect on lichenification scores also emerged early, at week 1 in monotherapy (p < 0.05) and week 2 in combination therapy (p < 0.001), with scores continuously improving without a clear plateau. Effect magnitude was highest in excoriation scores, exhibiting near-maximal reduction in week 1 of monotherapy and remaining highest across all timepoints in combination therapy. CONCLUSIONS Rapid and sustained improvements were observed across clinical signs of inflammation and particularly on excoriation following baricitinib treatment. Our findings suggest that selective inhibition of janus kinases 1 and 2 leads to rapid and sustained control of skin inflammation, and that rapid reductions in itch translate into early disruption of the itch-scratch cycle.
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Affiliation(s)
- Andreas Wollenberg
- Department of Dermatology and Allergy, Ludwig Maximilian University of Munich, Munich, Germany
- Department of Dermatology and Allergy, Augsburg University Hospital, Augsburg, Germany
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Berne, Switzerland
| | - Kanokvalai Kulthanan
- Allergy and Immunology Unit, Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ignasi Figueras-Nart
- Department of Dermatology, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain
| | - Laurent Misery
- Department of Dermatology, Venereology, and Allergology and French Expert Centre on Pruritus, University Hospital of Brest, Brest, France
| | | | - Lara Spina
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Na Lu
- Precision Statistics Consulting, Woodbury, Minnesota, USA
| | | | - Kilian Eyerich
- Department of Dermatology and Venerology, Medical Center, University of Freiburg, Freiburg, Germany
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Suehiro M, Tanaka A. A case of atopic dermatitis with self-healing acute diffuse and total alopecia during nemolizumab treatment. J Dermatol 2024; 51:e123-e124. [PMID: 37929306 DOI: 10.1111/1346-8138.17023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Masataka Suehiro
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akio Tanaka
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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14
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Heyer C. Ein junges Paar mit juckenden Quaddeln am Rumpf. MMW Fortschr Med 2024; 166:26-27. [PMID: 38581505 DOI: 10.1007/s15006-024-3785-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Affiliation(s)
- Cornelius Heyer
- Springer Medizin Verlag GmbH, Aschauer Str. 30, 81549, München, Deutschland
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Clague MD, Goodman G, Taing C, Stuart L, Orsatti ML, Holbrook J, Delaney J, Mackay B. Hyperdiluted Botulinum Toxin and Intense Pulsed Light Treatment: A Case Series to Illustrate a Novel Protocol for Hypertrophic Scar Reduction. Plast Aesthet Nurs (Phila) 2024; 44:116-123. [PMID: 38639968 DOI: 10.1097/psn.0000000000000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Hypertrophic scars can have significant and far-reaching effects on patients that range from itching to creating difficulty with mobility, all of which can negatively impact the individual's quality of life. A recent study showed that many patients with recent scars report pain, burning, pruritus, erythema, in combination with psychological difficulties that impact bodily movement, choice of clothing, and participation in leisure activities. Botulinum toxin Type A (BoNTA) and intense pulsed light (IPL) have shown promise in treating such scars. We propose a novel treatment protocol involving a 4-week intervention with hyperdiluted BoNTA injections and supplemental treatment with IPL for erythema, and a 6-month scar scale assessment and photographic documentation that occurs before and 6 months after treatment. We report four cases where using hyperdiluted BoNTA, either alone or in conjunction with IPL, substantially reduced scar size, improved overall scar appearance, and diminished erythema in areas on the face and the breasts. Although this report suggests that a schedule of alternating treatments with BoNTA and IPL may be beneficial in reducing scar size and enhancing appearance, further research is necessary to better understand the most effective dosages, the relationship between BoNTA and IPL, and the optimal management of scarring.
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Affiliation(s)
- Mike D Clague
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Greg Goodman
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Cindy Taing
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Lauren Stuart
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Margo-Louise Orsatti
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - John Holbrook
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - John Delaney
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Bridgina Mackay
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
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Hagino T, Hamada R, Yoshida M, Saeki H, Fujimoto E, Kanda N. Effectiveness of Dose Increase in Upadacitinib from 15 mg to 30 mg for Patients with Moderate-to-Severe Atopic Dermatitis: A Real-World Clinical Practice in Japan. Clin Drug Investig 2024; 44:261-269. [PMID: 38446396 DOI: 10.1007/s40261-024-01352-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Atopic dermatitis is characterized by persistent eczema and pruritus. Janus kinase inhibitors, including upadacitinib, are effective treatments for moderate-to-severe atopic dermatitis. If patients do not respond well to a certain dose of a Janus kinase inhibitor, increasing the dose may improve their treatment responsiveness. OBJECTIVES We assessed the outcomes of a dose increase in upadacitinib from 15 mg to 30 mg for Japanese patients with moderate-to-severe atopic dermatitis. METHODS In 23 patients who showed insufficient responses to upadacitinib 15-mg treatment, the dose of upadacitinib was increased to 30 mg. We evaluated total Eczema Area and Severity Index (EASI), EASI on the head and neck, trunk, upper, or lower limbs, EASI of erythema, edema/papulation, excoriation, or lichenification, and Peak Pruritus Numerical-Rating Scale at baseline (onset of upadactinib 15 mg), week 0 (time of increase), and weeks 4 and 12 after the increase. RESULTS Total EASI, EASI on each anatomical site, EASI of each clinical sign, and Peak Pruritus Numerical-Rating Scale were markedly reduced at weeks 4 or 12 compared with week 0. After the dose increase, the achievement rates of EASI 75 and EASI 90 significantly improved; EASI 75 4.3%, 68.2%, and 66.7%; EASI 90 0%, 18.2%, and 38.1% at weeks 0, 4, and 12, respectively. CONCLUSIONS These results suggest that upadacitinib 30 mg can ameliorate rash and pruritus insufficiently improved by upadacitinib 15 mg, and that the dose increase to 30 mg may be considered as a treatment option for patients with atopic dermatitis with a limited response to upadacitinib 15 mg.
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Affiliation(s)
- Teppei Hagino
- Department of Dermatology, Nippon Medical School, Chiba Hokusoh Hospital, Kamagari 1715, Inzai, Chiba, 270-1694, Japan.
| | - Risa Hamada
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Mai Yoshida
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | | | - Naoko Kanda
- Department of Dermatology, Nippon Medical School, Chiba Hokusoh Hospital, Kamagari 1715, Inzai, Chiba, 270-1694, Japan
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17
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Ünal HA, Demirel Öğüt N, Güler E, Alptekin A. Pain type and neuropathic pain components in acute herpes zoster. Agri 2024; 36:100-105. [PMID: 38558392 DOI: 10.14744/agri.2023.03743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the pain type (nociceptive or neuropathic) and neuropathic pain components in patients with acute herpes zoster (HZ). METHODS Patients with acute HZ referred to the outpatient Dermatology and Venereology clinic between January 2021 and January 2022 were retrospectively detected. The demographic data including gender and age, rash localization, pain severity, and neuropathic pain components were recorded. Pain severity and neuropathic pain components were evaluated using a Visual Analog Scale (VAS) and Douleur Neuropathique 4 (DN4), respectively. RESULTS The study included a total of 58 patients, comprising 33 females and 25 males. Of these patients, 35 (60.3%) were found to have neuropathic pain. Itching, burning, pins and needles, and tingling were the most frequently reported neuropathic pain signs and symptoms. The proportion of female patients with neuropathic pain was found to be significantly higher than that of male patients (p=0.021). No significant differences were observed in the distribution of pain across different body sites or in the age of patients with neuropathic pain (p>0.05). Itching was significantly more common in younger patients (p=0.02). CONCLUSION In conclusion, the study found that over half of the patients with acute HZ experienced neuropathic pain, and this was more frequently observed in female patients. Analysis of different components of neuropathic pain showed significant differences in age, gender, and site distribution. The findings of this study may have important implications for the manage-ment and treatment of acute HZ.
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Affiliation(s)
- Hanzade Aybüke Ünal
- Department of Algology, Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Neslihan Demirel Öğüt
- Department of Dermatology and Venereology, Uşak University Faculty of Medicine, Uşak, Türkiye
| | - Emel Güler
- Division of Algology, Department of Physical Medicine and Rehabilitation, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Türkiye
| | - Alp Alptekin
- Department of Algology, Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
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18
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Zhu J, Hassler C, Villena FB, Papadopoulou A, Navarini AA, Müller S. „Reverse underwear sign“ als Indikator für Alloknesis. J Dtsch Dermatol Ges 2024; 22:574-576. [PMID: 38574006 DOI: 10.1111/ddg.15320_g] [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: 06/26/2023] [Accepted: 11/03/2023] [Indexed: 04/06/2024]
Affiliation(s)
- Jie Zhu
- Abteilung für Dermatologie, Universitätsspital Basel, Basel, Schweiz
| | - Caterina Hassler
- Abteilung für Dermatologie, Universitätsspital Basel, Basel, Schweiz
| | | | | | | | - Simon Müller
- Abteilung für Dermatologie, Universitätsspital Basel, Basel, Schweiz
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19
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Wongjirattikarn R, Chaisuriya N, Chaowattanapanit S, Ungarreevittaya P, Poosekeaw P, Winaikosol K, Choonhakarn C, Julanon N, Utchariyaprasit E, Sawanyawisuth K. Increased tissue expression of IL-31 in patients with psoriasis. Cytokine 2024; 176:156531. [PMID: 38301356 DOI: 10.1016/j.cyto.2024.156531] [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: 02/03/2024]
Abstract
Psoriasis is a chronic inflammatory skin disease, and its pathogenesis remains unclear. Although many studies have demonstrated the role of serum interleukin-31 (IL-31) in psoriasis, only one study has examined histopathological expression in lesional skin. This study aimed to investigate the expression of IL-31 in skin biopsy specimens of psoriasis patients compared to healthy subjects and identify its possible correlation to disease severity and itch intensity. Psoriasis patients and healthy volunteers were recruited. Four-millimeter punch biopsy was performed at the lesional skin of psoriasis patients and normal skin of healthy subjects. Expression of IL-31 was measured by immunohistochemistry. Baseline characteristics, disease activity, itch intensity, and related laboratory results were collected. Twenty-six biopsy specimens of psoriasis patients and 10 tissue samples of healthy subjects were evaluated. Epidermal and dermal psoriasis lesions had significantly higher IL-31 expression compared to the healthy skin (P < 0.001). However, there was no significant difference in lesional expression of IL-31 by disease severity or itch intensity. Increased IL-31 expression in the lesions of psoriasis patients suggests the involvement of IL-31 in the pathogenesis of psoriasis.
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Affiliation(s)
- Rachot Wongjirattikarn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nipon Chaisuriya
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Suteeraporn Chaowattanapanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | - Piti Ungarreevittaya
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pirawan Poosekeaw
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kengkart Winaikosol
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Charoen Choonhakarn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Narachai Julanon
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Eakkapol Utchariyaprasit
- Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kittisak Sawanyawisuth
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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20
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Foley JF. Polarizing itch. Sci Signal 2024; 17:eadp2197. [PMID: 38502731 DOI: 10.1126/scisignal.adp2197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 03/21/2024]
Abstract
An itch-associated GPCR on neutrophils controls their activation during bacterial infection.
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Affiliation(s)
- John F Foley
- Science Signaling, AAAS, Washington, DC 20005, USA.
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21
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Ma EZ, Deng J, Parthasarathy V, Lee KK, Pritchard T, Guo S, Zhang C, Kwatra MM, Le A, Kwatra SG. Integrated plasma metabolomic and cytokine analysis reveals a distinct immunometabolic signature in atopic dermatitis. Front Immunol 2024; 15:1354128. [PMID: 38558806 PMCID: PMC10978712 DOI: 10.3389/fimmu.2024.1354128] [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: 12/11/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Importance Disease models for atopic dermatitis (AD) have primarily focused on understanding underlying environmental, immunologic, and genetic etiologies. However, the role of metabolic mechanisms in AD remains understudied. Objective To investigate the circulating blood metabolomic and cytokine profile of AD as compared to healthy control patients. Design This study collected plasma from 20 atopic dermatitis with moderate-to-severe itch (score of ≥5 on the itch Numeric Rating Scale and IGA score ≥3) and 24 healthy control patients. Mass-spectrometry based metabolite data were compared between AD and healthy controls. Unsupervised and supervised machine learning algorithms and univariate analysis analyzed metabolic concentrations. Metabolite enrichment and pathway analyses were performed on metabolites with significant fold change between AD and healthy control patients. To investigate the correlation between metabolites levels and cytokines, Spearman's rank correlation coefficients were calculated between metabolites and cytokines. Setting Patients were recruited from the Johns Hopkins Itch Center and dermatology outpatient clinics in the Johns Hopkins Outpatient Center. Participants The study included 20 atopic dermatitis patients and 24 healthy control patients. Main outcomes and measures Fold changes of metabolites in AD vs healthy control plasma. Results In patients with AD, amino acids isoleucine, tyrosine, threonine, tryptophan, valine, methionine, and phenylalanine, the amino acid derivatives creatinine, indole-3-acrylic acid, acetyl-L-carnitine, L-carnitine, 2-hydroxycinnamic acid, N-acetylaspartic acid, and the fatty amide oleamide had greater than 2-fold decrease (all P-values<0.0001) compared to healthy controls. Enriched metabolites were involved in branched-chain amino acid (valine, leucine, and isoleucine) degradation, catecholamine biosynthesis, thyroid hormone synthesis, threonine metabolism, and branched and long-chain fatty acid metabolism. Dysregulated metabolites in AD were positively correlated cytokines TARC and MCP-4 and negatively correlated with IL-1a and CCL20. Conclusions and relevance Our study characterized novel dysregulated circulating plasma metabolites and metabolic pathways that may be involved in the pathogenesis of AD. These metabolic pathways serve as potential future biomarkers and therapeutic targets in the treatment of AD.
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Affiliation(s)
- Emily Z. Ma
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, United States
- Maryland Itch Center, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Junwen Deng
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Varsha Parthasarathy
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kevin K. Lee
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Thomas Pritchard
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, United States
- Maryland Itch Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Shenghao Guo
- Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Cissy Zhang
- Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Madan M. Kwatra
- Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, United States
- Anesthesiology, Duke University School of Medicine, Durham, NC, United States
| | - Anne Le
- Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Shawn G. Kwatra
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, United States
- Maryland Itch Center, University of Maryland School of Medicine, Baltimore, MD, United States
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22
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Kaneko T, Oura A, Imai Y, Kusumoto-Yoshida I, Kanekura T, Okuno H, Kuwaki T, Kashiwadani H. Orexin neurons play contrasting roles in itch and pain neural processing via projecting to the periaqueductal gray. Commun Biol 2024; 7:290. [PMID: 38459114 PMCID: PMC10923787 DOI: 10.1038/s42003-024-05997-x] [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: 08/04/2023] [Accepted: 02/28/2024] [Indexed: 03/10/2024] Open
Abstract
Pain and itch are recognized as antagonistically regulated sensations; pain suppresses itch, whilst pain inhibition enhances itch. The neural mechanisms at the central nervous system (CNS) underlying these pain-itch interactions still need to be explored. Here, we revealed the contrasting role of orexin-producing neurons (ORX neurons) in the lateral hypothalamus (LH), which suppresses pain while enhancing itch neural processing, by applying optogenetics to the acute pruritus and pain model. We also revealed that the circuit of ORX neurons from LH to periaqueductal gray regions served in the contrasting modulation of itch and pain processing using optogenetic terminal inhibition techniques. Additionally, by using an atopic dermatitis model, we confirmed the involvement of ORX neurons in regulating chronic itch processing, which could lead to a novel therapeutic target for persistent pruritus in clinical settings. Our findings provide new insight into the mechanism of antagonistic regulation between pain and itch in the CNS.
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Affiliation(s)
- Tatsuroh Kaneko
- Department of Physiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Asuka Oura
- Department of Physiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiki Imai
- Department of Physiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Ikue Kusumoto-Yoshida
- Department of Physiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Kanekura
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hiroyuki Okuno
- Laboratory of Biochemistry and Molecular Biology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tomoyuki Kuwaki
- Department of Physiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hideki Kashiwadani
- Department of Physiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
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23
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Yeo E, Shim J, Oh SJ, Choi Y, Noh H, Kim H, Park JH, Lee KT, Kim SH, Lee D, Lee JH. Revisiting roles of mast cells and neural cells in keloid: exploring their connection to disease activity. Front Immunol 2024; 15:1339336. [PMID: 38524141 PMCID: PMC10957560 DOI: 10.3389/fimmu.2024.1339336] [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: 11/15/2023] [Accepted: 02/19/2024] [Indexed: 03/26/2024] Open
Abstract
Background Mast cells (MCs) and neural cells (NCs) are important in a keloid microenvironment. They might contribute to fibrosis and pain sensation within the keloid. However, their involvement in pathological excessive scarring has not been adequately explored. Objectives To elucidate roles of MCs and NCs in keloid pathogenesis and their correlation with disease activity. Methods Keloid samples from chest and back regions were analyzed. Single-cell RNA sequencing (scRNA-seq) was conducted for six active keloids (AK) samples, four inactive keloids (IK) samples, and three mature scar (MS) samples from patients with keloids. Results The scRNA-seq analysis demonstrated notable enrichment of MCs, lymphocytes, and macrophages in AKs, which exhibited continuous growth at the excision site when compared to IK and MS samples (P = 0.042). Expression levels of marker genes associated with activated and degranulated MCs, including FCER1G, BTK, and GATA2, were specifically elevated in keloid lesions. Notably, MCs within AK lesions exhibited elevated expression of genes such as NTRK1, S1PR1, and S1PR2 associated with neuropeptide receptors. Neural progenitor cell and non-myelinating Schwann cell (nmSC) genes were highly expressed in keloids, whereas myelinating Schwann cell (mSC) genes were specific to MS samples. Conclusions scRNA-seq analyses of AK, IK, and MS samples unveiled substantial microenvironmental heterogeneity. Such heterogeneity might be linked to disease activity. These findings suggest the potential contribution of MCs and NCs to keloid pathogenesis. Histopathological and molecular features observed in AK and IK samples provide valuable insights into the mechanisms underlying pain and pruritus in keloid lesions.
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Affiliation(s)
- Eunhye Yeo
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Joonho Shim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Jin Oh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - YoungHwan Choi
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hyungrye Noh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Heeyeon Kim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyeong-Tae Lee
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok-Hyung Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dongyoun Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Hee Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
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24
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Tracy A, Loop L, Bhatti S, Anterasian C, Kellogg C, Smiley K, Wu A, Geng B, Eichenfield L. Multidisciplinary atopic dermatitis program: A novel approach to managing difficult-to-control atopic dermatitis patients. Pediatr Dermatol 2024; 41:210-214. [PMID: 38234080 DOI: 10.1111/pde.15533] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/01/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND/OBJECTIVES Disease improvement for difficult-to-control pediatric atopic dermatitis may be more challenging to achieve when directed by single specialties due to disjointed and conflicting dialogue with patients. METHODS The Multidisciplinary Atopic Dermatitis Program (MADP) was developed through collaborations with the Rady Children's Hospital and UC San Diego Health Divisions of Dermatology, Allergy & Immunology and Clinical Pharmacy, to create team-based evaluation and management of children and adolescents with atopic dermatitis (AD). The MADP allows concurrent, comprehensive evaluations by multiple specialists to develop treatment plans. The program includes extensive patient education to support shared decision making, incorporating patient and family's perspectives along with those of clinical experts into their care. Objective severity measures and patient reported outcome data were collected, along with assessment of patient and family satisfaction with the MADP. RESULTS Data showed significant improvement in AD severity as assessed by providers, patients and families by the first follow-up visit. BSA mean percentage decreased by up to 56% by the 7th visit, and pruritus (NRS), CLDQI and POEM mean scores decreased by more than 4 points, 12 points, and over 11 points, respectively. After management was initiated in the MADP, 72.73% of patients achieved an EASI 50 and 47.73% achieved an EASI 75 from a baseline mean of 21.7. Patients who continued in clinic beyond the second visit showed further clinically significant decreases in disease measures. CONCLUSIONS The multidisciplinary approach shows success in the treatment of difficult-to-control AD patients with improvements in clinician and patient reported outcome measures.
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Affiliation(s)
- Alexis Tracy
- Division of Allergy and Immunology, Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics, University of California, San Diego, and Rady Children's Hospital, San Diego, California, USA
| | - Lauren Loop
- Department of Pediatrics, Division of Allergy and Immunology, University of California, San Diego and Rady's Children's Hospital, San Diego, California, USA
| | - Safiyyah Bhatti
- Division of Allergy and Immunology, Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics, University of California, San Diego, and Rady Children's Hospital, San Diego, California, USA
| | - Christine Anterasian
- Department of Pediatrics, Division of Pediatric and Infectious Diseases, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Caitlyn Kellogg
- Division of Allergy and Immunology, Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics, University of California, San Diego, and Rady Children's Hospital, San Diego, California, USA
| | - Kathryn Smiley
- Division of Allergy and Immunology, Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics, University of California, San Diego, and Rady Children's Hospital, San Diego, California, USA
| | - Alyssa Wu
- Division of Allergy and Immunology, Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics, University of California, San Diego, and Rady Children's Hospital, San Diego, California, USA
| | - Bob Geng
- Department of Pediatrics, Division of Allergy and Immunology, University of California, San Diego and Rady's Children's Hospital, San Diego, California, USA
| | - Lawrence Eichenfield
- Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics, University of California, San Diego and Rady Children's Hospital, San Diego, California, USA
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25
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Uchimura S, Yano T, Tsuneyoshi I. Effect of intravenous administration of hydroxyzine hydrochloride on intrathecal morphine-induced pruritus after cesarean section. Minerva Anestesiol 2024; 90:219-221. [PMID: 37987995 DOI: 10.23736/s0375-9393.23.17775-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Affiliation(s)
- Shuji Uchimura
- Department of Anesthesiology, Miyakonojo Medical Center, Miyakonojo, Japan -
- Department of Anesthesiology, University of Miyazaki Hospital, Miyazaki, Japan -
| | - Takeshi Yano
- Department of Anesthesiology, University of Miyazaki Hospital, Miyazaki, Japan
| | - Isao Tsuneyoshi
- Department of Anesthesiology, University of Miyazaki Hospital, Miyazaki, Japan
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26
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Lin J, Li S, Lv G, Si S. Phthirus Pubis Crawling Along the Palpebral Margin. J Pediatr Ophthalmol Strabismus 2024; 61:e13-e15. [PMID: 38529750 DOI: 10.3928/01913913-20240124-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
A 7-year-old boy was misdiagnosed as having contact dermatitis due to itching and redness of the eyelids. Later, with the assistance of a slit lamp, active pubic lice on the eyelid margin were discovered. Microorganisms and insect eggs were mechanically removed, and itching and redness symptoms complete disappeared after 1 week. [J Pediatr Ophthalmol Strabismus. 2024;61(2)e13-e15.].
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27
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Higuchi A, Fukui S, Tanaka H, Higami Y, Utsumi M, Suzuki T, Ikoma A. An Academic-Industry collaborative research activity related to "care DX" from a nursing perspective: Focusing on night-time itching in older adults using sensor technology. Geriatr Gerontol Int 2024; 24 Suppl 1:412-414. [PMID: 37787510 DOI: 10.1111/ggi.14691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Affiliation(s)
- Akari Higuchi
- Department of Human Health Sciences, Graduated School of Medicine, Kyoto University, Kyoto, Japan
- Department of Nursing, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Sakiko Fukui
- Department of Nursing, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruka Tanaka
- Department of Nursing, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Nursing, Graduate School of Nursing, Kobe City College of Nursing, Kobe, Japan
| | - Yoko Higami
- Department of Nursing, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Nursing, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Momoe Utsumi
- Department of Nursing, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tatsuto Suzuki
- Person Environment Activity Research Laboratory (PEARL), Department of Civil, Environmental & Geomatic Engineering, University College London, Dagenham, UK
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28
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Kook H, Park SY, Hong N, Lee DH, Jung HJ, Park MY, Ahn J. Severely pruritic mycosis fungoides successfully treated with upadacitinib. J Dtsch Dermatol Ges 2024; 22:450-451. [PMID: 38326084 DOI: 10.1111/ddg.15325] [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: 12/19/2022] [Accepted: 11/07/2023] [Indexed: 02/09/2024]
Affiliation(s)
- Hyungdon Kook
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - So Yun Park
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Narang Hong
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Dong Heon Lee
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Hye Jung Jung
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Mi Youn Park
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Jiyoung Ahn
- Department of Dermatology, National Medical Center, Seoul, Korea
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29
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Liu L, Zheng X, Lu Q, Yu C. Identification of a novel nonsense ATP2A2 gene variant in a patient with Darier's disease flare following COVID-19 infection: A case report. Medicine (Baltimore) 2024; 103:e37335. [PMID: 38428853 PMCID: PMC10906587 DOI: 10.1097/md.0000000000037335] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/01/2024] [Indexed: 03/03/2024] Open
Abstract
RATIONALE Darier disease (DD) is a rare autosomal dominant disorder that primarily manifests as hyperkeratotic papules and itching. The underlying etiology of DD is pathogenic variation in the ATP2A2 gene. However, this disease has a high penetrance but variable expressivity, indicating that patients inheriting the genotype may have different manifestations due to exogenous factors. Meanwhile, a few reports have documented that COVID-19 may be implicated in the flare of DD. PATIENT CONCERNS A 51-year-old man presented with keratotic papules and scaly erythematous rash on his trunk with pruritus after being infected with COVID-19. Laboratory test results were normal. Histological analysis revealed epidermal hyperkeratosis and intraepidermal lacunae containing dyskeratinized cells. Genetic analysis revealed a novel variant of ATP2A2 (c.815G>A, p.Trp272*), which was considered pathogenic in this case. DIAGNOSES The patient was diagnosed as having DD. INTERVENTIONS Oral acitretin and topical corticosteroid hormone ointments were used. OUTCOMES The patient achieved complete resolution of symptoms during the 3-month follow-up period. LESSONS We revealed the first novel ATP2A2 variant (c.815G>A, p.Trp272*) in the flare of DD following COVID-19 infection. Additionally, this pathogenic variant enriches the ATP2A2 gene mutation spectrum.
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Affiliation(s)
- Linli Liu
- Department of Dermatology, Suining Central Hospital, Suining, Sichuan, People’s Republic of China
| | - Xiaotao Zheng
- Department of Dermatology, Suining Central Hospital, Suining, Sichuan, People’s Republic of China
| | - Qinglian Lu
- Department of Dermatology, Suining Central Hospital, Suining, Sichuan, People’s Republic of China
| | - Chunshui Yu
- Department of Dermatology, Suining Central Hospital, Suining, Sichuan, People’s Republic of China
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30
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Kirchler CA, Fritz A, Spiegelfeld C, Müllegger RR. 19-month follow-up survey on women with atopic eruption of pregnancy postpartum: An encouraging outlook. J Dermatol 2024; 51:467-469. [PMID: 38217371 DOI: 10.1111/1346-8138.17087] [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: 08/10/2023] [Revised: 11/11/2023] [Accepted: 12/11/2023] [Indexed: 01/15/2024]
Affiliation(s)
- C A Kirchler
- Department of Dermatology, State Clinic Wiener Neustadt, Wiener Neustadt, Austria
| | - A Fritz
- Department of Dermatology, State Clinic Wiener Neustadt, Wiener Neustadt, Austria
| | - C Spiegelfeld
- Department of Dermatology, State Clinic Wiener Neustadt, Wiener Neustadt, Austria
| | - R R Müllegger
- Department of Dermatology, State Clinic Wiener Neustadt, Wiener Neustadt, Austria
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31
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Wheeler JJ, Williams N, Yu J, Mishra SK. Brain Natriuretic Peptide Exerts Inflammation and Peripheral Itch in a Mouse Model of Atopic Dermatitis. J Invest Dermatol 2024; 144:705-707. [PMID: 37832843 PMCID: PMC10922042 DOI: 10.1016/j.jid.2023.09.273] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/08/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Affiliation(s)
- Joshua J Wheeler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA; Comparative Medicine Institute, NC State University, Raleigh, North Carolina, USA
| | - Nidha Williams
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Junho Yu
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Santosh K Mishra
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA; Comparative Medicine Institute, NC State University, Raleigh, North Carolina, USA; Genetics and Genomics Academy, NC State University, Raleigh, North Carolina, USA.
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32
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Kook H, Park SY, Hong N, Lee DH, Jung HJ, Park MY, Ahn J. Stark juckende Mycosis fungoides erfolgreich mit Upadacitinib behandelt. J Dtsch Dermatol Ges 2024; 22:450-452. [PMID: 38450947 DOI: 10.1111/ddg.15325_g] [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: 12/19/2022] [Accepted: 11/07/2023] [Indexed: 03/08/2024]
Affiliation(s)
- Hyungdon Kook
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - So Yun Park
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - Narang Hong
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - Dong Heon Lee
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - Hye Jung Jung
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - Mi Youn Park
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - Jiyoung Ahn
- Department of Dermatology, National Medical Center, Seoul, South Korea
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33
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Kim DH, Kim SW, Kim SW, Stybayeva G, Hwang SH. An indirect comparative analysis of two posterior nasal nerve ablation techniques for treating chronic rhinitis: A systemic review and meta-analysis. Am J Otolaryngol 2024; 45:104130. [PMID: 38039909 DOI: 10.1016/j.amjoto.2023.104130] [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: 09/05/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis evaluates and compares the effects of two treatments that ablate the posterior nasal nerves for rhinitis-related symptoms: cryotherapy and radiofrequency neurolysis. METHODS We reviewed studies retrieved from PubMed, SCOPUS, Embase, the Web of Science and the Cochrane database up to June 2023. Papers reporting quality-of-life and rhinitis-related symptom scores before and after cryotherapy, and sham-controlled studies, were analyzed. RESULTS In total, 738 patients enrolled in 10 studies were evaluated. Both cryotherapy and radiofrequency neurolysis significantly improved rhinitis-related symptoms including congestion, itching, rhinorrhea, and sneezing, and quality of life during 12 months of follow-up. Radiofrequency neurolysis was significantly more effective than cryotherapy in terms of reducing total nasal symptom scores at up to 12 months postoperatively. In terms of individual symptoms, itching, rhinorrhea, and congestion were significantly alleviated or tended to be reduced more by radiofrequency neurolysis than by cryotherapy. The improvements in the minimal clinically important difference in total nasal symptom scores (1.0 point) after 3 months of cryotherapy and radiofrequency therapy were 81.8 % and 92.7 %, respectively. CONCLUSIONS Cryotherapy and radiofrequency neurolysis both improved rhinitis-symptom and quality-of-life scores. Especially, radiofrequency neurolysis showed the better effectiveness for improving the nasal symptoms related to the rhinitis than cryotherapy.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soo Whan Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Gulnaz Stybayeva
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Amaral LJ, Jada SR, Ndjanfa AK, Carter JY, Abd-Elfarag G, Okaro S, Logora MY, Bol YY, Lakwo T, Fodjo JNS, Colebunders R. Impact of annual community-directed treatment with ivermectin on the incidence of epilepsy in Mvolo, a two-year prospective study. PLoS Negl Trop Dis 2024; 18:e0012059. [PMID: 38512994 PMCID: PMC10986994 DOI: 10.1371/journal.pntd.0012059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/02/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES The potential impact of cumulative community-directed treatment with ivermectin (CDTI) on epilepsy epidemiology in Mvolo County, South Sudan, an onchocerciasis-endemic area with high epilepsy prevalence, was investigated. Annual CDTI was introduced in 2002 in Mvolo, with interruptions in 2016 and 2020. METHODS Comprehensive house-to-house surveys in Mvolo (June 2020 and 2022) identified cases of epilepsy, including probable nodding syndrome (pNS). Community workers screened households in selected sites for suspected epilepsy, and medical doctors confirmed the diagnosis and determined the year of seizure onset. The incidence of epilepsy, including pNS, was analysed using 95% confidence intervals (CIs). Data on ivermectin intake and onchocerciasis-associated manifestations (itching and blindness) were collected. RESULTS The surveys covered 15,755 (2020) and 15,092 (2022) individuals, identifying 809 (5.2%, 95% CI: 4.8-5.5%) and 672 (4.5%, 95% CI: 4.1-4.8%) epilepsy cases, respectively. Each survey reported that a third of the surveyed population experienced skin itching, and 3% were blind. Epilepsy incidence per 100,000 person-years gradually declined, from 326.5 (95% CI: 266.8-399.1) in 2013-2015 to 96.6 (95% CI: 65.5-141.7) in 2019-2021. Similarly, pNS incidence per 100,000 person-years decreased from 151.7 (95% CI: 112.7-203.4) to 27.0 (95% CI: 12.5-55.5). Coverage of CDTI was suboptimal, reaching only 64.0% of participants in 2019 and falling to 24.1% in 2021 following an interruption in 2020 due to COVID-19 restrictions. Additionally, while 99.4% of cases had active epilepsy in 2022, less than a quarter of these had access to antiseizure medication. CONCLUSIONS The observed decrease in epilepsy incidence despite suboptimal CDTI coverage highlights the potential impact of onchocerciasis control efforts and underscores the need to strengthen these efforts in Mvolo County and across South Sudan. As a proactive measure, Mvolo and neighbouring counties are transitioning to biannual CDTI. Furthermore, the substantial epilepsy treatment gap in Mvolo should be addressed.
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Affiliation(s)
| | | | | | | | - Gasim Abd-Elfarag
- Amref Health Africa, South Sudan
- Access for Humanity, Juba, South Sudan
- School of Public Health, University of Juba, Juba, South Sudan
| | | | - Makoy Yibi Logora
- Neglected Tropical Diseases Unit, Ministry of Health, Juba, South Sudan
| | - Yak Yak Bol
- Neglected Tropical Diseases Unit, Ministry of Health, Juba, South Sudan
| | - Thomson Lakwo
- Vector Control Division, Ministry of Health, Kampala, Uganda
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Murali A, Jose R, Giliyar S. Acute liver injury in pregnancy. BMJ Case Rep 2024; 17:e257138. [PMID: 38383125 PMCID: PMC10882453 DOI: 10.1136/bcr-2023-257138] [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: 02/23/2024] Open
Abstract
A woman in her fifth month of pregnancy presented to the outpatient department with vomiting, generalised itching and yellowish discolouration of the skin for 1 week. No history of rashes, fever, pain abdomen or altered stools. In view of four pregnancy losses previously, she was evaluated to have antiphospholipid antibody syndrome and was advised low molecular weight heparin. She was a known type-II diabetic on insulin. Prophylactic oral dydrogesterone and natural micronised progesterone were started at a local hospital 2 months prior, in view of threatened abortion. Investigations revealed grossly elevated serum bilirubin and liver enzymes. Other blood investigations were unremarkable and abdominal ultrasonography was normal. The most likely diagnosis in this case, is drug-induced liver injury due to oral progestin consumption. Causality assessment by Roussel Uclaf Causality Assessment Model was used to establish the diagnosis. High doses of progestin over a prolonged period resulted in acute hepatic toxicity causing itching, jaundice and transaminitis. Cautious use of progestins in appropriate dosage is recommended during pregnancy.
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Affiliation(s)
- Akshaya Murali
- Obstetrics and Gynaecology, St John's Medical College Hospital, Bangalore, Karnataka, India
| | - Riyamol Jose
- Obstetrics and Gynaecology, St John's Medical College Hospital, Bangalore, Karnataka, India
| | - Shobha Giliyar
- Obstetrics and Gynaecology, St John's Medical College Hospital, Bangalore, Karnataka, India
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Xu J, Zhou Q, Xie F, Cao Y, Yang X, Tao M. Effect of fire needle combined with traditional Chinese medicine on psoriasis: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e35832. [PMID: 38363920 PMCID: PMC10869083 DOI: 10.1097/md.0000000000035832] [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: 06/12/2023] [Accepted: 10/06/2023] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The mechanism of action of fire acupuncture and Chinese medicine in psoriasis is unclear. In this paper, the efficacy of the 2 therapies was compared through a comprehensive analysis of their recurrence rates for clinical reference. METHODS In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM data from the establishment of the databases to May 2023. The study proposed to use randomized controlled trial research methods, excluding published literature, unpublished literature, literature with incomplete or inadequate information, animal experiments, literature reviews and systematic studies. Data were processed using STATA 15.1 software. RESULTS Our group previous study found that the clinical efficacy of the fire-acupuncture group was significantly improved compared to that of Chinese herbal medicine alone (RR = 1.20, 95% CI: 1.13-1.27). Also, there were significant reductions in Psoriasis Area and Severity Index (PASI) score (SMD = -1.04,95% CI: -1.48 to -0.60), area of skin damage (SMD = -0.40,95% CI: -0.75 to -0.04), and pruritus (SMD = -1.04,95% CI: -1.32 to -0.76). Our previous study found that Dermatology Life Quality Index (DLQI) was significantly lower in the fire acupuncture group compared to herbal medicine alone (SMD = -1.61,95% CI: -3.08 to -0.15). The combined analysis found that the recurrence rate was significantly lower in the fire-acupuncture group compared to herbal medicine alone (RR = 0.21,95% CI:0.07-0.60). CONCLUSION Fire needle can improve the efficacy of TCM in the treatment of psoriasis, including the area, severity and itching of skin lesions, and reduce the recurrence rate, which is worthy of clinical promotion.
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Affiliation(s)
| | - Qiujun Zhou
- Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Fan Xie
- Jinhua Fifth Hospital, Jinhua, China
| | - Yi Cao
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Xiaohong Yang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Maocan Tao
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
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Hiroki CH, Yipp BG. Neutrophils are itching to specialize. Immunity 2024; 57:198-200. [PMID: 38354698 DOI: 10.1016/j.immuni.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/16/2024]
Abstract
Neutrophils are heterogeneous, but the mechanisms underlying their ability to polarize remain unclear. In this issue of Immunity, Gour et al. demonstrate that the GPCR Mrgpra1 and the neuropeptide NPFF, molecules involved in pain and itch, direct neutrophil polarization that impacts host defense and pneumonia susceptibility.
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Affiliation(s)
- Carlos H Hiroki
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bryan G Yipp
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Vilhena FDM, Pereira OV, Sousa FDJDD, Martins NCN, Albuquerque GPX, Lopes RGBDS, Sagica TDP, Ramos AMPC. Factors associated with the quality of life of women undergoing radiotherapy. Rev Gaucha Enferm 2024; 45:e20230062. [PMID: 38359280 DOI: 10.1590/1983-1447.2024.20230062.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 08/28/2023] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE To evaluate the skin characteristics and quality of life of patients with breast cancer undergoing radiotherapy. METHOD Cross-sectional study conducted with 60 women. The classification scales of skin changes resulting from exposure to ionizing radiation (RTOG) and the validated versions in Portuguese of those that classified skin types (Fitzpatrick), symptoms (RISRAS) and quality of life (DLQI) were applied. in the period between December 2021 and October 2022. For data analysis, Fisher's Exact Test, Chi-Square and Asymptotic General Independence Test were used. RESULTS 100% of patients had skin irritation. As the treatment progressed and the radiodermatitis appeared or worsened, there was a tendency for the intensity of signs and symptoms to increase, such as: sensitivity, discomfort or pain, itching, burning and heat, dry and wet desquamation, which may have impacted the quality of life and reflected in other aspects, such as: shopping activities or outings (p=0.0020), social activities or leisure activities (p=0.0420). CONCLUSION Radiodermatitis is a common condition that affects women with breast cancer undergoing radiotherapy, skin characteristics and quality of life of patients affected during this treatment.
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Kondou H, Nakano S, Mizuno T, Bessho K, Hasegawa Y, Nakazawa A, Tanikawa K, Azuma Y, Okamoto T, Inui A, Imagawa K, Kasahara M, Zen Y, Suzuki M, Hayashi H. Clinical symptoms, biochemistry, and liver histology during the native liver period of progressive familial intrahepatic cholestasis type 2. Orphanet J Rare Dis 2024; 19:57. [PMID: 38341604 PMCID: PMC10858576 DOI: 10.1186/s13023-024-03080-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Progressive familial intrahepatic cholestasis type 2 (PFIC2) is an ultra-rare disease caused by mutations in the ABCB11 gene. This study aimed to understand the course of PFIC2 during the native liver period. METHODS From November 2014 to October 2015, a survey to identify PFIC2 patients was conducted in 207 hospitals registered with the Japanese Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Investigators retrospectively collected clinical data at each facility in November 2018 using pre-specified forms. RESULTS Based on the biallelic pathogenic variants in ABCB11 and/or no hepatic immunohistochemical detection of BSEP, 14 Japanese PFIC2 patients were enrolled at seven facilities. The median follow-up was 63.2 [47.7-123.3] months. The median age of disease onset was 2.5 [1-4] months. Twelve patients underwent living donor liver transplantation (LDLT), with a median age at LDLT of 9 [4-57] months. Two other patients received sodium 4-phenylbutyrate (NaPB) therapy and survived over 60 months with the native liver. No patients received biliary diversion. The cases that resulted in LDLT had gradually deteriorated growth retardation, biochemical tests, and liver histology since the initial visit. In the other two patients, jaundice, growth retardation, and most of the biochemical tests improved after NaPB therapy was started, but pruritus and liver fibrosis did not. CONCLUSIONS Japanese PFIC2 patients had gradually worsening clinical findings since the initial visit, resulting in LDLT during infancy. NaPB therapy improved jaundice and growth retardation but was insufficient to treat pruritus and liver fibrosis.
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Affiliation(s)
- Hiroki Kondou
- Department of Pediatrics, Kindai University Nara Hospital, Nara, Japan
| | - Satoshi Nakano
- Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tadahaya Mizuno
- Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Science, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Bessho
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasuhiro Hasegawa
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Ken Tanikawa
- Department of Diagnostic Pathology, Kurume University Hospital, Fukuoka, Japan
| | - Yoshihiro Azuma
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Tatsuya Okamoto
- Department of Pediatric Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Ayano Inui
- Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Kazuo Imagawa
- Department of Pediatrics, University of Tsukuba Hospital, Ibaraki, Japan
| | - Mureo Kasahara
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoh Zen
- Institute of Liver Studies, King's College Hospital and King's College London, London, UK
| | - Mitsuyoshi Suzuki
- Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hisamitsu Hayashi
- Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Science, The University of Tokyo, Tokyo, Japan.
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Vivekanandan V, Khan ZH, Venugopal G, Musunuru B, Mishra P, Srivastava S, Ramadass B, Subhadra B. VagiBIOM Lactobacillus suppository improves vaginal health index in perimenopausal women with bacterial vaginosis: a randomized control trial. Sci Rep 2024; 14:3317. [PMID: 38336815 PMCID: PMC10858244 DOI: 10.1038/s41598-024-53770-1] [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: 04/29/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
Bacterial vaginosis (BV) can cause vaginal dysbiosis that may influence general vaginal health and pregnancy complications. Balancing vaginal microbiome using Lactobacillus spp. may be a new way to prevent and treat mild BV. We conducted a randomized, double-blind, placebo-controlled pilot study aimed at evaluating the effect of the product VagiBIOM, a multi-Lactobacillus vaginal suppository, on peri- and premenopausal women with BV in restoring vaginal pH and overall vaginal health by resetting the vaginal microbiome composition. Sixty-six peri- and premenopausal women with BV symptoms were randomized with a 2:1 ratio to be treated with VagiBIOM or placebo suppositories. Vaginal pH, VAS itching score, total Nugent score, and vaginal health index (VHI) were measured. Vaginal microbiome changes before and after the treatment were analyzed by 16S rRNA sequencing and bioinformatics analysis. After 4 weeks of intervention with VagiBIOM or a placebo, the mean score for vaginal pH, VAS itching, and total Nugent score was significantly decreased from the baseline. Compared to the baseline scores, the VHI scores improved significantly following 28-day intervention (p < 0.001). Our results revealed two Lactobacillus species, L. hamsteri, and L. helveticus, as indicator species occurring differentially in the VagiBIOM-treated group. Furthermore, the regression and species network analyses revealed significant bacterial associations after VagiBIOM treatment. Lactobacillus hamsteri was positively associated with the Nugent score and negatively associated with vaginal pH. L. iners and L. salivarius were positively and inversely associated with VHI. As is typical, Bacteroides fragilis was positively associated with vaginal pH and negatively associated with the Nugent score. Interestingly, the Lactobacillus spp. diversity improved after VagiBIOM treatment. The VagiBIOM suppository treatment for peri- and premenopausal women with BV significantly relieved vaginal itching by decreasing vaginal pH and Nugent scores and improving the overall VHI after 4 weeks' intervention. This effect was primarily the result of VagiBIOM improving vaginal Lactobacillus diversity.Trial Registration ClinicalTrials.gov registration: NCT05060029, first registration 09/28/2021: Title: A Pilot Study to Evaluate the Efficacy and Safety of Lactobacillus Species Suppositories on Vaginal Health and pH.
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Affiliation(s)
| | - Zaiba Hasan Khan
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Giriprasad Venugopal
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bhavana Musunuru
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Priyanka Mishra
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Shalini Srivastava
- Vedic LifeSciences, Clinical Research, Andheri (West), Mumbai, Maharashtra, India
| | - Balamurugan Ramadass
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - Bobban Subhadra
- Biom Pharmaceutical Corporation, 2203 Industrial Blvd, Sarasota, FL, USA.
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Braren-von Stülpnagel C, Augustin M, Sommer R, Westphal L. Psychosocial Burden in People with Atopic Dermatitis: Effects of a Substance-Free Basic Skincare in a Randomized Health Care Study. Skin Pharmacol Physiol 2024; 36:296-301. [PMID: 38325354 DOI: 10.1159/000536671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/01/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Atopic dermatitis (AD) is a physical, emotional, and social burden for patients. Most suffer from itching, pain, and dry skin as well as sleep disturbances, experienced stigmatization, anxiety, or depression. Therefore, it is important to consider the psychosocial well-being and also stigmatization in the treatment of people with AD. The aims of this study were to compare clinical and psychosocial parameters between patients with a different severity of AD and to analyse the effect of an omega-6-fatty-acid-skin therapy. METHODS Adult patients with clinically confirmed AD were asked about quality of life, stigmatization, and well-being after dermatological diagnosis. A second examination took place after 2-5 weeks. Meanwhile, after randomization, half of the patients used an omega-6-fatty-acid-skin therapy. RESULTS Seventy-nine patients were included in the study. The use of omega-6-fatty-acid-skin therapy resulted in a significant reduction in the severity of xerosis cutis compared to patients using another basic therapy. In addition, the health-related quality of life of all patients improved significantly in both groups (F = 7.56; p = 0.008), and no significant difference was found between the groups over time in the patient-reported outcomes. CONCLUSION Basic therapy for AD leads to relevant improvements in clinical status as well as quality of life. Patients using omega-6-fatty-acid-skin therapy experience greater improvement in xerosis cutis compared to free-choice basic therapy.
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Affiliation(s)
- Catharina Braren-von Stülpnagel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Rachel Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Lukas Westphal
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Yu G, Liu P, Huang X, Qi M, Li X, Feng W, Shang E, Zhou Y, Wang C, Yang Y, Zhu C, Wang F, Tang Z, Duan J. 20-HETE mediated TRPV1 activation drives allokinesis via MrgprA3 + neurons in chronic dermatitis. Theranostics 2024; 14:1615-1630. [PMID: 38389848 PMCID: PMC10879873 DOI: 10.7150/thno.85214] [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: 04/12/2023] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Rationale: Noxious stimuli are often perceived as itchy in patients with chronic dermatitis (CD); however, itch and pain mechanisms of CD are not known. Methods: TRPV1 involvement in CD was analyzed using a SADBE induced CD-like mouse model, and several loss- and gain-of-function mouse models. Trigeminal TRPV1 channel and MrgprA3+ neuron functions were analyzed by calcium imaging and whole-cell patch-clamp recordings. Lesional CD-like skin from mice were analyzed by unbiased metabolomic analysis. 20-HETE availability in human and mouse skin were determined by LC/MS and ELISA. And finally, HET0016, a selective 20-HETE synthase inhibitor, was used to evaluate if blocking skin TRPV1 activation alleviates CD-associated chronic itch or pain. Results: While normally a pain inducing chemical, capsaicin induced both itch and pain in mice with CD condition. DREADD silencing of MrgprA3+ primary sensory neurons in these mice selectively decreased capsaicin induced scratching, but not pain-related wiping behavior. In the mice with CD condition, MrgprA3+ neurons showed elevated ERK phosphorylation. Further experiments showed that MrgprA3+ neurons from MrgprA3;Braf mice, which have constitutively active BRAF in MrgprA3+ neurons, were significantly more excitable and responded more strongly to capsaicin. Importantly, capsaicin induced both itch and pain in MrgprA3;Braf mice in an MrgprA3+ neuron dependent manner. Finally, the arachidonic acid metabolite 20-HETE, which can activate TRPV1, was significantly elevated in the lesional skin of mice and patients with CD. Treatment with the selective 20-HETE synthase inhibitor HET0016 alleviated itch in mice with CD condition. Conclusion: Our results demonstrate that 20-HETE activates TRPV1 channels on sensitized MrgprA3+ neurons, and induces allokinesis in lesional CD skin. Blockade of 20-HETE synthesis or silencing of TRPV1-MrgprA3+ neuron signaling offers promising therapeutic strategies for alleviating CD-associated chronic itch.
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Affiliation(s)
- Guang Yu
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Pei Liu
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaobao Huang
- Department of Dermatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingxin Qi
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Li
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Weimeng Feng
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing, China
| | - Erxin Shang
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuan Zhou
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Changming Wang
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Yang
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chan Zhu
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fang Wang
- Department of Dermatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zongxiang Tang
- Key Laboratory for Chinese Medicine of Prevention and Treatment in Neurological Diseases, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jinao Duan
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing, China
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Murota H, Arima K, Yoshida T, Fujita H. Disease burden and treatment satisfaction in patients with prurigo nodularis in Japan. J Dermatol 2024; 51:223-233. [PMID: 38066728 DOI: 10.1111/1346-8138.17045] [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: 06/21/2023] [Revised: 09/28/2023] [Accepted: 11/02/2023] [Indexed: 02/04/2024]
Abstract
Prurigo nodularis (PN) is a chronic inflammatory skin disorder with a high disease burden. In this cross-sectional, web-based survey, Global Questions (GQ), the Numerical Rating Scales (NRS) for pruritus, burning sensation and sleep disturbance, the Short-Form-8 (SF-8) Health Survey, Dermatology Life Quality Index (DLQI), Patient Health Questionnaire 9 (PHQ-9), Work Productivity and Activity Impairment (WPAI), and Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9) scores were used to assess the current disease burden and treatment satisfaction among patients with PN in Japan. In total, 97 patients were included (55.7% male, median age 51 years, median duration of PN 36 months). Based on GQ scores, 35.1% of patients had mild disease, 50.5% moderate, and 14.4% severe disease. Disease burden increased as the severity of PN increased, as indicated by worsening of pruritus NRS scores and quality of life (DLQI, PHQ-9, WPAI presenteeism, work productivity loss, and activity impairment scores). Patients with comorbid atopic dermatitis (AD) also had more intense pruritus than those without AD. Mean ± standard deviation TSQM-9 scores for effectiveness, convenience, and global satisfaction were 54.7 ± 18.1%, 62.4 ± 15.2%, and 57.4 ± 15.9%, respectively. TSQM-9 scores were lowest in patients receiving the most intensive guideline-directed treatment (i.e., topical corticosteroids + systemic oral corticosteroids or cyclosporine), highlighting an unmet need for more effective treatment options for patients with PN. In summary, Japanese patients with PN reported increased disease burden and reduced treatment satisfaction with increased disease severity, despite the use of guideline-recommended therapies.
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Affiliation(s)
- Hiroyuki Murota
- Department of Dermatology, Nagasaki University School of Medical Sciences, Nagasaki, Japan
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Paller AS, Siegfried E, Marron SE, Clark M, DiBenedetti D, Nelson L, Chao J, Bansal A, Chuang CC, Wang Z. Development and validation of a caregiver-reported Numeric Rating Scale for measuring worst scratch/itch in patients aged 6 months to younger than 6 years with atopic dermatitis. J Am Acad Dermatol 2024; 90:382-385. [PMID: 37778662 DOI: 10.1016/j.jaad.2023.08.104] [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: 03/10/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Dermatology, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois.
| | - Elaine Siegfried
- Department of Pediatrics, Saint Louis University, St. Louis, Missouri; Department of Pediatric Dematology, Cardinal Glennon Children's Hospital, St. Louis, Missouri
| | - Servando E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI + PD), Partnered with Aragon Health Sciences Institute (IACS), University Hospital Miguel Servet, Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Marci Clark
- Department of Patient-Centered Outcomes Assessment, RTI Health Solutions, Ann Arbor, Michigan
| | - Dana DiBenedetti
- Department of Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, North Carolina
| | - Lauren Nelson
- Department of Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, North Carolina
| | - Jingdong Chao
- Department of Health Economics and Outcomes Research, Regeneron Pharmaceuticals Inc., Tarrytown, New York
| | - Ashish Bansal
- Department of Immunology and Inflammation Clinical Development, Regeneron Pharmaceuticals Inc., Tarrytown, New York
| | - Chien-Chia Chuang
- Department of Health Economics and Value Assessment, Sanofi, Cambridge, Massachusetts
| | - Zhixiao Wang
- Department of Health Economics and Outcomes Research, Regeneron Pharmaceuticals Inc., Tarrytown, New York
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Schlösser AR, Boeijink N, Olydam J, Nijsten TEC, Hijnen D. Upadacitinib treatment in a real-world difficult-to-treat atopic dermatitis patient cohort. J Eur Acad Dermatol Venereol 2024; 38:384-392. [PMID: 37864486 DOI: 10.1111/jdv.19581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/29/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Upadacitinib was the first JAK-1 selective inhibitor registered for the treatment of moderate-to-severe atopic dermatitis (AD). Although efficacy and safety have been shown in clinical trials, real-world data on the use of upadacitinib in patients that have been treated with other immunosuppressants and targeted therapies is limited. OBJECTIVES To provide real-world evidence on the use of upadacitinib treatment in moderate-to-severe atopic dermatitis. METHODS In this prospective observational single-centre study, all AD patients treated with upadacitinib treatment in the context of standard care were included between August 2021 and September 2022. Clinical outcome measures and adverse events (AEs) were analysed. RESULTS Forty-eight patients were included. The majority (n = 39; 81%) had failed (ineffectiveness) on other targeted therapies, including other JAK inhibitors and biologics. Thirty-four (71%) patients were still using upadacitinib treatment at last follow up (median duration 46.5 weeks). Fourteen (29%) patients discontinued treatment due to ineffectiveness or AE. Upadacitinib treatment led to a significant decrease of disease severity during a median follow up of 37.5 weeks. Median IGA at baseline decreased from 3 (IQR 2-3) to 1.5 (IQR 1-2) at last review (p < 0.001). Median NRS itch decreased from 7 (IQR 5-8) at baseline to 2.25 (IQR 0.25-6.5) at last review (p < 0.001). Three patients discontinued treatment due to AE. Forty-eight AEs were reported, including acne-like eruptions (25%), nausea (13%) and respiratory tract infections (10%). CONCLUSIONS In this real-world cohort, we confirmed that upadacitinib is an effective treatment in a subset of AD patients that have failed several previous systemic immunosuppressive and biologic treatments. Overall, AE were mostly well tolerated and not a reason to discontinue treatment for most patients.
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Affiliation(s)
- Anne R Schlösser
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Neill Boeijink
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jill Olydam
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - DirkJan Hijnen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Eyerich K, Gooderham MJ, Silvestre JF, Shumack SP, Mendes-Bastos P, Aoki V, Ortoncelli M, Silverberg JI, Teixeira HD, Chen SH, Calimlim BM, Takemoto S, Sancho C, Fritz B, Irvine AD. Real-world clinical, psychosocial and economic burden of atopic dermatitis: Results from a multicountry study. J Eur Acad Dermatol Venereol 2024; 38:340-353. [PMID: 37669868 DOI: 10.1111/jdv.19500] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 08/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Atopic dermatitis (AD), a relapsing, inflammatory skin disease, is associated with pruritus that can negatively affect patients' quality of life. Understanding the burden of AD is critical for informing and tailoring treatment and disease management to improve patient outcomes. This study characterized global treatment patterns and the clinical, psychosocial and economic burden of moderate-to-severe AD. METHODS MEASURE-AD was a cross-sectional 28-country study in patients with physician-confirmed moderate-to-severe AD who were either receiving or eligible for systemic therapy for AD. Patients ≥12 years were enrolled between December 2019 and December 2020 while attending routine office or clinic visit. Primary outcomes included Worst Pruritus Numeric Rating Scale (WP-NRS; range: 0-10) and Dermatology Life Quality Index (DLQI; range: 0-30) and Children's DLQI (CDLQI; range: 0-30). Secondary outcomes included physician- and patient-reported clinical, psychosocial and economic burden. RESULTS Of the 1591 patients enrolled, 1558 (1434 adults and 124 adolescents) fulfilled all patient selection criteria and were included in this analysis. Almost all patients (98.4%) in the total population were using AD medications and more than half (56%) were receiving systemic medication (15% systemic monotherapy). The most used systemic therapies were dupilumab (56.3%), systemic glucocorticoids (18.1%) and methotrexate (16.2%). Mean WP-NRS was 5.3 in the total population, and most patients (≥55%) reported moderate-to-severe pruritus (WP-NRS ≥4). Mean DLQI was 10.8 and mean CDLQI was 9.6. Secondary endpoints demonstrated substantial clinical, psychosocial, and economic burden of disease. Subgroup analysis demonstrated that patients receiving systemic therapy had lower disease burden than those not taking systemic medications. CONCLUSIONS While systemic therapy lowers overall disease burden, patients with moderate-to-severe AD continue to have substantial multidimensional disease burden and uncontrolled disease. Overall, there is a need for effective disease management, including effective treatments that improve patients' psychosocial outcomes and reduce the economic burden of AD.
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Affiliation(s)
- Kilian Eyerich
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Melinda J Gooderham
- SKiN Centre for Dermatology, Peterborough, Ontario, Canada
- Queen's University, Kingston, Ontario, Canada
- Probity Medical Research Inc, Waterloo, Ontario, Canada
| | | | - Stephen P Shumack
- Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | | | - Valeria Aoki
- Department of Dermatology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - Michela Ortoncelli
- Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | | | | | | | | | - Björn Fritz
- AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
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Tupker RA, Rustemeyer T, Frölich M, Babri S, Soliman M, de Haan W, Hillebrand A. Functional brain alterations in symptomatic dermographism patients-An exploratory magnetoencephalography study. Exp Dermatol 2024; 33:e15023. [PMID: 38414092 DOI: 10.1111/exd.15023] [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: 06/08/2023] [Revised: 11/17/2023] [Accepted: 12/26/2023] [Indexed: 02/29/2024]
Abstract
Symptomatic dermographism (SD) is a common form of urticaria, which is triggered by stroking the skin. Brain involvement in its aetiology was investigated by means of magnetoencephalography (MEG) after provocation with histamine and dermography. Wheals were induced by histamine skin prick test and dermography in twelve SD patients and fourteen controls. Itch severity was scored on a Visual Analogue Scale (VAS). Relative power and functional connectivity (FC) were measured using a 306-channel whole-head MEG system at baseline and 10 min after histamine and dermography, and contrasted between groups and conditions. Furthermore, wheal diameter and itch scores after these procedures were correlated with the MEG values. SD patients had higher itch scores after histamine and dermography. No significant group-differences were observed in relative power or FC for any condition. In both groups, power decreases were mostly observed in the beta band, and power increases in the alpha bands, after provocation, with more regions involved in patients compared to controls. Increased FC was seen after histamine in patients, and after dermography in controls. In patients only, dermography and histamine wheal size correlated with the alpha2 power in the regions of interest that showed significant condition effects after these procedures. Our findings may be cautiously interpreted as aberrant itch processing, and suggest involvement of the central nervous system in the aetiology of SD.
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Affiliation(s)
- Ron A Tupker
- Dermatology Department, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Thomas Rustemeyer
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Dermatology, Amsterdam, The Netherlands
| | - Mira Frölich
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Dermatology, Amsterdam, The Netherlands
| | - Shakiba Babri
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Dermatology, Amsterdam, The Netherlands
| | - Marwa Soliman
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Dermatology, Amsterdam, The Netherlands
| | - Willem de Haan
- Amsterdam UMC Location Vrije Universiteit Medical Center (VUmc) Amsterdam, Neurology, Amsterdam, The Netherlands
| | - Arjan Hillebrand
- Amsterdam UMC Location Vrije Universiteit Medical Center (VUmc) Amsterdam, Neurology, Amsterdam, The Netherlands
- Amsterdam UMC Location VUmc Amsterdam, Clinical Neurophysiology and MEG Center, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imagin, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems & Network Neuroscience, Amsterdam, The Netherlands
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Zangouri V, Roshanshad A, Ranjbar A, Izadi M, Rajaeifar S, Goodarzi A, Nasrollahi H. Outcomes and complications of intraoperative radiotherapy versus external beam radiotherapy for early breast cancer. Cancer Rep (Hoboken) 2024; 7:e1950. [PMID: 38205671 PMCID: PMC10849931 DOI: 10.1002/cnr2.1950] [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: 06/07/2023] [Revised: 09/19/2023] [Accepted: 11/12/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Intraoperative radiotherapy (IORT) is an alternative for external beam radiotherapy (EBRT) for early stage breast cancer (BC). Herein, we compared outcomes, postoperative and post-radiation complications of IORT and EBRT. METHODS We conducted a cohort study to compare complications of IORT and EBRT in patients. A checklist of the complications of IORT and EBRT, was used to assess and post-radiation complications and outcomes. RESULTS Overall, 264 women (121 in IORT and 143 in EBRT group) with a mean (SD) age of 55 ± 8.6 years analyzed in this study. The IORT group (quadrantectomy + SLNB + IORT) had more severe post-operative pain compared to the EBRT group (quadrantectomy + SLNB) (OR = 1.929, 95% CI: 1.116-3.332). Other postoperative complications, including edema, erythema, seroma, hematoma, and wound complications were not significantly different between the IORT and EBRT groups. EBRT was associated with higher rates post-radiation complications, including erythema (95.8% vs. 21.5%), skin dryness (30.8% vs. 12.4%), pruritus (26.6% vs. 17.4%), hyperpigmentation (48.3% vs. 9.9%), and telangiectasia (1.4% vs. 0.8%). Multivariate analysis showed that erythema, skin dryness and pruritus, and hyperpigmentation were more severe in the EBRT group, while breast induration was higher in the IORT group (OR = 4.109, 95% CI: 2.242-7.531). Excellent, good, and fair cosmetic outcome was seen in 11.2%, 72%, and 16.8% of the patients in the EBRT group and 29.8%, 63.6%, and 6.6% in the IORT group, respectively, suggesting that the cosmetic outcome was significantly better in the IORT group (P < .001). There wasn't statistically significant difference in recurrence-free survival and overall survival rates between two groups of patients who received either IORT or EBRT (P = .953, P = .56). CONCLUSION IORT is considered to have lower post-radiation complications and better cosmetic outcomes in breast cancer patients. Therefore, IORT might be used as the treatment of choice in eligible patients.
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Affiliation(s)
- Vahid Zangouri
- Surgical Oncology Division, General Surgery DepartmentShiraz University of Medical SciencesShirazIran
- Breast Diseases Research CenterShiraz University of Medical SciencesShirazIran
| | - Amirhossein Roshanshad
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
- Poostchi Ophthalmology Research CenterShiraz University of Medical SciencesShirazIran
| | - Aliyeh Ranjbar
- Breast Diseases Research CenterShiraz University of Medical SciencesShirazIran
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Mahsa Izadi
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Sara Rajaeifar
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Ali Goodarzi
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Hamid Nasrollahi
- Radiation Oncology, Radio‐Oncology Department, School of MedicineShiraz University of Medical SciencesShirazIran
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El-Mesidy MS, Metwally YA, Nour ZA, Elmasry MF. Excimer light effect on neurogenic inflammation in active versus stable psoriasis lesions. Lasers Med Sci 2024; 39:54. [PMID: 38296870 PMCID: PMC10830591 DOI: 10.1007/s10103-024-04005-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/22/2024] [Indexed: 02/02/2024]
Abstract
Neurogenic inflammation, mediated by T helper 17 cell (Th17) and neurons that release neuropeptides such as substance P (SP), is thought to play a role in the pathogenesis of psoriasis. Excimer light is used in the treatment of psoriasis via induction of T cell apoptosis. The objective of this study is to study the effect of excimer light on active versus stable psoriasis and investigate the levels of substance P and its receptor in both groups. The study included 27 stable and 27 active psoriatic patients as well as 10 matched healthy controls. Clinical examination (in the form of local psoriasis severity index (PSI) and visual analogue scale (VAS)) was done to determine disease severity, level of itching, and quality of life. Tissue levels of SP and neurokinin-1 receptor (NK-1R) were measured by ELISA before and after 9 excimer light sessions in 43 patients. A statistically significant lower levels of PSI and VAS were reached after therapy with no significant difference between the stable and active groups. The mean tissue levels of SP before therapy were significantly higher than the control group. Lower levels of SP and NK-1 receptor were found after treatment overall and in each group. Excimer therapy can be effective for both stable and active plaque psoriasis and this effect could be partly through its role on ameliorating the neurogenic inflammation.
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Affiliation(s)
- Marwa S El-Mesidy
- Dermatology Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Yomna A Metwally
- Dermatology Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Zeinab A Nour
- Biochemistry Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha F Elmasry
- Dermatology Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Napolitano M, Genco L, Noto M, Fabbrocini G, Patruno C. Parapsoriasis during dupilumab treatment in three patients with a long-lasting history of atopic dermatitis. J Cosmet Dermatol 2024; 23:714-716. [PMID: 37950426 DOI: 10.1111/jocd.15995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Maddalena Napolitano
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lucia Genco
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Noto
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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