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Immune-Mediated and Allergic Skin Diseases: Clinical Diagnosis and Treatment
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Immune-Mediated and Allergic Skin Diseases: Clinical Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 13984

Special Issue Editor

Prof. Dr. Angelo Valerio Marzano

E-Mail Website
Guest Editor
1. Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
2. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
Interests: neutrophilic dermatoses, including pyoderma gangrenosum, sweet syndrome, and amicrobial pustulosis of the folds; autoinflammatory skin diseases; hidradenitis suppurativa; autoimmune bullous dermatoses; connective tissue diseases; chronic urticaria; atopic dermatitis; psoriasis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The skin is a site commonly involved in pathological immune responses that can take place in the epidermal and/or dermal compartments. These immunopathological reactions often occur towards self-antigens and may be due to T cell-dependent and/or autoantibody-dependent mechanisms. In many inflammatory diseases, signals of the innate immune system typically initiate skin immune responses, while cells and cytokines of the adaptive immune system perpetuate the inflammation. An extensive crosstalk between the different cell types of the immune system, tissue cells, and pathogens is responsible for the complexity of skin immune reactions.

The recent increase in the understanding of immune-mediated and allergic skin disease pathogenesis has been enormous, leading to the development and introduction of new targeted therapeutic regimens. Moreover, identifying both clinical phenotypes and possible trajectories of treatment outcome has allowed for the most selective management to be applied to each patient. Hopefully, the near future will see a genetic and pathogenesis-driven treatment of those diseases.

This Special Issue aims to bring together the most relevant scientific research on immune-mediated and allergic skin diseases, focusing on clinical diagnosis, pathophysiology, and recent advancements in therapy.

Prof. Angelo Valerio Marzano
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • immune-mediated skin diseases
  • psoriasis
  • urticaria
  • vasculitis
  • atopic dermatitis
  • connective tissue diseases
  • neutrophilic dermatoses
  • drug-induced skin reactions
  • autoinflammatory diseases
  • autoimmune bullous diseases

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Published Papers (3 papers)

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Research

11 pages, 274 KiB  
Article
Prevalence of Neuropathic Pain and Related Characteristics in Hidradenitis Suppurativa: A Cross-Sectional Study
by Simone Garcovich, Simona Muratori, Chiara Moltrasio, Agata Alba Buscemi, Giulia Giovanardi, Dalma Malvaso, Enrico Di Stasio, Angelo Valerio Marzano and Ketty Peris
J. Clin. Med. 2020, 9(12), 4046; https://doi.org/10.3390/jcm9124046 - 15 Dec 2020
Cited by 14 | Viewed by 2020
Abstract
Background: Pain is a core symptom of hidradenitis suppurativa (HS) and is of complex, multifactorial origin. HS patients frequently report typical neuropathic pain qualities, but its prevalence has been poorly described. Methods: In this cross-sectional study, we examine the prevalence of neuropathic pain [...] Read more.
Background: Pain is a core symptom of hidradenitis suppurativa (HS) and is of complex, multifactorial origin. HS patients frequently report typical neuropathic pain qualities, but its prevalence has been poorly described. Methods: In this cross-sectional study, we examine the prevalence of neuropathic pain (NP) component and related pain-characteristics of a hospital-based cohort of patients with symptomatic HS. We administered the pain-DETECT tool (PDQ), a validated screening tool for NP, collecting clinical and patient-reported data on pain, pruritus and pain-management. We obtained 110 complete datasets from symptomatic HS patients (49.1% females; Hurley I (27.3%])–II (45.5%)–III (27.3%)). According to the PDQ tool, 30% of patients were classified with a high probability (>90%) of neuropathic pain (LNP). LNP status was significantly associated with increased pain severity, disease activity, pruritus intensity and use of pain medication. Regression analysis showed a significant impact of the PDQ score on patient-reported outcomes, including pain severity and the dimensions of activity and affective pain interference. HS patients may present a mixed chronic pain phenotype with a neuropathic component, thus requiring additional pain-assessments. A multi-modal approach to pain management, in combination with disease-specific treatment, should be implemented in future interventional studies. Full article
(This article belongs to the Special Issue Immune-Mediated and Allergic Skin Diseases: Clinical Diagnosis and Treatment)
9 pages, 261 KiB  
Article
Efficacy of Dupilumab on Different Phenotypes of Atopic Dermatitis: One-Year Experience of 221 Patients
by Simona Tavecchio, Luisa Angileri, Francesco Pozzo Giuffrida, Francesca Germiniasi, Angelo Valerio Marzano and Silvia Ferrucci
J. Clin. Med. 2020, 9(9), 2684; https://doi.org/10.3390/jcm9092684 - 19 Aug 2020
Cited by 37 | Viewed by 5958
Abstract
Background: The clinical features of adult-onset atopic dermatitis (AD) are heterogeneous and the diagnosis can be a challenge. A new biologic drug (dupilumab) has been approved for moderate to severe AD in adult patients. The efficacy and safety have been demonstrated in clinical [...] Read more.
Background: The clinical features of adult-onset atopic dermatitis (AD) are heterogeneous and the diagnosis can be a challenge. A new biologic drug (dupilumab) has been approved for moderate to severe AD in adult patients. The efficacy and safety have been demonstrated in clinical trials, but these studies do not reflect conditions in daily practice and do not consider the different clinical manifestations of AD. Objectives: Analyzing the dupilumab activity in a real-world setting and comparing its efficacy on different AD phenotypes. Methods: We retrospectively evaluated 221 AD patients treated with dupilumab, stratified into six clinical phenotypes: classic, generalized eczema inflammatory and lichenoid patterns, prurigo, nummular eczema, and erythroderma. At baseline and at weeks 4, 16, and 52, the disease severity was assessed through the Eczema Area and Severity Index (EASI) and the quality of life was assessed through the Dermatology Life Quality Index (DLQI) questionnaire, Peak Pruritus Numerical Rating Scale (itch NRS), and Peak Sleep NRS. Results: We found a significant improvement after 16 weeks of treatment (p < 0.0001) in all six phenotypes for all the assessed scores mentioned above, persisting up to week 52. The best improvement was seen in the more severe phenotypes, particularly the erythrodermic one. Conclusions: The present study confirmed the efficacy and safety of dupilumab in the treatment of severe AD. Its strength was in the stratification of AD patients in six different phenotypes based on their clinical presentation, all of whom markedly improved in terms of both clinically evident and reported symptoms, as well as their quality of life. Full article
(This article belongs to the Special Issue Immune-Mediated and Allergic Skin Diseases: Clinical Diagnosis and Treatment)
10 pages, 246 KiB  
Article
Clinical Response and Quality of Life in Patients with Severe Atopic Dermatitis Treated with Dupilumab: A Single-Center Real-Life Experience
by Silvia Ferrucci, Giovanni Casazza, Luisa Angileri, Simona Tavecchio, Francesca Germiniasi, Emilio Berti, Angelo Valerio Marzano and Giovanni Genovese
J. Clin. Med. 2020, 9(3), 791; https://doi.org/10.3390/jcm9030791 - 13 Mar 2020
Cited by 35 | Viewed by 5510
Abstract
Dupilumab is an anti-interleukin-4 receptor monoclonal antibody that was recently approved for the treatment of atopic dermatitis (AD). In this single-center retrospective study, clinical baseline data of 117 severe AD patients treated with dupilumab were collected. At baseline and at weeks 4 and [...] Read more.
Dupilumab is an anti-interleukin-4 receptor monoclonal antibody that was recently approved for the treatment of atopic dermatitis (AD). In this single-center retrospective study, clinical baseline data of 117 severe AD patients treated with dupilumab were collected. At baseline and at weeks 4 and 16, disease severity was assessed through the Eczema Area and Severity Index (EASI) and quality of life through the Dermatology Life Quality Index (DLQI) questionnaire, Patient-Oriented Eczema Measure (POEM), Hospital Anxiety and Depression Scale (HADS), Peak Pruritus Numerical Rating Scale (NRS-itch), and VAS-sleep. Response to dupilumab was defined as an improvement of ≥75% in EASI from baseline (EASI75). At multivariate analysis, AD onset before 18 years [OR, 2.9; 95% CI, 1.2–7.2; p = 0.0207] and absence of hypereosinophilia [OR, 2.24; 95% CI, 1.03–4.86; p = 0.0412] were identified as significant predictive parameters for response to dupilumab in terms of EASI75 at week 4 but not at week 16. Significant reductions in EASI, DLQI, POEM, HADS, NRS-itch, and VAS-sleep were found between week 4 versus baseline (p < 0.0001 for all) and week 16 versus baseline (p < 0.0001 for all). Early AD onset and absence of hypereosinophilia may be suggested as predictive markers of early response to dupilumab. We confirmed the efficacy and safety of this agent along with the improvement of life quality in severe AD patients. Full article
(This article belongs to the Special Issue Immune-Mediated and Allergic Skin Diseases: Clinical Diagnosis and Treatment)
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