1
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Chanda T, Hauser K, Hobelsberger S, Bucher TC, Garcia CN, Wies C, Kittler H, Tschandl P, Navarrete-Dechent C, Podlipnik S, Chousakos E, Crnaric I, Majstorovic J, Alhajwan L, Foreman T, Peternel S, Sarap S, Özdemir İ, Barnhill RL, Llamas-Velasco M, Poch G, Korsing S, Sondermann W, Gellrich FF, Heppt MV, Erdmann M, Haferkamp S, Drexler K, Goebeler M, Schilling B, Utikal JS, Ghoreschi K, Fröhling S, Krieghoff-Henning E, Brinker TJ. Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma. Nat Commun 2024; 15:524. [PMID: 38225244 PMCID: PMC10789736 DOI: 10.1038/s41467-023-43095-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/31/2023] [Indexed: 01/17/2024] Open
Abstract
Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance. Explainable AI (XAI) methods can help to increase transparency, yet often lack precise, domain-specific explanations. Moreover, the impact of XAI methods on dermatologists' decisions has not yet been evaluated. Building upon previous research, we introduce an XAI system that provides precise and domain-specific explanations alongside its differential diagnoses of melanomas and nevi. Through a three-phase study, we assess its impact on dermatologists' diagnostic accuracy, diagnostic confidence, and trust in the XAI-support. Our results show strong alignment between XAI and dermatologist explanations. We also show that dermatologists' confidence in their diagnoses, and their trust in the support system significantly increase with XAI compared to conventional AI. This study highlights dermatologists' willingness to adopt such XAI systems, promoting future use in the clinic.
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Affiliation(s)
- Tirtha Chanda
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katja Hauser
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sarah Hobelsberger
- Department of Dermatology, University Hospital, Technical University Dresden, Dresden, Germany
| | - Tabea-Clara Bucher
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Carina Nogueira Garcia
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christoph Wies
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty of University Heidelberg, Heidelberg, Germany
| | - Harald Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Philipp Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastian Podlipnik
- Dermatology Department, Hospital Clínic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Emmanouil Chousakos
- 1st Department of Pathology, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Iva Crnaric
- Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | | | - Linda Alhajwan
- Department of Dermatology, Dubai London Clinic, Dubai, United Arab Emirates
| | | | - Sandra Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | | | - İrem Özdemir
- Department of Dermatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Raymond L Barnhill
- Department of Translational Research, Institut Curie, Unit of Formation and Research of Medicine University of Paris, Paris, France
| | | | - Gabriela Poch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Berlin, Germany
| | - Sören Korsing
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Wiebke Sondermann
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Markus V Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Erdmann
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Haferkamp
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Konstantin Drexler
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Bastian Schilling
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Jochen S Utikal
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - Kamran Ghoreschi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Berlin, Germany
| | - Stefan Fröhling
- Division of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eva Krieghoff-Henning
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Titus J Brinker
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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2
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Cao AL, Adelman M, Sivesind TE, Contreras-Ruiz J, Peternel S, Dellavalle RP. From the Cochrane Library: Interventions for Pityriasis Rosea. J Am Acad Dermatol 2023:S0190-9622(23)00683-7. [PMID: 37062465 DOI: 10.1016/j.jaad.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/28/2023] [Accepted: 04/09/2023] [Indexed: 04/18/2023]
Affiliation(s)
- Annie L Cao
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Madeline Adelman
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Torunn E Sivesind
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Sandra Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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3
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Hlaca N, Zagar T, Kastelan M, Peternel S, Brajac I, Dujmovic-Hasanbegovic K, Prpic-Massari L. Pityriasis rubra pilaris following booster dose of mRNA (Pfizer-BioNTech) COVID-19 vaccine. Dermatol Ther 2022; 35:e15791. [PMID: 36029037 PMCID: PMC9538535 DOI: 10.1111/dth.15791] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/27/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Nika Hlaca
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tina Zagar
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Marija Kastelan
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Sandra Peternel
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Ines Brajac
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Katarina Dujmovic-Hasanbegovic
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Larisa Prpic-Massari
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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4
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Hlaca N, Zagar T, Kastelan M, Peternel S, Brajac I, Prpic‐Massari L. New-onset lichen planus and lichen planus flare in elderly women after COVID-19 vaccination. J Cosmet Dermatol 2022; 21:3679-3681. [PMID: 35754299 PMCID: PMC9349570 DOI: 10.1111/jocd.15185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/08/2022] [Accepted: 06/20/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Nika Hlaca
- Department of DermatovenerologyClinical Hospital Centre RijekaRijekaCroatia,Faculty of MedicineUniversity of RijekaRijekaCroatia
| | - Tina Zagar
- Department of DermatovenerologyClinical Hospital Centre RijekaRijekaCroatia,Faculty of MedicineUniversity of RijekaRijekaCroatia
| | - Marija Kastelan
- Department of DermatovenerologyClinical Hospital Centre RijekaRijekaCroatia,Faculty of MedicineUniversity of RijekaRijekaCroatia
| | - Sandra Peternel
- Department of DermatovenerologyClinical Hospital Centre RijekaRijekaCroatia,Faculty of MedicineUniversity of RijekaRijekaCroatia
| | - Ines Brajac
- Department of DermatovenerologyClinical Hospital Centre RijekaRijekaCroatia,Faculty of MedicineUniversity of RijekaRijekaCroatia
| | - Larisa Prpic‐Massari
- Department of DermatovenerologyClinical Hospital Centre RijekaRijekaCroatia,Faculty of MedicineUniversity of RijekaRijekaCroatia
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5
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Batinac T, Hlača N, Simetić L, Valković F, Peternel S, Prpić-Massari L. Stevens-Johnson Syndrome and Severe Anaemia: A Case of Toxicity Induced by Vemurafenib plus Cobimetinib following Pembrolizumab for Metastatic Melanoma. Acta Derm Venereol 2022; 102:adv00650. [PMID: 35146529 PMCID: PMC9558335 DOI: 10.2340/actadv.v102.1433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | | | | | - Sandra Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, HR-51000, Rijeka, Croatia.
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6
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Žagar T, Hlača N, Brajac I, Prpić-Massari L, Peternel S, Kaštelan M. Bullous Sweet syndrome following SARS-CoV-2 Oxford AstraZeneca vaccine. Br J Dermatol 2021; 186:e110. [PMID: 34817862 DOI: 10.1111/bjd.20876] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 01/17/2023]
Affiliation(s)
- T Žagar
- Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - N Hlača
- Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - I Brajac
- Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - L Prpić-Massari
- Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - S Peternel
- Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - M Kaštelan
- Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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7
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de la Fouchardière A, Tee MK, Peternel S, Valdebran M, Pissaloux D, Tirode F, Busam KJ, LeBoit PE, McCalmont TH, Bastian BC, Yeh I. Fusion partners of NTRK3 affect subcellular localization of the fusion kinase and cytomorphology of melanocytes. Mod Pathol 2021; 34:735-747. [PMID: 32968185 PMCID: PMC7985048 DOI: 10.1038/s41379-020-00678-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 02/08/2023]
Abstract
A subset of Spitz tumors harbor fusions of NTRK3 with ETV6, MYO5A, and MYH9. We evaluated a series of 22 melanocytic tumors in which an NTRK3 fusion was identified as part of the diagnostic workup. Tumors in which NTRK3 was fused to ETV6 occurred in younger patients were predominantly composed of epithelioid melanocytes and were classified by their histopathologic features as Spitz tumors. In contrast, those in which NTRK3 was fused to MYO5A were predominantly composed of spindled melanocytes arrayed in fascicles with neuroid features such as pseudo-Verocay bodies. To further investigate the effects of the fusion kinases ETV6-NTRK3 and MYO5A-NTRK3 in melanocytes, we expressed them in immortalized melanocytes and determined their subcellular localization by immunofluorescence. ETV6-NTRK3 was localized to the nucleus and diffusely within the cytoplasm and caused melanocytes to adopt an epithelioid cytomorphology. In contrast, MYO5A-NTRK3, appeared excluded from the nucleus of melanocytes, was localized to dendrites, and resulted in a highly dendritic cytomorphology. Our findings indicate that ETV6-NTRK3 and MYO5A-NTRK3 have distinct subcellular localizations and effects on cellular morphology.
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Affiliation(s)
- Arnaud de la Fouchardière
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Meng Kian Tee
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Sandra Peternel
- Department of Dermatovenereology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Manuel Valdebran
- Department of Dermatology and Dermatologic Surgery, Medical College of South Carolina, Charleston, SC, USA
| | - Daniel Pissaloux
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Franck Tirode
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Philip E LeBoit
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
- Departments of Dermatology and Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Timothy H McCalmont
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
- Departments of Dermatology and Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Boris C Bastian
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
- Departments of Dermatology and Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Iwei Yeh
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
- Departments of Dermatology and Pathology, University of California San Francisco, San Francisco, CA, USA.
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8
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Peinemann F, Harari M, Peternel S, Chan T, Chan D, Labeit AM, Gambichler T. Indoor balneophototherapy for chronic plaque psoriasis: Abridged Cochrane Review. Dermatol Ther 2020; 34:e14588. [PMID: 33236826 DOI: 10.1111/dth.14588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 01/20/2023]
Abstract
Artificial exposure to ultraviolet B light (UVB) while soaking in an indoor salt bath, also called balneophototherapy, could simulate the natural exposure to the sun while bathing in the Dead Sea. We aimed to assess the effects of this intervention on patients with chronic plaque psoriasis. We searched CENTRAL, MEDLINE, Embase, and LILACS up to June 2019. We included randomized controlled trials (RCTs). The primary efficacy outcome was psoriasis area and severity index (PASI)-75 to detect people with a 75% or more reduction in the PASI score from baseline. The primary adverse outcome was treatment-related adverse events requiring withdrawal. We included eight RCTs (2105 participants; 1976 analyzed). With respect to PASI-75, two studies found that salt bath + UVB may improve psoriasis when compared to UVB alone (risk ratio 1.71, 95% confidence interval 1.24 to 2.35; 278 participants). With respect to treatment-related adverse events requiring withdrawal, two other studies found little to no difference when compared to UVB alone (risk ratio 0.96, 95% confidence interval 0.35 to 2.64; 404 participants). Salt bath + UVB could improve psoriasis when compared to UVB alone, though, results are based on a limited number of studies and provide low-certainty evidence.
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Affiliation(s)
- Frank Peinemann
- Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Marco Harari
- Dead-Sea and Arava Science Center, Ein Bokek, Israel
| | - Sandra Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, Rijeka, Croatia.,University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - Thalia Chan
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - David Chan
- c/o Cochrane Skin Group, The University of Nottingham, Nottingham, UK
| | - Alexander M Labeit
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Thilo Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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9
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Saint-Georges V, Peternel S, Brajac I, Prpić Massari L, Kaštelan M. Biologic and Targeted Therapy in the Treatment of Psoriasis - A Retrospective Study from a National Referral Center. Acta Dermatovenerol Croat 2020; 28:127-132. [PMID: 33422165] [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: 06/12/2023]
Abstract
Psoriasis is one of the most common chronic inflammatory skin disorders worldwide with a significant number of patients suffering from moderate to severe disease and requiring systemic therapy. Over the past two decades, better knowledge of disease pathophysiology has translated into treatment advances for both primary disease and its associated comorbidities. However, it is important to review the use of biologic or targeted therapy in a clinical setting in order to understand how to optimize therapeutic results and recognize any unmet needs in this patient subpopulation. We conducted a retrospective study on a cohort of patients diagnosed with psoriasis that had received at least one dose of biologic or targeted therapy for the treatment of psoriasis at the Rijeka Clinical Hospital Center. By documenting treatment trends and specific patient characteristics, we will be able to address any unmet needs in this patient population and provide individualized care strategies.
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Affiliation(s)
- Valentina Saint-Georges
- Valentina Saint-Georges, MD, Department of Dermatovenereology , Pula General Hospital, Zagrebačka 32, 52100 Pula, Croatia;
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10
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Peinemann F, Harari M, Peternel S, Chan T, Chan D, Labeit AM, Gambichler T. Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis: abridged Cochrane review. Br J Dermatol 2020; 183:1123-1124. [PMID: 32628281 DOI: 10.1111/bjd.19385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
- F Peinemann
- Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - M Harari
- Dead Sea and Arava Science Center, Dead Sea Branch, Ein Bokek, Israel
| | - S Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, Rijeka, Croatia.,University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - T Chan
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - D Chan
- Cochrane Skin Group, The University of Nottingham, Nottingham, UK
| | - A M Labeit
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - T Gambichler
- Department of Dermatology, Ruhr-Universität Bochum, Bochum, Germany
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11
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Raghavan SS, Peternel S, Mully TW, North JP, Pincus LB, LeBoit PE, McCalmont TH, Bastian BC, Yeh I. Spitz melanoma is a distinct subset of spitzoid melanoma. Mod Pathol 2020; 33:1122-1134. [PMID: 31900433 PMCID: PMC7286778 DOI: 10.1038/s41379-019-0445-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 11/28/2019] [Indexed: 01/20/2023]
Abstract
Melanomas that have histopathologic features that overlap with those of Spitz nevus are referred to as spitzoid melanomas. However, the diagnostic concept is used inconsistently and genomic analyses suggest it is a heterogeneous category. Spitz tumors, the spectrum of melanocytic neoplasms extending from Spitz nevi to their malignant counterpart Spitz melanoma, are defined in the 2018 WHO classification of skin tumors by the presence of specific genetic alterations, such as kinase fusions or HRAS mutations. It is unclear what fraction of "spitzoid melanomas" defined solely by their histopathologic features belong to the category of Spitz melanoma or to other melanoma subtypes. We assembled a cohort of 25 spitzoid melanomas diagnosed at a single institution over an 8-year period and performed high-coverage DNA sequencing of 480 cancer related genes. Transcriptome wide RNA sequencing was performed for select cases. Only nine cases (36%) had genetic alterations characteristic of Spitz melanoma, including HRAS mutation or fusion involving BRAF, ALK, NTRK1, or MAP3K8. The remaining cases were divided into those with an MAPK activating mutation and those without an MAPK activating mutation. Both Spitz melanoma and spitzoid melanomas in which an MAPK-activating mutation could not be identified tended to occur in younger patients on skin with little solar elastosis, infrequently harbored TERT promoter mutations, and had a lower burden of pathogenic mutations than spitzoid melanomas with non-Spitz MAPK-activating mutations. The MAPK-activating mutations identified affected non-V600 residues of BRAF as well as NRAS, MAP2K1/2, NF1, and KIT, while BRAF V600 mutations, the most common mutations in melanomas of the WHO low-CSD category, were entirely absent. While the "spitzoid melanomas" comprising our cohort were enriched for bona fide Spitz melanomas, the majority of melanomas fell outside of the genetically defined category of Spitz melanomas, indicating that histomorphology is an unreliable predictor of Spitz lineage.
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Affiliation(s)
| | - Sandra Peternel
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA
- Department of Dermatovenerology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Thaddeus W Mully
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey P North
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Laura B Pincus
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Philip E LeBoit
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Timothy H McCalmont
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Boris C Bastian
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Iwei Yeh
- Departments of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA.
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12
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Peinemann F, Harari M, Peternel S, Chan T, Chan D, Labeit AM, Gambichler T. Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis. Cochrane Database Syst Rev 2020; 5:CD011941. [PMID: 32368795 PMCID: PMC7199317 DOI: 10.1002/14651858.cd011941.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chronic plaque psoriasis is an immune-mediated, chronic, inflammatory skin disease, which can impair quality of life and social interaction. Disease severity can be classified by the psoriasis area and severity index (PASI) score ranging from 0 to 72 points. Indoor artificial salt bath with or without artificial ultraviolet B (UVB) light is used to treat psoriasis, simulating sea bathing and sunlight exposure; however, the evidence base needs clear evaluation. OBJECTIVES To assess the effects of indoor (artificial) salt water baths followed by exposure to artificial UVB for treating chronic plaque psoriasis in adults. SEARCH METHODS We searched the following databases up to June 2019: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trial registers, and checked the reference lists of included studies, recent reviews, and relevant papers for further references to relevant trials. SELECTION CRITERIA Randomised controlled trials (RCTs) of salt bath indoors followed by exposure to artificial UVB in adults who have been diagnosed with chronic plaque type psoriasis. We included studies reporting between-participant data and within-participant data. We evaluated two different comparisons: 1) salt bath + UVB versus other treatment without UVB; eligible comparators were exposure to psoralen bath, psoralen bath + artificial ultraviolet A UVA) light, topical treatment, systemic treatment, or placebo, and 2) salt bath + UVB versus other treatment + UVB or UVB only; eligible comparators were exposure to bath containing other compositions or concentrations + UVB or UVB only. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. We used GRADE to assess the certainty of the evidence. The primary efficacy outcome was PASI-75, to detect people with a 75% or more reduction in PASI score from baseline. The primary adverse outcome was treatment-related adverse events requiring withdrawal. For the dichotomous variables PASI-75 and treatment-related adverse events requiring withdrawal, we estimated the proportion of events among the assessed participants. The secondary outcomes were health-related quality of life using the Dermatology Life Quality Index, (DLQI) pruritus severity measured using a visual analogue scale, time to relapse, and secondary malignancies. MAIN RESULTS We included eight RCTs: six reported between-participant data (2035 participants; 1908 analysed), and two reported within-participant data (70 participants, 68 analysed; 140 limbs; 136 analysed). One study reported data for the comparison salt bath with UVB versus other treatment without UVB; and eight studies reported data for salt bath with UVB versus other treatment with UVB or UVB only. Of these eight studies, only five reported any of our pre-specified outcomes and assessed the comparison of salt bath with UVB versus UVB only. The one included trial that assessed salt bath plus UVB versus other treatment without UVB (psoralen bath + UVA) did not report any of our primary outcomes. The mean age of the participants ranged from 41 to 50 years of age in 75% of the studies. None of the included studies reported on the predefined secondary outcomes of this review. We judged seven of the eight studies as at high risk of bias in at least one domain, most commonly performance bias. Total trial duration ranged between at least two months and up to 13 months. In five studies, the median participant PASI score at baseline ranged from 15 to 18 and was balanced between treatment arms. Three studies did not report PASI score. Most studies were conducted in Germany; all were set in Europe. Half of the studies were multi-centred (set in spa centres or outpatient clinics); half were set in a single centre in either an unspecified settings, a psoriasis daycare centre, or a spa centre. Commercial spa or salt companies sponsored three of eight studies, health insurance companies funded another, the association of dermatologists funded another, and three did not report on funding. When comparing salt bath plus UVB versus UVB only, two between-participant studies found that salt bath plus UVB may improve psoriasis when measured using PASI 75 (achieving a 75% or more reduction in PASI score from baseline) (risk ratio (RR) 1.71, 95% confidence interval (CI) 1.24 to 2.35; 278 participants; low-certainty evidence). Assessment was conducted at the end of treatment, which was equivalent to six to eight weeks after start of treatment. The two trials which contributed data for the primary efficacy outcome were conducted by the same group, and did not blind outcome assessors. The German Spas Association funded one of the trials and the funding source was not stated for the other trial. Two other between-participant studies found salt bath plus UVB may make little to no difference to outcome treatment-related adverse events requiring withdrawal compared with UVB only (RR 0.96, 95% CI 0.35 to 2.64; 404 participants; low-certainty evidence). One of the studies reported adverse events, but did not specify the type of events; the other study reported skin irritation. One within-participant study found similar results, with one participant reporting severe itch immediately after Dead Sea salt soak in the salt bath and UVB group and two instances of inadequate response to phototherapy and conversion to psoralen bath + UVA reported in the UVB only group (low-certainty evidence). AUTHORS' CONCLUSIONS Salt bath with artificial ultraviolet B (UVB) light may improve psoriasis in people with chronic plaque psoriasis compared with UVB light treatment alone, and there may be no difference in the occurrence of treatment-related adverse events requiring withdrawal. Both results are based on data from a limited number of studies, which provided low-certainty evidence, so we cannot draw any clear conclusions. The reporting of our pre-specified outcomes was either non-existent or limited, with a maximum of two studies reporting a given outcome. The same group conducted the two trials which contributed data for the primary efficacy outcome, and the German Spas Association funded one of these trials. We recommend further RCTs that assess PASI-75, with detailed reporting of the outcome and time point, as well as treatment-related adverse events. Risk of bias was an issue; future studies should ensure blinding of outcome assessors and full reporting.
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Affiliation(s)
- Frank Peinemann
- Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Marco Harari
- Dead-Sea and Arava Science Center, Dead Sea Branch, Ein Bokek, Israel
| | - Sandra Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, Rijeka, Croatia
- University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - Thalia Chan
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - David Chan
- c/o Cochrane Skin Group, The University of Nottingham, Nottingham, UK
| | - Alexander M Labeit
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Thilo Gambichler
- Department of Dermatology, Ruhr-Universität Bochum, Bochum, Germany
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Zigante M, Peternel S, Muhvic Urek M, Rincic Mlinaric M, Pop Acev D, Spalj S. Smell and taste in titanium and nickel allergic sensitization in orthodontic patients. Orthod Craniofac Res 2020; 23:517-522. [PMID: 32301238 DOI: 10.1111/ocr.12379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/04/2020] [Accepted: 04/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the prevalence of allergic sensitization to titanium and nickel in orthodontic patients and to evaluate alterations of smell and taste. SUBJECTS AND METHODS A total of 250 subjects were invited to participate, 245 accepted. The age range was 11-45 years, 68% were females and 52% adolescents. An epicutaneous patch test was performed. Of the positive subjects in the patch test, 26 participated in the taste and smell testing and were matched by age and sex with 26 negative subjects. RESULTS The prevalence of hypersensitivity to titanium and/or nickel in orthodontic patients was 15.5%. Taste and smell were more impaired in sensitized subjects (P ≤ .025), taste was more affected than smell and the tastes most affected were sour and bitter tastes, while the sweet taste was least impaired. CONCLUSION The allergic sensitization to titanium is more uncommon than to nickel, with altered smell and taste related to those hypersensitivities.
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Affiliation(s)
- Martina Zigante
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Sandra Peternel
- Department of Dermatovenereology, Faculty of Medicine, University of Rijeka, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Miranda Muhvic Urek
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | | | | | - Stjepan Spalj
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Clinical Hospital Center Rijeka, Rijeka, Croatia
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Behrouz-Pirnia A, Liu H, Peternel S, Dervishi G, Labeit A, Peinemann F. Early laser intervention to reduce scar formation in wound healing by primary intention: A systematic review. J Plast Reconstr Aesthet Surg 2019; 73:528-536. [PMID: 31757687 DOI: 10.1016/j.bjps.2019.09.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/24/2019] [Accepted: 09/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypertrophic scars frequently follow primary closure of surgical wounds. Laser application at or shortly after suture may be associated with a reduction in scar formation, although the respective study results vary. AIM The objective was to evaluate the efficacy of early laser applied within the first six months after surgery to reduce scar formation compared to no treatment. METHODS We searched the databases MEDLINE and CENTRAL on 14 January 2019 and included randomized controlled trials (RCTs). Primary outcome was the Vancouver Scar Scale (VSS). Measure of treatment effect was the mean difference from baseline. RESULTS Seventeen relevant RCTs randomized 430 scars (413 assessed) and compared laser versus no treatment. Fourteen studies applied a split-scar and three applied a simple parallel design. Three studies with a split-scar design favored the laser group on VSS, and one study had indifferent findings. Considerable heterogeneity I2 = 86% did not justify a meta-analysis. The remaining 13 studies did not report appropriate data. CONCLUSION On the basis of the currently available evidence, we are uncertain whether early laser can reduce scar formation, and more high-quality research is needed for a definitive conclusion.
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Affiliation(s)
- Armin Behrouz-Pirnia
- Children's Hospital, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
| | - Haibo Liu
- Department of Dermatology, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Rd, Xuanwu District, 210002 Nanjing, Jiangsu, China.
| | - Sandra Peternel
- Department of Dermatovenereology, Clinical Hospital Centre Rijeka, Krešimirova ul. 42, 51000 Rijeka, Croatia; Faculty of Medicine, University of Rijeka, Ul. Braće Branchetta 20/1, 51000, Rijeka, Croatia.
| | - Gezim Dervishi
- Children's Hospital, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
| | - Alexander Labeit
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549 Singapore.
| | - Frank Peinemann
- Children's Hospital, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; FOM University of Applied Science for Economics & Management, Leimkugelstraße 6, 45141 Essen, Germany.
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Contreras‐Ruiz J, Peternel S, Jiménez Gutiérrez C, Culav‐Koscak I, Reveiz L, Silbermann‐Reynoso MDL. Interventions for pityriasis rosea. Cochrane Database Syst Rev 2019; 2019:CD005068. [PMID: 31684696 PMCID: PMC6819167 DOI: 10.1002/14651858.cd005068.pub3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pityriasis rosea is a scaly, itchy rash that mainly affects young adults and lasts for 2 to 12 weeks. The effects of many available treatments are uncertain. This is an update of a Cochrane Review first published in 2007. OBJECTIVES To assess the effects of interventions for the management of pityriasis rosea in any individual diagnosed by a medical practitioner. SEARCH METHODS We updated our searches of the following databases to October 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We searched five trials registers. We also checked the reference lists of included and excluded studies, contacted trial authors, scanned the abstracts from major dermatology conference proceedings, and searched the CAB Abstracts database. We searched PubMed for adverse effects to November 2018. SELECTION CRITERIA Randomised controlled trials of interventions in pityriasis rosea. Treatment could be given in a single therapy or in combination. Eligible comparators were no treatment, placebo, vehicle only, another active compound, or placebo radiation treatment. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by the Cochrane. Our key outcomes were good or excellent rash improvement within two weeks, rated separately by the participant and medical practitioner; serious adverse events; resolution of itch within two weeks (participant-rated); reduction in itch score within two weeks (participant-rated); and minor participant-reported adverse events not requiring withdrawal of the treatment. MAIN RESULTS We included 14 trials (761 participants). In general, risk of selection bias was unclear or low, but risk of performance bias and reporting bias was high for 21% of the studies. Participant age ranged from 2 to 60 years, and sex ratio was similar. Disease severity was measured by various severity indices, which the included studies did not categorise. Six studies were conducted in India, three in Iran, two in the Philippines, and one each in Pakistan, the USA, and China. The included studies were conducted in dermatology departments and a paediatric clinic. Study duration ranged from 5 to 26 months. Three studies were funded by drug manufacturers; most studies did not report their funding source. The included studies assessed macrolide antibiotics, an antiviral agent, phototherapy, steroids and antihistamine, and Chinese medicine. None of the studies measured participant-rated good or excellent rash improvement. All reported outcomes were assessed within two weeks of treatment, except for adverse effects, which were measured throughout treatment. There is probably no difference between oral clarithromycin and placebo in itch resolution (risk ratio (RR) 0.84, 95% confidence interval (CI) 0.47 to 1.52; 1 study, 28 participants) or rash improvement (medical practitioner-rated) (RR 1.13, 95% CI 0.89 to 1.44; 1 study, 60 participants). For this comparison, there were no serious adverse events (1 study, 60 participants); minor adverse events and reduction in itch score were not measured; and all evidence was of moderate quality. When compared with placebo, erythromycin may lead to increased rash improvement (medical practitioner-rated) (RR 4.02, 95% CI 0.28 to 56.61; 2 studies, 86 participants, low-quality evidence); however, the 95% CI indicates that the result may also be compatible with a benefit of placebo, and there may be little or no difference between treatments. Itch resolution was not measured, but one study measured reduction in itch score, which is probably larger with erythromycin (MD 3.95, 95% CI 3.37 to 4.53; 34 participants, moderate-quality evidence). In the same single, small trial, none of the participants had a serious adverse event, and there was no clear difference between groups in minor adverse events, which included gastrointestinal upset (RR 2.00, CI 0.20 to 20.04; moderate-quality evidence). Two trials compared oral azithromycin to placebo or vitamins. There is probably no difference between groups in itch resolution (RR 0.83, 95% CI 0.28 to 2.48) or reduction in itch score (MD 0.04, 95% CI -0.35 to 0.43) (both outcomes based on one study; 70 participants, moderate-quality evidence). Low-quality evidence from two studies indicates there may be no difference between groups in rash improvement (medical practitioner-rated) (RR 1.02, 95% CI 0.52 to 2.00; 119 participants). In these same two studies, no serious adverse events were reported, and there was no clear difference between groups in minor adverse events, specifically mild abdominal pain (RR 5.82, 95% CI 0.72 to 47.10; moderate-quality evidence). Acyclovir was compared to placebo, vitamins, or no treatment in three trials (all moderate-quality evidence). Based on one trial (21 participants), itch resolution is probably higher with placebo than with acyclovir (RR 0.34, 95% CI 0.12 to 0.94); reduction in itch score was not measured. However, there is probably a significant difference between groups in rash improvement (medical practitioner-rated) in favour of acyclovir versus all comparators (RR 2.45, 95% CI 1.33 to 4.53; 3 studies, 141 participants). Based on the same three studies, there were no serious adverse events in either group, and there was probably no difference between groups in minor adverse events (only one participant in the placebo group experienced abdominal pain and diarrhoea). One trial compared acyclovir added to standard care (calamine lotion and oral cetirizine) versus standard care alone (24 participants). The addition of acyclovir may lead to increased itch resolution (RR 4.50, 95% CI 1.22 to 16.62) and reduction in itch score (MD 1.26, 95% CI 0.74 to 1.78) compared to standard care alone. Rash improvement (medical practitioner-rated) was not measured. The trial reported no serious adverse events in either group, and there may be no difference between groups in minor adverse events, such as headache (RR 7.00, 95% CI 0.40 to 122.44) (all results based on low-quality evidence). AUTHORS' CONCLUSIONS When compared with placebo or no treatment, oral acyclovir probably leads to increased good or excellent, medical practitioner-rated rash improvement. However, evidence for the effect of acyclovir on itch was inconclusive. We found low- to moderate-quality evidence that erythromycin probably reduces itch more than placebo. Small study sizes, heterogeneity, and bias in blinding and selective reporting limited our conclusions. Further research is needed to investigate different dose regimens of acyclovir and the effect of antivirals on pityriasis rosea.
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Affiliation(s)
- Jose Contreras‐Ruiz
- Hospital General Dr. Manuel Gea GonzálezDepartment of DermatologyPuente de Piedra 150‐T1‐C111. Col. Toriello GuerraMexico CityMexico14050
| | - Sandra Peternel
- Clinical Hospital Center RijekaDepartment of DermatovenereologyKresimirova 42RijekaCroatia51000
- University of Rijeka, Faculty of MedicineRijekaCroatia51000
| | - Carlos Jiménez Gutiérrez
- Universidad Tecnologica de México‐Laureate International UniversitiesAdscrito Unidad de Investigación TraslacionalKinchil 234‐3Col. Heroes de Padierna. Delegación TlalpanMéxico.DFDFMexico14200
| | - Ivana Culav‐Koscak
- General hospital "Dr. Ivo Pedisic"Department of Dermatology and VenereologyJ.J. Strossmayera 59SisakCroatia44000
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Dervishi G, Liu H, Peternel S, Labeit A, Peinemann F. Autologous platelet-rich plasma therapy for pattern hair loss: A systematic review. J Cosmet Dermatol 2019; 19:827-835. [PMID: 31452328 DOI: 10.1111/jocd.13113] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/14/2019] [Accepted: 07/29/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Androgenetic alopecia (male pattern and female pattern hair loss) is characterized by thinning of the scalp hair. Intradermal injection of autologous platelet-rich plasma (PRP) might have an effect on hair regrowth. AIMS The aim was to evaluate efficacy and safety of platelet-rich plasma compared to placebo or no treatment in people with pattern hair loss. PATIENTS/METHODS We searched the databases CENTRAL and MEDLINE on December 24, 2018 and included randomized controlled trials (RCTs). Primary outcomes were mean change of hair density from baseline and serious treatment-related adverse events. Secondary outcome was mean change of hair thickness from baseline. Time point of outcome assessment was 6 months after start of treatment. RESULTS We identified 13 relevant randomized controlled trials with 356 randomized (343 analyzed) people or half-head areas who received PRP in a simple parallel or half-head design. The pooled data of seven studies (171 analyzed people or half-head areas) were favorable in the PRP group on hair density. We estimated a mean difference from baseline of 30.35 associated with a wide 95% confidence interval (1.77-58.93), a considerable heterogeneity (I2 = 100%), and unclear risk of bias in most of the studies. Regarding hair thickness, data were also favorable in the PRP group, but these data were limited to a single study. We did not identify serious treatment-related adverse events. CONCLUSION The results of seven RCTs indicated that autologous platelet-rich plasma was associated with an increase of hair density when compared to placebo.
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Affiliation(s)
- Gezim Dervishi
- Children's Hospital, University Hospital Cologne, Cologne, Germany
| | - Haibo Liu
- Department of Dermatology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Sandra Peternel
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Alexander Labeit
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Frank Peinemann
- Children's Hospital, University Hospital Cologne, Cologne, Germany.,FOM University of Applied Science for Economics & Management, Essen, Germany
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See SHC, Peternel S, Adams D, North JP. Distinguishing histopathologic features of acantholytic dermatoses and the pattern of acantholytic hypergranulosis. J Cutan Pathol 2018; 46:6-15. [DOI: 10.1111/cup.13356] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Sharlene Helene C. See
- Department of Dermatology; University of California San Francisco; San Francisco California
- Department of Pathology; University of California San Francisco; San Francisco California
| | - Sandra Peternel
- Department of Dermatology; University of California San Francisco; San Francisco California
- Department of Pathology; University of California San Francisco; San Francisco California
- Department of Dermatovenereology, University of Rijeka, Faculty of Medicine; Rijeka Croatia
| | - Derrick Adams
- Lassen Medical Clinic, Dermatology division; Red Bluff California
| | - Jeffrey P. North
- Department of Dermatology; University of California San Francisco; San Francisco California
- Department of Pathology; University of California San Francisco; San Francisco California
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Saint-Georges V, Peternel S, Kaštelan M, Brajac I. Tumor Necrosis Factor Antagonists in the Treatment of Pyoderma Gangrenosum, Acne, and Suppurative Hidradenitis (PASH) Syndrome. Acta Dermatovenerol Croat 2018; 26:173-178. [PMID: 29989876] [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: 06/08/2023]
Abstract
The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (HS) has been described under the acronym PASH syndrome and is considered to represent a distinct entity in the group of autoinflammatory diseases. It is a fairly new, only recently recognized disorder with a limited number of reported cases and without defined treatment recommendations. We aimed to summarize currently available data on the use of tumor necrosis factor (TNF) antagonists in the management of PASH syndrome and report on our own experience with the use of adalimumab in a patient presenting with this specific constellation of clinical signs and symptoms. Among the 11 cases identified in the literature, infliximab and adalimumab were the most commonly used agents, both exhibiting favorable effects in the majority of, but not all, patients. This was particularly evident in terms of relatively rapid remission of PG whereas HS lesions seemed to be more resistant to treatment. In our patient, adalimumab monotherapy resulted in a remarkable and sustained remission, although significant improvement of HS lesions was observed only from week 16 of therapy onwards. In summary, TNF antagonists are a promising treatment for PASH; however, conclusions regarding the choice of a specific agent, optimal dosing or use in combination with other treatment modalities cannot yet be drawn.
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Affiliation(s)
| | - Sandra Peternel
- Assist. Prof. Sandra Peternel, MD, PhD, Department of Dermatology and Venereology, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia;
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Vičić M, Peternel S, Simonić E, Sotošek-Tokmadžić V, Massari D, Brajac I, Kaštelan M, Prpić-Massari L. Cytotoxic T lymphocytes as a potential brake of keratinocyte proliferation in psoriasis. Med Hypotheses 2015; 87:66-8. [PMID: 26826643 DOI: 10.1016/j.mehy.2015.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 11/18/2015] [Accepted: 12/07/2015] [Indexed: 01/08/2023]
Abstract
Psoriasis is a chronic papulosquamous skin disease, histologically characterized by epidermal hyperproliferation and dermal infiltration of inflammatory cells. The majority of T lymphocytes infiltrating dermis are CD4+ T lymphocytes secreting type 1 and type 17 cytokines. These cytokines are responsible for triggering keratinocyte proliferation as well as chemokine secretion and subsequent migration of other inflammatory cells in the skin. Contrarily, lymphocytes that accumulate in epidermis are mainly CD8+ T lymphocytes. According to the recent findings, these cells can also secrete type 1 and type 17 cytokines. However, it is demonstrated so far that epidermal CD8+ T lymphocytes contain higher amounts of cytolytic molecules, such as perforin, granzyme B and granulysin whose role in psoriasis pathogenesis is still unknown. Therefore, in this article we hypothesize the active involvement of cell mediated cytotoxicity in killing the proliferating keratinocytes as a mechanism of potential self-defense and possible brake in psoriatic plaque formation, maintaining skin homeostasis.
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Affiliation(s)
- Marijana Vičić
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Sandra Peternel
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Edita Simonić
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Vlatka Sotošek-Tokmadžić
- Department of Physiology and Immunology, Medical Faculty, University of Rijeka, B. Branchetta 20, 51000 Rijeka, Croatia
| | - Dražen Massari
- Division of Rheumatology and Physical Medicine, Hospital for Medical Rehabilitation of the Hearth and Lung Diseases and Rheumatism "Thalassotherapia" Opatija, M. Tita 188, 51410 Opatija, Croatia
| | - Ines Brajac
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Marija Kaštelan
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Larisa Prpić-Massari
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia.
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Peinemann F, Harari M, Peternel S, Chan T, Gambichler T. Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis. Hippokratia 2015. [DOI: 10.1002/14651858.cd011941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Frank Peinemann
- Children's Hospital, University of Cologne; Pediatric Oncology and Hematology; Kerpener Str. 62 Cologne NW Germany 50937
| | - Marco Harari
- Dead-Sea and Arava Science Center, Dead Sea Branch; Lot Spa Hotel, the Dead Sea Ein Bokek Israel 86930
| | - Sandra Peternel
- Clinical Hospital Centre Rijeka; Department of Dermatovenerology; Kresimirova 42 Rijeka Croatia 51000
- University in Rijeka; School of Medicine; Rijeka Croatia
| | - Thalia Chan
- King's College London; Faculty of Life Sciences & Medicine; Flat 24, 71G Drayton Park London UK N5 1DT
| | - Thilo Gambichler
- Ruhr-Universität Bochum; Department of Dermatology; Gudrunstrasse 56 Bochum Germany 44791
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Simonić E, Peternel S, Stojnić-Soša L, Rončević-Gržeta I, Prpić-Massari L, Massari D, Periša D, Čabrijan L, Kaštelan M. Erratum to: Negative and positive life experiences in patients with psoriatic arthritis. Rheumatol Int 2013. [DOI: 10.1007/s00296-012-2655-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Peternel S, Manestar-Blažić T, Brajac I, Prpić-Massari L, Kaštelan M. Expression of TWEAK in normal human skin, dermatitis and epidermal neoplasms: association with proliferation and differentiation of keratinocytes. J Cutan Pathol 2011; 38:780-9. [PMID: 21797919 DOI: 10.1111/j.1600-0560.2011.01762.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) has been implicated in the pathogenesis of various inflammatory pathologies and cancer. We aimed to investigate its expression in normal human skin, inflammatory skin diseases and epidermal neoplasms. METHODS Immunohistochemistry for TWEAK was performed in samples of healthy skin, plaque psoriasis, lichen planus, prurigo nodularis, discoid lupus erythematosus, lichen sclerosus, seborrheic keratosis, common warts, actinic keratosis, Bowen's disease, keratoacanthoma and basal and squamous cell carcinoma. Double immunofluorescence was used to investigate co-localization of TWEAK with cytokeratin-10 and proliferating cell nuclear antigen (PCNA). RESULTS TWEAK was robustly expressed in the epidermis of healthy skin and decreased in inflammatory conditions, both in the context of epidermal hyperplasia and atrophy. Decreased TWEAK immunoreactivity was regularly observed in common warts, actinic keratosis and Bowen's disease, particularly in areas of marked proliferation as evidenced by PCNA-positive nuclei. In squamous cell carcinoma, expression of TWEAK ranged from strong to completely absent, and it mostly corresponded with the expression of cytokeratin-10. TWEAK was absent in keratoacanthoma and basal cell carcinoma. CONCLUSIONS TWEAK is a constitutively expressed epidermal protein whose downregulation might be an early indicator of disturbed differentiation or pathologic proliferation of keratinocytes that accompany inflammatory and neoplastic skin diseases.
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Affiliation(s)
- Sandra Peternel
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia.
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23
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Simonić E, Kaštelan M, Peternel S, Pernar M, Brajac I, Rončević-Gržeta I, Kardum I. Childhood and adulthood traumatic experiences in patients with psoriasis. J Dermatol 2011; 37:793-800. [PMID: 20883363 DOI: 10.1111/j.1346-8138.2010.00870.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
It is well known that several psychiatric disorders may be related to childhood psychological trauma. Recent studies have associated childhood exposure to trauma to some skin diseases. Our study aimed at exploring whether psoriasis is related to the reported positive and negative traumatic life events in different age intervals beginning from early childhood to adulthood. Furthermore, we investigated differences between psoriatics with early and late onset according to traumatic experiences in different age intervals. Also, we investigated the possible correlation of traumatic experiences with the disease severity. One hundred patients with psoriasis and 101 controls (patients with skin conditions considered to be "non-psychosomatic") were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The severity of psoriasis was estimated according to the Psoriasis Area and Severity Index (PASI), a standardized measuring instrument. The amount of positive experiences did not differ significantly among groups, except for safety scores that were higher in controls compared with both psoriatic groups (early and late onset). On the other side, negative traumatic experiences appeared more frequently in patients with psoriasis during all developmental periods. We found no correlation between severity of psoriasis and traumatic experiences. The present study demonstrates an increased history of childhood and adulthood negative traumatic experiences in patients with psoriasis compared to the control group. Our findings suggest a relationship between retrospectively reported negative traumatic experiences and psoriasis.
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Affiliation(s)
- Edita Simonić
- Department of Dermatovenerology, Medical Faculty of Rijeka, Clinical Hospital Center Rijeka, Croatia.
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24
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Kastelan M, Massari LP, Peternel S. [The role of perforin mediated cell cytotoxicity in psoriasis]. Lijec Vjesn 2010; 132:361-364. [PMID: 21294326] [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: 05/30/2023]
Abstract
Psoriasis is a common chronic inflammatory skin disease characterized by hyperproliferation and incomplete differentiation of epidermal keratinocytes as well as by inflammatory infiltrate of T-lymphocytes in dermis and epidermis. Psoriasis is nowadays also recognized as a T cell mediated disease resulting from aberrant activation of both innate and adaptive immunity. The main effector cells in mediating psoriatic phenotype are helper CD4+ T cells and cytotoxic CD8+ T cells. Both, CD4+ and CD8+ T cells, mediate apoptosis via the release of cell granules, perforin and granzymes or by binding of ligands to their death receptors on target cells. The role of cell cytotoxicity mechanisms, particularly those mediated by perforin, in psoriasis is as yet unclear. Perforin is a pore forming molecule, located within the cytoplasm of cytotoxic T cells and natural killer cells, which enables entry of granzymes and other apoptotic molecules into the target cell in order to mediate programmed cell death. The importance of perforin-mediated cytotoxicity has been demonstrated in several autoimmune diseases and in some inflammatory skin diseases. Recent studies claimed its role in the immunopathogenesis of psoriasis as well. Accumulation of perforin-positive cells in psoriatic epidermis close to damaged keratinocytes suggests that T lymphocytes induce damage to keratinocytes by releasing cytolytic molecules. On the other hand, apoptotic keratinocytes might trigger an injury response program causing regenerative hyperplasia of epidermal keratinocytes, a hallmark of psoriasis. Progress in understanding of effector part of cell cytotoxicity in psoriatic plaque might in future enable more specific treatment of psoriatic patients by blocking selectively each of proposed cytolytic mechanisms and molecules as potential new therapeutic targets.
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Affiliation(s)
- Marija Kastelan
- Klinika za kozne i spolne bolesti, Medicinski fakultet i KBC Rijeka.
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25
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Batinac T, KujundžiÄ M, Peternel S, Äabrijan L, TroÅ¡elj-VukiÄ B, PetranoviÄ D. Pityriasis rubra pilaris in association with laryngeal carcinoma. Clin Exp Dermatol 2009; 34:e917-9. [DOI: 10.1111/j.1365-2230.2009.03701.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Abstract
Psoriasis is a common inflammatory skin disease triggered by dysregulated immune response and characterized by hyperproliferation and altered differentiation of keratinocytes. Formation of psoriatic lesions is thought to be elicited by the complex cellular and cytokine network arising from the pathogenic interactions between keratinocytes and components of innate and acquired immune system. Natural killer T (NKT) cells are a heterogenous T-cell lineage that has been implicated in the pathogenesis of various autoimmune diseases including psoriasis. Due to the numerous functions of NKT cells that link innate and adaptive immunity, their role in psoriasis is complex and still elusive. We summarize the currently available literature data on this issue and discuss the possible role of NKT cells in the immunopathogenesis of this autoimmune disease.
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Affiliation(s)
- S Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia.
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27
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Peternel S, Pilipović K, Zupan G. Seizure susceptibility and the brain regional sensitivity to oxidative stress in male and female rats in the lithium-pilocarpine model of temporal lobe epilepsy. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:456-62. [PMID: 19439251 DOI: 10.1016/j.pnpbp.2009.01.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Revised: 12/24/2008] [Accepted: 01/13/2009] [Indexed: 01/30/2023]
Abstract
Several studies have shown the existence of sex differences in the sensitivity to various convulsants in animals and to the development of some epilepsy types in humans. The purpose of this study was to investigate whether there are sex differences in seizure susceptibility and sensitivity of different brain regions to oxidative stress in rats with status epilepticus (SE) induced by lithium-pilocarpine administration, that provides a common experimental model of temporal lobe epilepsy (TLE) in humans. Latencies to isolated full limbic seizures or SE onset as well as the number of the animals presenting full limbic seizures, SE or full limbic seizures that progressed to SE were recorded for 2 h after pilocarpine administration. Number of animals which survived 24 h after SE onset was also monitored. Levels of lipid peroxidation as well as the superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities in the piriform and entorhinal cortices, temporal neocortex, thalamus, and hippocampus in rats of both sexes, at 24 h after SE onset were determined. Results of our study showed that males developed full limbic seizures and SE more rapidly and in greater number than females. Levels of lipid peroxidation in all brain regions examined, the SOD activities in the piriform and entorhinal cortices, and temporal neocortex as well as the GSH-Px activities in the piriform and entorhinal cortices, and thalamus were significantly higher in rats with SE in comparison to the values of mentioned biochemical parameters in rats of the control groups. Lipid peroxidation level in the temporal neocortex as well as the GSH-Px activity in the hippocampus in male rats were significantly higher in comparison to the values registered in females. With the exception of the thalamus, where SOD activity in male rats with SE was significantly higher in relation to the respective control group and also to females with SE, sex differences in the response of other brain regions investigated to oxidative stress were not obtained, at 24 h after SE.
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Affiliation(s)
- Sandra Peternel
- Department of Pharmacology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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28
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Cabrijan L, Lipozencić J, Batinac T, Peternel S, Pastar Z. The role of CD4 and CD8 lymphocytes and macrophages in psoriasis vulgaris. Acta Dermatovenerol Croat 2009; 17:162-165. [PMID: 19818213] [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: 05/28/2023]
Abstract
Current knowledge of the immunopathogenesis of psoriasis vulgaris is based on the crucial role of CD4 and CD8 lymphocytes. Also, the connection of activated lymphocytes with macrophages, especially dendritic cells and plasmacytoid dendritic cells, is considered to be significant. In the present study, the expression of CD4+ lymphocytes as well as CD8+ lymphocytes (P < 0.001) and macrophages (P < 0.001) was found to be significantly increased in lesional skin epidermis and dermis in psoriasis vulgaris patients as compared with healthy skin. These findings suggested a cascade or chain reaction with cells and cytokines playing an important role to be involved in the immunopathogenesis of psoriasis vulgaris.
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Affiliation(s)
- Leo Cabrijan
- University Department of Dermatology and Venereology, Rijeka University Hospital Center and School of Medicine, Kresimirova 42, HR-51000 Rijeka, Croatia.
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29
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Peternel S, Prpić-Massari L, Guina T, Novak S, Brajac I, Kastelan M. Treatment of severe psoriasis with infliximab: report of two cases. Acta Dermatovenerol Croat 2009; 17:204-206. [PMID: 19818221] [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: 05/28/2023]
Abstract
Infliximab is an anti-tumor necrosis factor-monoclonal antibody shown to be effective in the treatment of moderate-to-severe psoriasis and psoriatic arthritis. We report on the first two patients in Croatia in which the efficacy of infliximab therapy was monitored and evaluated primarily on the basis of cutaneous manifestations of psoriasis. Both patients had severe, treatment-resistant chronic plaque psoriasis and psoriatic arthritis and were on methotrexate therapy before the initiation and throughout the course of infliximab treatment. Infliximab was administered intravenously at a dose of 4 or 5 mg/kg at week 0, 2, 6 and every 8 weeks thereafter. Disease severity was measured before each infusion by means of Psoriasis Area and Severity Index (PASI) score. A remarkable clinical response was achieved in both patients with a 50% or greater improvement in baseline PASI at week 2 after therapy initiation and a 90% or greater improvement at week 6 in one patient and at week 14 in the other. Both patients also reported a significant decline in their arthritis symptoms shortly after the introduction of infliximab. The concomitant use of infliximab and methotrexate in these two patients resulted in rapid and sustained remission of psoriasis with no major adverse effects detected.
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Affiliation(s)
- Sandra Peternel
- Department of Dermatology and Venereology, Rijeka University Hospital Center, Kresimirova 42, HR-51000 Rijeka, Croatia.
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30
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Zupan G, Pilipović K, Hrelja A, Peternel S. Oxidative stress parameters in different rat brain structures after electroconvulsive shock-induced seizures. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:771-7. [PMID: 18201811 DOI: 10.1016/j.pnpbp.2007.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2007] [Revised: 11/23/2007] [Accepted: 12/09/2007] [Indexed: 12/31/2022]
Abstract
Electroconvulsive therapy has been used in the treatment of psychiatric disorders since the 1930s, but little progress has been made in understanding the cellular mechanisms underlying its therapeutic and adverse effects. Electroconvulsive shock (ECS) in animals provides a common experimental model for studying the effects of electroconvulsive therapy in humans. In order to examine the changes of the brain oxidative stress parameters in several brain structures in the early time period after ECS-induced seizures, the levels of lipid peroxidation as well as superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities in the rat hippocampus, cerebellum, frontal cortex and the pons/medulla region were determined at different time points during the first 24 h after single ECS-induced seizures. In the hippocampus and cerebellum the levels of lipid peroxidation were unchanged, while the SOD and GSH-Px activities were significantly increased. Levels of lipid peroxidation and the activities of SOD and GSH-Px were not statistically changed in the pons/medulla region. Levels of lipid peroxidation in the frontal cortex were significantly higher in comparison to the control group at all time points examined while the SOD and GSH-Px activities were not statistically changed. In conclusion, the results of the present study indicate that single ECS causes the rat brain structure-specific alterations in the levels of lipid peroxidation as well as in the SOD and GSH-Px activities at different time points within the first 24 h after the seizures induction. Oxidative lipid damage was evident only in the frontal cortex, while the hippocampus, cerebellum and the pons/medulla region remained oxidatively unaffected in our experimental conditions.
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Affiliation(s)
- Gordana Zupan
- Department of Pharmacology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia.
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31
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Mrsić-Pelcić J, Pelcić G, Peternel S, Pilipović K, Simonić A, Zupan G. Effects of the hyperbaric oxygen treatment on the Na+,K+ -ATPase and superoxide dismutase activities in the optic nerves of global cerebral ischemia-exposed rats. Prog Neuropsychopharmacol Biol Psychiatry 2004; 28:667-76. [PMID: 15276692 DOI: 10.1016/j.pnpbp.2004.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2004] [Indexed: 11/18/2022]
Abstract
The effects of hyperbaric oxygen (HBO) treatment on the Na+,K+ -ATPase and superoxide dismutase (SOD) activities were examined in the optic nerves of the rats exposed to global cerebral ischemia. Animals were exposed to global cerebral ischemia of 20-min duration and were either sacrificed or exposed to the first HBO treatment immediately, 0.5, 1, 2, 6, 24, 48, 72 or 168 h after ischemic procedure (for Na+,K+ -ATPase activities measurement) or 2, 24, 48 or 168 h after ischemia (for SOD activities measurement). HBO procedure was repeated for 7 consecutive days. It was found that global cerebral ischemia induced a statistically significant decrease in the Na+,K+ -ATPase activity of the optic nerves, starting from 0.5 to 168 h of reperfusion. Maximal enzymatic inhibition was registered 24 h after the ischemic damage. The decline in the Na+,K+ -ATPase activity was prevented in the animals exposed to HBO treatment within the first 6 h of reperfusion. The results of the presented experiments demonstrated also a statistically significant increase in the SOD activity after 24, 48 and 168 h of reperfusion in the optic nerves of non-HBO-treated ischemic animals as well as in the ischemic animals treated with HBO. Our results indicate that global cerebral ischemia induced a significant alterations in the Na+,K+ -ATPase and SOD activities in the optic nerves during different periods of reperfusion. HBO treatment, started within the first 6 h of reperfusion, prevented ischemia-induced changes in the Na+,K+ -ATPase activity, while the level of the SOD activity in the ischemic animals was not changed after HBO administration.
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Affiliation(s)
- Jasenka Mrsić-Pelcić
- Department of Pharmacology, School of Medicine, University of Rijeka, Brace Brancheta 20/1, 51 000, Croatia.
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