We present a case of myasthenia gravis that occurred after alopecia areata and evaluate the literature on the comorbidity of alopecia and myasthenia gravis. A 41-year-old male noticed hair loss on his scalp 4 months ago, and his hair loss progressed with drooping of both upper eyelids and diplopia. Physical and laboratory examination identified the comorbidity of myasthenia gravis and alopecia areata. Prednisolone 10 mg/day and tacrolimus 3 mg/day were administered for 7 days following hospitalization, which served to improve diplopia and ptosis. Following methylprednisolone therapy, hair loss in alopecia areata improved without the enlargement of bald areas. Based on the literature review, a total of 29 cases with alopecia and myasthenia gravis including our case have been reported. Among them, seven cases of myasthenia gravis developed after alopecia. The average time for the onset of myasthenia gravis after alopecia was 16.6 months. Four cases showed other autoimmune disease comorbidity, such as vitiligo, lichen planus, cutaneous lupus erythematosus, and pemphigus foliaceus, suggesting the involvement of Th1-significant immunological states in these patients.
{"title":"A case of myasthenia gravis following alopecia areata","authors":"Naoki Sasaki MD, Yu Sawada MD, PhD","doi":"10.1002/cia2.12327","DOIUrl":"10.1002/cia2.12327","url":null,"abstract":"<p>We present a case of myasthenia gravis that occurred after alopecia areata and evaluate the literature on the comorbidity of alopecia and myasthenia gravis. A 41-year-old male noticed hair loss on his scalp 4 months ago, and his hair loss progressed with drooping of both upper eyelids and diplopia. Physical and laboratory examination identified the comorbidity of myasthenia gravis and alopecia areata. Prednisolone 10 mg/day and tacrolimus 3 mg/day were administered for 7 days following hospitalization, which served to improve diplopia and ptosis. Following methylprednisolone therapy, hair loss in alopecia areata improved without the enlargement of bald areas. Based on the literature review, a total of 29 cases with alopecia and myasthenia gravis including our case have been reported. Among them, seven cases of myasthenia gravis developed after alopecia. The average time for the onset of myasthenia gravis after alopecia was 16.6 months. Four cases showed other autoimmune disease comorbidity, such as vitiligo, lichen planus, cutaneous lupus erythematosus, and pemphigus foliaceus, suggesting the involvement of Th1-significant immunological states in these patients.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"237-240"},"PeriodicalIF":1.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139015679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We demonstrated that there were abundant neutrophil extracellular traps (NETs) in the skin biopsies from various types of pyoderma gangrenosum (PG), based on the observation of extended and compact areas of immunolabeling of MPO and Cit H3 proteins. We suggest that neutrophils could undergo an aberrant NET formation in the lesions of PG patients, in the vast majority of idiopathic PG. We did not detect NETs in the skin ulcers of an antiphospholipid syndrome patient with a similar appearance to classical ulcerative PG, while rich NETs were found in the various types of PG. These findings suggest that the presence of NETs in skin tissues could serve as a marker for making differential diagnoses of various types of PG from other similar conditions.
{"title":"The presence of neutrophil extracellular traps in different forms of pyoderma gangrenosum","authors":"Takaharu Ikeda MD, PhD, Tamihiro Kawakami MD, PhD, Kae Yokoyama MD, Yuka Nishibata PhD, Sakiko Masuda PhD, Utano Tomaru MD, PhD, Akihiro Ishizu MD, PhD","doi":"10.1002/cia2.12331","DOIUrl":"10.1002/cia2.12331","url":null,"abstract":"<p>We demonstrated that there were abundant neutrophil extracellular traps (NETs) in the skin biopsies from various types of pyoderma gangrenosum (PG), based on the observation of extended and compact areas of immunolabeling of MPO and Cit H3 proteins. We suggest that neutrophils could undergo an aberrant NET formation in the lesions of PG patients, in the vast majority of idiopathic PG. We did not detect NETs in the skin ulcers of an antiphospholipid syndrome patient with a similar appearance to classical ulcerative PG, while rich NETs were found in the various types of PG. These findings suggest that the presence of NETs in skin tissues could serve as a marker for making differential diagnoses of various types of PG from other similar conditions.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"241-244"},"PeriodicalIF":1.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23DOI: 10.37191/mapsci-2582-6549-4(2)-045
Samira Khandaker Shuvra
Escherichia coli O157:H7, a Shiga toxin producing microbe was first acknowledged as a virulent organism in 1982 during an analysis of an outbreak of haemorrhagic colitis associated with consumption of hamburgers from a fast-food chain restaurant. Ability of Escherichia coli O157:H7 to induce injury in humans is a result of its ability to produce numerous virulence factors, most notably Shiga toxins Stx1 and Stx2, both of which constitute one of the most potent toxins known to man. Besides, Shiga toxin, Escherichia coli O157:H7 produces several other virulence factors, which include proteins which aid in the attachment and colonization of the bacteria in the intestinal wall and which can break down red blood cells and release iron to help support metabolism in Escherichia coli . Virulence factors facilitate this organism’s ability to cause intestinal and extra-intestinal diseases such as diarrhoea, haemorrhagic colitis (HC), haemolytic uremic syndrome (HUS), urinary tract infections (UTI), septicaemia and neonatal meningitis. In this study r, 7 samples from Dhaka city was collected, cultured in various media for enumeration, isolation and screening of Escherichia coli colonies which were further analysed to check for the presence of stx genes using PCR and gel electrophoresis. The seven samples collected were: Door knob swab, tea water, bhel puri, kitchen pipe swab, vegetable water, Lake water and Skin swab. The samples collected initially were enriched in enrichment media overnight, followed by a dilution series which were then used for spread plating on nutrient agar and MacConkey agar and EMB for confirmation with the observation of pink colonies and metallic sheen. The confirmed Escherichia coli isolates were later subjected to DNA extraction and amplification after which the bands for stx genes were observed and recorded. Out of the seven samples tested for stx1 and stx2 genes, two showed the presence of stx1 genes and one showed the presence of stx2 gene. The presence of the stx1 and stx2 genes in regular food and in the surrounding signifies how close is a large outbreak. Knowledge of processing such food or avoiding such environmental contacts or taking precautions when possible may prevent occurrence of diseases.
{"title":"Isolation of Shiga Toxin Producing Escherichia coli 0157:H7 from Environmental and Clinical Samples in Dhaka City","authors":"Samira Khandaker Shuvra","doi":"10.37191/mapsci-2582-6549-4(2)-045","DOIUrl":"https://doi.org/10.37191/mapsci-2582-6549-4(2)-045","url":null,"abstract":"Escherichia coli O157:H7, a Shiga toxin producing microbe was first acknowledged as a virulent organism in 1982 during an analysis of an outbreak of haemorrhagic colitis associated with consumption of hamburgers from a fast-food chain restaurant. Ability of Escherichia coli O157:H7 to induce injury in humans is a result of its ability to produce numerous virulence factors, most notably Shiga toxins Stx1 and Stx2, both of which constitute one of the most potent toxins known to man. Besides, Shiga toxin, Escherichia coli O157:H7 produces several other virulence factors, which include proteins which aid in the attachment and colonization of the bacteria in the intestinal wall and which can break down red blood cells and release iron to help support metabolism in Escherichia coli . Virulence factors facilitate this organism’s ability to cause intestinal and extra-intestinal diseases such as diarrhoea, haemorrhagic colitis (HC), haemolytic uremic syndrome (HUS), urinary tract infections (UTI), septicaemia and neonatal meningitis. In this study r, 7 samples from Dhaka city was collected, cultured in various media for enumeration, isolation and screening of Escherichia coli colonies which were further analysed to check for the presence of stx genes using PCR and gel electrophoresis. The seven samples collected were: Door knob swab, tea water, bhel puri, kitchen pipe swab, vegetable water, Lake water and Skin swab. The samples collected initially were enriched in enrichment media overnight, followed by a dilution series which were then used for spread plating on nutrient agar and MacConkey agar and EMB for confirmation with the observation of pink colonies and metallic sheen. The confirmed Escherichia coli isolates were later subjected to DNA extraction and amplification after which the bands for stx genes were observed and recorded. Out of the seven samples tested for stx1 and stx2 genes, two showed the presence of stx1 genes and one showed the presence of stx2 gene. The presence of the stx1 and stx2 genes in regular food and in the surrounding signifies how close is a large outbreak. Knowledge of processing such food or avoiding such environmental contacts or taking precautions when possible may prevent occurrence of diseases.","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135365547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to evaluate long-term changes in nailfold videocapillaroscopy (NVC) findings in dermatomyositis patients with antinuclear matrix protein 2 (NXP-2) antibody (Ab). All four patients with anti-NXP-2 Ab presented irregularly enlarged and reduced capillaries and hemorrhages at the initial assessment. After disease stabilization, irregularly enlarged capillaries and hemorrhages disappeared within the mean observation period of 6 months. These early improvements were not observed in patients with anti-TIF1 Ab. The results of this study show that long-term changes in NVC findings should be assessed using myositis-specific Ab information.
本研究旨在评估抗核基质蛋白2（NXP-2）抗体（Ab）皮肌炎患者甲襞视频毛细血管镜（NVC）检查结果的长期变化。四名抗核基质蛋白2（NXP-2）抗体患者在初次评估时均出现毛细血管不规则扩大和缩小以及出血。病情稳定后，不规则扩大的毛细血管和出血在平均 6 个月的观察期内消失。而抗 TIF1 Ab 患者则没有观察到这些早期改善。本研究结果表明，应使用肌炎特异性抗体信息来评估 NVC 结果的长期变化。
{"title":"Early improvement of nailfold videocapillaroscopy abnormalities in dermatomyositis patients with anti-NXP-2 antibody","authors":"Naoki Mugii PhD, Yasuhito Hamaguchi MD, PhD, Natsumi Fushida MD, Motoki Horii MD, PhD, Tasuku Kitano MD, Ko Fujii MD, Kaori Sawada MD, PhD, Kyosuke Oishi MD, PhD, Shintaro Maeda MD, PhD, Takashi Matsushita MD, PhD","doi":"10.1002/cia2.12334","DOIUrl":"10.1002/cia2.12334","url":null,"abstract":"<p>This study aimed to evaluate long-term changes in nailfold videocapillaroscopy (NVC) findings in dermatomyositis patients with antinuclear matrix protein 2 (NXP-2) antibody (Ab). All four patients with anti-NXP-2 Ab presented irregularly enlarged and reduced capillaries and hemorrhages at the initial assessment. After disease stabilization, irregularly enlarged capillaries and hemorrhages disappeared within the mean observation period of 6 months. These early improvements were not observed in patients with anti-TIF1 Ab. The results of this study show that long-term changes in NVC findings should be assessed using myositis-specific Ab information.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"245-248"},"PeriodicalIF":1.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135918298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Prurigo-type atopic dermatitis (AD) is an AD variant characterized by excoriated papules, indurated nodules, and intense itching associated with type 2 cytokine responses.<span><sup>1</sup></span> Recently, upadacitinib, an oral selective Janus kinase (JAK) 1 inhibitor, was found to be efficacious and safe in treating moderate-to-severe AD in patients aged >12 years in a clinical trial.<span><sup>2</sup></span> However, few reports have demonstrated evidence of upadacitinib in prurigo-type AD. Here, we present four Japanese patients with prurigo-type AD who received upadacitinib.</p><p>Our cases included two male and two female patients with moderate-to-severe AD (Table S1). The patients fulfilled the AD criteria.<span><sup>3</sup></span> Cases 3 and 4 were also confirmed AD pathologically. They were treated with 15 or 30 mg upadacitinib, topical corticosteroid, and moisturizers once a day. Case 1: a 49-year-old female with widespread areas of erythema, nodules, and itching on her legs (Figure 1A). We initiated 30 mg of upadacitinib. After 8 weeks, she achieved Eczema Area and Severity Index (EASI)-90 and was itch-free (Figure 1B). Case 2: a 50-year-old female. She applied corticosteroid ointments on her refractory nodules for decades (Figure 1C). She had difficulty throughout her life due to insomnia caused by itching. We initiated 30 mg of upadacitinib; she was pruritus-free after 2 weeks, achieving EASI-90 after 4 weeks (Figure 1D). Case 3: a 64-year-old male with multiple pruritic nodules on his trunk and extremities (Figure 1E). We first initiated 30 mg of upadacitinib for his severe itchiness. After 4 weeks, his skin lesions and itching improved noticeably. Thus, we decreased the upadacitinib dose to 15 mg. After 12 weeks, his skin lesions almost disappeared (Figure 1F). Case 4: a 66-year-old male. He had multiple nodules on his neck and arms, forming plaque (Figure 1G). Although we diagnosed him with severe AD, we prescribed 15 mg of upadacitinib because of his age. After 12 weeks, he achieved EASI-90, and his skin lesions almost disappeared (Figure 1H). No adverse events were observed in the patients.</p><p>Figure 1I–K shows the transition of EASI, patient-oriented eczema measure (POEM), and pruritus numerical rating scale (NRS). A rapid decrease was seen in all categories from baseline to Week 4, and this effectiveness lasted for 12 weeks. Thymus and activation-regulated chemokine and immunoglobulin E in the serum were decreased from baseline to Week 4; however, some cases increased at Week 12 (Figure 1L,M).</p><p>The effectiveness of dupilumab and baricitinib against prurigo-type AD was recently reported.<span><sup>4, 5</sup></span> Dupilumab showed a significantly lower achievement rate of EASI-50 at 2 months in the prurigo compared with the non-prurigo group.<span><sup>4</sup></span> These results indicate the importance of suppressing not only IL-4 and IL-13 but also other cytokines, including IL-31 and thymic stromal lymphopoi
瘙痒型特应性皮炎（AD）是特应性皮炎的一种变异型，其特征为与 2 型细胞因子反应相关的剥脱性丘疹、硬化性结节和剧烈瘙痒。1 最近，在一项临床试验中发现，口服选择性 Janus 激酶（JAK）1 抑制剂达帕替尼（upadacitinib）在治疗 12 岁中重度 AD 患者方面具有良好的疗效和安全性。我们的病例包括两名男性和两名女性中重度 AD 患者（表 S1）。我们的病例包括两男两女中重度 AD 患者（表 S1），患者均符合 AD 标准。他们接受了 15 或 30 毫克达帕替尼、局部皮质类固醇激素和保湿剂的治疗，每天一次。病例 1：49 岁女性，腿部出现大面积红斑、结节和瘙痒（图 1A）。我们给她服用了 30 毫克的达帕替尼。8 周后，她的湿疹面积和严重程度指数（EASI）达到 90，并且不再瘙痒（图 1B）。病例 2：女性，50 岁。几十年来，她一直在难治性结节上涂抹皮质类固醇软膏（图 1C）。由于瘙痒导致失眠，她终生难以入眠。我们给她服用了30毫克的达帕替尼，2周后她的瘙痒症状消失，4周后达到EASI-90（图1D）。病例 3：64 岁男性，躯干和四肢有多个瘙痒性结节（图 1E）。我们首先给他服用了 30 毫克的达帕替尼，以缓解他的剧烈瘙痒。4 周后，他的皮损和瘙痒症状明显好转。因此，我们将达帕替尼的剂量降至 15 毫克。12 周后，他的皮损几乎消失（图 1F）。病例 4：66 岁男性。他的颈部和手臂上有多个结节，形成斑块（图 1G）。虽然我们诊断他患有严重的 AD，但考虑到他的年龄，我们给他开了 15 毫克的达达替尼。12 周后，他的 EASI 达到 90，皮损也几乎消失（图 1H）。图1I-K显示了EASI、以患者为导向的湿疹测量（POEM）和瘙痒数字评分量表（NRS）的变化情况。从基线到第4周，所有类别的数据都迅速下降，这种效果持续了12周。从基线到第 4 周，血清中胸腺和活化调节趋化因子及免疫球蛋白 E 均有所下降；但在第 12 周，部分病例有所上升（图 1L、M）、4 这些结果表明，在瘙痒型 AD 的治疗过程中，不仅要抑制 IL-4 和 IL-13，还要抑制其他细胞因子，包括 IL-31 和胸腺基质淋巴细胞生成素，因为它们会诱发瘙痒。6 我们的病例（图 1K）和之前关于巴利昔替尼的报道显示，巴利昔替尼可在 4 周内达到 NRS-Itch-50 的疗效。5 JAK 抑制剂可通过强烈抑制瘙痒，使瘙痒型 AD 早期得到改善：本研究未涉及人类参与者：注册表和注册号：不适用。动物研究：不适用：动物研究：不详。
{"title":"Effectiveness of upadacitinib in Japanese patients with prurigo-type atopic dermatitis: Four cases report","authors":"Keiji Kosaka MD, Akihiko Uchiyama MD, PhD, Mai Ishikawa MD, Sei-ichiro Motegi MD, PhD","doi":"10.1002/cia2.12333","DOIUrl":"10.1002/cia2.12333","url":null,"abstract":"<p>Prurigo-type atopic dermatitis (AD) is an AD variant characterized by excoriated papules, indurated nodules, and intense itching associated with type 2 cytokine responses.<span><sup>1</sup></span> Recently, upadacitinib, an oral selective Janus kinase (JAK) 1 inhibitor, was found to be efficacious and safe in treating moderate-to-severe AD in patients aged >12 years in a clinical trial.<span><sup>2</sup></span> However, few reports have demonstrated evidence of upadacitinib in prurigo-type AD. Here, we present four Japanese patients with prurigo-type AD who received upadacitinib.</p><p>Our cases included two male and two female patients with moderate-to-severe AD (Table S1). The patients fulfilled the AD criteria.<span><sup>3</sup></span> Cases 3 and 4 were also confirmed AD pathologically. They were treated with 15 or 30 mg upadacitinib, topical corticosteroid, and moisturizers once a day. Case 1: a 49-year-old female with widespread areas of erythema, nodules, and itching on her legs (Figure 1A). We initiated 30 mg of upadacitinib. After 8 weeks, she achieved Eczema Area and Severity Index (EASI)-90 and was itch-free (Figure 1B). Case 2: a 50-year-old female. She applied corticosteroid ointments on her refractory nodules for decades (Figure 1C). She had difficulty throughout her life due to insomnia caused by itching. We initiated 30 mg of upadacitinib; she was pruritus-free after 2 weeks, achieving EASI-90 after 4 weeks (Figure 1D). Case 3: a 64-year-old male with multiple pruritic nodules on his trunk and extremities (Figure 1E). We first initiated 30 mg of upadacitinib for his severe itchiness. After 4 weeks, his skin lesions and itching improved noticeably. Thus, we decreased the upadacitinib dose to 15 mg. After 12 weeks, his skin lesions almost disappeared (Figure 1F). Case 4: a 66-year-old male. He had multiple nodules on his neck and arms, forming plaque (Figure 1G). Although we diagnosed him with severe AD, we prescribed 15 mg of upadacitinib because of his age. After 12 weeks, he achieved EASI-90, and his skin lesions almost disappeared (Figure 1H). No adverse events were observed in the patients.</p><p>Figure 1I–K shows the transition of EASI, patient-oriented eczema measure (POEM), and pruritus numerical rating scale (NRS). A rapid decrease was seen in all categories from baseline to Week 4, and this effectiveness lasted for 12 weeks. Thymus and activation-regulated chemokine and immunoglobulin E in the serum were decreased from baseline to Week 4; however, some cases increased at Week 12 (Figure 1L,M).</p><p>The effectiveness of dupilumab and baricitinib against prurigo-type AD was recently reported.<span><sup>4, 5</sup></span> Dupilumab showed a significantly lower achievement rate of EASI-50 at 2 months in the prurigo compared with the non-prurigo group.<span><sup>4</sup></span> These results indicate the importance of suppressing not only IL-4 and IL-13 but also other cytokines, including IL-31 and thymic stromal lymphopoi","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"262-263"},"PeriodicalIF":1.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bullous pemphigoid (BP) is a representative autoimmune subepidermal blister disease, and approximately 20% of cases recognized the absence of a typical blister. Those cases result in delayed diagnosis and appropriate therapeutic selection results, leading to an increased mortality rate. Herein, we present a case of initial misdiagnosed as persistent eczematous eruption, which was finally confirmed as nonbullous pemphigoid by repeated histological examinations
{"title":"Nonbullous pemphigoid representing clinical manifestation as eczematous skin eruption","authors":"Noriko Kagawa MD, Kayo Yamamoto MD, Eri Ohta MD, Yoko Akamatsu MD, Etsuko Okada MD, PhD, Yu Sawada MD, PhD","doi":"10.1002/cia2.12322","DOIUrl":"10.1002/cia2.12322","url":null,"abstract":"<p>Bullous pemphigoid (BP) is a representative autoimmune subepidermal blister disease, and approximately 20% of cases recognized the absence of a typical blister. Those cases result in delayed diagnosis and appropriate therapeutic selection results, leading to an increased mortality rate. Herein, we present a case of initial misdiagnosed as persistent eczematous eruption, which was finally confirmed as nonbullous pemphigoid by repeated histological examinations\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"251-252"},"PeriodicalIF":1.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135645570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pityriasis rubra pilaris (PRP) is a rare, chronic, inflammatory dermatosis characterized by follicular, hyperkeratotic papules and palmoplantar keratoderma at any age. The exact etiology of the disease remains unknown, but it can be triggered by multiple factors and genetic backgrounds. Here, we describe a case of PRP occurring after SARS-CoV-2 vaccination. While the vaccination is generally safe, it should be kept in mind that PRP may be evoked by SARS-CoV-2 vaccination for early recognition of the cause and prognosis of the patients.
{"title":"Pityriasis rubra pilaris following administration of SARS-CoV-2 vaccine","authors":"Shumpei Kondo MD, Yasuaki Ogura MD, Masaki Ohtsuka MD, PhD, Yoshiki Tokura MD, PhD","doi":"10.1002/cia2.12326","DOIUrl":"10.1002/cia2.12326","url":null,"abstract":"<p>Pityriasis rubra pilaris (PRP) is a rare, chronic, inflammatory dermatosis characterized by follicular, hyperkeratotic papules and palmoplantar keratoderma at any age. The exact etiology of the disease remains unknown, but it can be triggered by multiple factors and genetic backgrounds. Here, we describe a case of PRP occurring after SARS-CoV-2 vaccination. While the vaccination is generally safe, it should be kept in mind that PRP may be evoked by SARS-CoV-2 vaccination for early recognition of the cause and prognosis of the patients.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"234-236"},"PeriodicalIF":1.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CXCL14 is a member of CXC chemokine family, constitutively expressed in various normal tissues unlike many other chemokines. Other than the capacity to recruit natural killer cells, macrophages, and dendritic cells, CXCL14 suppresses CXCL12-CXCR4 interactions by inducing CXCR4 internalization. Thus, CXCL14 can both promote and hinder immune responses. Psoriasis is a chronic skin inflammatory disorder in which various chemokines play an important role.
Methods
To investigate possible roles of CXCL14 in psoriasis, we examined CXCL14 expression in lesional skin by immunohistochemistry and measured serum CXCL14 levels in psoriasis. We also assessed the effect of ultraviolet irradiation, one of the main therapies for psoriasis, on CXCL14 expression by HaCaT cells.
Results
CXCL14 expression was decreased in epidermal keratinocytes in lesional skin and serum CXCL14 levels were negatively correlated with Psoriasis Area and Severity Index scores in psoriasis patients. Serum CXCL14 levels were increased in nbUVB-treated psoriasis patients and UVB irradiation induced CXCL14 mRNA expression from HaCaT cells.
Conclusion
Our results suggest that decreased CXCL14 expression may contribute to the exacerbation of psoriasis and that the amplification of CXCL14 can be a therapeutic option for psoriasis. One of the mechanisms of the efficacy of nbUVB therapy in psoriasis may be the upregulation of CXCL14.
{"title":"Decreased CXCL14 expression in psoriasis recovered by narrow-band ultraviolet B therapy","authors":"Kaori Nakajima MD, Tomomitsu Miyagaki MD, PhD, Miho Tanaka MD, Reo Komaki MD, Tatsuro Okano MD, PhD, Sora Takeuchi MD, PhD, Hidenori Watabe MD, PhD, Takafumi Kadono MD, PhD","doi":"10.1002/cia2.12332","DOIUrl":"10.1002/cia2.12332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>CXCL14 is a member of CXC chemokine family, constitutively expressed in various normal tissues unlike many other chemokines. Other than the capacity to recruit natural killer cells, macrophages, and dendritic cells, CXCL14 suppresses CXCL12-CXCR4 interactions by inducing CXCR4 internalization. Thus, CXCL14 can both promote and hinder immune responses. Psoriasis is a chronic skin inflammatory disorder in which various chemokines play an important role.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To investigate possible roles of CXCL14 in psoriasis, we examined CXCL14 expression in lesional skin by immunohistochemistry and measured serum CXCL14 levels in psoriasis. We also assessed the effect of ultraviolet irradiation, one of the main therapies for psoriasis, on CXCL14 expression by HaCaT cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CXCL14 expression was decreased in epidermal keratinocytes in lesional skin and serum CXCL14 levels were negatively correlated with Psoriasis Area and Severity Index scores in psoriasis patients. Serum CXCL14 levels were increased in nbUVB-treated psoriasis patients and UVB irradiation induced CXCL14 mRNA expression from HaCaT cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results suggest that decreased CXCL14 expression may contribute to the exacerbation of psoriasis and that the amplification of CXCL14 can be a therapeutic option for psoriasis. One of the mechanisms of the efficacy of nbUVB therapy in psoriasis may be the upregulation of CXCL14.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"225-230"},"PeriodicalIF":1.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135247428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to clarify how patient-perceived aggravating factors change during the course of AD.
Methods
This study involved a questionnaire-based survey administered to 115 patients with AD at our hospital. The changes in patient-perceived aggravating factors were examined as treatment progressed by readministering the questionnaire to 36 patients 6 months later.
Results
The most frequent aggravating factors at the first visit were sweating, emotional stress, and house dust. The number of patients who identified food, dust mites, house dust, pollen, and pets as aggravating factors decreased during the course of the disease. However, the number of patients who identified sweating, environmental factors, emotional stress, and lack of sleep as aggravating factors did not differ from those at the first visit; this included those who newly identified these as aggravating factors.
Conclusion
Many patients with AD are concerned about the aggravating factors, and it may be possible to reduce aggravating factor-related anxiety by informing patients that certain aggravating factors may change during treatment. Hence, it is necessary to ask patients about the aggravating factors at the first visit and fixed intervals and resolve them immediately.
目的 本研究旨在阐明在 AD 的病程中，患者感知的加重因素是如何变化的。 方法 本研究对本院的 115 名 AD 患者进行了问卷调查。通过在 6 个月后再次对 36 名患者进行问卷调查，考察了随着治疗的进展，患者感知的加重因素的变化情况。 结果 首次就诊时最常见的加重因素是出汗、情绪紧张和室内灰尘。在病程中，认为食物、尘螨、室内灰尘、花粉和宠物是加重病情因素的患者人数有所减少。然而，认为出汗、环境因素、情绪压力和睡眠不足是加重病情因素的患者人数与首次就诊时的人数没有差异；这包括那些新近认为这些因素是加重病情因素的患者。 结论 许多注意力缺失症患者都会担心加重病情的因素，通过告知患者某些加重病情的因素可能会在治疗过程中发生变化，或许可以减轻患者与加重病情因素相关的焦虑。因此，有必要在首次就诊和固定时间段内询问患者加重病情的因素，并立即予以解决。
{"title":"Changes in patient-perceived aggravating factors during the course of atopic dermatitis","authors":"Nozomi Yanagida MD, Ryo Saito MD, PhD, Akiko Kamegashira MD, PhD, Satoshi Morioke MD, PhD, Akio Tanaka MD, PhD","doi":"10.1002/cia2.12329","DOIUrl":"10.1002/cia2.12329","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to clarify how patient-perceived aggravating factors change during the course of AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study involved a questionnaire-based survey administered to 115 patients with AD at our hospital. The changes in patient-perceived aggravating factors were examined as treatment progressed by readministering the questionnaire to 36 patients 6 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most frequent aggravating factors at the first visit were sweating, emotional stress, and house dust. The number of patients who identified food, dust mites, house dust, pollen, and pets as aggravating factors decreased during the course of the disease. However, the number of patients who identified sweating, environmental factors, emotional stress, and lack of sleep as aggravating factors did not differ from those at the first visit; this included those who newly identified these as aggravating factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Many patients with AD are concerned about the aggravating factors, and it may be possible to reduce aggravating factor-related anxiety by informing patients that certain aggravating factors may change during treatment. Hence, it is necessary to ask patients about the aggravating factors at the first visit and fixed intervals and resolve them immediately.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"219-224"},"PeriodicalIF":1.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135244619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is characterized by the proliferation of small- to medium-sized atypical, usually CD4+ T cells in the skin.<span><sup>1</sup></span> Mycosis fungoides with large-cell transformation (LCT) is an aggressive subtype defined by the presence of large cells comprising >25% of the lesion infiltrate or the presence of microscopic nodules of large cells. Large-cell transformation occurs in 20%–55% of advanced MF cases and is often a histological marker of poor prognosis and is associated with a mean 5-year survival rate of <20%.<span><sup>1</sup></span> Herein, we present a patient with MF-LCT in its early stage that was successfully treated with brentuximab vedotin (BV), an anti-CD30 antibody.</p><p>A woman in her early 30s had erythema with pruritus and pigmentation on her trunk and thighs for 3 years (Figure 1A). Following subsequent histopathological diagnosis as MF (negative CD30+ lymphocytes at this time), she was successfully treated with topical steroids and ultraviolet therapy and showed no progression for approximately 10 years. In her early 40s, the rash slowly expanded and was treated with bexarotene (450–150 mg/day). One year later, the eruption intensified, with erythema observed on 40% of the body and multiple skin tumors of ≥1 cm (Figure 1B,C). Histopathology and immunohistochemistry of the tumors confirmed infiltration with CD3+, CD4+, CD5+, CD8+ (CD4/CD8: 10/1), CD30+, and CD20− lymphocytes, and CD30+ lymphocytes with large nuclei comprised 30% of the infiltrate (Figure 1D,E). The patient's complete blood count was normal, and the peripheral blood smear was negative for Sézary cells. Bone marrow examination showed no infiltration of atypical lymphocytes. No lymph node metastasis was found on positron emission tomography–computed tomography. Mycosis fungoides stage IIB (T3M0N0) with CD30+ LCT was diagnosed, and BV treatment was initiated instead of bexarotene. After three doses, the eruption area decreased, and the nodules became flattened (Figure 1E,F). After a total of 16 BV treatments, the only side effect observed was mild sensory polyneuropathy.</p><p>Brentuximab vedotin is an antibody–drug conjugate (ADC) in which monomethyl auristatin E (MMAE), which has cytotoxic activity, and an anti-CD30 IgG1-type chimeric antibody are linked via a protease-cleavable linker. The ADC inhibits tumor growth by first binding to CD30+ cells. Then, after being taken up into the cells as an ADC–CD30 complex, it releases MMAE through a proteolytic reaction. The free MMAE further inhibits microtubule formation and induces cell cycle arrest and apoptosis.<span><sup>2</sup></span> In a clinical trial of 30 patients (MF and Sézary syndrome), the response rate for BV was 70%, wherein 54% of the respondents were free of disease progression for 1 year<span><sup>3</sup></span>; however, the information on MF-LCT is still limited.</p><p>Bhari N et al. reported that the survival p
{"title":"Brentuximab vedotin treatment for mycosis fungoides with CD30+ large-cell transformation in the early stage","authors":"Shujiro Hayashi MD, PhD, Shown Tokoro MD, Ken Igawa MD, PhD","doi":"10.1002/cia2.12330","DOIUrl":"10.1002/cia2.12330","url":null,"abstract":"<p>Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is characterized by the proliferation of small- to medium-sized atypical, usually CD4+ T cells in the skin.<span><sup>1</sup></span> Mycosis fungoides with large-cell transformation (LCT) is an aggressive subtype defined by the presence of large cells comprising >25% of the lesion infiltrate or the presence of microscopic nodules of large cells. Large-cell transformation occurs in 20%–55% of advanced MF cases and is often a histological marker of poor prognosis and is associated with a mean 5-year survival rate of <20%.<span><sup>1</sup></span> Herein, we present a patient with MF-LCT in its early stage that was successfully treated with brentuximab vedotin (BV), an anti-CD30 antibody.</p><p>A woman in her early 30s had erythema with pruritus and pigmentation on her trunk and thighs for 3 years (Figure 1A). Following subsequent histopathological diagnosis as MF (negative CD30+ lymphocytes at this time), she was successfully treated with topical steroids and ultraviolet therapy and showed no progression for approximately 10 years. In her early 40s, the rash slowly expanded and was treated with bexarotene (450–150 mg/day). One year later, the eruption intensified, with erythema observed on 40% of the body and multiple skin tumors of ≥1 cm (Figure 1B,C). Histopathology and immunohistochemistry of the tumors confirmed infiltration with CD3+, CD4+, CD5+, CD8+ (CD4/CD8: 10/1), CD30+, and CD20− lymphocytes, and CD30+ lymphocytes with large nuclei comprised 30% of the infiltrate (Figure 1D,E). The patient's complete blood count was normal, and the peripheral blood smear was negative for Sézary cells. Bone marrow examination showed no infiltration of atypical lymphocytes. No lymph node metastasis was found on positron emission tomography–computed tomography. Mycosis fungoides stage IIB (T3M0N0) with CD30+ LCT was diagnosed, and BV treatment was initiated instead of bexarotene. After three doses, the eruption area decreased, and the nodules became flattened (Figure 1E,F). After a total of 16 BV treatments, the only side effect observed was mild sensory polyneuropathy.</p><p>Brentuximab vedotin is an antibody–drug conjugate (ADC) in which monomethyl auristatin E (MMAE), which has cytotoxic activity, and an anti-CD30 IgG1-type chimeric antibody are linked via a protease-cleavable linker. The ADC inhibits tumor growth by first binding to CD30+ cells. Then, after being taken up into the cells as an ADC–CD30 complex, it releases MMAE through a proteolytic reaction. The free MMAE further inhibits microtubule formation and induces cell cycle arrest and apoptosis.<span><sup>2</sup></span> In a clinical trial of 30 patients (MF and Sézary syndrome), the response rate for BV was 70%, wherein 54% of the respondents were free of disease progression for 1 year<span><sup>3</sup></span>; however, the information on MF-LCT is still limited.</p><p>Bhari N et al. reported that the survival p","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":"6 6","pages":"260-261"},"PeriodicalIF":1.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135246702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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