Hasil untuk "Dermatology"

Pinar Avci, Asheesh Gupta, Magesh Sadasivam et al.

C Geo Danny, D Manoharan, G Sukanya et al.

A 60-year-old male patient came to the Dermatology outpatient department with multiple asymptomatic raised lesions over both sides of the nose for the past 10 years, which started as skin coloured raised lesions over the nose, initially small in size and gradually progressed to the current size. There was no history of pain, itching or bleeding from the lesion. There was no history of other constitutional symptoms, weight loss, loss of appetite, lesions elsewhere in the body, significant family history or history of alcohol intake. The patient did not give any proper history of previous treatment for the same. On examination, there was a bulbous outgrowth of size 2×2 cm with prominent pores and erythematous nodules over the ala of the nose, forehead and chin [Table/Fig-1]. A differential diagnosis of rhinophyma, lupus pernio and lymphocytoma cutis was considered based on the history and examination findings. A 4 mm punch biopsy was taken from the nose and it revealed orthokeratosis, flattened rete ridges, dermal perivascular and perifollicular lymphohistiocytic infiltrate with prominent sebaceous gland hyperplasia, along with lymphatic dilatation [Table/Fig-2a-c]. A final diagnosis of phyma was made with involvement of the nose, chin and forehead based on histopathological findings. The patient was started on a daily low dose of oral isotretinoin 10 mg OD for four weeks and was suggested other treatment modalities like excision followed by fractional CO2 laser, following which the patient was lost to follow-up.

Chia-Wei Chang, Hsiu-Mei Huang, Nai-Wen Tsai et al.

Abstract Background Myelin oligodendrocyte glycoprotein-associated disease (MOGAD) is an inflammatory neurological disorder rarely associated with autoimmune disorders. We report the first case of MOGAD-associated optic neuritis in an Asian patient with psoriasis vulgaris and psoriatic arthritis. Case presentation A 53-year-old female with psoriasis vulgaris and psoriatic arthritis presented with bilateral optic neuritis. She was treated with intravenous methylprednisolone 1 g/day for three days, followed by a three-month oral prednisolone taper. The patient experienced near-complete visual recovery and remained relapse-free until present. Conclusions Although rare, this case highlights the importance of recognizing MOGAD-associated optic neuritis in autoimmune patients, as prompt diagnosis and treatment can significantly improve outcomes.

Saritha Mohanan, Shamma Aboobacker, Kaliaperumal Karthikeyan

Netherton syndrome is a rare autosomal recessive ichthyosis caused by serine peptidase inhibitor Kazal 5 mutation, characterized by congenital ichthyosis, trichorrhexis invaginata, atopy, high serum immunoglobulin E levels, and hyper eosinophilia. The demonstration of bamboo hair by microscopy is used as a method to diagnose Netherton syndrome. We report a rare patient with Netherton syndrome confirmed by genetic analysis and protein expression studies who had normal hair and was successfully treated with low dose isotretinoin, without any adverse events.

Alexandra-Cristiana Gache, Alexandra-Florentina Bîlbă, Andreea-Raluca Pricop et al.

<b>Introduction:</b> About one in four people show an immunological reaction to an infection with <i>Mycobacterium tuberculosis</i>, which can remain latent or lead to active forms of the disease. Psoriasis is a chronic, immune-mediated skin disease that can be associated with numerous comorbidities. Biologic therapies have revolutionized psoriasis treatment but carry the risk of reactivating latent tuberculosis infection. However, the link between tuberculosis as a triggering factor for the onset of psoriasis remains unknown. <b>Clinical Case:</b> We present the case of a patient initially diagnosed with secondary pulmonary tuberculosis, who, two months after the diagnosis, showed a remarkable clinical evolution by developing lesions consistent with vulgar psoriasis, necessitating a multidisciplinary treatment approach. <b>Discussions:</b> This unique case highlights the shared immune mechanism of these diseases, particularly involving TNF-α, IL-17, and CD4+ T cells. <b>Conclusions:</b> The coexistence of these conditions raises critical questions about the interplay between infectious and autoimmune diseases and the impact of genetic susceptibility.

Saravanan Youvalakshmi, Vijayasankar Palaniappan, Kaliaperumal Karthikeyan

Stefan J. Jodl, Margitta Worm, Frauke Friedrichs et al.

Abstract Introduction Interleukin-1 receptor-associated kinase 4 (IRAK4) is expressed in various immune cells and regulates proinflammatory cytokine production. Its inhibition represents a novel, promising therapeutic option in the treatment of atopic dermatitis (AD). Zabedosertib (BAY1834845) is a potent, selective IRAK4 inhibitor that suppresses markers of local and systemic immune responses. This study aimed to evaluate the efficacy and safety of zabedosertib in adults with moderate-to-severe AD. Methods DAMASK was a randomized, double-blind, 12-week, placebo-controlled, phase 2a, proof-of-concept study. Patients were randomized 2:1 to receive oral zabedosertib 120 mg twice daily or placebo. The primary efficacy endpoint was a composite of 75% reduction from baseline on the Eczema Area and Severity Index (EASI-75), no discontinuation of study medication for lack of efficacy, no rescue medication during the 4 weeks before Day 84, and no initiation of systemic AD treatment. Other efficacy assessments included validated Investigator’s Global Assessment for Atopic Dermatitis (vIGA-AD), Peak Pruritus numerical rating scale score, and affected body surface area (BSA); for safety, it included frequency and severity of treatment-emergent adverse events (TEAEs). Results Of 77 randomized patients, 69 were included in the primary efficacy analysis (zabedosertib, n = 47; placebo, n = 22); 55 patients completed treatment. At Week 12, there was no significant difference between zabedosertib and placebo in the primary efficacy endpoint (32.3% vs. 37.4%) or percentage change in EASI from baseline (− 44.6% vs. − 55.9%). There were also no significant differences between zabedosertib and placebo at Week 12 in vIGA-AD response (15.9% vs. 28.5%), Peak Pruritus response (16.4% vs. 25.0%), percentage change in Peak Pruritus (− 20.7% vs. − 27.3%), or percentage change in BSA affected by AD (− 13.3% vs. − 20.3%). No severe or serious TEAEs were reported throughout the study. Conclusions Zabedosertib was safe and well tolerated in adults with moderate-to-severe AD but showed no evidence of efficacy in reducing disease severity or pruritus in this placebo-controlled study. Trial Registration ClinicalTrials.gov identifier, NCT05656911.

Sandra Ropret, Preeti Khurana, Tara Fabčič et al.

We have generated MLi005-A, a new induced pluripotent stem cell (iPSC) line derived from skin fibroblasts of a male patient with dominant dystrophic epidermolysis bullosa (DDEB). This iPSC line may be used as a model system for studies on skin integrity, the extracellular matrix and skin barrier function. The characterization of the MLi005-A cell line consisted of molecular karyotyping, next-generation sequencing of the COL7A1 alleles, pluripotency and differentiation potentials testing by immunofluorescence of associated markers in vitro. The MLi-005A line has been also tested for ability to differentiate into fibroblasts and keratinocytes and markers associated with these cell types.

Saman Al‐Zahawi, Maryam Nasimi, Vahidesadat Azhari et al.

Thilo Gambichler, Nadine Schuleit, Laura Susok et al.

With the end of the pandemic, COVID-19 has entered an endemic phase with expected seasonal spikes. Consequently, the implementation of easily accessible prognostic biomarkers for patients with COVID-19 remains an important area of research. In this monocentric study at a German tertiary care hospital, we determined the prognostic performance of different clinical and blood-based parameters in 412 COVID-19 patients. We evaluated the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and absolute eosinopenia (AEP, 0/µL) of COVID-19 patients (<i>n</i> = 412). The Siddiqui and Mehra staging proposal, the WHO clinical progression scale, and COVID-19-associated death were used as COVID-19 outcome measures. With respect to Siddiqi and Mehra staging, patient age of older than 75 years, high C-reactive protein (CRP), absolute eosinopenia (AEP), cardiovascular comorbidities, and high ferritin were significant independent predictors for severe COVID-19. When outcome was determined according to the WHO clinical progression scale, patient age of older than 75 years, high CRP, high LDH, AEP, high neutrophil-to-lymphocyte ratio (NLR), and the presence of pulmonal comorbidities were significant independent predictors for severe COVID-19. Finally, COVID-19-associated death was predicted independently by patient age of older than 75 years, high LDH, high NLR, and AEP. Eosinopenia (< 40/µL) was observed in 74.5% of patients, and AEP in almost 45%. In conclusion, the present real-world data indicate that the NLR is superior to more complex systemic immune-inflammation biomarkers (e.g., SII and PIV) in COVID-19 prognostication. A decreased eosinophil count emerged as a potential hallmark of COVID-19 infection, whereas AEP turned out to be an accessible independent biomarker for COVID-19 severity and mortality.

Wang Y, Zhu M, Wu S et al.

Yun Wang, Mingfang Zhu, Shuhui Wu, Huie Zheng Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People’s Republic of ChinaCorrespondence: Mingfang Zhu, Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, 233 Cai E North Road, Kaifu District, Changsha, People’s Republic of China, Tel +86-13907317358, Fax +86-731-84917727, Email cszmf@162.comAbstract: Acne vulgaris is a multifactorial chronic inflammatory disorder of the pilosebaceous unit, and it represents the most common skin disease affecting about 85% of adolescents in Western populations. The prevalence of acne vulgaris in developed countries is higher than that in developing countries.Emerging data has shown some systemic diseases closely associated with acne, including obesity, diabetes mellitus, cardiovascular diseases, metabolic syndrome (Mets), and so on.This review summarizes acne-associated diseases that have been reported in studies, and analyzes the possible co-pathogenesis of these diseases and acne.Keywords: acne, comorbidity, metabolic diseases, diabetes mellitus, obesity

Kinjal Prahaladbhai Patel, Haridas Neelakandan Nilayangode, Pragya Ashok Nair

Introduction: Acrochordons {Skin Tags (ST)} are common benign skin tumours usually occurring on the neck and major flexors of older and obese people. A few studies with conflicting results have been reported regarding the abnormalities of carbohydrate or lipid metabolisms, and the involvement of some inflammatory markers in patients with acrochordons. Aim: Comparisons of Fasting Blood Sugar (FBS), lipid profile, andC-Reactive Protein (CRP) between patients of acrochordon, and healthy controls. Materials and Methods: The present case control study was conducted in the Department of Biochemistry and Dermatology of Pramukhswami Medical College, Karamsad, Gujarat. A total number of 160 subjects (80 healthy controls and 80 cases with acrochordons) were included. FBS, Lipid Profile, and CRP were measured. Statistical analysis was performed by independent t-test, On-way Anova, Frequency, Descriptive Statistics, Pearson’s correlation coefficient (r). Results: Basal Metabolic Index (BMI), FBS, Lipid profile and CRP were measured. There were significant differences between mean of various parameters (p<0.001) for cases compare to controls.There were significant correlations between all parameters of two groups in the aspect of various size, colour, and number of acrochordons (p<0.001). Conclusion: Threat of progress of metabolic syndrome is significantly higher in patients with Acrochordons. Among the many elements of inflammations and metabolic syndrome, BMI, CRP, lipid profile and plasma sugar are remarkably linked with Acrochordons.

Teresa Schmidt, Teresa Schmidt, Teresa Schmidt et al.

Immune checkpoint inhibitors (ICIs) have considerably expanded the effective treatment options for malignant melanoma. ICIs revert tumor-associated immunosuppression and potentiate T-cell mediated tumor clearance. Immune-related neurologic adverse events (irNAEs) manifest in the central (CNS) or peripheral nervous system (PNS) and most frequently present as encephalitis or myasthenia gravis respectively. We report on a 47-year old male patient with metastatic melanoma who developed signs of cerebellar disease five weeks after the start of ICI treatment (ipilimumab and nivolumab). Magnetic resonance imaging (MRI) of the brain and spine revealed multiple new contrast enhancements suggestive of parenchymal and leptomeningeal metastasis. Cerebral spinal fluid (CSF) evaluation showed a lymphomononuclear pleocytosis in the absence of tumor cells. Subsequent stereotactic brain biopsy confirmed demyelinating disease. High-dose corticosteroid treatment resulted in immediate improvement of the clinical symptoms. MRI scans and CSF re-evaluation were conducted six weeks later and showed a near-complete remission. The strong resemblance to neoplastic CNS dissemination and irNAEs is a particularly difficult diagnostic challenge. Treating physicians should be aware of irNAEs as those can be effectively treated with high-dose steroids.

Komal Agarwal, Indrashis Podder, Abhisekh Bandyopadhyay et al.

Ángela Zuluaga de Cadena

Las onicomicosis representan el 50% de las enfermedades de las uñas y afectan del 2 al 8% de la población general. Son una causa frecuente de consulta y, aunque generalmente son asintomáticas y no ponen en peligro la vida del paciente, producen detrimento de su calidad de vida y pueden ser la puerta de entrada de infecciones, cuando las condiciones inmunitarias se deterioran por cualquier circunstancia.

Thierry Olivry, Keith E. Linder, Frane Banovic

Abstract Since the first description of discoid lupus erythematosus (LE) in two dogs in 1979, the spectrum of canine cutaneous lupus erythematosus (CLE) variants has expanded markedly. In this review, we first propose an adaptation of the Gilliam-Sontheimer classification of CLE for dogs. We then review the signalment, clinical signs, laboratory and histopathology and treatment outcome of the currently recognized variants of canine CLE, which are vesicular CLE, exfoliative CLE, mucocutaneous LE and facial or generalized discoid LE. We end with a short description of the rare cutaneous manifestations of systemic LE in dogs. Canine CLE variants are heterogeneous, some of them mirror their human counterparts while others appear—thus far—unique to the dog. As most CLE subtypes seem to have a good prognosis after diagnosis, veterinarians are encouraged to become familiar with the spectrum of often-characteristic and unique clinical signs that would permit an early diagnosis and the rapid implementation of an effective treatment.

Katrin Peschke, Anke Weitzmann, Klaus Heger et al.

The immunoglobulin E (IgE)-mediated mast cell (MC) response is central to the pathogenesis of type I allergy and asthma. IκB kinase 2 (IKK2) was reported to couple IgE-induced signals to MC degranulation by phosphorylating the SNARE protein SNAP23. We investigated MC responses in mice with MC-specific inactivation of IKK2 or NF-κB essential modulator (NEMO), or animals with MC-specific expression of a mutant, constitutively active IKK2. We show that the IgE-induced late-phase cytokine response is reduced in mice lacking IKK2 or NEMO in MCs. However, anaphylactic in vivo responses of these animals are not different from those of control mice, and in vitro IKK2-deficient MCs readily phosphorylate SNAP23 and degranulate similarly to control cells in response to allergen or calcium ionophore. Constitutive overactivation of the NF-κB pathway has only slight effects on allergen-triggered MC responses. Thus, IKK2 is dispensable for MC degranulation, and the important question how IgE-induced signals trigger MC vesicle fusion remains open.