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Porter M. Is the varying management of incontinence-associated dermatitis due to a lack of understanding of etiology? Br J Community Nurs 2024; 29:S34-S36. [PMID: 38728164 DOI: 10.12968/bjcn.2024.29.sup5.s34] [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: 05/12/2024]
Abstract
Incontinence-associated dermatitis, previously and sometimes still referred to as moisture lesions or moisture damage, is a commonly seen contact dermatitis that is a reactive response of the skin to chronic contact to urine and faecal matter. Understanding the etiology is fundamental to creating a skin care plan and successfully prevention. Systemic reviews and studies have shown that the continued variability in management results from a combination of knowledge base, observation, diagnosis, and product selection. This article aims to improve clinicians' understanding of incontinence-associated dermatitis and its management.
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Affiliation(s)
- Michelle Porter
- Effective Practice Facilitator, Lincolnshire Community Health Services
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Isak V, Azizi S, Zhou XK, Mehta D, Ding W, Bulmer Z, Aivazi DS, Dellinger RW, Granstein RD. Inhibition of UVB radiation-induced tissue swelling and immune suppression by nicotinamide riboside and pterostilbene. Photodermatol Photoimmunol Photomed 2024; 40:e12961. [PMID: 38676310 DOI: 10.1111/phpp.12961] [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] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Environmental ultraviolet radiation has deleterious effects on humans, including sunburn and immune perturbations. These immune changes are involved in skin carcinogenesis. OBJECTIVES To determine whether nicotinamide riboside and/or pterostilbene administered systemically inhibits inflammatory and immune effects of exposure to mid-range ultraviolet radiation. METHODS To examine UVB radiation-induced inflammatory effects, mice were fed standard chow/water, 0.04% pterostilbene in chow and 0.2% nicotinamide riboside in drinking water, diet with nicotinamide riboside alone, or diet with pterostilbene alone. After 4 weeks, mice were exposed to UVB radiation (3500 J/m2), and 24-/48-h ear swelling was assessed. We also asked if each agent or the combination inhibits UVB radiation suppression of contact hypersensitivity in two models. Mice were fed standard diet/water or chow containing 0.08% pterostilbene, water with 0.4% nicotinamide riboside, or both for 4 weeks. Low-dose: Half the mice in each group were exposed on the depilated dorsum to UVB radiation (1700 J/m2) daily for 4 days, whereas half were mock-irradiated. Mice were immunized on the exposed dorsum to dinitrofluorobenzene 4 h after the last irradiation, challenged 7 days later on the ears with dinitrofluorobenzene, and 24-h ear swelling assessed. High dose: Mice were treated similarly except that a single dose of 10,000 J/m2 of radiation was administered and immunization was performed on the unirradiated shaved abdomen 3 days later. RESULTS Nicotinamide riboside and pterostilbene together inhibited UVB-induced skin swelling more than either alone. Pterostilbene alone and both given together could inhibit UVB-induced immune suppression in both the low-dose and high-dose models while nicotinamide riboside alone was more effective in the low-dose model than the high-dose model. CONCLUSION Nicotinamide riboside and pterostilbene have protective effects against UVB radiation-induced tissue swelling and immune suppression.
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Affiliation(s)
- Verena Isak
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| | - Shayan Azizi
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| | - Xi K Zhou
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Devina Mehta
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| | - Wanhong Ding
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| | - Zakir Bulmer
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| | - Daniella S Aivazi
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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3
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De Marchi S, Cecchin E, De Marchi SU, Sechi LA. Impact of atopic respiratory disease on contact dermatitis. Allergy 2024; 79:242-245. [PMID: 37705339 DOI: 10.1111/all.15890] [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: 08/01/2023] [Revised: 08/26/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Sergio De Marchi
- Department of Medicine, University of Udine, School of Medicine, Udine, Italy
| | - Emanuela Cecchin
- Department of Medicine, University of Udine, School of Medicine, Udine, Italy
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4
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Rončević M, Radas K, Ljubojević Hadžavdić S. Hypersensitivity Reactions to Homemade Topical Preparations. Acta Dermatovenerol Croat 2023; 31:117-124. [PMID: 38439720] [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: 03/06/2024]
Abstract
Homemade topical preparations are becoming increasingly popular due to the widespread belief that herbal and natural products are a safer and better option in the treatment of various conditions. However, homemade topical preparations can precipitate allergic and irritant reactions, depending on the herbal composition of the preparation. Hypersensitivity reactions to such preparations range from contact allergic dermatitis, contact irritant dermatitis, contact urticaria, toxic reaction, photosensitivity, and phototoxic reaction. In Europe, and especially in the Mediterranean area, medicinal herbs from the Compositae family and aromatic Mediterranean herbs are most frequently used in the formulation of topical preparations. Although plants are regarded as strong sensitizers, the number of reported cases of hypersensitivity reactions is relatively small. The problems are limitations in diagnostics due to the lack of necessary patch test substances and the danger of active sensitization during testing. Caution is required in patients prone to allergies and those with existing dermatoses, who should be advised to use registered preparations. The first step in management is cessation of exposure, followed by implementation of topical corticosteroids. Systemic corticosteroid therapy is reserved for more severe cases.
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Affiliation(s)
| | | | - Suzana Ljubojević Hadžavdić
- Professor Suzana Ljubojević Hadžavdić, MD, PhD, Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Kišpatićeva 12, 10000 Zagreb, Croatia;
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Orii A, Kurohane K, Sekiguchi K, Tsutsumi M, Imai Y. Comparison of adjuvant mechanisms of medium-chain triacylglycerol in a mouse FITC-induced contact hypersensitivity model. Toxicology 2023; 488:153482. [PMID: 36870414 DOI: 10.1016/j.tox.2023.153482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/06/2023]
Abstract
The number of allergy sufferers has been increasing with the increase in chemicals to which we are potentially exposed. We have discovered that tributyrin, a short-chain triacylglycerol (TAG), enhanced fluorescein isothiocyanate (FITC)-induced contact hypersensitivity in a mouse model. Medium-chain triacylglycerols (MCTs) are used in cosmetics, with which we come into direct contact frequently, to maintain skin conditions and as a thickening agent for cosmetics. In this study, we examined whether MCTs with different side chain lengths enhanced skin sensitization to FITC in the mouse model. During skin sensitization to FITC, the presence of tributyrin (side chain carbon number, 4; C4) as well as that of each MCT, tricaproin (C6), tricaprylin (C8), or tricaprin (C10), resulted in enhanced skin sensitization, whereas that of trilaurin (C12) did not. As to the mechanism underlying the enhanced sensitization, three MCTs (C6, C8 and C10) facilitated migration of FTIC-presenting CD11c+ dendritic cells to draining lymph nodes. These results indicated that not only tributyrin but also MCTs, up to side chain carbon number 10, have an adjuvant effect on FITC-induced skin hypersensitivity in mice.
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Affiliation(s)
- Akimasa Orii
- Laboratory of Microbiology and Immunology, School of Pharmaceutical Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka City, Shizuoka 422-8526, Japan
| | - Kohta Kurohane
- Laboratory of Microbiology and Immunology, School of Pharmaceutical Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka City, Shizuoka 422-8526, Japan
| | - Kota Sekiguchi
- Laboratory of Microbiology and Immunology, School of Pharmaceutical Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka City, Shizuoka 422-8526, Japan
| | - Masato Tsutsumi
- Laboratory of Microbiology and Immunology, School of Pharmaceutical Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka City, Shizuoka 422-8526, Japan
| | - Yasuyuki Imai
- Laboratory of Microbiology and Immunology, School of Pharmaceutical Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka City, Shizuoka 422-8526, Japan.
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Akahoshi N, Hasegawa R, Yamamoto S, Takemoto R, Yoshizawa T, Kamichatani W, Ishii I. Differential Roles of Cystathionine Gamma-Lyase and Mercaptopyruvate Sulfurtransferase in Hapten-Induced Colitis and Contact Dermatitis in Mice. Int J Mol Sci 2023; 24:ijms24032659. [PMID: 36768979 PMCID: PMC9916491 DOI: 10.3390/ijms24032659] [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: 12/31/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Hydrogen sulfide (H2S) has been shown to act as both anti-inflammatory and pro-inflammatory mediators. Application of H2S donors generally protects against inflammation; however, experimental results using mice lacking endogenous H2S-producing enzymes, such as cystathionine γ-lyase (CTH) and mercaptopyruvate sulfurtransferase (MPST), are often contradictory. We herein examined two types of model hapten-induced inflammation models, colitis (an inflammatory bowel disease model of mucosal immunity) and contact dermatitis (a type IV allergic model of systemic immunity), in CTH-deficient (Cth-/-) and MPST-deficient (Mpst-/-) mice. Both mice exhibited no significant alteration from wild-type mice in trinitrobenzene sulfonic acid (Th1-type hapten)-induced colitis (a Crohn's disease model) and oxazolone (Th1/Th2 mix-type; Th2 dominant)-induced colitis (an ulcerative colitis model). However, Cth-/- (not Mpst-/-) mice displayed more exacerbated phenotypes in trinitrochlorobenzene (TNCB; Th1-type)-induced contact dermatitis, but not oxazolone, at the delayed phase (24 h post-administration) of inflammation. CTH mRNA expression was upregulated in the TNCB-treated ears of both wild-type and Mpst-/- mice. Although mRNA expression of pro-inflammatory cytokines (IL-1β and IL-6) was upregulated in both early (2 h) and delayed phases of TNCB-triggered dermatitis in all genotypes, that of Th2 (IL-4) and Treg cytokines (IL-10) was upregulated only in Cth-/- mice, when that of Th1 cytokines (IFNγ and IL-2) was upregulated in wild-type and Mpst-/- mice at the delayed phase. These results suggest that (upregulated) CTH or H2S produced by it helps maintain Th1/Th2 balance to protect against contact dermatitis.
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Hou Y, Griffin L, Bernatchez SF, Hommes J, Kärpänen T, Palka-Santini M. Comparative Effectiveness of 2 Chlorhexidine Gluconate-Containing Dressings in Reducing Central Line-Associated Bloodstream Infections, Hospital Stay, and Costs. Inquiry 2023; 60:469580231214751. [PMID: 38037829 PMCID: PMC10693226 DOI: 10.1177/00469580231214751] [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] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023]
Abstract
Chlorhexidine gluconate (CHG)-containing dressings are recommended to prevent central line associated bloodstream infections (CLABSIs) and other catheter-related infections. This study compared the effect of 2 CHG dressings on CLABSI, cost of care, and contact dermatitis. A retrospective analysis was conducted using the Premier Healthcare Database of hospitalized patients (n = 53 149) with central venous catheters (CVCs) and receiving either a transparent CHG gel dressing (n = 14 488) or an opaque CHG sponge dressing (n = 38 661) between January 2019 and September 2020. Two cohorts (n = 14 488 each), CHG-Gel and CHG-Sponge, were matched 1:1 using a propensity score method on 33 patient and facility characteristics. CLABSI and contact dermatitis rates, hospital length of stay (LOS), and hospitalization costs were compared using mixed-effect multiple regression. This approach effectively controlled for random clustering effects across hospitals and patients' Diagnosis-Related Group (DRG) classifications. CHG gel dressings were associated with a 41% decrease in CLABSI rates (P = .0008) compared to CHG sponge dressings (0.35%vs 0.60%). A 0.4-day shorter LOS (9.53vs 9.90 days, P = .0001) and a cost saving of $3576 per hospital stay ($40 197 vs $43 774, P = .0179) was observed with CHG gel dressing use. There was no statistically significant difference in contact dermatitis rates (P = .7854) between the CHG-Gel and CHG-Sponge cohorts. The findings of this study suggest that the use of CHG gel dressings may be more effective in reducing the risk of CLABSIs and associated clinical costs compared to CHG sponge dressings in hospitalized patients. Moreover, there appears to be no significant discrepancy in contact dermatitis rates between CHG gel and CHG sponge dressings. Healthcare providers may consider using CHG gel dressings as a standard practice for patients with CVCs to reduce the risk of infections and improve patient outcomes.
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Affiliation(s)
| | - Leah Griffin
- 3M Health Care, 3M Company, San Antonio, TX, USA
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Tesfaye AH, Engdaw GT, Aragaw FM, Kabito GG. Prevalence and risk factors of work-related contact dermatitis symptoms among healthcare cleaners during the COVID-19 pandemic in Northwest Ethiopia: a multicentre cross-sectional survey. BMJ Open 2022; 12:e069019. [PMID: 36446456 PMCID: PMC9710345 DOI: 10.1136/bmjopen-2022-069019] [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] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study was aimed to explore the prevalence and risk factors of work-related contact dermatitis (WRCD) symptoms among cleaners working in healthcare institutions in Gondar city, Northwest Ethiopia, during the COVID-19 pandemic. DESIGN A multicentre cross-sectional study was conducted from September to October 2021. An interviewer-administered standardised Nordic Occupational Skin Questionnaire, V.2002 (NOSQ-2002) was used to assess WRCD. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. SETTING The study was conducted in Gondar city healthcare institutions, Northwestern Ethiopia. PARTICIPANTS A total of 409 cleaners participated in this study. OUTCOME MEASURES The primary outcome is the prevalence of WRCD symptoms, which was measured using the NOSQ-2002. RESULTS The response rate was 95.6%. The majority, 302 (73.8%), of the study participants were female. The mean age (±SD) was 31 (±7.87) years old. The overall prevalence of self-reported WRCD during the last 12 months was 213 (52.1%) (95% CI (47.1% to 57.0%)). The highest symptoms reported were skin redness, 51.6% (n=110), and the most affected skin body sites were hands (hand dermatitis), 74.2% (n=158). Hand washing frequency more than 20 times per day (AOR=1.73, 95% CI (1.03 to 2.92)), personal history of eczema (AOR=1.46, 95% CI (1.01 to 2.42)) and lack of training on skin hazards (AOR=2.06, 95% CI (1.16 to 3.63)) were factors influencing the occurrence of WRCD. CONCLUSIONS This study revealed the prevalence of WRCD is common during the COVID-19 pandemic. Adjusting hand washing frequency per day, educating people with atopy about the avoidance of exposure to skin irritants and providing training on skin hazards were recommended to minimise the condition.
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Affiliation(s)
- Amensisa Hailu Tesfaye
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Garedew Tadege Engdaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebisa Guyasa Kabito
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Che D, Gao J, Du X, Zheng Y, Hou Y, Peng B, Jia T, Geng S, He L. p-Phenylenediamine induces immediate contact allergy and non-histaminergic itch via MRGPRX2. Chem Biol Interact 2022; 351:109751. [PMID: 34826398 DOI: 10.1016/j.cbi.2021.109751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 10/21/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Abstract
p-phenylenediamine (PPD) is a common component of hair dye known to induce immediate allergy, even acute dermatitis and contact dermatitis. MAS-related G protein coupled receptor-X2 (MRGPRX2) in mast cells (MCs) mediates small molecular substances-induced pseudo-allergic reactions. However, the role of MRGPRX2 in PPD-induced immediate contact allergy needs further exploration. The aim of this study was to investigate whether PPD activates MCs via MRGPRX2 and induces immediate allergies that contribute to contact dermatitis. Wild-type (WT) and kitw-sh/w-sh mice (MUT) were treated with PPD to observe local inflammation and MC degranulation in vivo. The release of inflammatory mediators was measured in vitro. Histamine 1 receptor (H1R)-/- mice were used to analyze itch type. PPD caused immediate contact allergy in WT mice, induced scratching, and local inflammatory reactions, while exhibiting minimal effects on MUT mice. PPD did not induce histamine release, but induced significant tryptase release in vivo and in vitro. PPD activated MRGPRX2 to induce MC degranulation in vitro. PPD caused immediate contact allergy in WT mice, induced scratching and local inflammatory reactions, while exhibited minimal effect on MUT mice. PPD did not induce histamine release, while induced significant tryptase release in vivo and in vitro. PPD induced immediate contact allergy by MCs activation via MRGPRX2 and lead to tryptase release. The scratching times showed no significant difference in WT mice or H1R-/- mice, which indicated PPD caused non-histaminergic itch. The results showed that PPD activated MCs via MRGPRX2 and induced immediate contact allergy, leading to the release of tryptase without monoamine release, which might induce non-histaminergic itch.
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Affiliation(s)
- Delu Che
- Department of Dermatology, Northwest Hospital, The Second Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi, China; Center for Dermatology Disease, Precision Medical Institute, Xi'an, China
| | - Jiapan Gao
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | - Xueshan Du
- Department of Dermatology, Northwest Hospital, The Second Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yi Zheng
- Department of Dermatology, Northwest Hospital, The Second Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yajing Hou
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | - Bin Peng
- Department of Dermatology, Northwest Hospital, The Second Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi, China; Center for Dermatology Disease, Precision Medical Institute, Xi'an, China
| | - Tao Jia
- Department of Dermatology, Northwest Hospital, The Second Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Songmei Geng
- Department of Dermatology, Northwest Hospital, The Second Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi, China; Center for Dermatology Disease, Precision Medical Institute, Xi'an, China.
| | - Langchong He
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Pazhou Lab., Guangzhou, China.
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Santos MN, Widowski TM, Kiarie EG, Guerin MT, Edwards AM, Torrey S. In Pursuit of a Better Broiler: Walking Ability and Incidence of Contact Dermatitis in Conventional and Slower-Growing Strains of Broiler Chickens. Poult Sci 2022; 101:101768. [PMID: 35245808 PMCID: PMC8892009 DOI: 10.1016/j.psj.2022.101768] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/06/2022] [Accepted: 01/28/2022] [Indexed: 11/30/2022] Open
Abstract
In this study, the mobility, incidence, and severity of contact dermatitis and litter moisture content were assessed in 14 strains of broiler chickens differing in growth rate. The strains encompassed 2 conventional (CONV; ADG0-48 > 60 g/d) and 12 slower growing (SG) strains categorized as FAST (ADG0-62 = 53-55 g/d), MOD (ADG0-62 = 50-51 g/d), and SLOW (ADG0-62 < 50 g/d), with 4 strains in each category. A total of 7,216 mixed-sex birds were equally allocated into 164 pens (44 birds/pen; 30 kg/m2) in a randomized incomplete block design, with each strain represented in 8 to 12 pens over 2–3 trials. From each pen, 4 to 6 birds were tested in the latency-to-lie (LTL) and group obstacle tests 1 wk prior to the birds reaching 2 target weights (TWs) of approximately 2.1 kg (TW1: 34 d for CONV and 48 d for SG strains) and 3.2 kg (TW2: 48 d for CONV and 62 d for SG strains). The incidence of footpad dermatitis (FPD) and hock burns (HB) were evaluated a day prior to each TW. Litter moisture content was determined biweekly from d 14 to d 56. At TW1, CONV and SLOW had longer LTL than FAST birds. At TW2, CONV, MOD, and FAST birds had similar LTL. At both TWs, CONV birds were lighter than FAST birds in the group obstacle test, yet their number of obstacle crossings was similar. At TW1, CONV birds had greater incidence of FPD than FAST and MOD, while at TW2, CONV birds had greater incidence than the other categories. The incidence of HB in CONV and MOD was greater than SLOW birds at TW1, while at TW2, the incidence of HB was greater in CONV and FAST birds vs. MOD and SLOW birds. Litter moisture content was high in all categories from d 28 onward. Our results indicate that both BW and growth rate influence leg strength and walking ability, whereas the overall high litter moisture content and to a lesser extent growth rate influenced the incidence of contact dermatitis.
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Affiliation(s)
- Midian N Santos
- Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada; Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Tina M Widowski
- Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada; Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Elijah G Kiarie
- Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Michele T Guerin
- Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, N1G 2W1, Canada; Department of Population Medicine, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - A Michelle Edwards
- Ontario Agricultural College, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Stephanie Torrey
- Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada; Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, N1G 2W1, Canada.
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Passanisi S, Salzano G, Galletta F, Aramnejad S, Caminiti L, Pajno GB, Lombardo F. Technologies for Type 1 Diabetes and Contact Dermatitis: Therapeutic Tools and Clinical Outcomes in a Cohort of Pediatric Patients. Front Endocrinol (Lausanne) 2022; 13:846137. [PMID: 35370980 PMCID: PMC8965381 DOI: 10.3389/fendo.2022.846137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
The increasing use of technological devices for the management of diabetes is related to the prolonged exposure of patients' skin to chemical and mechanical agents and, consequently, to the increased risk of developing dermatological complications. Among these, contact dermatitis is the most insidious skin disorder. Despite the magnitude of the issue, no universally accepted recommendations on the management of this common complication are currently available. Our observational study aimed to describe all the solutions adopted by patients and their caregivers to treat and prevent the appearance of contact dermatitis and to describe the clinical impact of this cutaneous complication. Twenty-one pediatric patients (mean age 12.1 ± 3.7 years) with type 1 diabetes were recruited in the study. The most common treatment used to treat acute skin lesions was the application of topical corticosteroids, sometimes associated with topical antibiotics (9.5%). In order to prevent the further appearance of dermatitis, the most frequently adopted measure was the use of hydrocolloid and/or silicone-based adhesives, followed by the application of protective barrier films. One patient reported benefit from the off-label use of fluticasone propionate nasal spray. However, only 52.4% of the study participants achieved a definitive resolution of the skin issue, and 38.1% of patients were forced to discontinue insulin pump therapy and/or continuous glucose monitoring. No differences were observed in glycated hemoglobin values between the period before and after the onset of contact dermatitis. Our study confirms the severity of this dermatological complication that may hinder the spread of new technologies for the management of diabetes. Finally, our findings highlight the importance of establishing close collaboration both with pediatric allergy specialists to prescribe the most suitable treatment and with manufacturing companies to ensure that adhesives of technological devices are free of harmful well-known sensitizers.
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Affiliation(s)
- Stefano Passanisi
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
- *Correspondence: Stefano Passanisi,
| | - Giuseppina Salzano
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Francesca Galletta
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Allergy Unit, University of Messina, Messina, Italy
| | - Sara Aramnejad
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Lucia Caminiti
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Allergy Unit, University of Messina, Messina, Italy
| | - Giovanni B. Pajno
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Allergy Unit, University of Messina, Messina, Italy
| | - Fortunato Lombardo
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
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Sugino H, Sawada Y. [A Case of Contact Dermatitis Due to Ultrasonography Gel]. J UOEH 2022; 44:379-383. [PMID: 36464312 DOI: 10.7888/juoeh.44.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A 60-year-old female had a subcutaneous mass in the B region of the left breast. A needle aspiration cytologic examination revealed class IV, and she was referred to our surgical department for examination and treatment. She underwent an ultrasound echography on bilateral the mammary glands and axillary lymph nodes. Erythematous papules and plaques were revealed on her left breast, left axilla, and in the center of the chest area. The patient was referred to our dermatology department for evaluation of her skin eruption. Histopathological examination revealed the infiltration of lymphocytes and eosinophils in the perivascular of the upper dermis with spongiosis and liquid degeneration in the epidermis. A patch testing showed a positive reaction to ultrasonography gel. Based on the clinical course and examinations, we diagnosed her skin eruption as contact dermatitis due to ultrasonography gel. Her skin eruption improved rapidly by topical application of betamethasone butyrate propionate ointment. Recurrence of her skin eruption could be avoided by the removal of the gel after the ultrasonography examination. Our case report demonstrated to us that contact dermatitis could be prevented by promptly wiping off the ultrasonography gel from the skin after the examination.
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Affiliation(s)
- Hitomi Sugino
- Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Japan. Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Yu Sawada
- Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Japan. Yahatanishi-ku, Kitakyushu 807-8555, Japan
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Lebwohl MG, Stein Gold L, Strober B, Papp KA, Armstrong AW, Bagel J, Kircik L, Ehst B, Hong HCH, Soung J, Fromowitz J, Guenthner S, Piscitelli SC, Rubenstein DS, Brown PM, Tallman AM, Bissonnette R. Phase 3 Trials of Tapinarof Cream for Plaque Psoriasis. N Engl J Med 2021; 385:2219-2229. [PMID: 34879448 DOI: 10.1056/nejmoa2103629] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [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: 11/19/2022]
Abstract
BACKGROUND Tapinarof cream is a topical aryl hydrocarbon receptor-modulating agent under investigation for the treatment of psoriasis. Tapinarof modulates the expression of interleukin-17 and the skin-barrier proteins filaggrin and loricrin. METHODS We conducted two identical phase 3 randomized trials of tapinarof in patients with mild-to-severe plaque psoriasis. Adults with a baseline Physician's Global Assessment (PGA) score of 2 (mild) to 4 (severe) (on a scale from 0 to 4, with higher scores indicating more severe psoriasis) and a percent of total body-surface area affected of 3 to 20% were randomly assigned in a 2:1 ratio to use tapinarof 1% cream or vehicle cream once daily for 12 weeks. The primary end point, PGA response, was a PGA score of 0 (clear) or 1 (almost clear) and a decrease from baseline of at least 2 points at week 12. Secondary efficacy end points at week 12 were a reduction of at least 75% in the Psoriasis Area and Severity Index (PASI) score, a PGA score of 0 or 1, the mean change from baseline in the percent of body-surface area affected, and a reduction of at least 90% in the PASI score. Patient-reported outcomes were the mean changes from baseline to week 12 in the proportion of patients who had a decrease of at least 4 points in the Peak Pruritus Numeric Rating Scale (PP-NRS) score (range, 0 [no itch] to 10 [worst imaginable itch]), the PP-NRS total score, the Dermatology Life Quality Index total score, and the Psoriasis Symptom Diary score. RESULTS In trials 1 and 2, a total of 692 and 674 patients, respectively, were screened, with 510 and 515 patients being enrolled. A PGA response occurred in 35.4% of the patients in the tapinarof group and in 6.0% of those in the vehicle group in trial 1 and in 40.2% and 6.3%, respectively, in trial 2 (P<0.001 for both comparisons). Results for secondary end points and patient-reported outcomes were generally in the same direction as those for the primary end point. Adverse events with tapinarof cream included folliculitis, nasopharyngitis, contact dermatitis, headache, upper respiratory tract infection, and pruritus. CONCLUSIONS Tapinarof 1% cream once daily was superior to vehicle control in reducing the severity of plaque psoriasis over a period of 12 weeks but was associated with local adverse events and headache. Larger and longer trials are needed to evaluate the efficacy and safety of tapinarof cream as compared with existing treatments for psoriasis. (Funded by Dermavant Sciences; PSOARING 1 and 2 ClinicalTrials.gov numbers, NCT03956355 and NCT03983980, respectively.).
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Affiliation(s)
- Mark G Lebwohl
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Linda Stein Gold
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Bruce Strober
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Kim A Papp
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - April W Armstrong
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Jerry Bagel
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Leon Kircik
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Benjamin Ehst
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - H Chih-Ho Hong
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Jennifer Soung
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Jeff Fromowitz
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Scott Guenthner
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Stephen C Piscitelli
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - David S Rubenstein
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Philip M Brown
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Anna M Tallman
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
| | - Robert Bissonnette
- From the Icahn School of Medicine at Mount Sinai, New York (M.G.L., L.K.); Henry Ford Health System, Detroit (L.S.G.); Yale University, New Haven, and Central Connecticut Dermatology Research, Cromwell - both in Connecticut (B.S.); Probity Medical Research, Waterloo, ON (K.A.P.), the University of British Columbia and Probity Medical Research, Surrey (H.C.H.), and Innovaderm Research, Montreal (R.B.) - all in Canada; Keck School of Medicine, University of Southern California, Los Angeles (A.W.A.), and Southern California Dermatology, Santa Ana (J.S.) - both in California; the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.); Skin Sciences, Louisville, KY (L.K.); Oregon Medical Research Center, Portland (B.E.); Dermatology of Boca, Boca Raton, FL (J.F.); the Indiana Clinical Trials Center, Plainfield (S.G.); and Dermavant Sciences, Morrisville, NC (S.C.P., D.S.R., P.M.B., A.M.T.)
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Abstract
OBJECTIVE To explore the experience of incontinence-associated dermatitis (IAD) as perceived by nurses, obstacles in the nursing process, and need for IAD training and management. METHODS This single-setting descriptive qualitative study was conducted from June 5, 2018, to June 22, 2018. Ten nurses working in the respiratory ICU of a local hospital participated in semistructured interviews. The content analysis method was used to analyze, summarize, and refine the interview data. RESULTS The experience of ICU nurses with IAD can be divided into four types: nursing based on experiential knowledge, seeking self-improvement, disunity of cleaning methods and wiping skills, and postponement of nursing care because of priority allocation. Obstacles in the nursing process include a lack of relevant nursing knowledge and awareness, as well as the medical supplies needed. The goals of training and management include establishing IAD preventive nursing procedures, providing IAD care products, enhancing the practicality of training content and diversifying training methods, and establishing an information system to assist nurses caring for patients with IAD. CONCLUSIONS The knowledge and behavior of ICU nurses regarding IAD need to be improved. Training and management are imperative. Facilities and nurse managers should actively seek solutions to stated obstacles, formulate training methods suitable for clinical needs, and promote the standardization of nursing for IAD.
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Affiliation(s)
- Yu Zhang
- At the Capital Medical University in Beijing, China, Yu Zhang, MSN, RN, is Nurse, Department of Respiratory and Critical Care Medicine; Peng Zhang, MSc, is Attending Doctor, Department of Urology, Beijing Chao-Yang Hospital; Jun-E Liu, MD, is Professor, School of Nursing; and Fengli Gao, MD, is Director, Nursing Department, Beijing Chao-Yang Hospital. Acknowledgment: The authors thank the Nursing Department of Beijing Chao-Yang Hospital for supporting this study, including the ICU nurses who agreed to share their experience and devote time and effort to this project. The authors have disclosed no financial relationships related to this article. Submitted September 24, 2020; accepted in revised form December 10, 2020
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16
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Kim Y, Oh Y, Lee H, Yang B, Choi CH, Jeong H, Kim H, An W. Prediction of the therapeutic mechanism responsible for the effects of Sophora japonica flower buds on contact dermatitis by network-based pharmacological analysis. J Ethnopharmacol 2021; 271:113843. [PMID: 33493588 DOI: 10.1016/j.jep.2021.113843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/16/2021] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The flower buds of Sophora japonica L. are a major traditional medicine in China, Japan, and Korea and are used to stop bleeding and 'cool the blood'. Accordingly, they are used to treat bleeding haemorrhoids, hypertension, and pyoderma. In addition, it was recently found that the flower buds of S. japonica (SJ) have cosmetic whitening properties. MATERIALS AND METHODS Compounds in SJ and their targets and related diseases were investigated using the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database and analysis platform. Target gene information was obtained from the UniProt database. Network construction was carried out using Cytoscape 3.72. Contact dermatitis (CD)-related gene searching was performed using the Cytoscape string App. Docking analysis was conducted using AutoDock Vina. Six-week-old Balb/c male mice with DNFB (1-fluoro-2,4-dinitrofluorobenzene)-induced CD were treated with a methanol extract of the flower buds of S. japonica (MESJ), and its effects on skin colour, lesions, and immune cell infiltration, and on histopathological abnormalities such as epidermal hyperplasia were investigated. RESULTS Eleven compounds targeted 13 CD-related genes, that is, serum albumin (ALB), prostaglandin G/H synthase (COX) 2, C-X-C motif chemokine (CXCL) 2, CXCL10, ICAM1, IFN-γ, IL-10, IL-1α, IL-1β, IL-2, IL-6, E-selectin, and TNF. In the murine DNFB model, MESJ significantly suppressed scaling, erythema, and skin thickening as compared with DNFB controls and epithelial hyperplasia and immune cell infiltrations induced by repeated DNFB application. CONCLUSIONS Our animal study showed that the mode of action of MESJ was closely related to the prevention of epithelial hyperplasia and immune cell infiltration. The results obtained demonstrated that the flower buds of S. japonica offer a potential means of treating CD, and suggest that the therapeutic mechanism of CD is explained by relations between 11 major components of SJ, including kaempferol and quercetin, and 13 CD-related genes.
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MESH Headings
- Animals
- Cyclooxygenase 2/chemistry
- Cyclooxygenase 2/metabolism
- Cytokines/metabolism
- Databases, Factual
- Dermatitis, Contact/drug therapy
- Dermatitis, Contact/etiology
- Dermatitis, Contact/metabolism
- Dermatitis, Contact/pathology
- Dinitrofluorobenzene/toxicity
- Disease Models, Animal
- Drugs, Chinese Herbal/chemistry
- Drugs, Chinese Herbal/pharmacology
- Drugs, Chinese Herbal/therapeutic use
- Flowers/chemistry
- Gene Expression Regulation/drug effects
- Hyperplasia/chemically induced
- Hyperplasia/drug therapy
- Hyperplasia/metabolism
- Hyperplasia/pathology
- Inflammation/chemically induced
- Inflammation/drug therapy
- Keratosis/chemically induced
- Keratosis/drug therapy
- Keratosis/metabolism
- Keratosis/pathology
- Male
- Metabolic Networks and Pathways/drug effects
- Mice, Inbred BALB C
- Molecular Docking Simulation
- Sophora/chemistry
- Mice
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Affiliation(s)
- Younsook Kim
- Gene & Cell Therapy Research Center for Vessel-associated Diseases, Pusan National University, Yangsan, Gyeongnam, 50612, South Korea
| | - Yoona Oh
- Division of Pharmacology, School of Korean Medicine, Pusan National University, Yangsan, Gyeongnam, 50612, South Korea
| | - Hongbum Lee
- Division of Pharmacology, School of Korean Medicine, Pusan National University, Yangsan, Gyeongnam, 50612, South Korea
| | - Beodeul Yang
- Division of Pharmacology, School of Korean Medicine, Pusan National University, Yangsan, Gyeongnam, 50612, South Korea
| | - Chan-Hun Choi
- Department of Physiology, College of Korean Medicine, Dongshin University, South Korea
| | - Hyunwoo Jeong
- Department of Pathology, College of Korean Medicine, Dongshin University, Naju, Jeonnam, 58245, South Korea
| | - Hyungwoo Kim
- Division of Pharmacology, School of Korean Medicine, Pusan National University, Yangsan, Gyeongnam, 50612, South Korea.
| | - Wongun An
- Division of Pharmacology, School of Korean Medicine, Pusan National University, Yangsan, Gyeongnam, 50612, South Korea
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Abstract
Contact dermatitis (CD) is commonly encountered in the pediatric population. Allergic and irritant are the two forms of CD and both cause significant clinical problems in children, but they are often underrecognized. The skin lesions in CD may be polymorphic and closely mimic other common pediatric skin diseases. The diagnosis usually requires patch testing after obtaining a detailed history and performing a physical examination. Metals, fragrances, and certain preservatives are the most common causative agents in children. This article discusses the pathophysiology, diagnosis, and management of this common skin condition in the pediatric population. [Pediatr Ann. 2021(5):e198-e205.].
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Abstract
Eczematous drug eruptions are a heterogenous group of skin reactions that resemble eczema both clinically and histologically. We reviewed the literature and cataloged the systemically administered medications that cause these eruptions, along with their characteristic clinical presentations. We identified three primary pathophysiologic etiologies: (1) cutaneous immunomodulation, (2) skin dehydration, and (3) delayed hypersensitivity. Notably, eczematous eruptions caused by altered immunity in the skin may be increasing in incidence as some responsible drugs, in particular biologic therapies (such as tumor necrosis factor-α and interleukin-17 inhibitors) and targeted cancer treatments (including immune checkpoint inhibitors and epidermal growth factor receptor inhibitors), become more commonly employed in clinical practice. Other notable causes of eczematous eruptions include antiviral agents for hepatitis C virus and cardiovascular medications in elderly individuals, and notable subtypes of eczematous reactions include systemic contact dermatitis and photoallergic reactions, which are also discussed. The diagnostic gold standard is drug rechallenge and most reactions may be treated effectively with emollients, topical corticosteroids, and oral antihistamines.
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Affiliation(s)
| | - Susan Burgin
- Harvard Medical School, Boston, MA, USA.
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA.
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Zhang Q, Zhang K, Wang Y, Jia Y, Gu J, Li X, Li M. Psychometric properties of the Chinese version of the attitude towards the prevention of incontinence-associated dermatitis (C-APrIAD) among Chinese nurses. J Tissue Viability 2021; 30:421-426. [PMID: 33820693 DOI: 10.1016/j.jtv.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/28/2021] [Accepted: 03/23/2021] [Indexed: 12/26/2022]
Abstract
AIM Nurses' attitude is a significant determinant of incontinence-associated dermatitis (IAD) prevention, and a positive attitude may benefit quality improvement projects. This research aimed to translate the attitude towards the prevention of incontinence-associated dermatitis instrument (C-APrIAD) into Chinese and test the reliability and validity among Chinese nurses. METHODS The C-APrIAD was translated into Chinese using a standard procedure of backward-forward translation and cross-cultural adaption. Totally 170 nurses were recruited through the convenience sampling method from three tertiary hospitals in Tianjin, Shandong, and Heilongjiang province of China. Reliability (internal consistency, stability) and validity (content validity, structure validity, and convergent validity), were assessed. Convergent Validity was evaluated by correlation with the General Self-Efficacy Scale (GSES). RESULTS Of the 170 completed questionnaires, 158 (93%) were suitable for analysis. The item-total correlation coefficients ranged from 0.39 to 0.80. The content validity of C-APrIAD was 0.96. A factor analysis indicated the construct of a 14-item instrument in a four factors solution: (1) beliefs about the impact of IAD on patients, (2) beliefs about team responsibility to prevent IAD, (3) beliefs about personal responsibility to prevent IAD, and (4) beliefs about the effectiveness of IAD prevention products and procedures. The correlation coefficient between the GSES and C-APrIAD was 0.49 (P < 0.01). For the total instrument, the Cronbach's α coefficient was 0.87 and the test-retest reliability was 0.99. CONCLUSION The C-APrIAD is reliable and valid. The C-APrIAD may benefit nursing research as well as clinical practice to optimize interventions to improve IAD prevention.
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Affiliation(s)
- Qi Zhang
- School of Nursing, Peking University, Beijing, China
| | - Ke Zhang
- Faculty of Education Science and Technology, Shanxi Datong University, Datong, Shanxi Province, China
| | - Yuxin Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yibo Jia
- Department of Nursing, Tianjin Chest Hospital, Tianjin, China
| | - Jiaxin Gu
- School of Nursing, Peking University, Beijing, China
| | - Xintong Li
- School of Nursing, Fenyang College of Shanxi Medical University, Lvliang, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China.
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Ochiai T, Sasaki Y, Kuwata H, Nakatani Y, Yokoyama C, Hara S. Coordinated action of microsomal prostaglandin E synthase-1 and prostacyclin synthase on contact hypersensitivity. Biochem Biophys Res Commun 2021; 546:124-129. [PMID: 33582554 DOI: 10.1016/j.bbrc.2021.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/19/2021] [Accepted: 02/01/2021] [Indexed: 12/18/2022]
Abstract
Microsomal prostaglandin (PG) E synthase-1 (mPGES-1) and prostacyclin (PGI2) synthase (PGIS) are PG terminal synthases that work downstream of cyclooxygenase and synthesize PGE2 and PGI2, respectively. Although the involvement of PG receptors in acquired cutaneous immune responses was recently shown, the roles of these PG terminal synthases remain unclear. To identify the pathophysiological roles of mPGES-1 and PGIS in cutaneous immune systems, we applied contact hypersensitivity (CHS) to mPGES-1 and PGIS knockout (KO) mice as a model of acquired immune responses. Mice were treated with 1-fluoro-2,4-dinitrobenzene (DNFB) and evaluated for ear thickness and histopathological features. The results showed that the severity of ear swelling in both gene-deficient mice was much lower than that in wild-type (WT) mice. Histological examination of DNFB-treated ears showed that inflammatory cell infiltration and edema in the dermis were also less apparent in both genotypic mice. LC-MS analysis further showed that the increment in PGE2 levels in DNFB-treated ear tissue was reduced in mPGES-1 KO mice, and that 6-keto PGF1α (a stable metabolite of PGI2) was not detected in PGIS KO mice. Furthermore, we made bone marrow (BM) chimera and found that transplantation of WT mouse-derived BM cells restored the impaired CHS response in mPGES-1 KO mice but did not restore the response in PGIS KO mice. These results indicated that mPGES-1 in BM-derived cells and PGIS in non-BM-derived cells might play critical roles in DNFB-induced CHS. mPGES-1-derived PGE2 and PGIS-derived PGI2 might coordinately promote acquired cutaneous immune responses.
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Affiliation(s)
- Tsubasa Ochiai
- Division of Health Chemistry, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan
| | - Yuka Sasaki
- Division of Health Chemistry, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan
| | - Hiroshi Kuwata
- Division of Health Chemistry, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan
| | - Yoshihito Nakatani
- Division of Health Chemistry, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan
| | | | - Shuntaro Hara
- Division of Health Chemistry, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan.
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Bussin E, Cairns B, Gerschman T, Fredericson M, Bovard J, Scott A. Topical diclofenac vs placebo for the treatment of chronic Achilles tendinopathy: A randomized controlled clinical trial. PLoS One 2021; 16:e0247663. [PMID: 33661967 PMCID: PMC7932128 DOI: 10.1371/journal.pone.0247663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/04/2020] [Accepted: 02/11/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The application of topical diclofenac has been suggested as a possible treatment for Achilles tendinopathy. Our aim was to answer the question, is topical diclofenac more effective than placebo for the treatment of Achilles tendinopathy?. METHODS 67 participants with persistent midportion or insertional Achilles tendinopathy were randomly assigned to receive a 4 week course of 10% topical diclofenac (n = 32) or placebo (n = 35). The a priori primary outcome measure was change in severity of Achilles tendinopathy (VISA-A score) at 4 and 12 weeks. Secondary outcome measures included numeric pain rating, and patient-reported change in symptoms using a 7 point scale, from substantially worse to substantially better. Pressure pain threshold (N) and transverse tendon stiffness (N/m) were measured over the site of maximum Achilles tendon pathology at baseline and 4 weeks. RESULTS There were no statistically or clinically significant differences between the diclofenac and placebo groups in any of the primary or secondary outcome measures at any timepoint. Average VISA-A score improved in both groups (p<0.0001), but the improvements were marginal: at 4 weeks, the improvements in VISA-A were 9 (SD 11) in the diclofenac group and 8 (SD 12) in the placebo group, and at 12 weeks the improvements were 9 (SD 16) and 11 (SD13) respectively-these average changes are smaller than the minimum clinically important difference of the VISA-A. CONCLUSION The regular application of topical diclofenac for Achilles tendinopathy over a 4 week period was not associated with superior clinical outcomes to that achieved with placebo.
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Affiliation(s)
- Erin Bussin
- Fortius Sports Medicine, Burnaby, British Columbia, Canada
| | - Brian Cairns
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Tommy Gerschman
- Department of Pediatrics, University of British Colombia, Vancouver, Canada
| | - Michael Fredericson
- Department of Orthpaedic Surgery, Stanford University, Stanford, California, United States of America
| | - Jim Bovard
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Alex Scott
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- * E-mail:
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22
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Desai SR, Glick B, Del Rosso JQ, Harris S, Jacobson A. Once-Daily Halobetasol Propionate 0.01% Lotion for Moderate-to-Severe Plaque Psoriasis: Phase 3 Analysis of Hispanic Participants. J Drugs Dermatol 2021; 20:252-258. [PMID: 33683083 DOI: 10.36849/jdd.5698] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Psoriasis is a chronic, inflammatory disease that may differ in prevalence and clinical presentation among patients from various racial and ethnic groups. Two phase 3 studies demonstrated efficacy and safety of halobetasol propionate (HP) 0.01% lotion in the treatment of moderate-to-severe plaque psoriasis (NCT02514577, NCT02515097). These post hoc analyses evaluated HP 0.01% lotion in Hispanic participants. METHODS Participants were randomized (2:1) to receive once-daily HP or vehicle lotion for 8 weeks, with a 4-week posttreatment follow-up. Post hoc efficacy assessments in Hispanic participants (HP, n=76; vehicle, n=43) included treatment success (≥2‑grade improvement in Investigator’s Global Assessment and score of ‘clear’ or ‘almost clear’), psoriasis signs, and affected body surface area (BSA). Treatment-emergent adverse events (TEAEs) were evaluated. RESULTS At week 8, 38.8% of participants achieved treatment success with HP versus 10.3% on vehicle (P=0.001). HP‑treated participants achieved greater improvements in psoriasis signs, compared with vehicle (P<0.01 all). HP group had a greater reduction in affected BSA versus vehicle (P=0.001). Treatment-related TEAEs with HP were application site infection and dermatitis (n=1 each). CONCLUSIONS Once-daily HP 0.01% lotion was associated with significant reductions in disease severity in Hispanic participants with moderate-to-severe psoriasis, with good tolerability and safety over 8 weeks. J Drugs Dermatol. 2021;20(3):252-258. doi:10.36849/JDD.5698.
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23
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Barakat-Johnson M, Basjarahil S, Campbell J, Cunich M, Disher G, Geering S, Ko N, Lai M, Leahy C, Leong T, McClure E, O'Grady M, Walsh J, White K, Coyer F. Implementing best available evidence into practice for incontinence-associated dermatitis in Australia: A multisite multimethod study protocol. J Tissue Viability 2021; 30:67-77. [PMID: 33158742 DOI: 10.1016/j.jtv.2020.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/04/2020] [Revised: 09/13/2020] [Accepted: 10/15/2020] [Indexed: 01/25/2023]
Abstract
AIMS Incontinence-associated dermatitis (IAD) is an insidious and under-reported hospital-acquired complication which substantially impacts on patients' quality of life. A published international guideline and the Ghent Global IAD Categorisation Tool (GLOBIAD) outline the best available evidence for the optimal management of IAD. This study aims to implement theguideline and the GLOBIAD tool and evaluate the effect on IAD occurrences and sacral pressure injuries as well as patient, clinician and cost-effectiveness outcomes. MATERIALS AND METHODS The study will employ a multi-method design across six hospitals in five health districts in Australia, and will be conducted in three phases (pre-implementation, implementation and post-implementation) over 19 months. Data collection will involve IAD and pressure injury prevalence audits for patient hospital admissions, focus groups with, and surveys of, clinicians, patient interviews, and collection of the cost of IAD hospital care and patient-related outcomes including quality of life. Eligible participants will be hospitalised adults over 18 years of age experiencing incontinence, and clinicians working in the study wards will be invited to participate in focus groups and surveys. CONCLUSION The implementation of health district-wide evidence-based practices for IAD using a translational research approach that engages key stakeholders will allow the standardisation of IAD care that can potentially be applicable to a range of settings. Knowledge gained will inform future practice change in patient care and health service delivery and improve the quality of care for patients with IAD. Support at the hospital, state and national levels, coupled with a refined stakeholder-inclusive strategy, will enhance this project's success, sustainability and scalability beyond this existing project.
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Affiliation(s)
- Michelle Barakat-Johnson
- Executive Nursing and Midwifery Services, Sydney Local Health District, Level 11, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, 2050, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, 88 Mallett Street, Camperdown, New South Wales, 2050, Australia; School of Nursing, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia.
| | - Shifa Basjarahil
- Nursing and Midwifery Services, South Eastern Sydney Local Health District, The Sutherland Hospital, The Kingsway, Caringbah, New South Wales, 2229, Australia
| | - Jayne Campbell
- Nursing and Midwifery Services, Hunter New England Local Health District, Ground Floor, Officers Quarters, James Fletcher Campus, 72 Watt Street, Newcastle, New South Wales, 2300, Australia
| | - Michelle Cunich
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, 2006, Australia; Sydney Health Economics Collaborative, Sydney Local Health District, Camperdown, New South Wales, 2050, Australia
| | - Gary Disher
- Strategic Reform and Planning Branch, New South Wales Ministry of Health, 1 Reserve Road, St Leonards, New South Wales, 2065, Australia
| | - Samara Geering
- Nursing and Midwifery Services, South Western Sydney Local Health District, Eastern Campus, Liverpool Hospital, Scrivener Street, Warrick Farm, New South Wales, 2170, Australia
| | - Natalie Ko
- Nursing and Midwifery Services, Concord Repatriation General Hospital, Level 4, Building 75, Hospital Road, Concord, New South Wales, 2139, Australia
| | - Michelle Lai
- Executive Nursing and Midwifery Services, Sydney Local Health District, Level 11, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, 2050, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, 88 Mallett Street, Camperdown, New South Wales, 2050, Australia
| | - Catherine Leahy
- Quality, Clinical Safety and Nursing, Western New South Wales Local Health District, Building 3, Bloomfield Campus, Forest Road, Orange, New South Wales, 2800, Australia
| | - Thomas Leong
- Nursing and Midwifery Services, Royal Prince Alfred Hospital, Level 7, King George V Building, 83-117 Missenden Road, Camperdown, New South Wales, 2050, Australia
| | - Eve McClure
- Aged and Chronic Care and Rehabilitation Services, Sydney Local Health District, 29 Booth Street, Balmain, New South Wales, 2041, Australia
| | - Melissa O'Grady
- Aged and Chronic Care and Rehabilitation Services, Sydney Local Health District, 29 Booth Street, Balmain, New South Wales, 2041, Australia
| | - Joan Walsh
- Nursing and Midwifery Services, South Eastern Sydney Local Health District, The Sutherland Hospital, The Kingsway, Caringbah, New South Wales, 2229, Australia
| | - Kate White
- Executive Nursing and Midwifery Services, Sydney Local Health District, Level 11, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, 2050, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, 88 Mallett Street, Camperdown, New South Wales, 2050, Australia
| | - Fiona Coyer
- School of Nursing, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia; Clinical Outcomes, Safety and Implementation Research Program, Centre for Healthcare Transformation, Faculty of Health, Queensland University Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia; Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, 4029, Australia
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Dong X, He Y, Ye F, Zhao Y, Cheng J, Xiao J, Yu W, Zhao J, Sai Y, Dan G, Chen M, Zou Z. Vitamin D3 ameliorates nitrogen mustard-induced cutaneous inflammation by inactivating the NLRP3 inflammasome through the SIRT3-SOD2-mtROS signaling pathway. Clin Transl Med 2021; 11:e312. [PMID: 33634989 PMCID: PMC7882108 DOI: 10.1002/ctm2.312] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
Nitrogen mustard (NM) causes severe skin injury with an obvious inflammatory response, which is lack of effective and targeted therapies. Vitamin D3 (VD3) has excellent anti-inflammatory properties and is considered as a potential candidate for the treatment of NM-induced dermal toxicity; however, the underlying mechanisms are currently unclear. Cyclooxygenase-2 (COX2; a widely used marker of skin inflammation) plays a key role in NM-induced cutaneous inflammation. Herein, we initially confirmed that NM markedly promoted COX2 expression in vitro and in vivo. NM also increased NOD-like receptor family pyrin domain containing 3 (NLRP3) expression, caspase-1 activity, and interleukin-1β (IL-1β) release. Notably, treatment with a caspase-1 inhibitor (zYVAD-fmk), NLRP3 inhibitor (MCC950), and NLRP3 or caspase-1 siRNA attenuated NM-induced NLRP3 inflammasome activation, with subsequent suppression of COX2 expression and IL-1β release in keratinocytes. Meanwhile, NM increased mitochondrial reactive oxygen species (mtROS) and decreased manganese superoxide dismutase 2 (SOD2) and sirtuin 3 (SIRT3) activities. Mito-TEMPO (a mtROS scavenger) ameliorated NM-caused NLRP3 inflammasome activation in keratinocytes. Moreover, VD3 improved SIRT3 and SOD2 activities, decreased mtROS contents, inactivated the NLRP3 inflammasome, and attenuated cutaneous inflammation induced by NM in vitro and in vivo. The beneficial activity of VD3 against NM-triggered cutaneous inflammation was enhanced by the inhibitors of IL-1, mtROS, NLRP3, caspase-1, and NLRP3 or caspase-1 siRNAs, which was abolished in SIRT3 inhibitor or SIRT3 siRNA-treated keratinocytes and skins from SIRT3-/- mice. In conclusion, VD3 ameliorated NM-induced cutaneous inflammation by inactivating the NLRP3 inflammasome, which was partially mediated through the SIRT3-SOD2-mtROS signaling pathway.
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Affiliation(s)
- Xunhu Dong
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Ying He
- Department of UltrasoundXinqiao HospitalThird Military Medical University (Army Medical University)ChongqingChina
| | - Feng Ye
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Yuanpeng Zhao
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Jin Cheng
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Jingsong Xiao
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Wenpei Yu
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Jiqing Zhao
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Yan Sai
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Guorong Dan
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
| | - Mingliang Chen
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Pathology and Southwest Cancer Centre, Southwest HospitalThird Military Medical University (Army Medical University)ChongqingChina
| | - Zhongmin Zou
- Department of Chemical Defense Medicine, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
- Institute of Toxicology, School of Military Preventive MedicineThird Military Medical University (Army Medical University)ChongqingChina
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25
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Koudounas S, Mugita Y, Minematsu T, Nakagami G, Weller C, Sanada H. Does the presence of bacterial urinary infection contribute to the development of incontinence-associated dermatitis? A scoping review. J Tissue Viability 2021; 30:256-261. [PMID: 33579585 DOI: 10.1016/j.jtv.2021.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/18/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Incontinence-associated dermatitis (IAD) is an inflammatory skin condition caused by the repeated exposure to urine and faeces. It is not common for urinary incontinence only to cause IAD, however patients with urinary tract infections (UTIs) are also at increased risk for IAD. This scoping review aimed to provide a summary of the relationship between bacterial urinary infections and IAD. METHODS We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, CINAHL, Medline, and Web of Science were searched for relevant articles from January 2007 through February 2020. RESULTS Based on eligibility criteria, 13 research studies and review articles were included. Despite the acknowledged role of bacterial infections can play in IAD and the importance of eradicating infections for the prevention of skin breakdown, there have been limited studies that have investigated how uropathogenic bacteria, in combination with urine, lead to skin damage and IAD. The use of urinary catheters also predisposes to UTIs; however, prevalence/incidence rates of IAD in these patients are not clear, as they were considered as continent of urine in the included studies. CONCLUSION Further research is needed to elucidate the mechanisms of how bacteria, in combination with urine, lead to IAD.
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Affiliation(s)
- Sofoklis Koudounas
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan.
| | - Yuko Mugita
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan.
| | - Takeo Minematsu
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan; Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan.
| | - Gojiro Nakagami
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan; Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan.
| | - Carolina Weller
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan; Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 113-0033, Tokyo, Japan.
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26
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Neill BC, Seger EW, Rickstrew J, Rajpara A. Use of petroleum jelly to improve surgical mask and eyewear associated skin irritation and fogging. Dermatol Online J 2020; 26:13030/qt4h05v29c. [PMID: 33423432] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023] Open
Affiliation(s)
- Brett C Neill
- Division of Dermatology, University of Kansas Medical Center, Kansas City, KS.
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Kline JM, Arriaga-Gomez E, Yangdon T, Boo B, Landry J, Saldías-Montivero M, Neamonitaki N, Mengistu H, Silverio S, Zacheis H, Pasha D, Martinov T, Fife BT, Chatterjea D. Repeated dermal application of the common preservative methylisothiazolinone triggers local inflammation, T cell influx, and prolonged mast cell-dependent tactile sensitivity in mice. PLoS One 2020; 15:e0241218. [PMID: 33104726 PMCID: PMC7588120 DOI: 10.1371/journal.pone.0241218] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/09/2020] [Indexed: 11/26/2022] Open
Abstract
Occupational exposure to toxic chemicals increases the risk of developing localized provoked vulvodynia-a prevalent, yet poorly understood, chronic condition characterized by sensitivity to touch and pressure, and accumulation of mast cells in painful tissues. Here, we topically sensitized female ND4 Swiss mice to the common household and industrial preservative methylisothiazolinone (MI) and subsequently challenged them daily with MI or acetone and olive oil vehicle on the labiar skin. MI-challenged mice developed significant, persistent tactile sensitivity and long-lasting local accumulation of mast cells alongside early, transient increases in CD4+ and CD8+ T cells, eosinophils, neutrophils, and increases in pro-inflammatory cytokines. Therapeutic administration of imatinib, a c-Kit inhibitor known to inhibit mast cell survival, led to reduced mast cell accumulation and alleviated tactile genital pain. We provide the first pre-clinical evidence of dermal MI-induced mast-cell dependent pain and lay the groundwork for detailed understanding of these intersections between MI-driven immunomodulation and chronic pain.
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Affiliation(s)
- Jaclyn M. Kline
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Erica Arriaga-Gomez
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Tenzin Yangdon
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Beebie Boo
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Jasmine Landry
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | | | - Nefeli Neamonitaki
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Hanna Mengistu
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Sayira Silverio
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Hayley Zacheis
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Dogukan Pasha
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
| | - Tijana Martinov
- Department of Medicine, Center for Immunology, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Brian T. Fife
- Department of Medicine, Center for Immunology, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Devavani Chatterjea
- Biology Department, Macalester College, Saint Paul, Minnesota, United States of America
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Abstract
The evolution of modern laser and light-based systems has mirrored the demand for clinically effective treatments and the need for safer technologies with reduced postoperative recovery, side effects, and complications. With each new generation of lasers, more selective tissue destruction can be achieved with reduced unwanted sequelae. Patient selection and preparation, operator technique, and expeditious recognition and management of post-treatment side effects are paramount in avoiding complications and patient dissatisfaction. An overview of important variables to consider for dermatologic laser treatments are presented in order to provide a framework to reduce the severity and duration of possible post-treatment side effects and complications.
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Affiliation(s)
- Tina S Alster
- Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA.
| | - Monica K Li
- City Medical Aesthetics Center, Vancouver, BC, Canada
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Tay C, Yuh AS, Sheau Lan EL, Ong CE, Aloweni F, Lopez V. Development and validation of the incontinence associated dermatitis knowledge, attitude and practice questionnaire. J Tissue Viability 2020; 29:244-251. [PMID: 32773358 DOI: 10.1016/j.jtv.2020.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/21/2019] [Revised: 05/04/2020] [Accepted: 06/23/2020] [Indexed: 01/04/2023]
Abstract
AIM This study aimed to develop and test the validity and reliability of the Knowledge, Attitudes and Practices of Incontinence-associated Dermatitis Questionnaire (KAP-IAD-Q) for Nurses. METHODS A psychometric validation design was employed. Phase I of the study entailed the development of items through an extensive literature review and a double Delphi procedure with 11 experts specialised in wound, ostomy and continence to examine content validity of the KAP-IAD-Q. Phase II involved administering the KAP-IAD-Q to a convenience sample of 263 Registered Nurses from a public hospital in Singapore to evaluate its construct validity, internal consistency and test-retest reliability. RESULTS The instrument showed acceptable content validity (S-CVI = 0.85). Exploratory factor analysis showed all 22 items demonstrated strong factor loadings >0.4 and the four factors KAP-IAD-Q explained 58.1% of total variance. The four factors were☹1) knowledge om IAD aetiology and identification, (2) knowledge on IAD risk factors; (3) attitudes, and (4) practices. The overall internal consistency was excellent (Cronbach's α = 0.913). The KAP-IAD-Q showed good overall test-retest reliability as well (ICC = 0.89 (95% CI 0.69-0.96, p < 0.001). CONCLUSION The KAP-IAD-Q demonstrated good psychometric properties and is effective in measuring levels of IAD-related KAP among nurses. Further confirmation of the proposed factor structure is recommended. Future research should explore determinants of nurses' KAP and associations between IAD knowledge, attitudes and practices.
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Affiliation(s)
- Cheryl Tay
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Centre for Nursing Studies, Singapore.
| | - Ang Shin Yuh
- Singapore General Hospital, Nursing Department, Singapore.
| | | | - Choo Eng Ong
- Singapore General Hospital, Nursing Department, Singapore
| | - Fazila Aloweni
- Singapore General Hospital, Nursing Department, Singapore.
| | - Violeta Lopez
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Centre for Nursing Studies, Singapore; School of Nursing, Hubei University of Medicine, Shiyan, China.
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30
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Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore) 2020; 99:e20603. [PMID: 32541493 PMCID: PMC7302613 DOI: 10.1097/md.0000000000020603] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/28/2020] [Accepted: 05/07/2020] [Indexed: 11/25/2022] Open
Abstract
In December 2019, a new coronavirus was found in Wuhan, Hubei Province, China, and spread rapidly throughout the country, attracting global attention. On February 11, the World Health Organization (WHO) officially named the disease caused by 2019-nCoV coronavirus disease 2019 (COVID-19). With the increasing number of cases, health care workers (HCWs) from all over China volunteered to work in Hubei Province. Because of the strong infectivity of COVID-19, HCWs need to wear personal protective equipment (PPE), such as N95 masks, latex gloves, and protective clothing. Due to the long-term use of PPE, many adverse skin reactions may occur. Therefore, the purpose of this study is to explore the adverse skin reactions among HCWs using PPE.Questionnaires were used for the research; a quantitative study was carried out to determine the incidence of adverse skin reactions among HCWs using PPE.A total of 61 valid questionnaires were collected. The most common adverse skin reactions among HCWs wearing N95 masks were nasal bridge scarring (68.9%) and facial itching (27.9%). The most common adverse skin reactions among HCWs wearing latex gloves were dry skin (55.7%), itching (31.2%), and rash (23.0%). The most common adverse skin reactions among HCWs wearing protective clothing were dry skin (36.1%) and itching (34.4%).When most HCWs wear PPE for a long period of time, they will experience adverse skin reactions. The incidence of adverse skin reactions to the N95 mask was 95.1%, that to latex gloves was 88.5%, and that to protective clothing was 60.7%.
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Affiliation(s)
- Kaihui Hu
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Jing Fan
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Xueqin Li
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Xin Gou
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Xinyuan Li
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
| | - Xiang Zhou
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
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31
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Anderson K, Ryan N, Siddiqui A, Pero T, Volpedo G, Cooperstone JL, Oghumu S. Black Raspberries and Protocatechuic Acid Mitigate DNFB-Induced Contact Hypersensitivity by Down-Regulating Dendritic Cell Activation and Inhibiting Mediators of Effector Responses. Nutrients 2020; 12:nu12061701. [PMID: 32517233 PMCID: PMC7352349 DOI: 10.3390/nu12061701] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/04/2020] [Indexed: 11/16/2022] Open
Abstract
Contact hypersensitivity (CHS) is the most common occupational dermatological disease. Dendritic cells (DCs) mediate the sensitization stage of CHS, while T-cells facilitate the effector mechanisms that drive CHS. Black raspberry (Rubus occidentalis, BRB) and BRB phytochemicals possess immunomodulatory properties, but their dietary effects on CHS are unknown. We examined the effects of diets containing BRB and protocatechuic acid (PCA, a constituent of BRB and an anthocyanin metabolite produced largely by gut microbes), on CHS, using a model induced by 2,4-dinitrofluorobenze (DNFB). Mice were fed control diet or diets supplemented with BRB or PCA. In vitro bone-marrow derived DCs and RAW264.7 macrophages were treated with BRB extract and PCA. Mice fed BRB or PCA supplemented diets displayed decreased DNFB-induced ear swelling, marked by decreased splenic DC accumulation. BRB extract diminished DC maturation associated with reduced Cd80 expression and Interleukin (IL)-12 secretion, and PCA reduced IL-12. Dietary supplementation with BRB and PCA induced differential decreases in IL-12-driven CHS mediators, including Interferon (IFN)-γ and IL-17 production by T-cells. BRB extracts and PCA directly attenuated CHS-promoting macrophage activity mediated by nitric oxide and IL-12. Our results demonstrate that BRB and PCA mitigate CHS pathology, providing a rationale for CHS alleviation via dietary supplementation with BRB or BRB derived anthocyanins.
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Affiliation(s)
- Kelvin Anderson
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (K.A.); (N.R.); (A.S.); (T.P.); (G.V.)
| | - Nathan Ryan
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (K.A.); (N.R.); (A.S.); (T.P.); (G.V.)
- Division of Anatomy, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Arham Siddiqui
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (K.A.); (N.R.); (A.S.); (T.P.); (G.V.)
| | - Travis Pero
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (K.A.); (N.R.); (A.S.); (T.P.); (G.V.)
- College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Greta Volpedo
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (K.A.); (N.R.); (A.S.); (T.P.); (G.V.)
- Department of Microbiology, The Ohio State University, Columbus, OH 43210, USA
| | - Jessica L. Cooperstone
- Department of Horticulture and Crop Science, The Ohio State University, Columbus, OH 43210, USA;
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA
| | - Steve Oghumu
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (K.A.); (N.R.); (A.S.); (T.P.); (G.V.)
- Correspondence: ; Tel.: +1-614-685-7556
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Sitohang IBS, Prayogo RL, Rihatmadja R, Sirait SP. The diagnostic conundrum of Riehl melanosis and other facial pigmentary disorders: a case report with overlapping clinical, dermoscopic, and histopathological features. Acta Dermatovenerol Alp Pannonica Adriat 2020; 29:81-83. [PMID: 32566956] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Riehl melanosis (RM) is a form of pigmented contact dermatitis that often poses a diagnostic challenge due to overlaps in its clinical, dermoscopic, and histopathological features with other pigmentary disorders. This report highlights significant findings and the proper approach for diagnosis. We present the case of a 47-year-old female with progressive facial hyperpigmentation (irregular, blotchy, grayish patches on the forehead, cheeks, and around the mouth) that acknowledged applying a lightening product before her complaint. Dermoscopy revealed brownish-gray dots and pseudonetwork pigmentation. The histopathological findings were comprised of hypergranulosis, interface dermatitis, and pigment incontinence. The patient's history and clinical, dermoscopic, and histopathological examination results showed features consistent with-but not exclusive to-RM, such that it was not possible to rule out lichen planus pigmentosus (LPP) and ashy dermatosis (AD). We finally diagnosed the patient with RM and treated her with medications consisting of alpha hydroxy acid, tretinoin, hydroquinone, and sunscreen. Patch testing might help because higher positivity rates were found in RM patients compared to LPP and AD. However, positive patch testing favors RM, and, regardless of diagnosis, provides a basis for substance avoidance in the treatment plan.
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Affiliation(s)
- Irma Bernadette S Sitohang
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rizky Lendl Prayogo
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rahadi Rihatmadja
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Sondang P Sirait
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Abstract
BACKGROUND Both surgical personnel and patients undergoing procedures are exposed regularly to different antiseptic chemicals in various forms. Little is known about the ingredients in these antiseptics and the risk these products may provoke allergic contact dermatitis. OBJECTIVE The aim of the study was to identify and characterize common allergens in surgical scrubs and patient surgical cleansers that health care workers and surgical patients may encounter in the perioperative period. METHODS DailyMed website was searched using numerous terms for surgical disinfectants. Products used for health care worker handwashing/scrubbing or patient surgical cleansing/disinfecting were included. Each product's ingredients were recorded; those found on the 2017 American Contact Dermatitis Society (ACDS) Core Allergen Series were noted from each product. CONCLUSIONS A total of 1940 products were identified, of which 267 were included in the analysis. A total of 66.3% contained iodine, 25.8% contained chlorhexidine digluconate, and 2.6% contained chloroxylenol. Within the group analyzed, 1586 ingredients were identified. Of these, 241 were ACDS Core Series allergens. Most products contained a single ACDS allergen. There were significant differences in allergens based on product type and active ingredient, with iodine-containing products having the fewest number of allergens. The most common ACDS allergens found were cocamide diethanolamide (22.5%), fragrance (21.7%), lanolin (19.5%), propylene glycol (6.7%), alkyl glucosides (6.0%), and sorbic acid derivatives (5.6%).
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Affiliation(s)
- Jamie P Schlarbaum
- From the Park Nicollet Contact Dermatitis Clinic
- University of Minnesota Medical School
| | - Sara A Hylwa
- From the Park Nicollet Contact Dermatitis Clinic
- Department of Dermatology, University of Minnesota, Minneapolis
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Gupta MK, Lipner SR. Hand hygiene in preventing COVID-19 transmission. Cutis 2020; 105:233-234. [PMID: 32603385] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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35
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Stein Gold L, Elewski B, Draelos Z, Jacobson A, Lin T. Halobetasol 0.01%/Tazarotene 0.045% Lotion for Moderate-to-Severe Psoriasis: Pooled Phase 3 Analysis of Males and Females. J Drugs Dermatol 2020; 19:504-514. [PMID: 32484629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous results from two phase 3 studies demonstrated efficacy and safety of fixed combination halobetasol propionate 0.01%/tazarotene 0.045% (HP/TAZ) lotion in participants with moderate-to-severe plaque psoriasis. This post hoc analysis evaluated sex-specific efficacy and safety of HP/TAZ lotion. METHODS In two randomized, double-blind, phase 3 studies, participants were randomized (2:1) to receive HP/TAZ or vehicle lotion once daily for 8 weeks. Male and female participants were evaluated separately in this pooled analysis. Efficacy assessments included treatment success (at least 2‑grade improvement in Investigator's Global Assessment [IGA] score and score of clear/almost clear), impact on individual signs of psoriasis, and affected Body Surface Area (BSA). RESULTS The analysis included 272 males (HP/TAZ, n=175; vehicle, n=97) and 146 females (HP/TAZ, n=101; vehicle, n=45). Significantly more participants achieved overall treatment success at week 8 with HP/TAZ versus vehicle in both male (38.4% vs 9.8%) and female (44.5% vs 9.9%) subgroups (P<0.001, both). Erythema, plaque elevation, and scaling were also reduced by week 8 in both males and females, with significantly more HP/TAZ-treated participants achieving at least 2‑grade improvement in each sign of psoriasis than vehicle-treated participants (P<0.001 each, both groups). Mean reductions in affected BSA were significantly greater with HP/TAZ versus vehicle lotion in both males and females (P≤0.001, both). The most frequent treatment-related adverse events were contact dermatitis, pruritis, and application site pain (each 4.0%) in females and contact dermatitis (7.6%) in males. CONCLUSION HP/TAZ lotion was highly effective and safe in both males and females with moderate-to-severe psoriasis over 8 weeks of once-daily use. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.5021.
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Laggner M, Copic D, Nemec L, Vorstandlechner V, Gugerell A, Gruber F, Peterbauer A, Ankersmit HJ, Mildner M. Therapeutic potential of lipids obtained from γ-irradiated PBMCs in dendritic cell-mediated skin inflammation. EBioMedicine 2020; 55:102774. [PMID: 32403085 PMCID: PMC7218268 DOI: 10.1016/j.ebiom.2020.102774] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/08/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Since numerous pathological conditions are evoked by unwanted dendritic cell (DC) activity, therapeutic agents modulating DC functions are of great medical interest. In regenerative medicine, cellular secretomes have gained increasing attention and valuable immunomodulatory properties have been attributed to the secretome of γ-irradiated peripheral blood mononuclear cells (PBMCs). Potential effects of the PBMC secretome (PBMCsec) on key DC functions have not been elucidated so far. METHODS We used a hapten-mediated murine model of contact hypersensitivity (CH) to study the effects of PBMCsec on DCs in vivo. Effects of PBMCsec on human DCs were investigated in monocyte-derived DCs (MoDC) and ex vivo skin cultures. DCs were phenotypically characterised by transcriptomics analyses and flow cytometry. DC function was evaluated by cytokine secretion, antigen uptake, PBMC proliferation and T-cell priming. FINDINGS PBMCsec significantly alleviated tissue inflammation and cellular infiltration in hapten-sensitized mice. We found that PBMCsec abrogated differentiation of MoDCs, indicated by lower expression of classical DC markers CD1a, CD11c and MHC class II molecules. Furthermore, PBMCsec reduced DC maturation, antigen uptake, lipopolysaccharides-induced cytokine secretion, and DC-mediated immune cell proliferation. Moreover, MoDCs differentiated with PBMCsec displayed diminished ability to prime naïve CD4+T-cells into TH1 and TH2 cells. Furthermore, PBMCsec modulated the phenotype of DCs present in the skin in situ. Mechanistically, we identified lipids as the main biomolecule accountable for the observed immunomodulatory effects. INTERPRETATION Together, our data describe DC-modulatory actions of lipids secreted by stressed PBMCs and suggest PBMCsec as a therapeutic option for treatment of DC-mediated inflammatory skin conditions. FUNDING This research project was supported by the Austrian Research Promotion Agency (Vienna, Austria; grant "APOSEC" 862068; 2015-2019) and the Vienna Business Agency (Vienna, Austria; grant "APOSEC to clinic" 2343727).
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Affiliation(s)
- Maria Laggner
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Vienna, Austria; Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Dragan Copic
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Vienna, Austria; Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Lucas Nemec
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria
| | - Vera Vorstandlechner
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Vienna, Austria; Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Alfred Gugerell
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Vienna, Austria; Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Florian Gruber
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria
| | - Anja Peterbauer
- Austrian Red Cross Blood Transfusion Service of Upper Austria, Linz, Austria
| | - Hendrik J Ankersmit
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Vienna, Austria; Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Michael Mildner
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria.
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Camponogara C, Brum EDS, Belke BV, Brum TF, Jesus RDS, Piana M, Bauermann LDF, Oliveira SM. Casearia decandra leaves present anti-inflammatory efficacy in a skin inflammation model in mice. J Ethnopharmacol 2020; 249:112436. [PMID: 31785385 DOI: 10.1016/j.jep.2019.112436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Casearia decandra (guaçatonga) is popularly used as an anti-inflammatory. We investigated the antioxidant and anti-inflammatory effect of C.decandra leaves (CdE) ethanolic extract and of the rutin standard (present in the CdE). MATERIALS AND METHODS Male adult Swiss mice were used (25-30 g; 5-6 animals by a group). CdE phytochemical analysis was performed by HPLC method. The antioxidant potential of CdE and rutin was assessed by different methods. Topical anti-inflammatory effect of CdE (0.001-1mg/ear) and rutin (0.003-0.03mg/ear) was evaluated by ear edema formation and inflammatory cells infiltration (MPO activity and histology) on a skin inflammation model induced by topical application of croton oil (1mg/ear). RESULTS Rutin (27.81 ± 1.11 mg/g) was identified in CdE by HPLC analysis. The required amounts of CdE, rutin and ascorbic acid to reduce the initial concentration of radical DPPH by 50% (IC50) were 7.77 (6.31-9.57) μg/mL, 3.62 (3.26-4.01) μg/mL and 3.74 (3.37-4.14) μg/mL with a radical DPPH reduction of 91 ± 1.2%, 91 ± 0.5%, and 96 ± 0.44% (at 30 μg/mL), respectively. Moreover, CdE and rutin presented H2O2 scavenging activity with H2O2 levels reduction of 41 ± 7% and 46 ± 6%, respectively and SOD-like activity of 60 ± 4% and 51 ± 14%, respectively. On the other hand, just rutin presented nitric oxide scavenging activity of 54 ± 6%. CdE and rutin topically applied inhibited the ear edema with a maximum inhibition of 70 ± 5% (1 mg/ear) and 78 ± 10% (0.03 mg/ear), respectively. Treatments reduced the MPO activity (42 ± 4% to CdE; 1mg/ear and 30 ± 8% to rutin; 0.03 mg/ear). Histologically, the topical treatments also reduced the dermis thickness and the inflammatory cells infiltration. CONCLUSION We demonstrated the antioxidant and anti-inflammatory effect of C.decandra leaves and rutin. Its antioxidant potential may contribute to inflammatory process attenuation, supporting the C.decandra leaves used as a promising alternative in the therapy of the inflammatory diseases.
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Affiliation(s)
- Camila Camponogara
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Evelyne da Silva Brum
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Bianca Vargas Belke
- Graduate Program in Pharmaceutical Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Thiele Faccim Brum
- Graduate Program in Pharmaceutical Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Roberta da Silva Jesus
- Graduate Program in Pharmaceutical Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Mariana Piana
- Graduate Program in Pharmaceutical Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Sara Marchesan Oliveira
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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Peng F, Schwartz RA, Chen Z, Zhang JZ. High prevalence of contact hypersensitivity to metals and preservatives in Chinese patients with atopic dermatitis. Chin Med J (Engl) 2019; 132:2881-2882. [PMID: 31856061 PMCID: PMC6940085 DOI: 10.1097/cm9.0000000000000526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Received: 07/06/2019] [Indexed: 12/02/2022] Open
Affiliation(s)
- Fen Peng
- Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
| | - Robert A. Schwartz
- Department of Dermatology, New Jersey Medical School, NJ 07103-2714, USA
| | - Zhou Chen
- Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
| | - Jian-Zhong Zhang
- Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
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Birnbach DJ, McKenty NT, Rosen LF, Arheart KL, Everett-Thomas R, Lindsey SF. Does Adherence to World Health Organization Hand Hygiene Protocols in the Operating Room Have the Potential to Produce Irritant Contact Dermatitis in Anesthesia Providers? Anesth Analg 2019; 129:e182-e184. [PMID: 31743176 DOI: 10.1213/ane.0000000000004112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/05/2022]
Abstract
Anesthesia providers have the burden of constant hand hygiene during task dense periods. The requirement for hand hygiene often demands frequent application of alcohol-based hand rub. To assess whether frequent alcohol-based hand rub use leads to skin changes or irritant contact dermatitis, volunteers cleaned their hands with alcohol-based hand rub every 15 minutes for 8 hours for 5 sequential days. They were examined by a dermatologist before and after and asked about subjective skin changes. Results suggest an increase in irritant contact dermatitis scores and subjective complaints.
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Affiliation(s)
- David J Birnbach
- From the Department of Anesthesiology, University of Miami Miller School of Medicine
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Nathan T McKenty
- From the Department of Anesthesiology, University of Miami Miller School of Medicine
| | - Lisa F Rosen
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | | | - Scott F Lindsey
- Department of Dermatology, University of Miami Miller School of Medicine
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Perkins LE, Cribb BW, Pagendam DE, Zalucki MP. Variation in Morphology and Airborne Dispersal of the Urticating Apparatus of Ochrogaster lunifer (Lepidoptera: Notodontidae), an Australian Processionary Caterpillar, and Implications for Livestock and Humans. J Insect Sci 2019; 19:5634379. [PMID: 31782508 PMCID: PMC6883397 DOI: 10.1093/jisesa/iez112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Indexed: 05/05/2023]
Abstract
True setae borne on the abdominal tergites of Ochrogaster lunifer Herrich-Schӓffer caterpillars are the agents of an irritating contact dermatitis, osteomyelitis, ophthalmia, and severe allergic reactions in humans, and are the cause of Equine Amnionitis and Fetal Loss in Australia. The setae are detached and readily dislodge from the integument whereby they disperse throughout the environment. To better understand the true setae of O. lunifer as agents of medical and veterinary concern, we studied their characteristics and distance dispersed. Whereas members of the European Thaumetopoeinae have been widely studied, their southern-hemisphere counterparts such as O. lunifer are not well known despite their harmfulness and known medical and veterinary importance. The caterpillar's investment in true setae increased with age and size, and two distinct size classes co-occurred in setae fields. A previously undescribed morphological type of true seta was found on the first abdominal segment. All true setae were calculated to travel long distances in the air even under light breeze conditions. Our results show there is a high risk of exposure to airborne urticating setae within 100 m of elevated caterpillar activity, and a likely risk of exposure for some kilometers in the direction of the prevailing breeze. This information should be used to inform management strategies in areas where urticating processionary caterpillars are active, and especially during periods of an outbreak.
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Affiliation(s)
- Lynda E Perkins
- School of Biological Science, The University of Queensland, Brisbane, QLD, Australia
| | - Bronwen W Cribb
- School of Biological Science, The University of Queensland, Brisbane, QLD, Australia
- Centre for Microscopy & Microanalysis, The University of Queensland, Brisbane, QLD, Australia
| | | | - Myron P Zalucki
- School of Biological Science, The University of Queensland, Brisbane, QLD, Australia
- Corresponding author, e-mail:
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Lebwohl MG, Sugarman JL, Stein Gold L, Lin T, Israel R. Efficacy, Safety, and Tolerability of a Halobetasol 0.01% /Tazarotene 0.045% Fixed Combination in the Treatment of Severe Localized Plaque Psoriasis: Post Hoc Analysis of Two Phase III Randomized Controlled Trials. J Drugs Dermatol 2019; 18:1012-1018. [PMID: 31584780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: The use of topical therapy is a key component in the management of almost all psoriasis patients. Topicals are considered first-line therapy for mild disease and are having an increasing role in moderate or severe psoriasis as an integral part of combination therapy. Halobetasol has been shown be effective in moderate or severe localized plaque psoriasis, and tazarotene affords important effects on epidermal hyperproliferation that may be important in more severe disease. Objective: To investigate the efficacy, safety and tolerability of a once-daily application of a fixed combination halobetasol propionate 0.01% and tazarotene 0.045% (HP/TAZ) lotion in comparison with its vehicle in patients with severe localized plaque psoriasis (as defined by an Investigator Global Assessment (IGA) of 4 and Body Surface Area (BSA) of 3%-12%. Methods: Post hoc analysis of two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies. Sixty-two patients with severe localized psoriasis (mean BSA 7.4) randomized (2:1) to receive HP/TAZ lotion or vehicle, once-daily for 8 weeks, with a 4-week posttreatment follow-up. Efficacy assessments included treatment success (defined as at least a 2-grade improvement from baseline in the IGA score and a score of ‘clear’ or ‘almost clear’), impact on individual signs of psoriasis (erythema, plaque elevation, and scaling) at the target lesion, BSA, reduction in mean baseline IGAxBSA and achievement of a clinically meaningful response (number of patients who achieved at least a 75% improvement in IGAxBSA). Safety and treatment emergent adverse events (TEAEs) were evaluated throughout. Results: By week 8, 34.8% of patients were treatment successes compared with 0.0% on vehicle (P=0.004). HP/TAZ lotion was also significantly superior in reducing psoriasis signs and symptoms and improving BSA. At week 8, 47.4% (erythema), 66.4% (plaque elevation), and 65.4% (scaling) subjects achieved at least a 2-grade improvement, compared with 14.0% (P=0.016), 14.8% (P<0.001) and 14.7% (P<0.001) respectively with vehicle. Patients treated with HP/TAZ lotion achieved a 32.8% reduction in baseline mean BSA, compared with a 39.6% increase with vehicle (P=0.013). HP/TAZ lotion achieved a statistically significant superior reduction in mean IGAxBSA compared to vehicle from week 2 (P<0.001 versus vehicle). By week 8, almost half of the patients treated with HP/TAZ lotion achieved a clinically meaningful response (IGAxBSA-75) and a 52.9% reduction in mean IGAxBSA score compared with a 17.5% increase in those patients treated with vehicle (P<0.001). One patient (2.6%) treated with HP/TAZ lotion discontinued due to AE. Most frequently reported treatment related AEs were application site pain (7.9%), contact dermatitis (5.3%) and pruritus (5.3%). Conclusions: HP/TAZ lotion provides significantly greater efficacy than vehicle that is both rapid and sustained, in patients with severe localized plaque psoriasis, with good tolerability and safety over 8 weeks’ once-daily use. J Drugs Dermatol. 2019;18(10):1012-1018.
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Pleus S, Ulbrich S, Zschornack E, Kamann S, Haug C, Freckmann G. Documentation of Skin-Related Issues Associated with Continuous Glucose Monitoring Use in the Scientific Literature. Diabetes Technol Ther 2019; 21:538-545. [PMID: 31335203 DOI: 10.1089/dia.2019.0171] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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] [Indexed: 12/13/2022]
Abstract
Background: The average wear time of continuous glucose monitoring (CGM) systems steadily increased over the last years. Increased wear times are likely achieved by using adhesives with a longer adherence time, which may have a more pronounced effect on the skin than adhesives with shorter adherence time. Methods: In this project, a structured literature search was performed to assess how potential skin-related issues with CGM usage have been reported in scientific literature in the last 5 years. The literature search was performed with four search terms in the PubMed database. Results: In sum, 279 articles were analyzed. Skin-related issues were mentioned in 19.0% of articles (53 out of 279). With respect to articles mentioning skin-related issues, CGM performance or efficacy was the study's main topic of most of these studies, whereas the minority used CGM as "add-on" to assess other objectives. There was a varying degree in how detailed skin-related issues were described and no uniform structured documentation was given. While some articles only described findings, other articles already documented final diagnoses, such as contact dermatitis. Furthermore, inconsistent wordings for comparable issues were used. The most frequent issues were pain, itching, erythema, bleeding, bruising, and allergic reactions. Conclusion: To draw possible conclusions about the occurrence of skin-related issues during CGM use, more reports about skin-related issues in scientific literature are needed. A more detailed and uniformly structured documentation, possibly facilitated by a generally accepted guideline for structured descriptions, of skin-related issues could be helpful to enable clear differentiations between the described skin reactions.
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Affiliation(s)
- Stefan Pleus
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Sina Ulbrich
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Eva Zschornack
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | | | - Cornelia Haug
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Guido Freckmann
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
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Wang D, Assen YJ. [Itchy rash caused by the oak processionary caterpillar]. Ned Tijdschr Geneeskd 2019; 163:D4243. [PMID: 31433141] [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: 06/10/2023]
Abstract
BACKGROUND As a result of climate change, we will have to deal more and more often with the consequences of the oak processionary caterpillar. CASE DESCRIPTION In June, we saw a 6-year-old girl with a severely itchy rash all over her body. The rash had developed a day after school and consisted of erythematous papules on an erythematous base. Several other children at the school were suffering from a similar skin rash. The girl also seemed to have a bad cold. We diagnosed 'oak processionary caterpillar dermatitis'. It turned out there was indeed an oak processionary caterpillar nest at her school. The nest was removed. We prescribed cetirizine oral solution, followed by triamcinolone cream, after which the itch and skin rash disappeared. CONCLUSION The oak processionary caterpillar can cause a lot of symptoms in the period from April to July, including skin rash and eye and upper airway symptoms. The symptoms are usually self-limiting and automatically disappear within 2 weeks. In case of severe itching, menthol-based creams, topical corticosteroids and antihistamines may be prescribed.
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Affiliation(s)
- Da Wang
- Franciscus Gasthuis, afd. Dermatologie, Rotterdam
| | - Yvette J Assen
- Franciscus Gasthuis, afd. Dermatologie, Rotterdam
- Contact: Y.J. Assen
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Noda M, Sultana N, Hayashi I, Fukamachi M, Sugiyama M. Exopolysaccharide Produced by Lactobacillus paracasei IJH-SONE68 Prevents and Improves the Picryl Chloride-Induced Contact Dermatitis. Molecules 2019; 24:molecules24162970. [PMID: 31426284 PMCID: PMC6720527 DOI: 10.3390/molecules24162970] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 02/07/2023] Open
Abstract
Allergic disease is one of the most important and common health problems worldwide. We have previously demonstrated that a fig leaf-derived lactic acid bacterium Lactobacillus (Lb.) paracasei IJH-SONE68 produces a novel exopolysaccharide (EPS). Furthermore, we have shown that the EPS inhibits the catalytic activity of hyaluronidase (EC 3.2.1.36) promoting inflammatory reactions. To evaluate the anti-allergy and anti-inflammatory effects of the EPS, in the present study, we employed the picryl-chloride-induced delayed-type (type IV) allergy model mice, which is used to evaluate the contact dermatitis. Oral administration of the EPS was observed to reduce the ear swelling in the model mice. We also observed that the overexpression of ear interleukin-4 (T helper (Th) 2 cytokine) mRNA and the increase in serum immunoglobulin E (IgE) are repressed. However, the expression of interferon-γ (Th1 cytokine) was not accelerated in all of the allergen-challenged model mice. The improvement may be responsible for the Th2 downregulation rather than the Th1 upregulation. In addition, the symptom of immediate-type (type I) allergy model mice was improved by oral administration of the IJH-SONE68 cell (data not shown). We can conclude that the IJH-SONE68-derived EPS is useful to improve the type I and IV allergies including atopic dermatitis.
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Affiliation(s)
- Masafumi Noda
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan
| | - Nasrin Sultana
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan
| | - Ikue Hayashi
- Central Research Laboratory, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan
| | | | - Masanori Sugiyama
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
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Kim HS, Lee MB, Lee D, Min KY, Koo J, Kim HW, Park YH, Kim SJ, Ikutani M, Takaki S, Kim YM, Choi WS. The regulatory B cell-mediated peripheral tolerance maintained by mast cell IL-5 suppresses oxazolone-induced contact hypersensitivity. Sci Adv 2019; 5:eaav8152. [PMID: 31328158 PMCID: PMC6636983 DOI: 10.1126/sciadv.aav8152] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
The function of regulatory immune cells in peripheral tissues is crucial to the onset and severity of various diseases. Interleukin-10 (IL-10)-producing regulatory B (IL-10+ Breg) cells are known to suppress various inflammatory diseases. However, evidence for the mechanism by which IL-10+ Breg cells are generated and maintained is still very limited. Here, we found that IL-10+ Breg cells suppress the activation of IL-13-producing type 2 innate lymphoid cells (IL-13+ ILC2s) in an IL-10-dependent manner in mice with oxazolone-induced severe contact hypersensitivity (CHS). Mast cell (MC) IL-5 was important for maintaining the population of IL-10+ Breg cells in peripheral lymphoid tissues. Overall, these results uncover a previously unknown mechanism of MCs as a type of immunoregulatory cell and elucidate the cross-talk among MCs, IL-10+ Breg cells, and IL-13+ ILC2s in CHS.
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Affiliation(s)
- Hyuk Soon Kim
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Min Bum Lee
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Dajeong Lee
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Keun Young Min
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Jimo Koo
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Hyun Woo Kim
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Young Hwan Park
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Su Jeong Kim
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
| | - Masashi Ikutani
- Department of Immune Regulation, The Research Center for Hepatitis and Immunology, Research Institute, National Center for Global Health and Medicine, Chiba 272-8516, Japan
| | - Satoshi Takaki
- Department of Immune Regulation, The Research Center for Hepatitis and Immunology, Research Institute, National Center for Global Health and Medicine, Chiba 272-8516, Japan
| | - Young Mi Kim
- Department of Preventive Pharmacy, College of Pharmacy, Duksung Women’s University, Seoul 01369, Korea
| | - Wahn Soo Choi
- Department of Immunology, School of Medicine, Konkuk University, Chungju 27478, Korea
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Abstract
Relationships between the structure and properties of chemicals can be programmed into knowledge-based systems such as DEREK for Windows (DEREK is an acronym for "Deductive Estimation of Risk from Existing Knowledge"). The DEREK for Windows computer system contains a subset of over 60 rules describing chemical substructures (toxophores) responsible for skin sensitisation. As part of the European Phototox Project, the rule base was supplemented by a number of rules for the prospective identification of photoallergens, either by extension of the scope of existing rules or by the generation of new rules where a sound mechanistic rationale for the biological activity could be established. The scope of the rules for photoallergenicity was then further refined by assessment against a list of chemicals identified as photosensitisers by the Centro de Farmacovigilancia de la Comunidad Valenciana, Valencia, Spain. This paper contains an analysis of the mechanistic bases of activity for eight important groups of photoallergens and phototoxins, together with rules for the prospective identification of the photobiological activity of new or untested chemicals belonging to those classes. The mechanism of action of one additional chemical, nitrofurantoin, is well established; however, it was deemed inappropriate to write a rule on the basis of a single chemical structure.
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Affiliation(s)
- Martin D Barratt
- Marlin Consultancy, 10 Beeby Way, Carlton, Bedford MK43 7LW, UK.
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47
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Reeder M, Atwater AR. Parabens: the 2019 nonallergen of the year. Cutis 2019; 103:192-193. [PMID: 31116813] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Margo Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Amber Reck Atwater
- Department of Dermatology, Duke University School of Medicine, Durham, North Carolina, USA
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Affiliation(s)
| | - Silmara C. P. Cestari
- Dermatology Course, Escola Paulista de Medicina, Universidade
Federal de São Paulo, São Paulo (SP), Brazil
- Dermatology Outpatient Clinic, Hospital Sírio-Libanês,
São Paulo (SP), Brazil
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49
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Nagano T, Katase M, Tsumura K. Inhibitory effects of dietary soy isoflavone and gut microbiota on contact hypersensitivity in mice. Food Chem 2019; 272:33-38. [PMID: 30309552 DOI: 10.1016/j.foodchem.2018.08.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 04/06/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 01/06/2023]
Abstract
Soy isoflavones (SIs) are abundant in soybeans and have inhibitory effects on contact hypersensitivity (CHS), which is often used as a mouse model for allergic contact dermatitis (ACD); however, their therapeutic mechanisms remain unknown. We studied the suppressive activity of dietary SI and gut microbiota on dinitrofluorobenzene (DNFB)-induced CHS. Low-dose SI diets alleviated DNFB-induced ear swelling and oedema and decreased infiltration of Gr-1-positive cells into ear tissue. In addition, dietary SIs also decreased interleukin-1β and chemokine (C-X-C motif) ligand 1 production in ear tissue compared to controls. Furthermore, ciprofloxacin and metronidazole treatments blocked the suppressive activity of dietary SIs on CHS, whereas vancomycin treatment had a marginal effect. These antibiotic treatments differed in their effects on the gut microbiota composition. These results demonstrated that consumption of physiologically relevant doses of SIs reduced CHS symptoms, and suggested that the gut microbiota influenced their suppressive activities on CHS.
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MESH Headings
- Animals
- Anti-Bacterial Agents/pharmacology
- Bacteria/classification
- Bacteria/genetics
- Bacteria/isolation & purification
- Chemokines, C/metabolism
- Dermatitis, Contact/etiology
- Dermatitis, Contact/prevention & control
- Diet
- Dinitrofluorobenzene/toxicity
- Disease Models, Animal
- Edema/metabolism
- Edema/prevention & control
- Female
- Gastrointestinal Microbiome/drug effects
- Interleukin-1beta/metabolism
- Intestines/microbiology
- Isoflavones/chemistry
- Isoflavones/pharmacology
- Isoflavones/therapeutic use
- Mice
- Mice, Inbred BALB C
- Principal Component Analysis
- RNA, Ribosomal, 16S/classification
- RNA, Ribosomal, 16S/isolation & purification
- RNA, Ribosomal, 16S/metabolism
- Glycine max/chemistry
- Glycine max/metabolism
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Affiliation(s)
- Takao Nagano
- Department of Food Science, Faculty of Bioresources and Environmental Sciences, Ishikawa Prefectural University, 1-308, Suematsu, Nonoich, Ishikawa 921-8836, Japan; Department of Clinical Nutrition, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288, Matsushima, Kurashiki, Okayama 701-0193, Japan.
| | - Mitsuru Katase
- Quality Assurance Department, Fuji Oil Co., Ltd., 1 Sumiyoshi, Izumisano, Osaka 598-8540, Japan
| | - Kazunobu Tsumura
- Research Institute for Creating Future, Fuji Oil Holdings Inc., 1 Sumiyoshi, Izumisano, Osaka 598-8540, Japan
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Kelleher K, Hunt R, Hannigan A, Coffey JC, Moloney MC, Ahern M, Conway E, O'Sullivan L. A Single-arm, Practical Application Assessment of User Experience and Peristomal Skin Condition Among Persons With an Ileostomy Using a New Barrier Seal With Assisted Flow. Wound Manag Prev 2019; 65:14-19. [PMID: 30724745] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
UNLABELLED Peristomal skin complications are a common problem for persons with an ileostomy. PURPOSE The purpose of this pilot study was to solicit user feedback and perform an initial assessment of the performance of a new barrier seal designed to decrease the risk of chemical-induced dermatitis. METHODS Seven (7) potential participants who were at least 18 years of age, >6 months post surgery, with an end or loop ileostomy and unbroken peristomal skin, and who were capable of changing their appliance themselves or had the availability of care assistance were identified and recruited by the stoma care nurse at the University Hospital, Limerick, Ireland. At the initial visit and after 1 and 2 weeks, participants were asked to rate device comfort, security, and handling; skin condition was assessed by the research nurse using the Ostomy Skin Tool. Descriptive statistics were used to tabulate the results. RESULTS Five (5) participants completed the study. Discoloration, erosion, and tissue overgrowth scores improved in 3 of 5 patients, and the mean Ostomy Skin Tool score decreased from 5.4 ± 2.19 at the initial assessment to 4 ± 1.87 at the week 2 visit. Comfort, handling, and security ratings increased from a median of 8 at the beginning of the study to 10 at week 2. CONCLUSION Initial patient feedback regarding the new product was positive, and skin assessment results suggest the new seal may help improve peristomal skin condition. Larger studies with longer patient follow-up are needed to confirm the results of this pilot evaluation.
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Affiliation(s)
| | - Rhona Hunt
- University of Limerick, Limerick, Ireland
| | | | | | | | - Mary Ahern
- University of Limerick, Limerick, Ireland
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