Journal of Clinical Medicine

Research

10 pages, 2695 KiB

Open AccessArticle

The Impact of Biologic Treatment on PD-1/PD-L1 Pathway Disturbances in Psoriasis

by Michał Adamczyk, Joanna Bartosińska, Dorota Raczkiewicz, Anna Michalak-Stoma and Dorota Krasowska

J. Clin. Med. 2023, 12(13), 4179; https://doi.org/10.3390/jcm12134179 - 21 Jun 2023

Cited by 4 | Viewed by 1700

Abstract

The programmed death-1 (PD-1) receptor plays a major physiological role in the maintenance of immune tolerance and, by interaction with its ligands (PD-L1 and PD-L2), prevents the development of multiple immune-mediated diseases. There is growing evidence of the PD-1/PD-L1 pathway playing an important [...] Read more.

The programmed death-1 (PD-1) receptor plays a major physiological role in the maintenance of immune tolerance and, by interaction with its ligands (PD-L1 and PD-L2), prevents the development of multiple immune-mediated diseases. There is growing evidence of the PD-1/PD-L1 pathway playing an important role in the pathogenesis of psoriasis. In total, 84 subjects with psoriasis were included in this study, together with 29 healthy subjects as a control group. Twenty-eight of the psoriatic patients were treated with biologic therapy (TNF-alpha, interleukin (IL)-12/23, or IL-17 inhibitors). The amounts of PD-1- and PD-L1-positive T-cells in peripheral blood were evaluated using flow cytometry. Significantly lower levels of peripheral blood mononuclear cells (PBMCs) with the expression of PD-1 and PD-L1 were found in psoriatic patients compared to healthy individuals, i.e., CD3/PD-1-, CD3/PD-L1-, CD4/PD-1-, CD4/PD-L1-, CD8/PD-L1-, CD19/PD-1-, and CD19/PD-L1-positive cells. Biologic treatment resulted in the elevation of CD3/PD-L1- and CD8/PD-L1- and a decrease in CD8/PD-1-positive PBMCs. Our results confirm previous observations of the PD-1/PD-L1 pathway being disrupted in psoriasis, and that these disturbances may play an important role in development of the disease. Biologic drugs may reverse several abnormalities observed within this pathway, which may explain their excellent efficacy in the treatment of psoriasis. Further research should be conducted to fully explain the results obtained. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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12 pages, 2036 KiB

Open AccessArticle

Endogenous Opioid Imbalance as a Potential Factor Involved in the Pathogenesis of Chronic Kidney Disease-Associated Pruritus in Dialysis Patients

by Kamila Wala-Zielińska, Karolina Świerczyńska-Mróz, Piotr K. Krajewski, Danuta Nowicka-Suszko, Magdalena Krajewska and Jacek C. Szepietowski

J. Clin. Med. 2023, 12(7), 2474; https://doi.org/10.3390/jcm12072474 - 24 Mar 2023

Cited by 7 | Viewed by 1875

Abstract

Chronic pruritus is one of the most common symptoms of dermatological diseases. It may occur in the course of other disorders, such as kidney disease. Chronic kidney disease-associated pruritus (CKD-aP) most often affects people with end-stage renal disease. The etiology of this condition [...] Read more.

Chronic pruritus is one of the most common symptoms of dermatological diseases. It may occur in the course of other disorders, such as kidney disease. Chronic kidney disease-associated pruritus (CKD-aP) most often affects people with end-stage renal disease. The etiology of this condition is still not fully understood, but researchers are currently focusing on a thorough analysis of the association between disturbed opioid balance and increased neuronal signaling leading to pruritus. The aim of this study is to assess the concentration of endogenous opioids in dialysis patients with and without pruritus and in the control group, and to determine the correlation between the concentration of these substances and the occurrence and severity of itching. The study involved 126 dialysis patients and 50 healthy controls. Patients were divided into groups with pruritus (n = 62) and without pruritus (n = 64). The severity of pruritus was assessed using the NRS scale. The concentration of endogenous opioids was determined using the ELISA. The concentration of met-enkephalin was higher in the group of patients with pruritus compared to the control group. Moreover, significantly lower levels of β-endorphin and dynorphin A were observed in the group of dialysis patients compared to the control group. In addition, a statistically significant difference was seen between the β-endorphin concentration in the group of dialysis patients with pruritus compared to the group without pruritus. The ratio of β-endorphin/dynorphin A concentrations was significantly lower in the group of patients with pruritus compared to patients without pruritus and the control group. No correlations were found between serum level of studied opioids and the severity of pruritus. The concentrations of the studied opioids did not correlate with the severity of pruritus. Observed opioid imbalance may affect the occurrence of CKD-aP in dialysis patients, but a thorough understanding of the mechanism of action of these substances in the sensation of pruritus is necessary to assess the possibility of finding a new therapeutic target. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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11 pages, 293 KiB

Open AccessArticle

Serum Level of Protein-Bound Uraemic Toxins in Haemodialysis Patients with Chronic Kidney Disease-Associated Pruritus: Myths and Facts

by Karolina Świerczyńska-Mróz, Danuta Nowicka-Suszko, Mariusz G. Fleszar, Paulina Fortuna, Piotr K. Krajewski, Magdalena Krajewska, Rafał Białynicki-Birula and Jacek C. Szepietowski

J. Clin. Med. 2023, 12(6), 2310; https://doi.org/10.3390/jcm12062310 - 16 Mar 2023

Cited by 2 | Viewed by 1560

Abstract

Recent studies place great importance on Protein-Bound Uraemic Toxins (PBUT) in the context of etiopathogenesis of chronic kidney disease-associated pruritus (CKD-aP). This study aimed to investigate the possible contribution of free and total Indoxyl Sulfate (IS) and p-Cresol Sulfate (PCS) to the cause [...] Read more.

Recent studies place great importance on Protein-Bound Uraemic Toxins (PBUT) in the context of etiopathogenesis of chronic kidney disease-associated pruritus (CKD-aP). This study aimed to investigate the possible contribution of free and total Indoxyl Sulfate (IS) and p-Cresol Sulfate (PCS) to the cause of CKD-aP. Group A included 64 patients on maintenance haemodialysis (HD) with CKD-aP. Group B included 62 patients on maintenance HD that did not report CKD-aP, and group C included 50 healthy controls. Pruritus severity was assessed using a Numerical Rating Scale (NRS). Moreover, other tools like UP-Dial, ItchyQoL, and the 4-Item Itch Questionnaire evaluating CKD-aP were completed by the patients. The serum levels of free and total IS and PCS concentrations were measured using the Ultra Performance Liquid Chromatography System. No significant difference in the serum level of free and total IS, or PCS, was observed between the patients who reported CKD-aP and those without pruritus. Moreover, there was no correlation between serum IS or PCS levels and the severity of the itch. Our study does not support earlier findings about higher levels of IS and PCS in patients reporting CKD-aP. Further studies will be needed to investigate these discrepancies as well as to understand the cause of CKD-aP. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

13 pages, 4535 KiB

Open AccessArticle

Significant Reversal of Facial Wrinkle, Pigmented Spot and Roughness by Daily Application of Galactomyces Ferment Filtrate-Containing Skin Products for 12 Months—An 11-Year Longitudinal Skin Aging Rejuvenation Study

by Kukizo Miyamoto, Yasuko Inoue, Xianghong Yan, Shiomi Yagi, Sudarsana Suda and Masutaka Furue

J. Clin. Med. 2023, 12(3), 1168; https://doi.org/10.3390/jcm12031168 - 1 Feb 2023

Cited by 3 | Viewed by 4440

Abstract

Facial skin aging is an important psychophysical and social concern, especially in women. We compared facial parameters reflecting aging of the skin in 1999 and 2010 in 86 female volunteers. Then, all subjects applied three Galactomyces ferment filtrate-containing skin care products (G3 products; [...] Read more.

Facial skin aging is an important psychophysical and social concern, especially in women. We compared facial parameters reflecting aging of the skin in 1999 and 2010 in 86 female volunteers. Then, all subjects applied three Galactomyces ferment filtrate-containing skin care products (G3 products; SK-II Facial Treatment Essence, SK-II Cellumination Essence, and SK-II Skin Signature Cream) twice daily for 12 months (M), with the skin parameters being measured at 2 M, 8 M, and 12 M during this period. Facial skin aging parameters such as wrinkles, hyperpigmented spots, and roughness significantly deteriorated during the 11-year interval. This 11-year aging process was associated with reduced hydration and increased transepidermal water loss (TEWL). Notably, treatment with G3 products significantly and cumulatively increased skin hydration with a correlated reduction of TEWL during the 12 M treatment period. Such treatment also significantly and cumulatively reversed the 11-year facial skin aging in the three parameters of wrinkles, spots, and roughness. These results suggest that facial skin retains the potential to recover from the aging process when it is applied with appropriate cosmetic agents. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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14 pages, 1405 KiB

Open AccessArticle

Adiponectin, Leptin and Resistin in Patients with Psoriasis

by Sylwia Słuczanowska-Głabowska, Marzena Staniszewska, Mariola Marchlewicz, Ewa Duchnik, Karolina Łuczkowska, Krzysztof Safranow, Bogusław Machaliński and Andrzej Pawlik

J. Clin. Med. 2023, 12(2), 663; https://doi.org/10.3390/jcm12020663 - 13 Jan 2023

Cited by 15 | Viewed by 2141

Abstract

Psoriasis is a common chronic, inflammatory skin disease characterised by keratinocyte hyperproliferation, parakeratosis, and T-cell infiltration. Adipose tissue has an endocrine function, producing an abundance of cytokines and adipokines. It has also been described that the major adipokines, leptin, resistin, and adiponectin, may [...] Read more.

Psoriasis is a common chronic, inflammatory skin disease characterised by keratinocyte hyperproliferation, parakeratosis, and T-cell infiltration. Adipose tissue has an endocrine function, producing an abundance of cytokines and adipokines. It has also been described that the major adipokines, leptin, resistin, and adiponectin, may be involved in the pathogenesis of psoriasis. The aim of the study was to examine the plasma levels of adiponectin, leptin, and resistin in patients with psoriasis and their correlations with disease activity parameters: Psoriasis Activity Severity Index (PASI), Dermatology Life Quality Index (DLQI), and Body Surface Area (BSA) index, as well as selected clinical parameters. The study included 53 patients with the plaque type and 31 healthy controls. The plasma concentrations of adiponectin were significantly lower in patients with psoriasis (p < 0.001) than in the control group. The plasma concentrations of leptin were higher in patients with psoriasis, however, due to high intra-patient variability of leptin plasma concentrations these differences did not reach statistical significance (p = 0.2). The plasma concentrations of resistin were significantly increased in patients with psoriasis compared to healthy controls (p = 0.02). There were no statistically significant correlations between adiponectin and leptin plasma concentrations and values of PASI, DLQI, and BSA. The resistin plasma concentrations correlated significantly with DLQI values. Additionally, we examined the correlations between adiponectin, leptin, and resistin plasma concentrations, and selected clinical parameters. Plasma concentrations of adiponectin correlated significantly with CRP values and ALT values. Leptin plasma concentrations correlated significantly with creatinine values. The results of our study confirm the role of adiponectin, leptin, and resistin in the pathogenesis of psoriasis. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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11 pages, 1942 KiB

Open AccessArticle

Sleep Deprivation Increases Facial Skin Yellowness

by Akira Matsubara, Gang Deng, Lili Gong, Eileen Chew, Masutaka Furue, Ying Xu, Bin Fang and Tomohiro Hakozaki

J. Clin. Med. 2023, 12(2), 615; https://doi.org/10.3390/jcm12020615 - 12 Jan 2023

Cited by 2 | Viewed by 3846

Abstract

Sleep shortage is a major concern in modern life and induces various psycho-physical disorders, including skin problems. In cosmeceutics, females are aware that sleep deprivation worsens their facial skin tone. Here, we measured the effects of sleep deprivation on facial skin yellowness and [...] Read more.

Sleep shortage is a major concern in modern life and induces various psycho-physical disorders, including skin problems. In cosmeceutics, females are aware that sleep deprivation worsens their facial skin tone. Here, we measured the effects of sleep deprivation on facial skin yellowness and examined yellow chromophores, such as bilirubin and carotenoids, in blood serum as potential causes of yellowness. Total sleep deprivation (0 h sleep overnight, N = 28) and repeated partial sleep deprivation (4 h sleep for 5 consecutive days, N = 10) induced significant increases in facial skin yellowness. The higher yellowness was sustained even after both sleep deprivation types stopped. However, circulating levels of yellow chromophores were unchanged in the total sleep deprivation study. Neither circulating interleukin-6 nor urinary biopyrrin levels were affected by total sleep deprivation, suggesting that apparent oxidative stress in the body was not detected in the present total deprivation protocol. Facial redness was affected by neither total nor repeated partial sleep deprivation. Therefore, blood circulation may play a limited role in elevated yellowness. In conclusion, facial skin yellowness was indeed increased by sleep deprivation in our clinical studies. Local in situ skin-derived factors, rather than systemic chromophore change, may contribute to the sleep deprivation-induced elevation of facial skin yellowness. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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11 pages, 1421 KiB

Open AccessArticle

To Inject or to Reject? The Body Image Perception among Aesthetic Dermatology Patients

by Ida Yurtsever, Łukasz Matusiak and Jacek Cezary Szepietowski

J. Clin. Med. 2023, 12(1), 172; https://doi.org/10.3390/jcm12010172 - 26 Dec 2022

Cited by 3 | Viewed by 3905

Abstract

Background: Nowadays, aesthetic dermatology treatment has become not only physical beautification but also it can have positive effects on patients’ mental health. Body dysmorphic disorder can be the reason for treatment dissatisfaction. In the general population, the prevalence of BDD is 1.9% and [...] Read more.

Background: Nowadays, aesthetic dermatology treatment has become not only physical beautification but also it can have positive effects on patients’ mental health. Body dysmorphic disorder can be the reason for treatment dissatisfaction. In the general population, the prevalence of BDD is 1.9% and it is more common among cosmetic patients. The aim of this study was to conduct the most comprehensive evaluation of body image and BDD among aesthetic patients. Methods: We recruited a group of 412 individuals, who were asked to complete 6 different on-line questionnaires concerning self-image, i.e., COPS, AAI, FAS, BAS-2, BSQ-16, and RSES. Results: The prevalence of BDD ranged from 7.28% to 11.17%, depending on the screening tool that was used. Our research revealed that BDD susceptibility, body image, body appreciation, and self-esteem were strongly interrelated (p < 0.001). A higher BMI was a risk factor for BDD, body dissatisfaction, and depreciation. The financial status markedly influenced all of the features. A history of psychiatric treatment influenced the risk of BDD, body satisfaction, body appreciation, and self-esteem. A history of cosmetic procedures and treatment satisfaction had no impact on the obtained results. Conclusions: Improving recognition of body dissatisfaction among aesthetic patients is very important. The psychometric assessment of patients before cosmetic treatment could be of help in choosing the appropriate approach. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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16 pages, 3053 KiB

Open AccessArticle

Phase 1 and 2 Randomized Clinical Studies Determine Lack of Efficacy for Anti-IL-17C Antibody MOR106 in Moderate–Severe Atopic Dermatitis

by Diamant Thaçi, Dave Singh, Mark Lee, Helen Timmis, Dominique Jacobs, Paul Passier, Susanne Rohrer, Johan Beetens, De Phung, Eric Sondag, Goran Babic, Guido Würth, Pia Kloepfer, Stefan Härtle and Silke Hüttner

J. Clin. Med. 2022, 11(23), 7244; https://doi.org/10.3390/jcm11237244 - 6 Dec 2022

Cited by 5 | Viewed by 2037

Abstract

Interleukin 17C (IL-17C) modulates epithelial inflammation and has a possible role in atopic dermatitis (AD) pathology. Four randomized clinical studies (Phase 1 and 2) investigated the safety, tolerability, efficacy, and pharmacokinetic profile of the anti-IL-17C monoclonal antibody MOR106 for up to 12 weeks [...] Read more.

Interleukin 17C (IL-17C) modulates epithelial inflammation and has a possible role in atopic dermatitis (AD) pathology. Four randomized clinical studies (Phase 1 and 2) investigated the safety, tolerability, efficacy, and pharmacokinetic profile of the anti-IL-17C monoclonal antibody MOR106 for up to 12 weeks (NCT03568071: n = 207 adults with moderate–severe AD; NCT03689829 Part 1: n = 32 healthy males; NCT03689829 Part 2: n = 44 adults with moderate–severe AD; and NCT03864627: n = 76 adults with moderate–severe AD). In these studies, MOR106 was either administered intravenously (i.v.) every 2 or 4 weeks at doses between 1–10 mg/kg, or subcutaneously (s.c.), either as a single dose or doses every 2 weeks at 320 mg. Overall, MOR106 was well-tolerated, and the safety profile was consistent with monoclonal antibodies approved for AD. Bioavailability following s.c. dosing was 55%, and steady-state drug levels were reached at 2–4 weeks. Ongoing studies were terminated following a futility analysis of the Phase 2 placebo-controlled dose-finding study (NCT03568071) due to a low probability for achieving the primary efficacy endpoint. Cumulatively, MOR106 demonstrated ineffectiveness for the treatment of AD, but its safety and pharmacokinetic characteristics warrant further drug development in other indications. Funding: sponsored by Galapagos NV; funded by Novartis AG. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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10 pages, 604 KiB

Open AccessArticle

The Prevalence of Periodontitis and Assessment of Oral Micro-Biota in Patients with Hidradenitis Suppurativa: A Descriptive Cross-Sectional Study

by Beata Jastrząb, Barbara Paśnik-Chwalik, Tomasz Konopka, Piotr K. Krajewski, Jacek C. Szepietowski and Łukasz Matusiak

J. Clin. Med. 2022, 11(23), 7065; https://doi.org/10.3390/jcm11237065 - 29 Nov 2022

Cited by 6 | Viewed by 1838

Abstract

Periodontitis has been causally connected with the development of other immune-mediated inflammatory disorders previously. Nevertheless, the current literature does not provide knowledge on oral health in hidradenitis suppurativa (HS) individuals. The aim of this study was to assess the prevalence of periodontitis and [...] Read more.

Periodontitis has been causally connected with the development of other immune-mediated inflammatory disorders previously. Nevertheless, the current literature does not provide knowledge on oral health in hidradenitis suppurativa (HS) individuals. The aim of this study was to assess the prevalence of periodontitis and characterize an oral microbiome in HS patients. Fifty-five patients with HS and fifty-five healthy controls were enlisted in the study. The incidence of periodontitis was assessed in all patients during the periodontal evaluation. RT-PCR tests were used to quantification of bacterial content and assess the number and composition of nine crucial periodontal pathogens. HS patients had a significantly higher prevalence of periodontitis than healthy controls (45.5% versus 14.5%). Significantly higher values of average copy-count numbers of total bacteria were found in HS patients. The majority of periodontal pathogens were more frequently isolated in patients with HS than among controls. The most frequently detected pathogen in the HS group was Treponema denticola (70.9%), whereas among controls Capnocytophaga gingivalis (34.5%) was the most common isolate. There was no correlation between HS severity and the number of DNA copies of periodontal bacteria. The findings of this research suggest that periodontitis may contribute to the development of HS. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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11 pages, 1170 KiB

Open AccessArticle

Proactive versus Rank-Down Topical Corticosteroid Therapy for Maintenance of Remission in Pediatric Atopic Dermatitis: A Randomized, Open-Label, Active-Controlled, Parallel-Group Study (Anticipate Study)

by Koji Kamiya, Hidehisa Saeki, Yoshiki Tokura, Shigemi Yoshihara, Junichi Sugai and Mamitaro Ohtsuki

J. Clin. Med. 2022, 11(21), 6477; https://doi.org/10.3390/jcm11216477 - 31 Oct 2022

Cited by 3 | Viewed by 2370

Abstract

Topical corticosteroids are used as first-line treatment for atopic dermatitis (AD). Regarding the maintenance of remission achieved by topical corticosteroids, no previous studies have compared proactive therapy with rank-down therapy. We compared their efficacy and safety in Japanese children with moderate to severe [...] Read more.

Topical corticosteroids are used as first-line treatment for atopic dermatitis (AD). Regarding the maintenance of remission achieved by topical corticosteroids, no previous studies have compared proactive therapy with rank-down therapy. We compared their efficacy and safety in Japanese children with moderate to severe AD. Patients who had achieved remission with a very strong topical corticosteroid were randomized to 4-week maintenance treatment with either intermittent use of the same drug (proactive therapy) or daily use of a strong topical corticosteroid for 1 week followed by daily use of a medium-potency topical corticosteroid for 3 weeks (rank-down therapy); 49 patients were randomized (proactive therapy, n = 24; rank-down therapy, n = 25). During maintenance treatment, the relapse rate was 8.33% in the proactive therapy group and 20.0% in the rank-down therapy group (p = 0.0859). The mean (±standard deviation) itching score on a numerical rating scale in the rank-down therapy group increased significantly from 2.5 ± 1.9 to 3.6 ± 2.6 (p = 0.0438). Adverse events occurred in 2 patients receiving proactive therapy and 3 patients receiving rank-down therapy. Proactive therapy appears to be as safe as rank-down therapy and may be more effective for itch in pediatric AD in remission. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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11 pages, 1072 KiB

Open AccessArticle

Elevated Level of Serum Neurotrophin-4, but Not of Brain-Derived Neurotrophic Factor, in Patients with Chronic Kidney Disease-Associated Pruritus

by Kamila Wala-Zielińska, Karolina Świerczyńska-Mróz, Piotr K. Krajewski, Danuta Nowicka-Suszko, Magdalena Krajewska and Jacek C. Szepietowski

J. Clin. Med. 2022, 11(21), 6292; https://doi.org/10.3390/jcm11216292 - 26 Oct 2022

Cited by 5 | Viewed by 1692

Abstract

Chronic kidney disease-associated pruritus (CKD-aP) is a bothersome condition that occurs in patients with advanced chronic kidney disease (CKD) and severely reduces their quality of life. Recently, much research has focused on the search for markers that are involved in the pathogenesis of [...] Read more.

Chronic kidney disease-associated pruritus (CKD-aP) is a bothersome condition that occurs in patients with advanced chronic kidney disease (CKD) and severely reduces their quality of life. Recently, much research has focused on the search for markers that are involved in the pathogenesis of CKD-aP and may become a therapeutic target. One of the suggested hypotheses is the increased activation of sensory neurons by molecules such as neurotrophins (NTs). An increased serum concentration of NTs has been demonstrated in pruritic patients, which may suggest their involvement in the pathogenesis of itch. The purpose of this study is to assess the serum concentration of neurotrophin-4 (NT-4) and brain-derived neurotrophic factor (BDNF) in hemodialysis patients. The study enrolled 126 patients undergoing dialysis. Participants were divided into 2 groups: with and without CKD-aP. NRS scale was used to evaluate itch severity. Serum levels of NT-4 and BDNF have been assessed using ELISA. The results showed a significantly higher level of NT-4 in the group with pruritus. No significant difference was reported in the serum level of BDNF between the two groups of patients. There was also no correlation between serum NT-4 nor BDNF levels and the severity of pruritus. In summary, NT-4 may play an important role in the pathophysiology of pruritus in dialysis patients. More research is needed to understand the exact mechanism by which NTs influence the pathogenesis of CKD-aP. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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10 pages, 1483 KiB

Open AccessArticle

The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis

by Kamila Jaworecka, Marian Rzepko, Luiza Marek-Józefowicz, Funda Tamer, Aleksandra A. Stefaniak, Magdalena Szczegielniak, Joanna Chojnacka-Purpurowicz, Ayla Gulekon, Jacek C. Szepietowski, Joanna Narbutt, Agnieszka Owczarczyk-Saczonek and Adam Reich

J. Clin. Med. 2022, 11(19), 5553; https://doi.org/10.3390/jcm11195553 - 22 Sep 2022

Cited by 14 | Viewed by 2596

Abstract

Background: Quality of life (QoL) and sleep, which are essential for well-being in the mental, physical, and socioeconomic domains, are impaired in psoriatic patients. However, the exact role of the clinical subtype of psoriasis in this aspect remains poorly studied. Objectives: The aim [...] Read more.

Background: Quality of life (QoL) and sleep, which are essential for well-being in the mental, physical, and socioeconomic domains, are impaired in psoriatic patients. However, the exact role of the clinical subtype of psoriasis in this aspect remains poorly studied. Objectives: The aim of this study was to investigate differences in QoL impairment and sleeping problems in patients suffering from various clinical subtypes of psoriasis and to evaluate the effects of pruritus on QoL. Methods: This cross-sectional, multicenter study included 295 eligible subjects with diagnosed psoriasis. Each patient was examined with the use of the same questionnaire. Measures included predominant subtype of psoriasis, disease severity, pruritus scores, patients’ health-related QoL and the incidence of sleep disturbance. Results: The QoL of most patients was decreased irrespectively of clinical psoriasis subtype, however, the most impaired QoL was in patients with erythrodermic psoriasis. The majority of patients reported sleep disturbances caused by pruritus, albeit there was no relevant differences between analyzed subgroups in this aspect of patients’ well-being. Pruritus was an important factor determining QoL and sleeping problems in the studied population. Conclusions: Identifying the most disturbing area of life and recognizing the most bothersome subjective symptoms of psoriasis are pivotal to focusing on the most relevant treatment goal and achieving therapeutic success. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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15 pages, 537 KiB

Open AccessArticle

Patients’ Experiences and Communication with Teledermatology versus Face-to-Face Dermatology

by Cesar Leal-Costa, Antonio Lopez-Villegas, Mercedes Perez-Heredia, Miguel Angel Baena-Lopez, Carlos Javier Hernandez-Montoya and Remedios Lopez-Liria

J. Clin. Med. 2022, 11(19), 5528; https://doi.org/10.3390/jcm11195528 - 21 Sep 2022

Cited by 5 | Viewed by 2472

Abstract

(1) Background: Teledermatology (TD) has exponentially grown since the onset of COVID-19, as the Face-to-Face Dermatology (F-F/D) modality changed within Public Health Systems. Although studies have been conducted on health results, we did not find any that analyzed the experiences of individuals who [...] Read more.

(1) Background: Teledermatology (TD) has exponentially grown since the onset of COVID-19, as the Face-to-Face Dermatology (F-F/D) modality changed within Public Health Systems. Although studies have been conducted on health results, we did not find any that analyzed the experiences of individuals who received care through TD. Therefore, the main objective of the study was to analyze the experiences of dermatology patients and the communication with health personnel. (2) Methods: A multicenter, controlled, randomized, non-blinded clinical trial was designed. Data were collected during the six months of follow-up. Four-hundred and fifty patients participated in the present study, who were assigned to two different groups: TD and F-F/D. The sociodemographic and clinical characteristics of the participants were collected. The ‘Generic Short Patient Experiences Questionnaire’ (GS-PEQ) was used to assess patients’ experiences, and the Healthcare Communication Questionnaire (HCCQ) was used to measure the communication of patients with healthcare professionals. (3) Results: After six months of follow-up, 450 patients completed the study (TD = 225; F-F/D = 225) of which 53.3% were women, with an average age of 52.16 (SD = 19.97). The main reasons for the consultations were skin lesions (51.56%) located on the head and neck (46.8%), followed by the legs (20.7%). According to the GS-PEQ, TD users indicated having a greater confidence in the professional skills of the doctors (p < 0.01). However, the F-F/D group indicated having received more adequate information about their diagnosis/afflictions (p < 0.01), were more involved in the decisions related to their treatment (p < 0.01), and more satisfied with the help and treatment received (p < 0.01). Regarding the HCCQ, the TD group obtained better assessments with respect to if the patients had been treated in a rude and hasty manner, if the health professionals had addressed them with a smile, and if these could adequately manage the reason for the consultation (p < 0.01). (4) Conclusions: The results of the study generally showed positive experiences and communication. The TD group indicated having received less information about the diagnosis, were less involved in the decisions, and were less satisfied with the help and treatment received. However, they indicated having more confidence on the professional skills of the doctors, and that the work at the institution was better organized. In addition, they perceived better communication skills of the health professionals, although less respect for their privacy. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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11 pages, 759 KiB

Open AccessArticle

Plasma Levels of Interleukins 36α, 36β, and 37 in Patients with Psoriasis and Their Correlation with Disease Activity Parameters

by Sylwia Słucznowska-Głabowska, Weronika Jaworska, Marzena Staniszewska, Marta Tkacz, Krzysztof Safranow, Karolina Łuczkowska, Edyta Zagrodnik, Iwona Stecewicz, Bogusław Machaliński and Andrzej Pawlik

J. Clin. Med. 2022, 11(18), 5254; https://doi.org/10.3390/jcm11185254 - 6 Sep 2022

Cited by 2 | Viewed by 1816

Abstract

Psoriasis is a chronic, proliferative, inflammatory skin disease characterised by skin lesions and systemic symptoms. Numerous cytokines are produced in psoriasis as a result of inflammation. The aim of this study was to examine the plasma concentrations of IL-36α, IL-36β, and IL-37 in [...] Read more.

Psoriasis is a chronic, proliferative, inflammatory skin disease characterised by skin lesions and systemic symptoms. Numerous cytokines are produced in psoriasis as a result of inflammation. The aim of this study was to examine the plasma concentrations of IL-36α, IL-36β, and IL-37 in psoriasis and their correlations with disease activity parameters. This study recruited 84 individuals, 53 with plaque-type psoriasis and 31 healthy controls. The plaque type of psoriasis is the most common type and is typically characterized by circular-to-oval red plaques distributed over body surfaces of the extremities and scalp. In patients with psoriasis, we observed statistically significantly decreased plasma concentrations of IL-36β and IL-37. The concentrations of IL-36α were increased in comparison with control group. The plasma concentrations of IL-36α and IL-36β were statistically significantly correlated with all tested parameters of disease activity: the Psoriasis Activity Severity Index, Dermatology Life Quality Index, and Body Surface Area Index. There were no statistically significant correlations between plasma levels of IL-37 and the tested parameters of disease activity. These results indicate a role of IL36α, IL-36β, and IL-37 in the pathogenesis of psoriasis. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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10 pages, 856 KiB

Open AccessArticle

Transcriptomic Analysis of Human Keratinocytes Treated with Galactomyces Ferment Filtrate, a Beneficial Cosmetic Ingredient

by Akiko Nakajima, Nahoko Sakae, Xianghong Yan, Tomohiro Hakozaki, Wenzhu Zhao, Timothy Laughlin and Masutaka Furue

J. Clin. Med. 2022, 11(16), 4645; https://doi.org/10.3390/jcm11164645 - 9 Aug 2022

Cited by 4 | Viewed by 3160

Abstract

Galactomyces ferment filtrate (GFF, Pitera™) is a cosmetic ingredient known to have multiple skin care benefits, such as reducing redness and pore size via the topical application of its moisturizer form. Although GFF is known to act partly as an antioxidative agonist for [...] Read more.

Galactomyces ferment filtrate (GFF, Pitera™) is a cosmetic ingredient known to have multiple skin care benefits, such as reducing redness and pore size via the topical application of its moisturizer form. Although GFF is known to act partly as an antioxidative agonist for the aryl hydrocarbon receptor (AHR), its significance in keratinocyte biology is not fully understood. In this study, we conducted a transcriptomic analysis of GFF-treated human keratinocytes. Three different lots of GFF consistently modulated 99 (22 upregulated and 77 downregulated) genes, including upregulating cytochrome P450 1A1 (CYP1A1), a specific downstream gene for AHR activation. GFF also enhanced the expression of epidermal differentiation/barrier-related genes, such as small proline-rich proteins 1A and 1B (SPRR1A and SPRR1B), as well as wound healing-related genes such as serpin B2 (SERPINB2). Genes encoding components of tight junctions claudin-1 (CLDN1) and claudin-4 (CLDN4) were also target genes upregulated in the GFF-treated keratinocytes. In contrast, the three lots of GFF consistently downregulated the expression of inflammation-related genes such as chemokine (C-X-C motif) ligand 14 (CXCL14) and interleukin-6 receptor (IL6R). These results highlight the beneficial properties of GFF in maintaining keratinocyte homeostasis. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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9 pages, 620 KiB

Open AccessArticle

Impact of Hidradenitis Suppurativa Surgical Treatment on Health-Related Life Quality

by Marcin Gierek, Diana Kitala, Wojciech Łabuś, Karol Szyluk, Paweł Niemiec and Gabriela Ochała-Gierek

J. Clin. Med. 2022, 11(15), 4327; https://doi.org/10.3390/jcm11154327 - 26 Jul 2022

Cited by 12 | Viewed by 5154

Abstract

(1) Background: Hidradenitis suppurativa is a disease that affects the intimacy of patients. This disease reduces the quality of life and functioning of patients in everyday life. The surgical treatment of HS is one of the treatments for HS that can improve the [...] Read more.

(1) Background: Hidradenitis suppurativa is a disease that affects the intimacy of patients. This disease reduces the quality of life and functioning of patients in everyday life. The surgical treatment of HS is one of the treatments for HS that can improve the quality of life. (2) Methods: The main goal of this study was to assess quality of life before the surgical treatment and after the surgical treatment of HS at Center for Burn Treatment in Siemianowice Śląskie, Poland, using the EQ-5D-5L survey before the operation and at follow-up (6 months after). (3) Results: The average quality of life measured with the EQ-5D-5L survey before therapy was 39.3 ± 20.1 (min., 0; max., 60; most frequent value, 50), whereas after surgical treatment, the mean quality of life was 89.5 ± 12.5 (min., 50; max., 100; most frequent value, 100). The average increase in the quality of life was 50.2 ± 19.5 (min., 30; max., 100; most frequent value, 30), and it was statistically significant (p < 0.001). Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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9 pages, 620 KiB

Open AccessArticle

High Serum IL-31 Concentration Is Associated with Itch among Renal Transplant Recipients

by Piotr K. Krajewski, Kinga Tyczyńska, Klaudia Bardowska, Piotr Olczyk, Danuta Nowicka-Suszko, Dariusz Janczak, Hanna Augustyniak-Bartosik, Magdalena Krajewska and Jacek C. Szepietowski

J. Clin. Med. 2022, 11(15), 4309; https://doi.org/10.3390/jcm11154309 - 25 Jul 2022

Cited by 1 | Viewed by 1709

Abstract

Chronic itch (CI) is a common symptom caused by both dermatological and systemic disorders. CI is also a frequent, burdensome symptom among renal transplant recipients (RTR); however, its pathophysiology is not fully understood. The aim of this study was to assess the differences [...] Read more.

Chronic itch (CI) is a common symptom caused by both dermatological and systemic disorders. CI is also a frequent, burdensome symptom among renal transplant recipients (RTR); however, its pathophysiology is not fully understood. The aim of this study was to assess the differences in concentration of IL-31 among itchy RTR. The study was performed on a group of selected 129 RTRs (54 itchy and 75 non-itchy patients). Itch severity was assessed with the use of the numeral rating scale (NRS) and the 4-item itch questionnaire (4IIQ). Every subject had his blood drawn to measure the concentration of IL-31. The results were subsequently compared and correlated. The mean concentration differed significantly between RTR suffering from itch (602.44 ± 534.5 pg/mL), non-itchy RTR (161.49 ± 106.61 pg/mL), and HC (110.33 ± 51.81 pg/mL) (p < 0.001). Post-hoc analysis revealed a statistically significantly increased IL-31 serum concentration in itchy RTR in comparison to the non-itchy RTR group (p < 0.001) and HC (p < 0.001). No significant difference was observed in IL-31 serum levels between non-itchy RTRs and HC. No correlation between IL-31 and itch intensity was found. The results of our study clearly demonstrate the association between IL-31 levels and CI in patients after renal transplantation. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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12 pages, 5289 KiB

Open AccessArticle

Evaluating the Roles of Different Types of Laser Therapy in Becker’s Nevus Treatment

by Muhammad K. Al-Bakaa, Muhsin A. Al-Dhalimi, Prabhatchandra Dube and Fatimah K. Khalaf

J. Clin. Med. 2022, 11(14), 4230; https://doi.org/10.3390/jcm11144230 - 21 Jul 2022

Cited by 2 | Viewed by 5919

Abstract

Becker’s nevus (BN) is a cutaneous hamartoma of benign nature that develops through adolescence and affects mostly young men. The nevus is usually located unilaterally and is characterized by hypertrichosis and hyperpigmentation. Despite recent advances in treatment modalities, no effective treatment has been [...] Read more.

Becker’s nevus (BN) is a cutaneous hamartoma of benign nature that develops through adolescence and affects mostly young men. The nevus is usually located unilaterally and is characterized by hypertrichosis and hyperpigmentation. Despite recent advances in treatment modalities, no effective treatment has been established for BN hyperpigmentation. We sought to assess the efficacy and safety of fractional Erbium: YAG 2940 nm and Q-switched Nd: YAG 1064 nm lasers in the treatment of BN hyperpigmentation. Twenty-three patients with BN were included in a prospective, randomized-controlled, observer-blinded, split-lesion comparative technique trial. In each patient, two similar square test regions were randomized to either be treated with a fractional Erbium: YAG 2940 nm laser or with a Q-switched Nd: YAG 1064 nm laser. Each patient was treated with three sessions at six-week intervals. At the follow-up, clearance of hyperpigmentation was assessed by physician global assessment, visual analogue scale, grade of improvement, patient global assessment, and patient satisfaction. Regions treated with the fractional Erbium: YAG 2940 nm laser demonstrated significantly better improvement compared to ones treated with the Q-switched Nd: YAG 1064 nm (p-value = 0.001) laser. Adverse effects such as repigmentation and hypertrophic scarring were not reported during the follow-up period. The outcomes were cosmetically acceptable with overall high satisfaction among the included patients. Our data suggest a superior role for the fractional Erbium: YAG (2940 nm) laser in the treatment of BN hyperpigmentation compared to the Q-switched Nd: YAG (1064 nm) laser, along with being a safer method and having no reported side effects. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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10 pages, 2395 KiB

Open AccessArticle

Dermoscopic Features of Acute, Subacute, Chronic and Intermittent Subtypes of Cutaneous Lupus Erythematosus in Caucasians

by Magdalena Żychowska and Adam Reich

J. Clin. Med. 2022, 11(14), 4088; https://doi.org/10.3390/jcm11144088 - 14 Jul 2022

Cited by 8 | Viewed by 7355

Abstract

Cutaneous lupus erythematosus (CLE) is divided into the following four clinical subtypes: acute CLE (ACLE), subacute (SCLE), chronic CLE (CCLE) and lupus erythematosus tumidus (LET). The aim of this study was to describe the dermoscopic patterns of CLE by clinical variant. A total [...] Read more.

Cutaneous lupus erythematosus (CLE) is divided into the following four clinical subtypes: acute CLE (ACLE), subacute (SCLE), chronic CLE (CCLE) and lupus erythematosus tumidus (LET). The aim of this study was to describe the dermoscopic patterns of CLE by clinical variant. A total of 54 Caucasian patients from Poland (ACLE = 10; SCLE = 11; CCLE = 26; LET = 7) were included. The predefined parameters for dermoscopic assessment in inflammatory dermatoses were analyzed separately by two dermatologists. Under dermoscopy, all the variants of CLE showed predominantly polymorphous vessels on a pink–red background within the lesional skin. Dotted vessels, in association with other vessel morphologies, were observed more frequently in SCLE than in the other subtypes of CLE, but the difference did not reach statistical significance (p = 0.07). The findings associated with hair follicles, including rosettes (p = 0.02), follicular plugs (p = 0.01), follicular red dots (p < 0.01), perifollicular white halos (p < 0.01) and dermoscopic features corresponding to scarring, including white (p = 0.01) and pink (p < 0.01) structureless areas, were significantly more common in CCLE than in other variants of CLE. A lack of scaling, pigmentation, erosions and crusting were observed in all the cases of LET. The role of dermoscopy as an auxiliary tool in the differential diagnosis of CLE needs further elucidation. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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8 pages, 2687 KiB

Open AccessArticle

Enhanced Fluctuations in Facial Pore Size, Redness, and TEWL Caused by Mask Usage Are Normalized by the Application of a Moisturizer

by Kukizo Miyamoto, Yoko Munakata, Xianghong Yan, Gaku Tsuji and Masutaka Furue

J. Clin. Med. 2022, 11(8), 2121; https://doi.org/10.3390/jcm11082121 - 11 Apr 2022

Cited by 9 | Viewed by 3202

Abstract

Mask wearing is described as one of the main public health measures against COVID-19. Mask wearing induces various types of subjective and objective facial skin damage, such as hair pore dilatation and redness. Facial pore size and redness show morning-to-evening intra-day fluctuations. It [...] Read more.

Mask wearing is described as one of the main public health measures against COVID-19. Mask wearing induces various types of subjective and objective facial skin damage, such as hair pore dilatation and redness. Facial pore size and redness show morning-to-evening intra-day fluctuations. It remains unknown whether mask usage affects fluctuations in pore size and redness. We measured facial skin hydration, transepidermal water loss (TEWL), pore size, and redness four times a day for 6 weeks in 20 healthy young women. After a 2-week no-mask-usage period (baseline period), all subjects wore unwoven masks for 2 weeks; then, for the following 2 weeks, they applied masks after the topical application of a moisturizer containing a Galactomyces ferment filtrate (GFF) skin care formula (Pitera™). We demonstrated that mask wearing significantly increased the intra-day fluctuations of pore size, redness, and TEWL. In addition, significant correlations were evident among these three parameters. Notably, these mask-induced skin changes were significantly improved, achieving a return to baseline levels, by the application of a GFF-containing moisturizer. In conclusion, mask wearing aggravates intra-day fluctuations in pore size and redness. Appropriate moisturization can minimize this mask-related skin damage, most likely by normalizing the elevated TEWL. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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7 pages, 397 KiB

Open AccessArticle

Switching from Adalimumab Originator to Biosimilar: Clinical Experience in Patients with Hidradenitis Suppurativa

by Trinidad Montero-Vilchez, Carlos Cuenca-Barrales, Andrea Rodriguez-Tejero, Antonio Martinez-Lopez, Salvador Arias-Santiago and Alejandro Molina-Leyva

J. Clin. Med. 2022, 11(4), 1007; https://doi.org/10.3390/jcm11041007 - 15 Feb 2022

Cited by 13 | Viewed by 2736

Abstract

Adalimumab is currently the only biological medicine approved by the FDA for the treatment of hidradenitis suppurativa (HS). The breakout of biosimilar drugs made them more accessible due to their impact on pharmacoeconomics. However, packaging, formulation, or excipients are unique characteristics of each [...] Read more.

Adalimumab is currently the only biological medicine approved by the FDA for the treatment of hidradenitis suppurativa (HS). The breakout of biosimilar drugs made them more accessible due to their impact on pharmacoeconomics. However, packaging, formulation, or excipients are unique characteristics of each drug. In that way, switching from adalimumab originator to biosimilar and between biosimilars could have implications in the clinical practice. The objective of this study is to describe our clinical experience in switching from adalimumab originator to biosimilar and switching back again. A single-center retrospective cohort study was conducted that included seventeen patients with HS treated with adalimumab originator in the maintenance phase, and that achieved Hidradenitis Suppurativa Clinical Response (HiSCR), who were switched to adalimumab biosimilar for no medical reasons. The reason for the change was to improve pharmacoeconomic efficiency, following our hospital policies on biologics. Median duration with adalimumab originator treatment before switching was 48 weeks. After switching, 41.2% of patients maintained HiSCR response without additional issues, while 58.8% (10/17) reported problems after the change. Switching from adalimumab originator to biosimilar in well-controlled patients could imply problems in efficacy and adherence. Switching back to adalimumab originator appears to solve most of the problems, but some patients can lose confidence in the drug and discontinue it. It would be worthwhile to evaluate the benefit–risk ratio individually when switching an HS patient to adalimumab biosimilar. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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14 pages, 14112 KiB

Open AccessArticle

Dermoscopy and Trichoscopy in Dermatomyositis—A Cross-Sectional Study

by Magdalena Żychowska and Adam Reich

J. Clin. Med. 2022, 11(2), 375; https://doi.org/10.3390/jcm11020375 - 13 Jan 2022

Cited by 7 | Viewed by 4668

Abstract

Background: (Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in dermatooncology. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses. So far, little is known about the (video)dermoscopic features of dermatomyositis (DM). Methods: [...] Read more.

Background: (Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in dermatooncology. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses. So far, little is known about the (video)dermoscopic features of dermatomyositis (DM). Methods: Consecutive patients with DM were included in the study and videodermoscopic assessments of the nailfolds, scalp, and active skin lesions were performed. Results: Fifteen patients with DM (10 women and 5 men) were included. Capillaroscopy showed elongated capillaries (90.9%), avascular areas (81.8%), disorganized vessel architecture (81.8%), tortuous capillaries (72.7%), dilated capillaries (72.7%), and hemorrhages (72.7%). The trichoscopic findings included linear branched vessels (80.0%), linear vessels (60.0%), linear curved vessels (53.3%), perifollicular pigmentation (40.0%), perifollicular erythema (33.3%), scaling (20.0%), white (20.0%) or yellow (20%) interfollicular scales, and white (20.0%) or pinkish (13.3%) structureless areas. Polymorphic vessels of an unspecific distribution and white or pink structureless areas were frequently observed under dermoscopy in cutaneous manifestations of DM, including Gottron’s papules and Gottron’s sign. Conclusions: Dermoscopy of the nailfolds (capillaroscopy), scalp (tricoscopy), and active cutaneous lesions may be of value in the preliminary diagnosis of DM. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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14 pages, 1612 KiB

Open AccessArticle

Impact of Water Exposure and Temperature Changes on Skin Barrier Function

by Manuel Herrero-Fernandez, Trinidad Montero-Vilchez, Pablo Diaz-Calvillo, Maria Romera-Vilchez, Agustin Buendia-Eisman and Salvador Arias-Santiago

J. Clin. Med. 2022, 11(2), 298; https://doi.org/10.3390/jcm11020298 - 7 Jan 2022

Cited by 15 | Viewed by 5879

Abstract

The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on [...] Read more.

The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on skin barrier function in healthy individuals. A prospective observational study was conducted. Temperature, pH, transepidermal water loss (TEWL), erythema and stratum corneum hydration (SCH) were measured objectively before and after hot- and cold-water exposure and TempTest® (Microcaya TempTest, Bilbao, Spain) contact. Fifty healthy volunteers were enrolled. Hot-water exposure increased TEWL (25.75 vs. 58.58 g·h⁻¹·m⁻²), pH (6.33 vs. 6.65) and erythema (249.45 vs. 286.34 AU). Cold-water immersion increased TEWL (25.75 vs. 34.96 g·h⁻¹·m⁻²) and pH (6.33 vs. 6.62). TEWL (7.99 vs. 9.98 g·h⁻¹·m⁻²) and erythema (209.07 vs. 227.79 AU) increased after being in contact with the hot region (44 °C) of the TempTest. No significant differences were found after contact with the cold region (4 °C) of the TempTest. In conclusion, long and continuous water exposure damages skin barrier function, with hot water being even more harmful. It would be advisable to use cold or lukewarm water for handwashing and avoid hot water. Knowing the proper temperature for hand washing might be an important measure to prevent flares in patients with previous inflammatory skin diseases on their hands. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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9 pages, 969 KiB

Open AccessArticle

Lichen Planus Activity and Damage Index (LiPADI)–Creation of the Questionnaire

by Katarzyna Stępień, Ewa Żabska, Mansur Rahnama-Hezavah and Adam Reich

J. Clin. Med. 2022, 11(1), 23; https://doi.org/10.3390/jcm11010023 - 22 Dec 2021

Cited by 5 | Viewed by 3321

Abstract

Introduction: Lichen planus (LP) is a chronic autoimmune disease that affects skin, oral and genital mucosa, and other sites. Basic difficulties in assessment of LP are multitude of disease forms and diverse locations of lesions. Moreover, there is lack of objective and consolidated [...] Read more.

Introduction: Lichen planus (LP) is a chronic autoimmune disease that affects skin, oral and genital mucosa, and other sites. Basic difficulties in assessment of LP are multitude of disease forms and diverse locations of lesions. Moreover, there is lack of objective and consolidated tool for assessment of disease severity and LP progression. Objective: The aim of the study was to develop a valid evaluation tool of LP severity, which will enable disease assessment in a repetitive way. Materials and methods: A combined tool called Lichen Planus Activity and Damage Index (LiPADI) was developed to assess the severity of LP skin, mucosal, and nail lesions as well as hair loss/scaring alopecia to provide an integrative scoring for LP activity and damage caused by the disease. Skin lesions were assessed in nine locations: scalp, face, chest, abdomen, back and buttocks, arms, hands, legs, and feet. The assessment of lesion activity included erythema, hypertrophy, and scaling, while the damage was reflected by the assessment of hyperpigmentation and scaring/atrophy. In addition, mucosal lesions, nail abnormalities, hair loss, and scarring alopecia were evaluated as well. LiPADI scoring was compared with quality of life assessed with the Dermatology Life Quality Index, EQ-5D calculator, pain and pruritus intensity assessed with the Numerical Rating Scale as well as with the patient and physician global assessment. Results: Our results show that LiPADI well reflects the LP patient’s clinical condition. The obtained results were in line with other indicators assessed. In addition, it was possible to evaluate patients with various forms and locations of LP, what indicates its versatility. Conclusions: LiPADI seems to be a useful tool for measurement the severity of the LP and its progress over time, which could help to monitor the effectiveness of the patients’ treatment. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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Review

Jump to: Research, Other

33 pages, 48551 KiB

Open AccessReview

Recent Advances in Understanding of the Etiopathogenesis, Diagnosis, and Management of Hair Loss Diseases

by Misaki Kinoshita-Ise, Masahiro Fukuyama and Manabu Ohyama

J. Clin. Med. 2023, 12(9), 3259; https://doi.org/10.3390/jcm12093259 - 3 May 2023

Cited by 7 | Viewed by 12470

Abstract

Hair-loss diseases comprise heterogenous conditions with respective pathophysiology and clinicopathological characteristics. Major breakthroughs in hair follicle biology and immunology have led to the elucidation of etiopathogenesis of non-scarring alopecia (e.g., alopecia areata, AA) and cicatricial alopecia (e.g., lichen planopilaris, LPP). High-throughput genetic analyses [...] Read more.

Hair-loss diseases comprise heterogenous conditions with respective pathophysiology and clinicopathological characteristics. Major breakthroughs in hair follicle biology and immunology have led to the elucidation of etiopathogenesis of non-scarring alopecia (e.g., alopecia areata, AA) and cicatricial alopecia (e.g., lichen planopilaris, LPP). High-throughput genetic analyses revealed molecular mechanism underlying the disease susceptibility of hair loss conditions, such as androgenetic alopecia (AGA) and female pattern hair loss (FPHL). Hair loss attracted public interest during the COVID-19 pandemic. The knowledge of hair loss diseases is robustly expanding and thus requires timely updates. In this review, the diagnostic and measurement methodologies applied to hair loss diseases are updated. Of note, novel criteria and classification/scoring systems published in the last decade are reviewed, highlighting their advantages over conventional ones. Emerging diagnostic techniques are itemized with clinical pearls enabling efficient utilization. Recent advances in understanding the etiopathogenesis and management for representative hair diseases, namely AGA, FPHL, AA, and major primary cicatricial alopecia, including LPP, are comprehensively summarized, focusing on causative factors, genetic predisposition, new disease entity, and novel therapeutic options. Lastly, the association between COVID-19 and hair loss is discussed to delineate telogen effluvium as the predominating pathomechanism accounting for this sequela. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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16 pages, 1280 KiB

Open AccessReview

Nail Apparatus Melanoma: Current Management and Future Perspectives

by Takamichi Ito, Hiroki Hashimoto, Yumiko Kaku-Ito, Yuka Tanaka and Takeshi Nakahara

J. Clin. Med. 2023, 12(6), 2203; https://doi.org/10.3390/jcm12062203 - 12 Mar 2023

Cited by 5 | Viewed by 17896

Abstract

Nail apparatus melanoma (NAM) is a rare type of cutaneous melanoma that belongs to the acral melanoma subtype. NAM is managed principally in accordance with the general treatment for cutaneous melanoma, but there is scarce evidence in support of this in the literature. [...] Read more.

Nail apparatus melanoma (NAM) is a rare type of cutaneous melanoma that belongs to the acral melanoma subtype. NAM is managed principally in accordance with the general treatment for cutaneous melanoma, but there is scarce evidence in support of this in the literature. Acral melanoma is genetically different from non-acral cutaneous melanoma, while recently accumulated data suggest that NAM also has a different genetic background from acral melanoma. In this review, we focus on recent advances in the management of NAM. Localized NAM should be surgically removed; amputation of the digit and digit-preserving surgery have been reported. Sentinel lymph node biopsy can be considered for invasive NAM for the purpose of accurate staging. However, it is yet to be clarified whether patients with metastatic sentinel lymph nodes can be safely spared completion lymph node dissection. Similar to cutaneous melanoma, immune checkpoint inhibitors and BRAF/MEK inhibitors are used as the first-line treatment for metastatic NAM, but data on the efficacy of these therapies remain scarce. The therapeutic effects of immune checkpoint inhibitors could be lower for NAM than for cutaneous melanoma. This review highlights the urgent need to accumulate data to better define the optimal management of this rare melanoma. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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17 pages, 3390 KiB

Open AccessReview

Management of Stable Vitiligo—A Review of the Surgical Approach

by Małgorzata Grochocka, Adam Wełniak, Aleksandra Białczyk, Luiza Marek-Jozefowicz, Tadeusz Tadrowski and Rafał Czajkowski

J. Clin. Med. 2023, 12(5), 1984; https://doi.org/10.3390/jcm12051984 - 2 Mar 2023

Cited by 4 | Viewed by 4284

Abstract

At present, vitiligo is the most common depigmenting skin disorder, characterized by clearly demarcated discolored patches of various shapes and sizes. Depigmentation results from the initial dysfunction and subsequent destruction of melanin-producing cells, called melanocytes, which are located in the basal layer of [...] Read more.

At present, vitiligo is the most common depigmenting skin disorder, characterized by clearly demarcated discolored patches of various shapes and sizes. Depigmentation results from the initial dysfunction and subsequent destruction of melanin-producing cells, called melanocytes, which are located in the basal layer of the epidermis and in hair follicles. This review concludes that the extent of repigmentation, regardless of the treatment method, is greatest in stable localized vitiligo patients. The aim of this review is to provide an overview of the clinical evidence for which the vitiligo treatment method (cellular or tissue) is more effective. The treatment relies on multiple factors, ranging from patient skin predisposition for repigmentation to the experience of the facility performing the procedure. Vitiligo is a significant problem in modern society. Although it is a typically asymptomatic and not life-threatening disease, it may have significant psychological and emotional impacts. Standard treatment relies on pharmacotherapy and phototherapy; however, the treatment of patients with stable vitiligo varies. The stability of vitiligo more than often implies the exhaustion of the potential for skin self-repigmentation. Thus, the surgical methods that distribute normal melanocytes into the skin are crucial elements of these patients’ therapy. The most commonly used methods are described in the literature, with an indication of their recent progress and changes. In addition, information on the efficiency of the individual methods at specific locations is compiled in this study, and the prognostic factors indicating repigmentation are presented. Cellular methods are the best therapeutic option for large-sized lesions; although they are more exorbitant than tissue methods, they benefit from more rapid healing times and presenting fewer side effects. Dermoscopy is a valuable tool used to assess the further course of repigmentation, where it is of great value to evaluate the patient prior to and following an operation. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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13 pages, 654 KiB

Open AccessReview

Current Knowledge of the Molecular Pathogenesis of Cutaneous Lupus Erythematosus

by Fumi Miyagawa

J. Clin. Med. 2023, 12(3), 987; https://doi.org/10.3390/jcm12030987 - 27 Jan 2023

Cited by 4 | Viewed by 4540

Abstract

Cutaneous lupus erythematosus (CLE) is an autoimmune disease, which can be limited to the skin or associated with systemic lupus erythematosus (SLE). Gene expression analysis has revealed that both the innate and adaptive immune pathways are activated in CLE. Ultraviolet (UV) light, the [...] Read more.

Cutaneous lupus erythematosus (CLE) is an autoimmune disease, which can be limited to the skin or associated with systemic lupus erythematosus (SLE). Gene expression analysis has revealed that both the innate and adaptive immune pathways are activated in CLE. Ultraviolet (UV) light, the predominant environmental factor associated with CLE, induces apoptosis in keratinocytes, and the endogenous nucleic acids released from the apoptotic cells are recognized via pattern recognition receptors, including Toll-like receptors. This leads to the production of type I interferon, a major contributor to the pathogenesis of CLE, by plasmacytoid dendritic cells. UV irradiation can also induce the externalization of autoantigens, such as SS-A/Ro, exposing them to circulating autoantibodies. T-helper 1 cells have been reported to play important roles in the adaptive immune response to CLE. Other environmental factors associated with CLE include drugs and cigarette smoke. Genetic factors also confer a predisposition to the development of CLE, and many susceptibility genes have been identified. Monogenetic forms of CLE also exist. This article aims to review current knowledge about the pathogenesis of CLE. A better understanding of the environmental, genetic, and immunoregulatory factors that drive CLE may provide important insights for the treatment of CLE. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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15 pages, 977 KiB

Open AccessReview

Metal Allergy: State-of-the-Art Mechanisms, Biomarkers, Hypersensitivity to Implants

by Magdalena Zemelka-Wiacek

J. Clin. Med. 2022, 11(23), 6971; https://doi.org/10.3390/jcm11236971 - 25 Nov 2022

Cited by 4 | Viewed by 5581

Abstract

Metal allergy is mainly an environmental disorder which can cause allergic contact dermatitis. Environmental metal exposures include jewelry, everyday metal items, mobile phones, leather, metal-rich food and implants, including stents or anchors. While consumer exposure is liable for the majority of metal hypersensitivity [...] Read more.

Metal allergy is mainly an environmental disorder which can cause allergic contact dermatitis. Environmental metal exposures include jewelry, everyday metal items, mobile phones, leather, metal-rich food and implants, including stents or anchors. While consumer exposure is liable for the majority of metal hypersensitivity cases, the significance of occupational exposure to metals remains relevant. Although the most common metal allergens are nickel, chromium, and cobalt; however, lately, gold, palladium, titanium, and some others have also attracted attention. This review highlights advances in metal allergy mechanisms, biomarkers for potential patients’ stratification as well as biological treatments. The most recent evidence of human exposure to metal for risk assessment is discussed, as well as the relationship between the occurrence of metal hypersensitivity and implanted devices, including non-characteristic symptoms. The latest data on the diagnosis of metal hypersensitivity are also reported. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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33 pages, 6300 KiB

Open AccessReview

Artificial Intelligence in Dermatology Image Analysis: Current Developments and Future Trends

by Zhouxiao Li, Konstantin Christoph Koban, Thilo Ludwig Schenck, Riccardo Enzo Giunta, Qingfeng Li and Yangbai Sun

J. Clin. Med. 2022, 11(22), 6826; https://doi.org/10.3390/jcm11226826 - 18 Nov 2022

Cited by 58 | Viewed by 16284

Abstract

Background: Thanks to the rapid development of computer-based systems and deep-learning-based algorithms, artificial intelligence (AI) has long been integrated into the healthcare field. AI is also particularly helpful in image recognition, surgical assistance and basic research. Due to the unique nature of dermatology, [...] Read more.

Background: Thanks to the rapid development of computer-based systems and deep-learning-based algorithms, artificial intelligence (AI) has long been integrated into the healthcare field. AI is also particularly helpful in image recognition, surgical assistance and basic research. Due to the unique nature of dermatology, AI-aided dermatological diagnosis based on image recognition has become a modern focus and future trend. Key scientific concepts of review: The use of 3D imaging systems allows clinicians to screen and label skin pigmented lesions and distributed disorders, which can provide an objective assessment and image documentation of lesion sites. Dermatoscopes combined with intelligent software help the dermatologist to easily correlate each close-up image with the corresponding marked lesion in the 3D body map. In addition, AI in the field of prosthetics can assist in the rehabilitation of patients and help to restore limb function after amputation in patients with skin tumors. The aim of the study: For the benefit of patients, dermatologists have an obligation to explore the opportunities, risks and limitations of AI applications. This study focuses on the application of emerging AI in dermatology to aid clinical diagnosis and treatment, analyzes the current state of the field and summarizes its future trends and prospects so as to help dermatologists realize the impact of new technological innovations on traditional practices so that they can embrace and use AI-based medical approaches more quickly. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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13 pages, 1689 KiB

Open AccessReview

Galactomyces Ferment Filtrate Potentiates an Anti-Inflammaging System in Keratinocytes

by Xianghong Yan, Gaku Tsuji, Akiko Hashimoto-Hachiya and Masutaka Furue

J. Clin. Med. 2022, 11(21), 6338; https://doi.org/10.3390/jcm11216338 - 27 Oct 2022

Cited by 11 | Viewed by 5068

Abstract

Skincare products play a crucial role in preventing the dry skin induced by various causes. Certain ingredients can help to improve the efficacy of skincare products. Galactomyces ferment filtrate (GFF) is such a functional ingredient. Its use originated from the empirical observation that [...] Read more.

Skincare products play a crucial role in preventing the dry skin induced by various causes. Certain ingredients can help to improve the efficacy of skincare products. Galactomyces ferment filtrate (GFF) is such a functional ingredient. Its use originated from the empirical observation that the hands of sake brewers who deal with yeast fermentation retain a beautiful and youthful appearance. Consequently, skincare products based on GFF are widely used throughout the world. Recent studies have demonstrated that GFF activates an aryl hydrocarbon receptor (AHR) and upregulates the expression of filaggrin, a pivotal endogenous source of natural moisturizing factors, in epidermal keratinocytes. It also activates nuclear factor erythroid-2-related factor 2 (NRF2), the antioxidative master transcription factor, and exhibits potent antioxidative activity against oxidative stress induced by ultraviolet irradiation and proinflammatory cytokines, which also accelerate inflammaging. GFF-mediated NRF2 activation downregulates the expression of CDKN2A, which is known to be overexpressed in senescent keratinocytes. Moreover, GFF enhances epidermal terminal differentiation by upregulating the expression of caspase-14, claudin-1, and claudin-4. It also promotes the synthesis of the antiinflammatory cytokine IL-37 and downregulates the expression of proallergic cytokine IL-33 in keratinocytes. In addition, GFF downregulates the expression of the CXCL14 and IL6R genes, which are involved in inflammaging. These beneficial properties might underpin the potent barrier-protecting and anti-inflammaging effects of GFF-containing skin formulae. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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10 pages, 1186 KiB

Open AccessReview

The Dawn of a New Era in Atopic Dermatitis Treatment

by Kazuhiko Yamamura and Takeshi Nakahara

J. Clin. Med. 2022, 11(20), 6145; https://doi.org/10.3390/jcm11206145 - 18 Oct 2022

Cited by 9 | Viewed by 4364

Abstract

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, and the condition is typified by barrier dysfunction and immune dysregulation. Recent studies have characterized various phenotypes and endotypes of AD and elucidated the mechanism. Numerous topical and systemic narrow [...] Read more.

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, and the condition is typified by barrier dysfunction and immune dysregulation. Recent studies have characterized various phenotypes and endotypes of AD and elucidated the mechanism. Numerous topical and systemic narrow targeting therapies for AD have been developed according to these findings. Topical medications, including Janus kinase (JAK) inhibitors, phosphodiesterase 4 inhibitors, and the aryl hydrocarbon receptor agonist tapinarof, are effective and safe for AD compared to topical corticosteroids. Oral JAK inhibitors and monoclonal antibodies targeting interleukin (IL)-4, IL-13, IL-31, IL-33, OX40, thymic stromal lymphopoietin, and sphingosine 1-phosphate signaling have displayed outstanding efficacy against moderate-to-severe AD. We are currently in a new era of AD treatment. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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12 pages, 298 KiB

Open AccessReview

New Era in Systemic Sclerosis Treatment: Recently Approved Therapeutics

by Satoshi Ebata, Asako Yoshizaki-Ogawa, Shinichi Sato and Ayumi Yoshizaki

J. Clin. Med. 2022, 11(15), 4631; https://doi.org/10.3390/jcm11154631 - 8 Aug 2022

Cited by 22 | Viewed by 5843

Abstract

Systemic sclerosis (SSc) is a chronic autoimmune disease with a poor prognosis. Among the various complications of SSc, treatment options for the fibrotic lesions, skin sclerosis, and SSc-associated interstitial lung disease (SSc-ILD) have been limited. However, since 2019, the efficacy and safety of [...] Read more.

Systemic sclerosis (SSc) is a chronic autoimmune disease with a poor prognosis. Among the various complications of SSc, treatment options for the fibrotic lesions, skin sclerosis, and SSc-associated interstitial lung disease (SSc-ILD) have been limited. However, since 2019, the efficacy and safety of nintedanib, tocilizumab, and rituximab for SSc or SSc-ILD have been demonstrated in double-blind, randomized, placebo-controlled trials, respectively. The antifibrotic agent nintedanib was approved for SSc-ILD in all regions of the United States, Europe, and Japan after the SENSCIS study confirmed that it suppressed the reduction in forced vital capacity (FVC), a measure of SSc-ILD. Tocilizumab, an anti-interleukin-6 receptor antibody, was approved for the treatment of SSc-ILD in the United States after the FocuSSced study showed that it inhibited the decrease in FVC. Rituximab, an anti-CD20 antibody, showed improvement in both modified Rodnan skin score, a measure of skin sclerosis, and FVC in the DESIRES study, and was approved in Japan for the treatment of SSc itself. With the development of these three drugs, SSc treatment is entering a new era. This paper outlines the latest advances in SSc therapeutics, focusing on nintedanib, tocilizumab, and rituximab. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

11 pages, 634 KiB

Open AccessReview

Itch in Hidradenitis Suppurativa/Acne Inversa: A Systematic Review

by Puneet Agarwal, Snehal Balvant Lunge, Nandini Sundar Shetty, Priyanka Karagaiah, Steven Daveluy, Alex G. Ortega-Loayza, Thrasyvoulos Tzellos, Jacek C. Szepietowski, Christos C. Zouboulis, Stephan Grabbe and Mohamad Goldust

J. Clin. Med. 2022, 11(13), 3813; https://doi.org/10.3390/jcm11133813 - 30 Jun 2022

Cited by 5 | Viewed by 2844

Abstract

Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory disease of the pilosebaceous unit leading to formation of painful, inflammatory nodules, abscesses and tunnels in apocrine gland-bearing areas of the skin. Pain and drainage are the most important symptoms associated with reduction of quality [...] Read more.

Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory disease of the pilosebaceous unit leading to formation of painful, inflammatory nodules, abscesses and tunnels in apocrine gland-bearing areas of the skin. Pain and drainage are the most important symptoms associated with reduction of quality of life in HS. On the other hand, an overlooked symptom in quality of life studies is itch, despite the fact that several studies have reported its importance. Various theories have tried to explain the pathogenesis of itch in HS, such as the presence of mast cells in the cell infiltrates and elevated Ig E levels in the lesional skin. Smoking and advanced stage of disease have been found to be associated with increased intensity of itch. A PUBMED search was conducted to perform a systematic literature review using the term “hidradenitis suppurativa” [all fields], the keywords “pruritus”, “itching”, “itch” [all fields] and with “AND” as operator. Mast cells and mTor signaling were found to be raised in both lesional and perilesional skin. Itch as a presenting symptom has been found in 35–82.6% of patients across multiple studies. It often co-presents with pain and may be misinterpreted as burning, stinging, tickling, tweaking, prickling, etc. The presence of itch is associated with reduced quality of life, depression and impairment of social life. Brodalumab, a monoclonal antibody against IL-17A receptor, produced significant improvements in itch, pain, QoL and depression in patients with moderate to severe HS. Statins have shown some reduction in itch intensity score. Further studies are required to gain a better understanding of the etiopathogenesis and optimal therapeutic modalities for itch in HS that will allow clinicians to better address issue and reduce its impact on quality of life. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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15 pages, 325 KiB

Open AccessReview

Surgical Treatment in Hidradenitis Suppurativa

by Ratnakar Shukla, Priyanka Karagaiah, Anant Patil, Katherine Farnbach, Alex G. Ortega-Loayza, Thrasivoulos Tzellos, Jacek C. Szepietowski, Mario Giulini, Hadrian Schepler, Stephan Grabbe and Mohamad Goldust

J. Clin. Med. 2022, 11(9), 2311; https://doi.org/10.3390/jcm11092311 - 21 Apr 2022

Cited by 20 | Viewed by 5824

Abstract

Hidradenitis suppurativa (HS) is a chronic, progressive inflammatory disorder of follicular occlusion with pubertal onset that presents as painful inflammatory nodules, sinus tracts, and tunnelling in apocrine-gland-rich areas, such as the axilla, groin, lower back, and buttocks. The disease course is complicated by [...] Read more.

Hidradenitis suppurativa (HS) is a chronic, progressive inflammatory disorder of follicular occlusion with pubertal onset that presents as painful inflammatory nodules, sinus tracts, and tunnelling in apocrine-gland-rich areas, such as the axilla, groin, lower back, and buttocks. The disease course is complicated by contractures, keloids, and immobility and is often associated with a low quality of life. It is considered a disorder of follicular occlusion with secondary inflammation, though the exact cause is not known. Management can often be unsatisfactory and challenging due to the chronic nature of the disease and its adverse impact on the quality of life. A multidisciplinary approach is key to prompt optimal disease control. The early stages can be managed with medical treatment, but the advanced stages most likely require surgical intervention. Various surgical options are available, depending upon disease severity and patient preference. In this review an evidence-based outline of surgical options for the treatment of HS are discussed. Case reports, case series, cohort studies, case-control studies, and Randomized Clinical Trials (RCT)s available in medical databases regarding surgical options used in the treatment of HS were considered for the review presented in a narrative manner in this article. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

23 pages, 694 KiB

Open AccessReview

Thiol-Disulfide Homeostasis in Skin Diseases

by Simona Roxana Georgescu, Cristina Iulia Mitran, Madalina Irina Mitran, Clara Matei, Gabriela Loredana Popa, Ozcan Erel and Mircea Tampa

J. Clin. Med. 2022, 11(6), 1507; https://doi.org/10.3390/jcm11061507 - 9 Mar 2022

Cited by 20 | Viewed by 3981

Abstract

Oxidative stress represents the imbalance between oxidants and antioxidants and has been associated with a wide range of diseases. Thiols are the most important compounds in antioxidant defense. There is an equilibrium between thiols and their oxidized forms, disulfides, known as dynamic thiol-disulfide [...] Read more.

Oxidative stress represents the imbalance between oxidants and antioxidants and has been associated with a wide range of diseases. Thiols are the most important compounds in antioxidant defense. There is an equilibrium between thiols and their oxidized forms, disulfides, known as dynamic thiol-disulfide homeostasis (TDH). In 2014, Erel and Neselioglu developed a novel automated assay to measure thiol and disulfide levels. Subsequently, many researchers have used this simple, inexpensive and fast method for evaluating TDH in various disorders. We have reviewed the literature on the role of TDH in skin diseases. We identified 26 studies that evaluated TDH in inflammatory diseases (psoriasis, seborrheic dermatitis, atopic dermatitis, vitiligo, acne vulgaris and rosacea), allergic diseases (acute and chronic urticaria) and infectious diseases (warts, pityriasis rosea and tinea versicolor). The results are heterogeneous, but in most cases indicate changes in TDH that shifted toward disulfides or toward thiols, depending on the extent of oxidative damage. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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11 pages, 1600 KiB

Open AccessOpinion

Efficacy and Safety of Low-Dose Cyclosporine Relative to Immunomodulatory Drugs Used in Atopic Dermatitis: A Systematic Review and Meta-Analysis

by Kyunghoon Kim, Mina Kim, EunHee Rhee, Mi-Hee Lee, Hyeon-Jong Yang, Suyeon Park and Hwan Soo Kim

J. Clin. Med. 2023, 12(4), 1390; https://doi.org/10.3390/jcm12041390 - 9 Feb 2023

Cited by 2 | Viewed by 4870

Abstract

Cyclosporine A (CsA) is effective in treating moderate-to-severe atopic dermatitis (AD). This systematic review and meta-analysis aimed to summarize the effectiveness and safety of low-dose (<4 mg/kg) versus high-dose (≥4 mg/kg) CsA and other systemic immunomodulatory agents in patients with AD. Five randomized [...] Read more.

Cyclosporine A (CsA) is effective in treating moderate-to-severe atopic dermatitis (AD). This systematic review and meta-analysis aimed to summarize the effectiveness and safety of low-dose (<4 mg/kg) versus high-dose (≥4 mg/kg) CsA and other systemic immunomodulatory agents in patients with AD. Five randomized controlled trials met the inclusion criteria. The meta-analysis included 159 patients with moderate-to-severe AD who were randomized to receive low-dose CsA, and 165 patients randomized to receive high-dose CsA and other systemic immunomodulatory agents. We found that low-dose CsA was not inferior to high-dose CsA and other systemic immunomodulatory agents in reducing AD symptoms [standard mean difference (SMD) −1.62, 95% confidence interval (CI) −6.47; 3.23]. High-dose CsA and other systemic immunomodulatory agents showed a significantly lower incidence of adverse events [incidence rate ratio (IRR) 0.72, 95% CI 0.56; 0.93], however, after sensitivity analysis, there was no difference between the two groups except for one study (IRR 0.76, 95% CI 0.54; 1.07). Regarding serious adverse events requiring discontinuation of treatment, we observed no significant differences between low-dose CsA and other systemic immunomodulatory agents (IRR 1.83, 95% CI 0.62; 5.41). Our study may justify the use of low-dose CsA rather than high-dose CsA and other systemic immunomodulatory agents in moderate-to-severe AD. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)

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